1
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Yang C, Song Y, Wang P. Relationship between triglyceride-glucose index and new-onset hypertension in general population-a systemic review and meta-analysis of cohort studies. Clin Exp Hypertens 2024; 46:2341631. [PMID: 38615327 DOI: 10.1080/10641963.2024.2341631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/05/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is an alternative biomarker for insulin resistance that may be connected to incident hypertension. We performed the meta-analysis to clarify the connection between TyG index and new-onset hypertension in the general population. METHODS We recruited cohort studies that assessed the association between TyG index and the risk of hypertension in the general population by searching the databases of PubMed, EMBASE, and Web of Science (SCI) from their inception dates until July 18, 2023. The primary focus of the study was on the hazard ratio (HR) of hypertension in relation to the TyG index. The adjusted HR and 95% confidence interval (CI) were pooled by the random-effects model. Subgroup analyzes stratified by age, sex, follow-up duration, body mass index (BMI), and ethnicity were performed. RESULTS Our analysis comprised 35 848 participants from a total of 7 cohort studies. The highest TyG index category showed a 1.51-fold greater risk of hypertension in the general population than the lowest category (HR = 1.51, 95%CI 1.26-1.80, p < .001). Consistent results were obtained using sensitivity analysis by eliminating one trial at a time (p values all <0.001). Subgroup analysis showed that the relationship between TyG index and hypertension was not substantially influenced by age, sex, BMI, participant ethnicity, and follow-up times (P for interaction all >0.05). CONCLUSIONS Elevated TyG index significantly increased the risk of new-onset hypertension in the general population. It is necessary to conduct the research to clarify the probable pathogenic processes underpinning the link between the TyG index and hypertension.
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Affiliation(s)
- Changqiang Yang
- Department of Cardiology, the First Affiliated Hospital, Chengdu Medical College, Chengdu, P.R. China
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, China
| | - Yue Song
- Department of Pediatrics, the First Affiliated Hospital, Chengdu Medical College, Chengdu, P.R. China
| | - Peijian Wang
- Department of Cardiology, the First Affiliated Hospital, Chengdu Medical College, Chengdu, P.R. China
- Key Laboratory of Aging and Vascular Homeostasis of Sichuan Higher Education Institutes, Chengdu, China
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2
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Zhang J, Liu S, Ding W, Wan J, Qin JJ, Wang M. Resolution of inflammation, an active process to restore the immune microenvironment balance: A novel drug target for treating arterial hypertension. Ageing Res Rev 2024; 99:102352. [PMID: 38857706 DOI: 10.1016/j.arr.2024.102352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 05/11/2024] [Accepted: 05/27/2024] [Indexed: 06/12/2024]
Abstract
The resolution of inflammation, the other side of the inflammatory response, is defined as an active and highly coordinated process that promotes the restoration of immune microenvironment balance and tissue repair. Inflammation resolution involves several key processes, including dampening proinflammatory signaling, specialized proresolving lipid mediator (SPM) production, nonlipid proresolving mediator production, efferocytosis and regulatory T-cell (Treg) induction. In recent years, increasing attention has been given to the effects of inflammation resolution on hypertension. Furthermore, our previous studies reported the antihypertensive effects of SPMs. Therefore, in this review, we aim to summarize and discuss the detailed association between arterial hypertension and inflammation resolution. Additional, the association between gut microbe-mediated immune and hypertension is discussed. This findings suggested that accelerating the resolution of inflammation can have beneficial effects on hypertension and its related organ damage. Exploring novel drug targets by focusing on various pathways involved in accelerating inflammation resolution will contribute to the treatment and control of hypertensive diseases in the future.
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Affiliation(s)
- Jishou Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China; Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Siqi Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China; Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Wen Ding
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, China; Department of Radiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China; Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, China.
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital of Wuhan University, Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China; Center for Healthy Aging, Wuhan University School of Nursing, Wuhan, China.
| | - Menglong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China; Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, China.
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3
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Takase M, Hirata T, Nakaya N, Nakamura T, Kogure M, Hatanaka R, Nakaya K, Chiba I, Kanno I, Nochioka K, Tsuchiya N, Narita A, Metoki H, Satoh M, Obara T, Ishikuro M, Ohseto H, Uruno A, Kobayashi T, Kodama EN, Hamanaka Y, Orui M, Ogishima S, Nagaie S, Fuse N, Sugawara J, Kuriyama S, Tamiya G, Hozawa A, Yamamoto M. Associations of combined genetic and lifestyle risks with hypertension and home hypertension. Hypertens Res 2024; 47:2064-2074. [PMID: 38914703 DOI: 10.1038/s41440-024-01705-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 06/26/2024]
Abstract
No study, to our knowledge, has constructed a polygenic risk score based on clinical blood pressure and investigated the association of genetic and lifestyle risks with home hypertension. We examined the associations of combined genetic and lifestyle risks with hypertension and home hypertension. In a cross-sectional study of 7027 Japanese individuals aged ≥20 years, we developed a lifestyle score based on body mass index, alcohol consumption, physical activity, and sodium-to-potassium ratio, categorized into ideal, intermediate, and poor lifestyles. A polygenic risk score was constructed with the target data (n = 1405) using publicly available genome-wide association study summary statistics from BioBank Japan. Using the test data (n = 5622), we evaluated polygenic risk score performance and examined the associations of combined genetic and lifestyle risks with hypertension and home hypertension. Hypertension and home hypertension were defined as blood pressure measured at a community-support center ≥140/90 mmHg or at home ≥135/85 mmHg, respectively, or self-reported treatment for hypertension. In the test data, 2294 and 2322 participants had hypertension and home hypertension, respectively. Both polygenic risk and lifestyle scores were independently associated with hypertension and home hypertension. Compared with those of participants with low genetic risk and an ideal lifestyle, the odds ratios for hypertension and home hypertension in the low genetic risk and poor lifestyle group were 1.94 (95% confidence interval, 1.34-2.80) and 2.15 (1.60-2.90), respectively. In summary, lifestyle is important to prevent hypertension; nevertheless, participants with high genetic risk should carefully monitor their blood pressure despite a healthy lifestyle.
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Affiliation(s)
- Masato Takase
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Human Care Research Team, Tokyo metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Kyoto Women's University, Kyoto, Japan
| | - Mana Kogure
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ippei Chiba
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Akira Narita
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hirohito Metoki
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical and Pharmaceutical University, Miyagino-ku, Sendai, Japan
| | - Michihiro Satoh
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical and Pharmaceutical University, Miyagino-ku, Sendai, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hisashi Ohseto
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Masatsugu Orui
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Soichi Ogishima
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Satoshi Nagaie
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Nobuo Fuse
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Suzuki Memorial Hospital, Satonomori, Iwanumashi, Miyagi, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Gen Tamiya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
| | - Masayuki Yamamoto
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
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4
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Dinakis E, O'Donnell JA, Marques FZ. The gut-immune axis during hypertension and cardiovascular diseases. Acta Physiol (Oxf) 2024; 240:e14193. [PMID: 38899764 DOI: 10.1111/apha.14193] [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: 02/02/2024] [Revised: 05/04/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024]
Abstract
The gut-immune axis is a relatively novel phenomenon that provides mechanistic links between the gut microbiome and the immune system. A growing body of evidence supports it is key in how the gut microbiome contributes to several diseases, including hypertension and cardiovascular diseases (CVDs). Evidence over the past decade supports a causal link of the gut microbiome in hypertension and its complications, including myocardial infarction, atherosclerosis, heart failure, and stroke. Perturbations in gut homeostasis such as dysbiosis (i.e., alterations in gut microbial composition) may trigger immune responses that lead to chronic low-grade inflammation and, ultimately, the development and progression of these conditions. This is unsurprising, as the gut harbors one of the largest numbers of immune cells in the body, yet is a phenomenon not entirely understood in the context of cardiometabolic disorders. In this review, we discuss the role of the gut microbiome, the immune system, and inflammation in the context of hypertension and CVD, and consolidate current evidence of this complex interplay, whilst highlighting gaps in the literature. We focus on diet as one of the major modulators of the gut microbiota, and explain key microbial-derived metabolites (e.g., short-chain fatty acids, trimethylamine N-oxide) as potential mediators of the communication between the gut and peripheral organs such as the heart, arteries, kidneys, and the brain via the immune system. Finally, we explore the dual role of both the gut microbiome and the immune system, and how they work together to not only contribute, but also mitigate hypertension and CVD.
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Affiliation(s)
- Evany Dinakis
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Joanne A O'Donnell
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia
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5
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Chang MK, Wu GJ, Bao P, Yao S, Du MF, Chu C, Wang D, Jia H, Sun Y, Yan Y, Zhang X, Hu GL, Man ZY, Guo TS, Luo WJ, Li H, Wang Y, Mu JJ. Associations of E-proteinoid 3 receptor genetic polymorphisms with salt sensitivity, longitudinal blood pressure changes, and hypertension incidence in Chinese adults. J Clin Hypertens (Greenwich) 2024; 26:955-963. [PMID: 38952049 DOI: 10.1111/jch.14859] [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: 12/20/2023] [Revised: 04/13/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024]
Abstract
The E-proteinoid 3 receptor (PTGER3), a member of the prostaglandin E2 (PGE2) subtype receptor, belongs to the G-protein-coupled superfamily of receptors. Animal studies have demonstrated its involvement in salt sensitivity by regulating sodium reabsorption. This study aimed to investigate the association between genetic variants of PTGER3 and salt sensitivity, longitudinal blood pressure (BP) changes, and the incidence of hypertension in Chinese adults. A chronic salt intake intervention was conducted involving 514 adults from 124 families in the 2004 Baoji Salt-Sensitivity Study Cohort in northern China. These participants followed a 3-day regular baseline diet, followed by a 7-day low-salt diet (3.0 g/d) and a 7-day high-salt diet (18 g/d), and were subsequently followed for 14 years. The findings revealed a significant relationship between the single nucleotide polymorphism (SNP) rs17482751 of PTGER3 and diastolic blood pressure (DBP) response to high salt intervention. Additionally, SNPs rs11209733, rs3765894, and rs2268062 were significantly associated with longitudinal changes in systolic blood pressure (SBP), DBP, and mean arterial pressure (MAP) during the 14-year follow-up period. SNP rs6424414 was significantly associated with longitudinal changes in DBP over 14 years. Finally, SNP rs17482751 showed a significant correlation with the incidence of hypertension over 14 years. These results emphasize the significant role of PTGER3 gene polymorphism in salt sensitivity, longitudinal BP changes, and the development of hypertension in the Chinese population.
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Affiliation(s)
- Ming-Ke Chang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Guan-Ji Wu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Cardiology, Xi'an Central Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Peng Bao
- Department of General Practice, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Yao
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Ming-Fei Du
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Dan Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Hao Jia
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yue Sun
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Xi Zhang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Gui-Lin Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Zi-Yue Man
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Tong-Shuai Guo
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Wen-Jing Luo
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Hao Li
- Department of Critical Care Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
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6
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Wang F, Zhang X, Wang X, Zhao Y. Enhanced body shape change coupled with PA is the key to hypertension management for urban residents. Public Health Nurs 2024. [PMID: 39051758 DOI: 10.1111/phn.13374] [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: 01/17/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
The present study aimed to assess the relationship between body shape, physical activity (PA), and systolic blood pressure (SBP) and diastolic blood pressure (DBP). A novel visualization method was used to examine the effects of body shape combined with physical activity on hypertension. Data from 54,303 participants were obtained from the China Health and Nutrition Survey (CHNS) and analyzed using logistic regression models and standardized regression coefficients of linear models. These models were used to explore factors and effects of body shape indices and other parameters on SBP and DBP. The logistic regression model revealed that compared to transport-related PA, the aggregated variables (weight and waist) were associated with a 2.44-fold and 1.65-fold increase in the risk of hypertension, respectively (p < .05). The average aggregated standardized coefficient of the linear model, based on 1000 bootstrap resamples, indicated that the Base Shape group had the strongest explanatory power for hypertension, followed by the Habits group. However, the explanatory power of the PA group was around 10 and 22 times lower than that of the Base Shape group for DBP and SBP, respectively (p < .05). These results demonstrate that increasing physical activity, with emphasizing a healthy body shape, and adopting positive lifestyle habits can effectively contribute to the prevention and control of hypertension.
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Affiliation(s)
- Fei Wang
- Sports Science Institute, Shanxi University, Taiyuan, Shanxi, China
- School of Physical Education, Shanxi University, Taiyuan, Shanxi, China
| | - Xin Zhang
- School of Physical Education, Shanxi University, Taiyuan, Shanxi, China
| | - Xinyu Wang
- School of Physical Education, Shanxi University, Taiyuan, Shanxi, China
- College of Education, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yixuan Zhao
- School of Physical Education, Shanxi University, Taiyuan, Shanxi, China
- College of Physical Education, Soochow University, Suzhou, China
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7
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Assogba CO, Ale BM, Youm E, Houehanou YC, Sinsin AS, Assiongbon SJE, Ale OAJ, Noubiap JJ, Amidou SA, Houinato DS. Prevalence and associated factors of hypertension among people living with HIV/AIDS on antiretroviral therapy in Benin's National Teaching Hospital. Sci Rep 2024; 14:17035. [PMID: 39043662 PMCID: PMC11266684 DOI: 10.1038/s41598-024-64212-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/06/2024] [Indexed: 07/25/2024] Open
Abstract
Antiretroviral therapy (ART) has extended the lifespan of people living with HIV/AIDS (PLHIV), exposing them to a higher risk of cardiovascular diseases (CVD). Hypertension (HTN), the primary contributor to CVD burden, is increasingly concerning for PLHIV. This study aimed to assess the prevalence and associated factors of hypertension in PLHIV on ART at the National Teaching Hospital Hubert Koutoukou Maga (HKM) of Benin using a prospective cross-sectional study conducted between October and December 2021. Patients who had a systolic blood pressure ≥ 140 mmHg or/and diastolic blood pressure ≥ 90 mmHg or/and current use of antihypertensive medication from medical records were considered to have HTN. A total of 352 patients, including 260 women with a sex ratio of 0.3 were included. The mean age was 42.9 ± 11.9 years. Most patients were educated and did not use tobacco. 42.0% were current alcohol drinkers. The duration of ART treatment ranged from 0 to 22 years, with a median duration of 5.0 years. 14.2% were hypertensives with 3.1% newly diagnosed and 11.1% known with hypertension. Age above 40 years, living with a partner, alcohol consumption and body mass index greater than 25 were significantly associated with HTN. HTN in PLHIV is associated with numerous factors. Reducing the burden of the disease in target people in Benin requires a wide range of actions that need to be implemented.
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Affiliation(s)
- Calixte Oswald Assogba
- Ecole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, Benin
- Laboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, Benin
| | - Boni Maxime Ale
- Holo Global Health Research Institute, Cotonou, Benin.
- Health Data Acumen, Cotonou, Benin.
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.
| | - Eric Youm
- Holo Global Health Research Institute, Cotonou, Benin
| | - Yessito Corine Houehanou
- Ecole Nationale de Formation des Techniciens Supérieurs en Santé Publique et Surveillance Epidémiologique (ENATSE), University of Parakou, Parakou, Benin
| | - Amen Sèminvo Sinsin
- Faculty of Health Sciences, University of Abomey Calavi, Abomey Calavi, Benin
| | | | | | - Jean Jacques Noubiap
- Holo Global Health Research Institute, Cotonou, Benin
- Division of Cardiology, Department of Medicine, University of San Francisco, San Francisco, USA
| | - Salmane Ariyoh Amidou
- Ecole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, Benin
- Laboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, Benin
| | - Dismand Stephan Houinato
- Ecole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, Benin
- Laboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, Benin
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Brandao-Rangel MAR, Brill B, de Souza Carvalho E, Melamed D, Moraes-Ferreira R, Silva-Reis A, Leonardo PS, Frison CR, De Angelis K, Vieira RP. Physically Active Lifestyle Attenuates Impairments on Lung Function and Mechanics in Hypertensive Older Adults. Adv Respir Med 2024; 92:278-290. [PMID: 39051189 PMCID: PMC11270291 DOI: 10.3390/arm92040027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
AIM Physical activity attenuates hypertension in older adults, but its impact on pulmonary function and mechanics in hypertensive older adults is unknown. The study seeks to understand whether a physically active lifestyle can improve respiratory capacity, the mechanical efficiency of the lungs, and, consequently, the quality of life of these individuals, comparing data between groups of active and sedentary hypertensive older adults. METHODS This is a cross-sectional study. We evaluated 731 older adults, stratified into two initial groups: hypertensive older adults (HE; n = 445) and non-hypertensive older adults (NHE; n = 286). For a secondary analysis, we used the International Physical Activity Questionnaire to sub-stratify HE and NHE into four groups: physically inactive hypertensive (PIH; n = 182), active hypertensive (AH; n = 110), physically inactive non-hypertensive (PINH; n = 104), and active non-hypertensive (ANH; n = 65). Lung function was measured by spirometry, and lung mechanics were assessed by impulse oscillometry. RESULTS Hypertensive older adults presented reduced lung function compared to non-hypertensive older adults, and physical inactivity accentuated this decline. Regarding pulmonary mechanics, hypertensive older adults had higher resistance of the entire respiratory system (R5 Hz), the central airways (R20 Hz), and peripheral airways (R5-20 Hz), which may trigger bronchoconstriction. CONCLUSIONS Hypertension is associated with impaired lung function and mechanics in older adults, and a physically active lifestyle attenuates these dysfunctions.
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Affiliation(s)
- Maysa Alves Rodrigues Brandao-Rangel
- Federal University of Sao Paulo (UNIFESP), Post-graduation Program in Sciences of Human Movement and Rehabilitation, Avenida Ana Costa 95, Santos 11060-001, SP, Brazil; (M.A.R.B.-R.); (R.M.-F.); (C.R.F.)
| | - Boris Brill
- Leniado Medical Center, Divrei Khayim St 16, Nethanya 4244916, Israel;
| | - Edilson de Souza Carvalho
- Evangelical University of Goias (Unievangelica), Post-graduation Program in Humam Movement and Rehabilitation and in Pharmaceutical Sciences, Pharmacology and Therapeutics, Avenida Universitária Km 3,5, Anápolis 75083-515, GO, Brazil; (E.d.S.C.); (A.S.-R.); (P.S.L.)
| | - Dobroslav Melamed
- LibiPharm, Department of Research and Development, Derech Ben Gurion 70, Rehovot 7639461, Israel;
| | - Renilson Moraes-Ferreira
- Federal University of Sao Paulo (UNIFESP), Post-graduation Program in Sciences of Human Movement and Rehabilitation, Avenida Ana Costa 95, Santos 11060-001, SP, Brazil; (M.A.R.B.-R.); (R.M.-F.); (C.R.F.)
| | - Anamei Silva-Reis
- Evangelical University of Goias (Unievangelica), Post-graduation Program in Humam Movement and Rehabilitation and in Pharmaceutical Sciences, Pharmacology and Therapeutics, Avenida Universitária Km 3,5, Anápolis 75083-515, GO, Brazil; (E.d.S.C.); (A.S.-R.); (P.S.L.)
| | - Patricia Sardinha Leonardo
- Evangelical University of Goias (Unievangelica), Post-graduation Program in Humam Movement and Rehabilitation and in Pharmaceutical Sciences, Pharmacology and Therapeutics, Avenida Universitária Km 3,5, Anápolis 75083-515, GO, Brazil; (E.d.S.C.); (A.S.-R.); (P.S.L.)
| | - Claudio Ricardo Frison
- Federal University of Sao Paulo (UNIFESP), Post-graduation Program in Sciences of Human Movement and Rehabilitation, Avenida Ana Costa 95, Santos 11060-001, SP, Brazil; (M.A.R.B.-R.); (R.M.-F.); (C.R.F.)
| | - Kátia De Angelis
- Federal University of Sao Paulo (UNIFESP), Department of Physiology, Rua Botucatu 862, São Paulo 04023-901, SP, Brazil;
| | - Rodolfo P. Vieira
- Federal University of Sao Paulo (UNIFESP), Post-graduation Program in Sciences of Human Movement and Rehabilitation, Avenida Ana Costa 95, Santos 11060-001, SP, Brazil; (M.A.R.B.-R.); (R.M.-F.); (C.R.F.)
- Evangelical University of Goias (Unievangelica), Post-graduation Program in Humam Movement and Rehabilitation and in Pharmaceutical Sciences, Pharmacology and Therapeutics, Avenida Universitária Km 3,5, Anápolis 75083-515, GO, Brazil; (E.d.S.C.); (A.S.-R.); (P.S.L.)
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Rabinowitz J, Darawshi M, Burak N, Boehm M, Dmitrieva NI. Risk for hypertension and heart failure linked to high normal serum sodium and tonicity in electronic medical records. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.05.24309996. [PMID: 39072033 PMCID: PMC11275695 DOI: 10.1101/2024.07.05.24309996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Background and Aims Population aging is fueling an epidemic of age-related chronic diseases. Managing risk factors and lifestyle interventions have proven effective in disease prevention. Epidemiological studies have linked markers of poor hydration with higher risk of chronic diseases and premature mortality. Many individuals do not adhere to recommended hydration levels and could benefit from improved hydration habits. Our study evaluates the use of electronic medical records to confirm the relationship between inadequate hydration and the risk of chronic diseases, which may inform hydration-focused interventions in general healthcare. Methods We analyzed 20-year electronic medical records for 411,029 adults from Israel's Leumit Healthcare Services. Hydration status was assessed using serum sodium and tonicity. We included adults without significant chronic diseases or water balance issues, defined as having normal serum sodium (135-146 mmol/l) and no diagnosis of diabetes. We used Cox proportional hazards models, adjusted for age, to assess the risk of developing hypertension and heart failure. Results Our findings showed an increased risk of hypertension with elevated serum sodium levels: a 12% rise for the 140-142 mmol/l group and 30% for levels above 143 mmol/l (HR1.30, 95%CI:1.26-1.34). Tonicity over 287 mosmol/kg was associated with a 19% increased risk of hypertension (HR1.19, 95%CI:1.17-1.22). The risk of heart failure also increased, reaching 20% for sodium levels above 143 mmol/l (HR1.20,95%CI:1.12-1.29) and 16% for tonicity above 289 mosmol/kg (HR1.16, 95%CI: 1.10-1.22). The association between sodium and hypertension was observed across genders, while the risk of heart failure was more pronounced in females. Within the healthy Leumit cohort, 19% had serum sodium levels within the 143-146 mmol/l range, and 39% were in the 140-142 mmol/l range. Conclusions Data analysis from electronic medical records identified a link between serum sodium of 140 mmol/l and above and increased risk of hypertension and heart failure in the general Israeli population. Identifying individuals with high-normal sodium values in healthcare records could guide improvements in hydration habits, potentially leading to better health outcomes.
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10
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Sharma AK, Rastogi S, Goyal RK. Retrospective analysis of neoplasms in patients using angiotensin receptor blockers. Sci Rep 2024; 14:15774. [PMID: 38982193 PMCID: PMC11233655 DOI: 10.1038/s41598-024-64867-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 06/13/2024] [Indexed: 07/11/2024] Open
Abstract
In recent years, regulatory agencies have raised concerns about the presence of potentially carcinogenic substances in certain formulations of Angiotensin Receptor Blockers (ARBs). Specifically, nitrosamines and azido compounds have been identified in some ARB products. Nitrosamines are known to have carcinogenic properties and are associated with an increased risk of neoplasms. Spontaneous safety reports from the EudraVigilance Data Analysis System (EVDAS) database were analyzed to investigate cases of neoplasms associated with ARBs. A disproportionality analysis was conducted, calculating the reporting odds ratio (ROR) and 95% confidence intervals (CIs) using a case/non-case approach for each ARB drug. The EVDAS database contained 68,522 safety reports related to ARBs (including Azilsartan, Candesartan, Irbesartan, Olmesartan, Losartan, Valsartan, and Telmisartan), among which 3,396 (5%) cases were associated with neoplasms. The majority of these cases were reported in Germany (11.9%), followed by France (9.7%). Approximately 70% of the reports were submitted by healthcare professionals such as physicians and nurses. Among the ARBs, valsartan had the highest ROR for neoplasm (ROR 1.949, 95% CI 1.857-2.046). This association remained significant when comparing ARBs with other classes of antihypertensive drugs, including ACE inhibitors, beta-blockers, calcium channel blockers, and diuretics. Our study identifies a possible signal of an association between ARBs, particularly valsartan, and the risk of neoplasms. However, further observational and analytical studies are necessary to confirm these findings and elucidate the underlying mechanisms.
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Affiliation(s)
- Arvind Kumar Sharma
- Delhi Pharmaceutical Sciences and Research University, Pushp vihar Sector 3, New Delhi, 110017, India
- Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, Govt. of India, Sector-23, Raj Nagar, Ghaziabad, 201002, Uttar Pradesh, India
| | - Shruti Rastogi
- Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, Govt. of India, Sector-23, Raj Nagar, Ghaziabad, 201002, Uttar Pradesh, India.
| | - Ramesh K Goyal
- Delhi Pharmaceutical Sciences and Research University, Pushp vihar Sector 3, New Delhi, 110017, India
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Zhao Z, Jia J, Lyu X, Zhang L, Wang Y, He Y, Peng Z, Zhang Y, Zhang H, Wang Q, Shen H, Zhang Y, Yan D, Ma X, Yang Y. Association of psychological stress with wives' hypertension across over 10 million Chinese married female population aged 20-49 years. Chin Med J (Engl) 2024; 137:1583-1591. [PMID: 38932742 PMCID: PMC11230796 DOI: 10.1097/cm9.0000000000003065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women. METHODS Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension. RESULTS Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women ( Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratio (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands had no stress, those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives' hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21), and 1.28 (95% CI: 1.26-1.31), respectively. CONCLUSION Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.
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Affiliation(s)
- Zhenyan Zhao
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Jiajing Jia
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Xinyi Lyu
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Lihua Zhang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
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12
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Liang Y, Zhang M, Jin W, Zhao L, Wu Y. Association of heavy metals exposure with lower blood pressure in the population aged 8-17 years: a cross-sectional study based on NHANES. Front Public Health 2024; 12:1411123. [PMID: 39035189 PMCID: PMC11259964 DOI: 10.3389/fpubh.2024.1411123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024] Open
Abstract
Background The existing evidence regarding the joint effect of heavy metals on blood pressure (BP) in children and adolescents is insufficient. Furthermore, the impact of factors such as body weight, fish consumption, and age on their association remains unclear. Methods The study utilized original data from the National Health and Nutrition Examination Survey, encompassing 2,224 children and adolescents with complete information on 12 urinary metals (barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, tungsten, uranium, mercury and arsenic), BP, and core covariates. Various statistical methods, including weighted multiple logistic regression, linear regression, and Weighted Quantile Sum regression (WQS), were employed to evaluate the impact of mixed metal exposure on BP. Sensitivity analysis was conducted to confirm the primary analytical findings. Results The findings revealed that children and adolescents with low-level exposure to lead (0.40 μg/L, 95%CI: 0.37, 0.42), mercury (0.38 μg/L, 95%CI: 0.35, 0.42) and molybdenum (73.66 μg/L, 95%CI: 70.65, 76.66) exhibited reduced systolic blood pressure (SBP) and diastolic blood pressure (DBP). Conversely, barium (2.39 μg/L, 95%CI: 2.25, 2.54) showed a positive association with increased SBP. A 25th percentile increase in the WQS index is significantly associated with a decrease in SBP of 0.67 mmHg (95%CI, -1.24, -0.10) and a decrease in DBP of 0.59 mmHg (95% CI, -1.06, -0.12), which remains statistically significant even after adjusting for weight. Furthermore, among individuals who consume fish, heavy metals have a more significant influence on SBP. A 25 percentile increase in the WQS index is significantly associated with a decrease of 3.30 mmHg (95% CI, -4.73, -1.87) in SBP, primarily attributed to mercury (27.61%), cadmium (27.49%), cesium (17.98%), thallium (8.49%). The study also identified a declining trend in SBP among children aged 10-17, whereas children aged 11-18 exhibited lower levels of systolic and diastolic blood pressure, along with a reduced risk of hypertension. Conclusion Some heavy metals demonstrate an inverse association with the BP of children and adolescents, particularly notable in groups with fish consumption and older children and adolescents. Future studies are warranted to validate these findings and delve deeper into the interplay of heavy metals.
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Affiliation(s)
| | | | | | - Liqing Zhao
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yurong Wu
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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13
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Nazli SA, Rosman A, Mohd Kasim NA, Al-Khateeb A, Ul-Saufie AZ, Md Radzi AB, Ibrahim KS, Kasim SS, Nawawi H. Coronary risk factor profiles according to different age categories in premature coronary artery disease patients who have undergone percutaneous coronary intervention. Sci Rep 2024; 14:15326. [PMID: 38961082 PMCID: PMC11222582 DOI: 10.1038/s41598-024-53539-6] [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: 04/14/2023] [Accepted: 02/01/2024] [Indexed: 07/05/2024] Open
Abstract
Many studies have investigated the coronary risk factors (CRFs) among premature coronary artery disease (PCAD) patients. However, reports on the proportion and CRFs of PCAD according to different age cut-offs for PCAD is globally under-reported. This study aimed to determine the proportion of PCAD patients and analyse the significant CRFs according to different age cut-offs among percutaneous coronary intervention (PCI)-treated patients. Patients who underwent PCI between 2007 and 2018 in two cardiology centres were included (n = 29,241) and were grouped into four age cut-off groups that defines PCAD: (A) Males/females: < 45, (B) Males: < 50; Females: < 55, (C) Males: < 55; Females: < 60 and (D) Males: < 55; Females: < 65 years old. The average proportion of PCAD was 28%; 9.2% for group (A), 21.5% for group (B), 38.6% and 41.9% for group (C) and (D), respectively. The top three CRFs of PCAD were LDL-c level, TC level and hypertension (HTN). Malay ethnicity, smoking, obesity, family history of PCAD, TC level and history of MI were the independent predictors of PCAD across all age groups. The proportion of PCAD in Malaysia is higher compared to other studies. The most significant risk factors of PCAD are LDL-c, TC levels and HTN. Early prevention, detection and management of the modifiable risk factors are highly warranted to prevent PCAD.
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Affiliation(s)
- Sukma Azureen Nazli
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia.
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
| | - Azhari Rosman
- Institut Jantung Negara (IJN), Kuala Lumpur, Malaysia
| | - Noor Alicezah Mohd Kasim
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Alyaa Al-Khateeb
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Ahmad Zia Ul-Saufie
- Faculty of Computer and Mathematical Sciences, Universiti Teknologi MARA, Selangor, Malaysia
| | | | | | - Sazzli Shahlan Kasim
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
- Cardiac Vascular and Lung Research Institute (CaVaLRI), Universiti Teknologi MARA, Selangor, Malaysia
| | - Hapizah Nawawi
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Selangor, Malaysia.
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.
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Yin R, Wu Y, Li M, Liu C, Pu X, Yi W. Association between high-altitude polycythemia and hypertension: a cross-sectional study in adults at Tibetan ultrahigh altitudes. J Hum Hypertens 2024; 38:555-560. [PMID: 38802600 PMCID: PMC11239486 DOI: 10.1038/s41371-024-00916-3] [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: 02/17/2024] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
The study aimed to evaluate the association between high-altitude polycythemia and hypertension in adults residing on Anduo County's plateau, which is located 4700 meters above sea level. A total of 387 individuals participated in the cross-sectional survey conducted between April and May of 2021. Interviews, physical inspections, and laboratory tests were employed to gather information about all of the subjects. The association between high-altitude polycythemia and hypertension was assessed using multivariable logistic regression models. The average age of the 387 participants was 32.6 ± 6.3 years. Of these participants, 260 (67%) were male. The overall prevalence of hypertension was 27.1% (57/380). When stratified by gender, the prevalence was 12.6% (16/127) in females and 34.2% (89/260) in males. The overall prevalence of high-altitude polycythemia was 19.6% (76/387). When stratified by gender, the prevalence was 26.2% (68/260) in males and 6.3% (8/127) in females. During logistic regression analysis, we found that participants with elevated hemoglobin per 10 g/L had a 26% greater risk of hypertension (adjusting for odds ratio [OR], 1.26; 95% confidence interval [CI], 1.11-1.44). Additionally, high-altitude polycythemia greatly increased the risk of hypertension in comparison to non-high-altitude polycythemia (OR, 3.01; 95% CI, 1.66-5.44, P < 0.001). The consistency of the results was further demonstrated by stratified and interaction analyses, showing that Hans individuals had a higher risk of hypertension. High-altitude polycythemia is positively associated with hypertension in adults residing at Tibetan ultrahigh altitudes. The results of the investigation may aid in the planning of future research and guide the development of targeted healthcare practices for high-altitude populations, particularly among Han Chinese residents of the Tibetan Plateau.
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Affiliation(s)
- Rong Yin
- Department of Nephrology, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China
| | - Yunhong Wu
- Department of Endocrinology, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China.
| | - Man Li
- Department of Radiology, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China
| | - Chunrong Liu
- Intensive Care Unit, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China
| | - Xue Pu
- Department of Gastroenterology, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China
| | - Wen Yi
- Surgical Unit, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region, Chengdu, Sichuan, China
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15
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Cai J, Zhang N, Cui Y, Ning Y, Wu Q, Zhang Y, Chen H. Baseline systolic blood pressure, hypertension history, and efficacy of remote ischemic conditioning. Ann Clin Transl Neurol 2024; 11:1703-1714. [PMID: 38831636 PMCID: PMC11251468 DOI: 10.1002/acn3.52077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/14/2024] [Accepted: 04/09/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE We performed a post hoc exploratory analysis of Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke (RICAMIS) to determine whether hypertension history and baseline systolic blood pressure (SBP) affect the efficacy of remote ischemic conditioning (RIC). METHODS Based on the full analysis set of RICAMIS, patients were divided into hypertension versus non-hypertension group, or <140 mmHg versus ≥140 mmHg group. Each group was further subdivided into RIC and control subgroups. The primary outcome was modified Rankin Scale (mRS) 0-1 at 90 days. Efficacy of RIC was compared among patients with hypertension versus nonhypertension history and SBP of <140 mmHg versus ≥140 mmHg. Furthermore, the interaction effect of treatment with hypertension and SBP was assessed. RESULTS Compared with control group, RIC produced a significantly higher proportion of patients with excellent functional outcome in the nonhypertension group (RIC vs. control: 65.7% vs. 57.0%, OR 1.45, 95% CI 1.06-1.98; p = 0.02), but no significant difference was observed in the hypertension group (RIC vs. control: 69.1% vs. 65.2%, p = 0.17). Similar results were observed in SBP ≥140 mmHg group (RIC vs. control: 68.0% vs. 61.2%, p = 0.009) and SBP <140 mmHg group (RIC vs. control: 65.6% vs. 64.7%, p = 0.77). No interaction effect of RIC on primary outcome was identified. INTERPRETATION Hypertension and baseline SBP did not affect the neuroprotective effect of RIC, but they were associated with higher probability of excellent functional outcome in patients with acute moderate ischemic stroke who received RIC treatment.
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Affiliation(s)
- Ji‐Ru Cai
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
- Department of NeurologyPostgraduate Training Base of Jinzhou Medical University in the General Hospital of Northern Theater CommandShenyangChina
| | - Nan‐Nan Zhang
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Yu Cui
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Yue‐Xin Ning
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Qiong Wu
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Yi‐Na Zhang
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Hui‐Sheng Chen
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
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Napavichayanun S, Sujarit AS, Pienpinijtham P, Sarikaphuti A, Aramwit P. Effect of Lavandula angustifolia and Cananga odorata on decrease of blood pressure in high blood pressure volunteers: A randomized controlled trial. Explore (NY) 2024; 20:520-526. [PMID: 38087747 DOI: 10.1016/j.explore.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Hypertension is one of the most dangerous diseases. However, medicine for hypertension may cause adverse effects. Thus, alternative treatments may be beneficial to patients. The aims of the study were to evaluate efficacy and safety of sticker pads containing lavender and ylang ylang oil (LY pads) on decrease blood pressure. MATERIALS AND METHODS The LY pads had been developed since 2018. The safety of LY pads in healthy volunteers' study and the efficacy and safety of LY pads in high blood pressure volunteers' study were conducted at Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand in October 2020 to December 2022. In the safety of LY pads in healthy volunteers' study, the LY pad was attached to the shirts of 56 healthy volunteers for 2 h. Adverse reactions, irritation score, and quality of life were assessed. In the efficacy and safety of the LY pads in high blood pressure volunteers' study, 34 high blood pressure volunteers were randomly divided into the LY group or the placebo group. The volunteers attached the pad to their shirt for 14 days. Blood pressure, pulse rate, and adverse reactions were investigated. RESULTS The LY pad was safe for humans. Using the LY pad for 2 h had no significant adverse reactions in healthy volunteers. Moreover, it significantly improved quality of life (p<0.05). The blood pressure of the LY pad group after at least 3 days use was significantly lower than before using the pad (p<0.05). The systolic blood pressure difference and pulse rate difference were also superior in the LY pad group compared to the placebo group (p<0.05). CONCLUSIONS The LY pad was safe in healthy volunteers and could reduce blood pressure in high blood pressure volunteers without adverse effects. Thus, it may be a supportive or alternative treatment for hypertension.
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Affiliation(s)
- Supamas Napavichayanun
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand; Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand
| | - Alisara Sangviroon Sujarit
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Prompong Pienpinijtham
- Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand; Sensor Research Unit (SRU), Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand; National Nanotechnology Center of Advanced Structural and Functional Nanomaterials, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Ariya Sarikaphuti
- School of Anti-Aging and Regenerative Medicine, Mae FahLuang University, Bangkok, Thailand
| | - Pornanong Aramwit
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand; Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand.
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17
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Wei W, Ma D, Li L, Zhang L. Cognitive impairment in cerebral small vessel disease induced by hypertension. Neural Regen Res 2024; 19:1454-1462. [PMID: 38051887 PMCID: PMC10883517 DOI: 10.4103/1673-5374.385841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/22/2023] [Indexed: 12/07/2023] Open
Abstract
ABSTRACT Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease, the most common cerebrovascular disease. However, the causal relationship between hypertension and cerebral small vessel disease remains unclear. Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease. Chronic hypertension and lifestyle factors are associated with risks for stroke and dementia, and cerebral small vessel disease can cause dementia and stroke. Hypertension is the main driver of cerebral small vessel disease, which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction, leukoaraiosis, white matter lesions, and intracerebral hemorrhage, ultimately resulting in cognitive decline and demonstrating that the brain is the target organ of hypertension. This review updates our understanding of the pathogenesis of hypertension-induced cerebral small vessel disease and the resulting changes in brain structure and function and declines in cognitive ability. We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
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Affiliation(s)
- Weipeng Wei
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Denglei Ma
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Lin Li
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Lan Zhang
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
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18
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Jones KE, Hayden SL, Meyer HR, Sandoz JL, Arata WH, Dufrene K, Ballaera C, Lopez Torres Y, Griffin P, Kaye AM, Shekoohi S, Kaye AD. The Evolving Role of Calcium Channel Blockers in Hypertension Management: Pharmacological and Clinical Considerations. Curr Issues Mol Biol 2024; 46:6315-6327. [PMID: 39057019 PMCID: PMC11275245 DOI: 10.3390/cimb46070377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/16/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
Worldwide, hypertension is the leading risk factor for cardiovascular disease and death. An estimated 122 million people, per the American Heart Association in 2023, have been diagnosed with this common condition. It is generally agreed that the primary goal in the treatment of hypertension is to reduce overall blood pressure to below 140/90 mmHg, with a more optimal goal of 130/80 mmHg. Common medications for treating hypertension include calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and diuretics. CCBs are one of the most widely studied agents and are generally recommended as first-line therapy alone and in combination therapies. This is largely based on the vast knowledge of CCB mechanisms and their minimal side effect profile. CCBs can be separated into two classes: dihydropyridine and non-dihydropyridine. Non-dihydropyridine CCBs act on voltage-dependent L-type calcium channels of cardiac and smooth muscle to decrease muscle contractility. Dihydropyridine CCBs act by vasodilating the peripheral vasculature. For many patients with only mild increases in systolic and diastolic blood pressure (e.g., stage 1 hypertension), the medical literature indicates that CCB monotherapy can be sufficient to control hypertension. In this regard, CCB monotherapy in those with stage 1 hypertension reduced renal and cardiovascular complications compared to other drug classes. Combination therapy with CCBs and angiotensin receptor blockers or angiotensin-converting enzyme inhibitors has been shown to be an effective dual therapy based on recent meta-analyses. This article is a review of calcium channel blockers and their use in treating hypertension with some updated and recent information on studies that have re-examined their use. As for new information, we tried to include some information from recent studies on hypertensive treatment involving calcium channel blockers.
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Affiliation(s)
- Kamryn E. Jones
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA (S.L.H.)
| | - Shaun L. Hayden
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA (S.L.H.)
| | - Hannah R. Meyer
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA (S.L.H.)
| | - Jillian L. Sandoz
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA (S.L.H.)
| | - William H. Arata
- School of Medicine, St. George’s University, True Blue, West Indies FZ818, Grenada
| | - Kylie Dufrene
- School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA (S.L.H.)
| | - Corrado Ballaera
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (C.B.)
| | - Yair Lopez Torres
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (C.B.)
| | - Patricia Griffin
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (C.B.)
| | - Adam M. Kaye
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA;
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (C.B.)
| | - Alan D. Kaye
- Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA
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19
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Zhang X, Li C. Major depressive disorder increased the risk of hypertension: A Mendelian randomization study. J Affect Disord 2024; 355:184-189. [PMID: 38556096 DOI: 10.1016/j.jad.2024.03.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Despite the high prevalence of comorbid hypertension in patients with major depressive disorder (MDD), the relationship between the two diseases has received little attention. Previous observational studies have descripted the association between MDD and hypertension, the causality from MDD on hypertension remained unknown. The present Mendelian randomization (MR) study aimed to assess the causal effect of MDD on hypertension. METHODS A set of genetics instrument was used for analysis, derived from publicly available genetic meta-analysis data. A total of 44 single-nucleotide polymorphisms (SNPs) associated with MDD. The largest genome-wide association study (GWAS) for hypertension (54,358 cases and 408,652 controls) was used to assess the effect of MDD on hypertension. Inverse variance weighted method (IVW), weighted median method (WM), and MR-Egger regression were used for MR analyses. The MR-Egger_intercept test and Cochran's Q statistic were used to determine the pleiotropy and the heterogeneity, respectively. RESULTS A total of 28 independent and effective MDD genetic instrumental variables were extracted from the hypertension GWAS summary statistics. Pleiotropy analysis suggested no significant pleiotropic variant among the 28 selected MDD genetic instrument variants in hypertension GWAS datasets. As MDD based on genetic changes increased, the risk of hypertension increased using MR-Egger (OR = 1.004436, 95%CI 0.9884666-1.020663, P = 0.5932928), WM (OR = 1.000499, 95%CI 1.0000188-1.000980, P = 0.0416871), and IVW (OR = 1.000573, 95%CI 1.0000732-1.001074, P = 0.0246392). Our results were robust, with no obvious bias based on investigating the single MDD SNP on hypertension. CONCLUSIONS Our result suggested a causal associated between genetically increased MDD and increased hypertension risk in European population.
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Affiliation(s)
- Xu Zhang
- Department of Cardiovascular Surgery, the Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Cheng Li
- Department of Cardiovascular Center, the First Hospital of Jilin University, Changchun, Jilin, China.
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20
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Młynarczyk MA, Domian N, Kasacka I. Evaluation of the Canonical Wnt Signaling Pathway in the Hearts of Hypertensive Rats of Various Etiologies. Int J Mol Sci 2024; 25:6428. [PMID: 38928134 PMCID: PMC11204257 DOI: 10.3390/ijms25126428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
Wnt/β-catenin signaling dysregulation is associated with the pathogenesis of many human diseases, including hypertension and heart disease. The aim of this study was to immunohistochemically evaluate and compare the expression of the Fzd8, WNT1, GSK-3β, and β-catenin genes in the hearts of rats with spontaneous hypertension (SHRs) and deoxycorticosterone acetate (DOCA)-salt-induced hypertension. The myocardial expression of Fzd8, WNT1, GSK-3β, and β-catenin was detected by immunohistochemistry, and the gene expression was assessed with a real-time PCR method. In SHRs, the immunoreactivity of Fzd8, WNT1, GSK-3β, and β-catenin was attenuated in comparison to that in normotensive animals. In DOCA-salt-induced hypertension, the immunoreactivity of Fzd8, WNT1, GSK-3β, and β-catenin was enhanced. In SHRs, decreases in the expression of the genes encoding Fzd8, WNT1, GSK-3β, and β-catenin were observed compared to the control group. Increased expression of the genes encoding Fzd8, WNT1, GSK-3β, and β-catenin was demonstrated in the hearts of rats with DOCA-salt-induced hypertension. Wnt signaling may play an essential role in the pathogenesis of arterial hypertension and the accompanying heart damage. The obtained results may constitute the basis for further research aimed at better understanding the role of the Wnt/β-catenin pathway in the functioning of the heart.
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Affiliation(s)
| | | | - Irena Kasacka
- Department of Histology and Cytophysiology, Medical University of Bialystok, 15-222 Bialystok, Poland; (M.A.M.); (N.D.)
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21
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Zúniga-Gutiérrez M, Meléndez M, Montoya SSR, Escobar HAF, López J, Paz S, Sauceda-Acosta D. Dengue Burden and Factors Influencing Severity in Honduras: A Descriptive and Analytical Study. Rev Soc Bras Med Trop 2024; 57:e004072024. [PMID: 38896654 PMCID: PMC11178375 DOI: 10.1590/0037-8682-0594-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/09/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Dengue is a disease that accounts for a major morbidity and mortality in Honduras. METHODS This descriptive study used an analytical component based on the data from the National Virology Laboratory between 2016-2022. Ordinal logistic regression was used to identify the factors associated with the classification of dengue without warning signs (DWOS), dengue with warning signs (DWS), and severe dengue (SD). RESULTS Overall, 14,687 dengue cases were included; 50.1% had DWOS, 36.5% had DWS, and 13.4% had SD. Patients that were more associated with a higher probability of DWS and SD were patients in the age groups 1-4 years (DWS OR 1.61; 95%CI:1.33-1.94), (SD OR 1.52; 95% CI:1.26-1.84), 5-9 years (DWS OR 2.01; 95% CI:1.68-2.40), (SD OR 2.00; 95% CI:1.67-2.40), and 10-19 years (DWS OR 1.55; 95% CI:1.30-1.85) (SD OR 1.57; 95% CI:1.31-1.88). The departments that were associated with a higher probability of DWS and SD were La Paz (OR 6.35; 95% CI:3.53-11.42), (OR 10.94; 95% CI:5.96-20.08), Copán (OR 6.94; 95% CI:5.05-9.53) (OR 7.33; 95% CI: 5.35-10.03), Valle (OR 5.22; 95% CI:1.25-21.82) (OR 10.71; 95% CI:2.21-51.88). CONCLUSIONS During the study period, dengue presented endemic behavior, with peaks consistent with the last two epidemics in Honduras in 2015 and 2019. The main factors associated with dengue severity were age< 19 years, male sex, and being from La Paz, Copán, or Valle.
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Affiliation(s)
- Melba Zúniga-Gutiérrez
- Universidad Nacional Autónoma de Honduras, Research Institute in
Medical Sciences and Right to Health, Epidemiology Postgraduate Program Tegucigalpa,
Honduras
| | - Marlon Meléndez
- Universidad Nacional Autónoma de Honduras, Epidemiology Postgraduate
Program. Tegucigalpa, Honduras
| | | | | | - Jorge López
- Universidad Nacional Autónoma de Honduras, Demography and
Development Postgraduate Program. Tegucigalpa, Honduras
| | - Sandra Paz
- Ministry of Health, Health Surveillance Unit, National Virology
Laboratory. Tegucigalpa, Honduras
| | - Dilcia Sauceda-Acosta
- Universidad Nacional Autónoma de Honduras, Research Institute in
Medical Sciences and Right to Health, Epidemiology Postgraduate Program Tegucigalpa,
Honduras
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22
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Plante TB, Juraschek SP, Howard G, Howard VJ, Tracy RP, Olson NC, Judd SE, Kamin Mukaz D, Zakai NA, Long DL, Cushman M. Cytokines, C-Reactive Protein, and Risk of Incident Hypertension in the REGARDS Study. Hypertension 2024; 81:1244-1253. [PMID: 38487890 PMCID: PMC11095906 DOI: 10.1161/hypertensionaha.123.22714] [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: 01/08/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Hypertension is a highly prevalent cardiovascular disease risk factor that may be related to inflammation. Whether adverse levels of specific inflammatory cytokines relate to hypertension is unknown. The present study sought to determine whether higher levels of IL (interleukin)-1β, IL-6, TNF (tumor necrosis factor)-α, IFN (interferon)-γ, IL-17A, and CRP (C-reactive protein) are associated with a greater risk of incident hypertension. METHODS The REGARDS study (Reasons for Geographic and Racial Difference in Stroke) is a prospective cohort study that recruited 30 239 community-dwelling Black and White adults from the contiguous United States in 2003 to 2007 (visit 1), with follow-up 9 years later in 2013 to 2016 (visit 2). We included participants without prevalent hypertension who attended follow-up 9 years later and had available laboratory measures and covariates of interest. Poisson regression estimated the risk ratio of incident hypertension by level of inflammatory biomarkers. RESULTS Among 1866 included participants (mean [SD] aged of 62 [8] years, 25% Black participants, 55% women), 36% developed hypertension. In fully adjusted models comparing the third to first tertile of each biomarker, there was a greater risk of incident hypertension for higher IL-1β among White (1.24 [95% CI, 1.01-1.53]) but not Black participants (1.01 [95% CI, 0.83-1.23]) and higher TNF-α (1.20 [95% CI, 1.02-1.41]) and IFN-γ (1.22 [95% CI, 1.04-1.42]) among all participants. There was no increased risk with IL-6, IL-17A, or CRP. CONCLUSIONS Higher levels of IL-1β, TNF-α, and IFN-γ, representing distinct inflammatory pathways, are elevated in advance of hypertension development. Whether modifying these cytokines will reduce incident hypertension is unknown.
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Affiliation(s)
- Timothy B. Plante
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Stephen P. Juraschek
- Department of Medicine, Beth Israel Lahey Clinic/Harvard Medical School, Boston, MA (S.P.J)
| | - George Howard
- Departments of Biostatistics (G.H., S.E.J.), School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Virginia J. Howard
- Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Russell P. Tracy
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Nels C. Olson
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Suzanne E. Judd
- Departments of Biostatistics (G.H., S.E.J.), School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Debora Kamin Mukaz
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Neil A. Zakai
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
| | - D. Leann Long
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC (D.L.L.)
| | - Mary Cushman
- Departments of Medicine (T.B.P., D.K.M., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
- Pathology and Laboratory Medicine (R.P.T., N.C.O., N.A.Z., M.C.), Larner College of Medicine at the University of Vermont, Burlington, VT
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23
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Bakkar NAALH, Bakr AY, Alhusseini AH, Alourfi ZH. The relationship between serum 25-hydroxy vitamin D status and hypertension in Syrian population: retrospective cohort study. Ann Med Surg (Lond) 2024; 86:3222-3226. [PMID: 38846846 PMCID: PMC11152839 DOI: 10.1097/ms9.0000000000001989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Vitamin D is a liposoluble steroid hormone that plays a crucial role in the maintenance of bone metabolism and calcium homoeostasis. Many studies on the effects of vitamin D on general health have been significantly increased, driven by new findings concerning the systemic and extraskeletal effects of this hormone. This study was performed to determine whether low levels of vitamin D were associated with hypertension in Syrian people. Materials and methods This retrospective cohort study consisted of 207 subjects, including 83 (40.1%) patients suffering from essential hypertension and 124 (59.9%) patients with normal blood pressure. Aged older than 18 years, who was referred to the endocrinology clinic from September 2022 to September 2023. The data were analysed by using SPSS (version 25). Logistic regression analyses were performed with adjustments for age, sex, and waist circumference. Results Hypertension rates were 73%, 20%, and 5% in 25-hydroxyvitamin D groups less than 12 ng/ml, 12-20 ng/mL, and greater than or equal to 20 ng/ml, respectively. Odds ratios (95% CIs) for hypertension adjusting for age, sex, and waist circumference were 178.6 (30.5_1045.6), 5.13 (0.9_26.5) for 25-hydroxyvitamin D levels less than 12 ng/ml, and 12-20 ng/ml, respectively, compared with the greater than or equal to 20 ng/ml group. Conclusions This study has shown a high prevalence of low vitamin D levels (25OHVD/20 ng/ml) among a sample of Syrian people (78.3%). The lowest 25OHVD group was associated with a higher prevalence of hypertension, which refers to an adverse association between vitamin D level and essential hypertension. Further research is needed to confirm this relationship.
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24
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Kaisti M, Panula T, Sirkiä J, Pänkäälä M, Koivisto T, Niiranen T, Kantola I. Hemodynamic Bedside Monitoring Instrument with Pressure and Optical Sensors: Validation and Modality Comparison. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2307718. [PMID: 38647263 PMCID: PMC11200005 DOI: 10.1002/advs.202307718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/19/2024] [Indexed: 04/25/2024]
Abstract
Results from two independent clinical validation studies for measuring hemodynamics at the patient's bedside using a compact finger probe are reported. Technology comprises a barometric pressure sensor, and in one implementation, additionally, an optical sensor for photoplethysmography (PPG) is developed, which can be used to measure blood pressure and analyze rhythm, including the continuous detection of atrial fibrillation. The capabilities of the technology are shown in several form factors, including a miniaturized version resembling a common pulse oximeter to which the technology could be integrated in. Several main results are presented: i) the miniature finger probe meets the accuracy requirements of non-invasive blood pressure instrument validation standard, ii) atrial fibrillation can be detected during the blood pressure measurement and in a continuous recording, iii) a unique comparison between optical and pressure sensing mechanisms is provided, which shows that the origin of both modalities can be explained using a pressure-volume model and that recordings are close to identical between the sensors. The benefits and limitations of both modalities in hemodynamic monitoring are further discussed.
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Affiliation(s)
- Matti Kaisti
- Department of ComputingUniversity of Turku, Faculty of TechnologyVesilinnantie 5Turku20500Finland
| | - Tuukka Panula
- Department of ComputingUniversity of Turku, Faculty of TechnologyVesilinnantie 5Turku20500Finland
| | - Jukka‐Pekka Sirkiä
- Department of ComputingUniversity of Turku, Faculty of TechnologyVesilinnantie 5Turku20500Finland
| | - Mikko Pänkäälä
- Department of ComputingUniversity of Turku, Faculty of TechnologyVesilinnantie 5Turku20500Finland
| | - Tero Koivisto
- Department of ComputingUniversity of Turku, Faculty of TechnologyVesilinnantie 5Turku20500Finland
| | - Teemu Niiranen
- Department of Internal MedicineUniversity of TurkuKiinamyllynkatu 4‐8Turku20521Finland
| | - Ilkka Kantola
- Division of MedicineTurku University HospitalKiinamyllynkatu 4‐8Turku20521Finland
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25
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Liu F, Lu X. Hypertension and human health: Evidence and prospects. Chronic Dis Transl Med 2024; 10:89-91. [PMID: 38872759 PMCID: PMC11166676 DOI: 10.1002/cdt3.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Key Laboratory of Cardiovascular EpidemiologyChinese Academy of Medical SciencesBeijingChina
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Key Laboratory of Cardiovascular EpidemiologyChinese Academy of Medical SciencesBeijingChina
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26
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Pimenta AI, Bernardino RM, Pereira IAC. Role of sulfidogenic members of the gut microbiota in human disease. Adv Microb Physiol 2024; 85:145-200. [PMID: 39059820 DOI: 10.1016/bs.ampbs.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
The human gut flora comprises a dynamic network of bacterial species that coexist in a finely tuned equilibrium. The interaction with intestinal bacteria profoundly influences the host's development, metabolism, immunity, and overall health. Furthermore, dysbiosis, a disruption of the gut microbiota, can induce a variety of diseases, not exclusively associated with the intestinal tract. The increased consumption of animal protein, high-fat and high-sugar diets in Western countries has been implicated in the rise of chronic and inflammatory illnesses associated with dysbiosis. In particular, this diet leads to the overgrowth of sulfide-producing bacteria, known as sulfidogenic bacteria, which has been linked to inflammatory bowel diseases and colorectal cancer, among other disorders. Sulfidogenic bacteria include sulfate-reducing bacteria (Desulfovibrio spp.) and Bilophila wadsworthia among others, which convert organic and inorganic sulfur compounds to sulfide through the dissimilatory sulfite reduction pathway. At high concentrations, sulfide is cytotoxic and disrupts the integrity of the intestinal epithelium and mucus barrier, triggering inflammation. Besides producing sulfide, B. wadsworthia has revealed significant pathogenic potential, demonstrated in the ability to cause infection, adhere to intestinal cells, promote inflammation, and compromise the integrity of the colonic mucus layer. This review delves into the mechanisms by which taurine and sulfide-driven gut dysbiosis contribute to the pathogenesis of sulfidogenic bacteria, and discusses the role of these gut microbes, particularly B. wadsworthia, in human diseases.
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Affiliation(s)
- Andreia I Pimenta
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Raquel M Bernardino
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Inês A C Pereira
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal.
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Shahzadi Z, Yousaf Z, Anjum I, Bilal M, Yasin H, Aftab A, Booker A, Ullah R, Bari A. Network pharmacology and molecular docking: combined computational approaches to explore the antihypertensive potential of Fabaceae species. BIORESOUR BIOPROCESS 2024; 11:53. [PMID: 38767701 PMCID: PMC11106056 DOI: 10.1186/s40643-024-00764-6] [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: 01/31/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024] Open
Abstract
Hypertension is a major global public health issue, affecting quarter of adults worldwide. Numerous synthetic drugs are available for treating hypertension; however, they often come with a higher risk of side effects and long-term therapy. Modern formulations with active phytoconstituents are gaining popularity, addressing some of these issues. This study aims to discover novel antihypertensive compounds in Cassia fistula, Senna alexandrina, and Cassia occidentalis from family Fabaceae and understand their interaction mechanism with hypertension targeted genes, using network pharmacology and molecular docking. Total 414 compounds were identified; initial screening was conducted based on their pharmacokinetic and ADMET properties, with a particular emphasis on adherence to Lipinski's rules. 6 compounds, namely Germichrysone, Benzeneacetic acid, Flavan-3-ol, 5,7,3',4'-Tetrahydroxy-6, 8-dimethoxyflavon, Dihydrokaempferol, and Epiafzelechin, were identified as effective agents. Most of the compounds found non-toxic against various indicators with greater bioactivity score. 161 common targets were obtained against these compounds and hypertension followed by compound-target network construction and protein-protein interaction, which showed their role in diverse biological system. Top hub genes identified were TLR4, MMP9, MAPK14, AKT1, VEGFA and HSP90AA1 with their respective associates. Higher binding affinities was found with three compounds Dihydrokaempferol, Flavan-3-ol and Germichrysone, -7.1, -9.0 and -8.0 kcal/mol, respectively. The MD simulation results validate the structural flexibility of two complexes Flavan-MMP9 and Germich-TLR4 based on no. of hydrogen bonds, root mean square deviations and interaction energies. This study concluded that C. fistula (Dihydrokaempferol, Flavan-3-ol) and C. occidentalis (Germichrysone) have potential therapeutic active constituents to treat hypertension and in future novel drug formulation.
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Affiliation(s)
- Zainab Shahzadi
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Zubaida Yousaf
- Department of Botany, Lahore College for Women University, Lahore, Pakistan.
| | - Irfan Anjum
- Department of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Muhammad Bilal
- Centers for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Hamna Yasin
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Arusa Aftab
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Anthony Booker
- Research Centre for Optimal Health, School of Life Sciences, College of Liberal Arts and Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
- Research Group 'Pharmacognosy and Phytotherapy', UCL School of Pharmacy, Univ. London, 29 - 39 Brunswick Sq., London, WC1N 1AX, UK.
| | - Riaz Ullah
- Department of Pharmacognosy, College of Pharmacy King, Saud University, Riyadh, Saudi Arabia
| | - Ahmed Bari
- Department of Pharmaceutical Chemistry, College of Pharmacy King, Saud University, Riyadh, Saudi Arabia
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Hou Y, Liu B. Relationship Between Hypertension and Hearing Loss: Analysis of the Related Factors. Clin Interv Aging 2024; 19:845-856. [PMID: 38774248 PMCID: PMC11107936 DOI: 10.2147/cia.s458869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/03/2024] [Indexed: 05/24/2024] Open
Abstract
Purpose The impact of hypertension extends to hearing loss, aging, and mental Health. The purpose of this study was to investigate the characteristics of hearing loss and hearing thresholds at different frequencies in individuals with hypertension. Through a comprehensive analysis, in the present study, it aimed to uncover the contributing factors that underlie hearing loss in this patient cohort, shedding light on the complex relationship between hypertension and auditory impairment. Patients and Methods This was a single-center population-based observational study, and clinical, biological, and hospital data were collected from the inpatient ward. In the present study, 517 patients (1034 ears) with or without hypertension were included, and the proportion of patients with hearing loss, mean pure-tone average hearing threshold, low-frequency pure-tone average hearing threshold (LFPTA), medium-frequency pure-tone average hearing threshold (MFPTA) and high-frequency pure-tone average hearing threshold (HFPTA) were evaluated. Risk factors related to hearing loss and hearing threshold were also estimated at different frequencies. Results The proportion of patients with hearing loss was higher in the hypertensive group than in the nonhypertensive group (P<0.05). After including risk factors for cardiovascular disease that can have an impact on the parameters of hearing and ambulatory blood pressure in the regression model, factors related to hearing loss included the albumin-to-creatinine ratio (ACR) and the standard deviation of the 24-hour systolic blood pressure (24h-SSD). ACR, 24h-SSD, and day systolic blood pressure (Day SBP) were associated with the mean pure-tone average hearing threshold, LFPTA, MFPTA, and HFPTA. The area under the receiver operating characteristic curve of ACR + 24h-SSD for hearing loss was 0.873, with a sensitivity of 86.73%, specificity of 90.52%, and a 95% confidence interval of 0.821-0.914. Conclusion Hypertension is correlated with hearing loss, and the combination of ACR and 24h-SSD demonstrates an improved predictive capacity for hearing loss in hypertensive patients.
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Affiliation(s)
- Yinjing Hou
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China
| | - Bo Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, 100730, People’s Republic of China
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Hu GF, Meng LB, Li J, Xu J, Xu HX, Liu DP. HLA-B and TIMP1 as hub genes of the ventricular remodeling caused by hypertension. Aging (Albany NY) 2024; 16:8260-8278. [PMID: 38728374 PMCID: PMC11132017 DOI: 10.18632/aging.205816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024]
Abstract
RATIONALE Myocardial fibrosis is an important pathological change that occurs during ventricular remodeling in patients with hypertension and is an important pathophysiological basis of cardiovascular disease. However, the molecular mechanism underlying this ventricular remodeling is unclear. METHODS Bioinformatics analysis identified HLA-B and TIMP1 as hub genes in the process of myocardial fibrosis. Expression and correlation analyses of significant hub genes with ventricular remodeling were performed. Weighted gene co-expression network analysis (WGCNA) was performed to verify the role of HLA-B. ceRNA network was constructed to identify the candidate molecule drugs. Receiver operating characteristic (ROC) curves were analyzed. RESULTS RT-qPCR was performed to verify the roles of HLA-B and TIMP1 in seven control individuals with hypertension and seven patients with hypertension and ventricular remodeling. The WGCNA showed that HLA-B was in the brown module and the correlation coefficient between HLA-B and ventricular remodeling was 0.67. Based on univariate logistic proportional regression analysis, HLA-B influences ventricular remodeling (P<0.05). RT-qPCR showed that the relative expression levels of HLA-B and TIMP1 were significantly higher in HLVR samples compared with their expression in the control group. CONCLUSIONS HLA-B and TIMP1 might provide novel research targets for the diagnosis and treatment of HLVR.
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Affiliation(s)
- Gai-Feng Hu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Chaoyang 100029, Beijing, China
| | - Ling-Bing Meng
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping 102218, Beijing, China
| | - Jianyi Li
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dong Dan 100730, Beijing, China
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Dongcheng 100730, Beijing, China
| | - Jiapei Xu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dong Dan 100730, Beijing, China
| | - Hong-Xuan Xu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dong Dan 100730, Beijing, China
| | - De-Ping Liu
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dong Dan 100730, Beijing, China
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Dongcheng 100730, Beijing, China
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Yang L, Du H, Zhang X, Zhang D, Su X, Qiao Z, Gao B. Evaluation of the correlation between cerebral hemodynamics and blood pressure by comparative analysis of variation in cerebral blood flow in hypertensive versus normotensive individuals: A systematic review and meta-analysis. BIOMOLECULES & BIOMEDICINE 2024; 24:775-786. [PMID: 38709773 PMCID: PMC11293236 DOI: 10.17305/bb.2024.10230] [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: 01/03/2024] [Revised: 04/20/2024] [Accepted: 04/20/2024] [Indexed: 05/08/2024]
Abstract
Current understanding of the cerebral vascular response to variations in blood pressure (BP) among individuals with hypertension is limited. The aim of this meta-analysis was to determine the correlation between hypertension, risk of stroke, and cerebral blood flow (CBF). We reviewed studies published between 2000 and 2023 from PubMed, Google Scholar, and Science Direct that compared mean CBF in normotensive (NTN) and hypertensive (HTN) patients. A random effects model was used to construct the risk ratio (RR), 95% confidence interval (CI), forest plot, and inverse variance weighting. Additionally, a mixed-effects meta-regression was employed to examine the impact of study-specific patient variables. This meta-analysis included eight prospective cross-sectional studies published from 2002 to 2023. It revealed a significant average difference in the standard mean CBF of -0.45 (95% CI -0.60 to -0.30, I2 = 69%, P < 0.00001), distinguishing NTN from HTN subjects. A RR of 0.90 (95% CI 0.63 to 1.30, I2 = 89%, P = 0.04) indicated a significant decrease in CBF among individuals with hypertension. We found a statistically significant relationship between changes in diastolic and systolic BPs and the mean CBF (R -0.81, P = 0.001 and R = -0.90, P = 0.005, respectively). Our research demonstrates a strong relationship between elevated BP and reduced CBF, with hypertension reducing CBF compared to NTN individuals, by increasing cerebrovascular resistance.
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Affiliation(s)
- Lei Yang
- Department of Neurosurgery, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Hong Du
- Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuejing Zhang
- Center of Medical Research, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Dongliang Zhang
- Department of Neurosurgery, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Xianhui Su
- Department of Neurosurgery, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Zongrong Qiao
- Department of Neurosurgery, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Bulang Gao
- Center of Medical Research, Shijiazhuang People’s Hospital, Shijiazhuang, China
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Guo DC, Gao JW, Wang X, Chen ZT, Gao QY, Chen YX, Wang JF, Liu PM, Zhang HF. Remnant cholesterol and risk of incident hypertension: a population-based prospective cohort study. Hypertens Res 2024; 47:1157-1166. [PMID: 38212367 DOI: 10.1038/s41440-023-01558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/13/2024]
Abstract
Remnant cholesterol (RC) has been associated with atherosclerotic cardiovascular disease, but its relationship with hypertension remains unclear. This prospective cohort study aimed to investigate the association between RC and subsequent hypertension risk. Data from the UK Biobank, comprising 295,062 participants initially free of hypertension, were analyzed. Cox proportional hazards regression assessed the association between RC quartiles and hypertension risk. Discordance analysis evaluated the risk of hypertension in discordant/concordant groups of RC and low-density lipoprotein cholesterol (LDL-C) using the difference in percentile units (>10 units). Restricted cubic spline curves were used to model the relationship between RC and hypertension risk. The mean ± SD age of participants was 55.1 ± 8.1 years, with 40.6% being men and 94.7% White. During a median follow-up of 12.8 years, 39,038 participants developed hypertension. Comparing extreme quartiles of RC, the hazard ratio (HR) for incident hypertension was 1.20 (95% CI: 1.17-1.24). After adjusting for traditional risk factors, each 1 mmol/L increase in RC levels was associated with a 27% higher risk of incident hypertension (HR: 1.27; 95% CI: 1.23-1.31). The discordant group with high RC/low LDL-C exhibited a higher risk of incident hypertension compared to the concordant group (HR: 1.06; 95% CI: 1.03-1.09). Spline curves further demonstrated a positive association between RC and the risk of incident hypertension. We concluded that elevated RC emerged as an independent risk factor of incident hypertension, extending beyond traditional risk factors. Monitoring RC levels and implementing interventions to lower RC may have potential benefits in preventing hypertension.
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Affiliation(s)
- Da-Chuan Guo
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Jing-Wei Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Xiang Wang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Zhi-Teng Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Qing-Yuan Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yang-Xin Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Pin-Ming Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
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Morgan T, Basalely A, Singer P, Castellanos L, Sethna CB. The association between sleep duration and cardiometabolic risk among children and adolescents in the United States (US): A NHANES study. Child Care Health Dev 2024; 50:e13273. [PMID: 38738838 DOI: 10.1111/cch.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 04/16/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE This work aims to assess the association of sleep duration with cardiometabolic risk (adiposity, blood pressure, lipids, albuminuria and A1C) and to investigate lifestyle factors (physical activity, light exposure, caffeine consumption and sugar consumption) associated with sleep duration in children. METHODS A nationally representative sample of 3907 children ages 6-17 years enrolled in NHANES from 2011 to 2014 was included in this cross-sectional study. Sleep duration was defined as the daily average time spent sleeping over 7 days as measured by a physical activity monitor (PAM). Participants without valid sleep data for ≥95% of the study were excluded. Regression models were adjusted for age, sex, race, body mass index (BMI) Z score, physical activity and light exposure. RESULTS In adjusted regression models, longer sleep duration was associated with lower systolic blood pressure index (β = -3.63 * 10-5, 95% CI -6.99 * 10-5, -2.78 * 10-6, p = 0.035) and BMI Z score (β = -0.001, 95% CI -0.001, 0.000, p = 0.002). In logistic regression models, longer sleep duration was associated with lower odds of obesity (OR = 0.998, 95% CI 0.997, 0.999, p < 0.001) and overweight status (OR = 0.998, 95% CI 0.997, 0.999, p = 0.004). Greater light exposure (β = 6.64 * 10-5, 95% CI 3.50 * 10-5, 9.69 * 10-5, p < 0.001) and physical activity (β = 0.005, 95% CI 0.004, 0.006, p < 0.001) were associated with longer sleep. CONCLUSION Longer sleep duration was associated with lower blood pressure and adiposity measures in children. Improving sleep quality by increasing physical activity and light exposure in childhood may decrease the lifetime risk of cardiometabolic disease.
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Affiliation(s)
- Timothy Morgan
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, New York, USA
| | - Abby Basalely
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, New York, USA
| | - Pamela Singer
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, New York, USA
| | - Laura Castellanos
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, New York, USA
| | - Christine B Sethna
- Northwell, Cohen Children's Medical Center, Division of Pediatric Nephrology, New Hyde Park, New York, USA
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Lin JS, Petrera A, Hauck SM, Müller CL, Peters A, Thorand B. Associations of Proteomics With Hypertension and Systolic Blood Pressure: KORA S4/F4/FF4 and KORA Age1/Age2 Cohort Studies. Hypertension 2024; 81:1156-1166. [PMID: 38445514 PMCID: PMC11025610 DOI: 10.1161/hypertensionaha.123.22614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Hypertension, a complex condition, is primarily defined based on blood pressure readings without involving its pathophysiological mechanisms. We aimed to identify biomarkers through a proteomic approach, thereby enhancing the future definition of hypertension with insights into its molecular mechanisms. METHODS The discovery analysis included 1560 participants, aged 55 to 74 years at baseline, from the KORA (Cooperative Health Research in the Region of Augsburg) S4/F4/FF4 cohort study, with 3332 observations over a median of 13.4 years of follow-up. Generalized estimating equations were used to estimate the associations of 233 plasma proteins with hypertension and systolic blood pressure (SBP). For validation, proteins significantly associated with hypertension or SBP in the discovery analysis were validated in the KORA Age1/Age2 cohort study (1024 participants, 1810 observations). A 2-sample Mendelian randomization analysis was conducted to infer causalities of validated proteins with SBP. RESULTS Discovery analysis identified 49 proteins associated with hypertension and 99 associated with SBP. Validation in the KORA Age1/Age2 study replicated 7 proteins associated with hypertension and 23 associated with SBP. Three proteins, NT-proBNP (N-terminal pro-B-type natriuretic peptide), KIM1 (kidney injury molecule 1), and OPG (osteoprotegerin), consistently showed positive associations with both outcomes. Five proteins demonstrated potential causal associations with SBP in Mendelian randomization analysis, including NT-proBNP and OPG. CONCLUSIONS We identified and validated 7 hypertension-associated and 23 SBP-associated proteins across 2 cohort studies. KIM1, NT-proBNP, and OPG demonstrated robust associations, and OPG was identified for the first time as associated with blood pressure. For NT-proBNP (protective) and OPG, causal associations with SBP were suggested.
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Affiliation(s)
- Jie-sheng Lin
- Institute of Epidemiology (J.-s.L., A. Peters, B.T.), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, Munich, Germany (J.-s.L., B.T.)
| | - Agnese Petrera
- Metabolomics and Proteomics Core (A. Petrera, S.M.H.), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Stefanie M. Hauck
- Metabolomics and Proteomics Core (A. Petrera, S.M.H.), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Christian L. Müller
- Institute of Computational Biology (C.L.M.), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Department of Statistics (C.L.M.), Ludwig-Maximilians-Universität München, Munich, Germany
- Center for Computational Mathematics, Flatiron Institute, New York, NY (C.L.M.)
| | - Annette Peters
- Institute of Epidemiology (J.-s.L., A. Peters, B.T.), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty (A. Peters), Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research, Partner München-Neuherberg, Germany (A. Peters, B.T.)
| | - Barbara Thorand
- Institute of Epidemiology (J.-s.L., A. Peters, B.T.), Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, Munich, Germany (J.-s.L., B.T.)
- German Center for Diabetes Research, Partner München-Neuherberg, Germany (A. Peters, B.T.)
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Flack JM, Buhnerkempe MG, Moore KT. Resistant Hypertension: Disease Burden and Emerging Treatment Options. Curr Hypertens Rep 2024; 26:183-199. [PMID: 38363454 DOI: 10.1007/s11906-023-01282-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW To define resistant hypertension (RHT), review its pathophysiology and disease burden, identify barriers to effective hypertension management, and to highlight emerging treatment options. RECENT FINDINGS RHT is defined as uncontrolled blood pressure (BP) ≥ 130/80 mm Hg despite concurrent prescription of ≥ 3 or ≥ 4 antihypertensive drugs in different classes or controlled BP despite prescription of ≥ to 4 drugs, at maximally tolerated doses, including a diuretic. BP is regulated by a complex interplay between the renin-angiotensin-aldosterone system, the sympathetic nervous system, the endothelin system, natriuretic peptides, the arterial vasculature, and the immune system; disruption of any of these can increase BP. RHT is disproportionately manifest in African Americans, older patients, and those with diabetes and/or chronic kidney disease (CKD). Amongst drug-treated hypertensives, only one-quarter have been treated intensively enough (prescribed > 2 drugs) to be considered for this diagnosis. New treatment strategies aimed at novel therapeutic targets include inhibition of sodium-glucose cotransporter 2, aminopeptidase A, aldosterone synthesis, phosphodiesterase 5, xanthine oxidase, and dopamine beta-hydroxylase, as well as soluble guanylate cyclase stimulation, nonsteroidal mineralocorticoid receptor antagonism, and dual endothelin receptor antagonism. The burden of RHT remains high. Better use of currently approved therapies and integrating emerging therapies are welcome additions to the therapeutic armamentarium for addressing needs in high-risk aTRH patients.
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Affiliation(s)
- John M Flack
- Department of Medicine, Division of General Internal Medicine, Hypertension Section, Southern Illinois University, Southern Illinois University School of Medicine, 801 North Rutledge Street, Carbondale, IL, 62702, USA.
| | - Michael G Buhnerkempe
- Department of Medicine and the Center for Clinical Research, Southern Illinois University, Carbondale, IL, USA
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Sun J, Dong Y, Wang H, Guo X, Suo N, Li S, Ren X, Jiang S. The improvement of postoperative blood pressure and associated factors in patients with hormone-negative adrenal adenoma and hypertension. J Surg Oncol 2024; 129:1073-1081. [PMID: 38321865 DOI: 10.1002/jso.27594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To investigate the effect of adrenal surgery on blood pressure (BP) improvements in patients with hormone-negative adrenal adenoma (HNA) concomitant with hypertension and analyze associated prognostic factors. METHODS We retrospectively reviewed the clinical data of patients with HNA and hypertension and patients with aldosterone-producing adenoma (APA) and hypertension who underwent adrenal surgery at our center between 2019 and 2022. Hypertension outcomes were evaluated in all patients and subjects were divided into three groups according to follow-up BP and the administration of anti-hypertensive agents: a clinical curation group, an improvement group, and a no-improvement group. Logistic regression analysis was performed to predict factors associated with clinical curation in patients with HNA post-surgery. RESULTS Of the 182 patients with HNA, clinical curation was achieved in 58 patients (31.9%), improvement in 72 (39.5%), and no improvement in 52 (28.6%). The clinical curation, improvement and no improvement rates in patients with APA were 64.8% (n = 118), 15.9% (n = 29), and 19.2% (n = 35). Multivariate logistic regression analysis indicated that a duration of hypertension ≤6 years and a plasma aldosterone level >160 pg/ml were both independent factors for the clinical curation of hypertension in patients with HNA after adrenal surgery. CONCLUSION Adrenal surgery can cure or improve hypertension in most patients with HNA, especially in a short duration of hypertension and high plasma levels of aldosterone.
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Affiliation(s)
- Jiaxing Sun
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Yingchun Dong
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Hanbo Wang
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Xudong Guo
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Ning Suo
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Shangjian Li
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Xiangbin Ren
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Shaobo Jiang
- Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
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De Porras-Carrique T, Ramos-García P, González-Moles MÁ. Hypertension in oral lichen planus: A systematic review and meta-analysis. Oral Dis 2024; 30:1793-1805. [PMID: 37725328 DOI: 10.1111/odi.14727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/03/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES To perform a systematic review and meta-analysis in order to qualitatively and quantitatively evaluate the prevalence and magnitude of the association of hypertension in patients with oral lichen planus (OLP). METHODS MEDLINE, Embase, Scopus, and Web of Science databases were searched for studies published before May 2022, not restricted by publication language or date. The methodological quality and risk of bias of primary-level studies were critically assessed. Meta-analyses were performed, as well as meta-regression, stratified, sensitivity and small-study effects analyses, a Galbraith (radial) plot, and trial sequential analysis. Quality of evidence was evaluated using GRADE system. RESULTS 104 studies, including 16,587 patients, met the inclusion criteria. The results show that patients who suffer from OLP have a high prevalence of hypertension (PP = 24.17%, 95% CI = 21.45-27.00), with a low quality of evidence. A significant association between hypertension and oral lichen planus was also reported (OR = 1.28, 95% CI = 1.01-1.63, p = 0.04), showing a moderate quality of evidence. CONCLUSIONS Patients with OLP could be at an increased risk of suffering from hypertension which is probably due to multiple factors. Healthcare practitioners involved in OLP management should be aware of this comorbidity in order to apply suitable measures and make referrals if hypertension is suspected, although further research is needed.
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Affiliation(s)
- Teresa De Porras-Carrique
- Faculty of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pablo Ramos-García
- Faculty of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Miguel Ángel González-Moles
- Faculty of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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Wang X, Chu J, Zhao D, Gao T, Luo J, Wang X, Chai S, Li J, Sun J, Li P, Zhou C. The impact of hypertension follow-up management on the choices of signing up family doctor contract services: does socioeconomic status matter? BMC PRIMARY CARE 2024; 25:130. [PMID: 38658816 PMCID: PMC11040762 DOI: 10.1186/s12875-024-02383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND This study aimed to explore the association between hypertension follow-up management and family doctor contract services, as well as to examine whether socioeconomic status (SES) had an interaction effect on this relationship among older adults in China. METHODS We used data from the sixth National Health Service Survey of Shandong Province, China, including 3,112 older adults (age ≥ 60 years) with hypertension in 2018. Logistic regression models and a margins plot were used to analyze the role of SES in the relationship between hypertension follow-up management and family doctor contract services. RESULTS The regular hypertension follow-up management rate and family doctor contracting rate were 81.8% and 70.9%, respectively, among older adults with hypertension. We found that participants with regular hypertension follow-up management were more likely to sign family doctor contract services (OR=1.28, 95%CI: 1.04, 1.58, P=0.018). The interaction effect occurred in the groups who lived in rural areas (OR=1.55, 95%CI: 1.02, 2.35), with high education level (OR=0.53, 95%CI: 0.32, 0.88) and had high incomes (OR=0.53, 95%CI: 0.35, 0.81). CONCLUSIONS Our findings suggested that regular hypertension follow-up management was associated with family doctor contract services and SES influenced this relationship. Primary health care should improve the contracting rate of family doctors by strengthening follow-up management of chronic diseases. Family doctors should focus on improving services quality and enriching the content of service packages especially for older adults with higher income and education level.
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Affiliation(s)
- Xuehong Wang
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Jie Chu
- Shandong Center for Disease Control and Prevention, Jinan, 250012, China.
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Jingjing Luo
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Xueqing Wang
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Jiayan Li
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
| | - Jingjie Sun
- Shandong Health Commission Medical Management Service Center, Jinan, 250012, China
| | - Peilong Li
- Shandong Health Commission Medical Management Service Center, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
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Thang TT, Phuong PH, Huynh NS, Kien NT, Toan ND, Ha NTT, Khoa LH, Dung NH, Thang TD, Thang LV. Dry eye rate and its relationship with disease stage in patients with primary hypertension: a cross-sectional study in Vietnam. Int J Ophthalmol 2024; 17:653-658. [PMID: 38638268 PMCID: PMC10988073 DOI: 10.18240/ijo.2024.04.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/28/2023] [Indexed: 04/20/2024] Open
Abstract
AIM To determine the dry eye (DE) rate and its relationship with disease stage in patients with primary hypertension. METHODS A cross-sectional study included 432 patients with primary hypertension (with an equal number of patients in each group: 144 in stage I, II, and III hypertension) and 144 healthy subjects as a control group. The Ocular Surface Disease Index (OSDI) and Schirmer I test without anesthetics were conducted on all 576 subjects. Subjects with OSDI scores <13 and Schirmer I values equal to or under 10 mm were diagnosed with DE. RESULTS The ratio of DE in hypertension patients was higher than in the control group (41.7% versus 18.8%; P<0.001). The proportion of patients with DE increased gradually according to the hypertension stage: 27.1% in stage I, 40.3% in stage II, and 57.6% in stage III, P<0.001. Age, duration of hypertension, plasma urea, creatinine, and high-sensitivity C-reactive protein (CRP-hs) levels in hypertension patients with DE were higher than those without DE, P<0.001. Advanced age, a long duration of hypertension, diabetes mellitus, elevated plasma creatinine, and CRP-hs levels were independent factors associated with DE in primary hypertension patients, P<0.001. CONCLUSION DE is a common disorder associated with advanced age, a long duration of hypertension, diabetes mellitus, elevated plasma CRP-hs, and creatinine levels in patients with primary hypertension.
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Affiliation(s)
| | | | | | - Nguyen Trung Kien
- Military Hospital 103, Ha Noi 100000, Vietnam
- Vietnam Military Medical University, Ha Noi 100000, Vietnam
| | - Nguyen Duy Toan
- Military Hospital 103, Ha Noi 100000, Vietnam
- Vietnam Military Medical University, Ha Noi 100000, Vietnam
| | - Nguyen Thi Thu Ha
- Military Hospital 103, Ha Noi 100000, Vietnam
- Vietnam Military Medical University, Ha Noi 100000, Vietnam
| | - Le Ha Khoa
- Hanoi Medical University, Ha Noi 100000, Vietnam
| | | | | | - Le Viet Thang
- Military Hospital 103, Ha Noi 100000, Vietnam
- Vietnam Military Medical University, Ha Noi 100000, Vietnam
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Yang ZJ, Liu Y, Liu YL, Qi B, Yuan X, Shi WX, Miao L. Osteoarthritis and hypertension: observational and Mendelian randomization analyses. Arthritis Res Ther 2024; 26:88. [PMID: 38632649 PMCID: PMC11022320 DOI: 10.1186/s13075-024-03321-w] [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: 02/05/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The association between osteoarthritis (OA) and hypertension is a subject of ongoing debate in observational research, and the underlying causal relationship between them remains elusive. METHODS This study retrospectively included 24,871 participants in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020. Weighted logistic regression was performed to investigate the connection between OA and hypertension. Additionally, Mendelian randomization (MR) analysis was conducted to explore the potential causal relationship between OA and hypertension. RESULTS In the NHANES data, after adjusting for multiple confounding factors, there was no significant relationship between OA and hypertension (OR 1.30, 95% CI, 0.97-1.73, P = 0.089). However, among males, OA appeared to be associated with a higher risk of hypertension (OR 2.25, 95% CI, 1.17-4.32, P = 0.019). Furthermore, MR results indicate no relationship between multiple OA phenotypes and hypertension: knee OA (IVW, OR 1.024, 95% CI: 0.931-1.126, P = 0.626), hip OA (IVW, OR 0.990, 95% CI: 0.941-1.042, P = 0.704), knee or hip OA (IVW, OR 1.005, 95% CI: 0.915-1.105, P = 0.911), and OA from UK Biobank (IVW, OR 0.796, 95% CI: 0.233-2.714, P = 0.715). Importantly, these findings remained consistent across different genders and in reverse MR. CONCLUSIONS Our study found that OA patients had a higher risk of hypertension only among males in the observational study. However, MR analysis did not uncover any causal relationship between OA and hypertension.
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Affiliation(s)
- Zhi-Jie Yang
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Yuan Liu
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Yan-Li Liu
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Bin Qi
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Xin Yuan
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Wan-Xin Shi
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China
| | - Liu Miao
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, Guangxi, 545006, People's Republic of China.
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Bonnesen K, Schmidt M. Validity of Prescription-Defined and Hospital-Diagnosed Hypertension Compared with Self-Reported Hypertension in Denmark. Clin Epidemiol 2024; 16:249-256. [PMID: 38623485 PMCID: PMC11018126 DOI: 10.2147/clep.s448347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
Purpose Hypertension is an important risk factor in cardio-epidemiological research, but data quality remains a concern. We validated different registry-based definitions of hypertension. Patients and Methods The cohort included all first-time responders of the Danish National Health Surveys (2010, 2013, or 2017). Prescription-defined hypertension was defined as ≥1 or ≥2 filled prescriptions of antihypertensive specific drugs in ≥1 or ≥2 different antihypertensive drug classes within 90, 180, or 365 days before survey response. Hospital-diagnosed hypertension was defined from hypertension diagnoses within five years before the survey response. Considering self-reported hypertension as the reference, we calculated the positive predictive value (PPV), the negative predictive value (NVP), the sensitivity, and the specificity of prescription-defined and hospital-diagnosed hypertension. Results Among 442,490 survey responders, 127,247 (29%) had self-reported hypertension. For prescription-defined hypertension with 365-day lookback, the PPV was highest for ≥2 prescriptions in ≥2 drug classes (94%) and lowest for ≥1 prescription in ≥1 drug class (85%). The NPV was highest for ≥1 prescription in ≥2 drug classes (94%) and lowest for ≥1 prescription in ≥2 drug classes (80%). The sensitivity was highest for ≥1 prescription in ≥1 drug class (79%) and lowest for ≥2 prescriptions in ≥2 drug classes (30%). The specificity was ≥94% for all algorithms. The PPV and specificity did not change noteworthy with length of lookback period, whereas the NPV and the sensitivity generally were higher for longer lookback. The algorithm ≥1 prescription in ≥2 drug classes with 365-day lookback was among the best balanced across all measures of validity (PPV=88%, NPV=94%, sensitivity=75%, specificity=96%). For hospital-diagnosed hypertension, the PPV was 90%, the NPV was 76%, the sensitivity was 22%, and the specificity was 99%. Conclusion Compared with self-reported hypertension, the algorithms for prescription-defined and hospital-diagnosed hypertension had high predictive values and specificity, but low sensitivity.
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Affiliation(s)
- Kasper Bonnesen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Morten Schmidt
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
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Evans PG, Sajic M, Yu Y, Harrison IF, Hosford PS, Smith KJ, Lythgoe MF, Stuckey DJ, Wells JA. Changes in cardiac-driven perivascular fluid movement around the MCA in a pharmacological model of acute hypertension detected with non-invasive MRI. J Cereb Blood Flow Metab 2024; 44:508-515. [PMID: 37873754 PMCID: PMC10981406 DOI: 10.1177/0271678x231209641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/31/2023] [Accepted: 09/15/2023] [Indexed: 10/25/2023]
Abstract
Perivascular spaces mediate a complex interaction between cerebrospinal fluid and brain tissue that may be an important pathway for solute waste clearance. Their structural or functional derangement may contribute to the development of age-related neurogenerative conditions. Here, we employed a non-invasive low b-value diffusion-weighted ECG-gated MRI method to capture perivascular fluid movement around the middle cerebral artery of the anaesthetised rat brain. Using this method, we show that such MRI estimates of perivascular fluid movement directionality are highly sensitive to the cardiac cycle. We then show that these measures of fluid movement directionality are decreased in the angiotensin-II pharmacological model of acute hypertension, with an associated dampening of vessel pulsatility. This translational MRI method may, therefore, be useful to monitor derangement of perivascular fluid movement associated with cardiovascular pathologies, such as hypertension, in order to further our understanding of perivascular function in neurology.
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Affiliation(s)
- Phoebe G Evans
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Maria Sajic
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Yichao Yu
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Ian F Harrison
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Patrick S Hosford
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Ken J Smith
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Mark F Lythgoe
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Daniel J Stuckey
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
| | - Jack A Wells
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK
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Ordunez P, Campbell NRC, DiPette DJ, Jaffe MG, Rosende A, Martinez R, Gamarra A, Lombardi C, Parra N, Rodriguez L, Rodriguez Y, Brettler J. HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control. Curr Hypertens Rep 2024; 26:141-156. [PMID: 38041725 PMCID: PMC10904446 DOI: 10.1007/s11906-023-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE OF REVIEW HEARTS in the Americas is the regional adaptation of Global Hearts, the World Health Organization initiative for cardiovascular disease (CVD) prevention and control. Its overarching goal is to drive health services to change managerial and clinical practice in primary care settings to improve hypertension control and CVD risk management. This review describes the HEARTS in the Americas initiative. First, the regional epidemiological situation of CVD mortality and population hypertension control trends are summarized; then the rationale for its main intervention components: the primary care-oriented management system and the HEARTS Clinical Pathway are described. Finally, the key factors for accelerating the expansion of HEARTS are examined: medicines, team-based care, and a system for monitoring and evaluation. RECENT FINDINGS Thus far, 33 countries in Latin America and the Caribbean have committed to integrating this program across their primary healthcare network by 2025. The increase in hypertension coverage and control in primary health care settings compared with the traditional model is promising and confirms that the interventions under the HEARTS umbrella are feasible and acceptable to communities, patients, providers, decision-makers, and funders. This review highlights some cases of successful implementation. Scaling up effective treatment for hypertension and optimization of CVD risk management is a pragmatic way to accelerate the reduction of CVD mortality while strengthening primary healthcare systems to respond effectively, with quality, and equitably, to the challenge of non-communicable diseases, not only in low-middle income countries but in all communities globally.
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Affiliation(s)
- Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.
| | - Norm R C Campbell
- Department of Medicine, Libin Cardiovascular Institute, The University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Donald J DiPette
- University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA
| | - Marc G Jaffe
- Department of Endocrinology, The Permanente Medical Group, Kaiser San Francisco Medical Center, San Francisco, CA, USA
| | - Andres Rosende
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Ramon Martinez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Angelo Gamarra
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Cintia Lombardi
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Natalia Parra
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Libardo Rodriguez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Yenny Rodriguez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Jeffrey Brettler
- Southern California Permanente Medical Group, Department of Health Systems Science, Regional Hypertension Program, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, USA
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Elmarasi M, Elmakaty I, Elsayed B, Elsayed A, Zein JA, Boudaka A, Eid AH. Phenotypic switching of vascular smooth muscle cells in atherosclerosis, hypertension, and aortic dissection. J Cell Physiol 2024; 239:e31200. [PMID: 38291732 DOI: 10.1002/jcp.31200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/12/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
Vascular smooth muscle cells (VSMCs) play a critical role in regulating vasotone, and their phenotypic plasticity is a key contributor to the pathogenesis of various vascular diseases. Two main VSMC phenotypes have been well described: contractile and synthetic. Contractile VSMCs are typically found in the tunica media of the vessel wall, and are responsible for regulating vascular tone and diameter. Synthetic VSMCs, on the other hand, are typically found in the tunica intima and adventitia, and are involved in vascular repair and remodeling. Switching between contractile and synthetic phenotypes occurs in response to various insults and stimuli, such as injury or inflammation, and this allows VSMCs to adapt to changing environmental cues and regulate vascular tone, growth, and repair. Furthermore, VSMCs can also switch to osteoblast-like and chondrocyte-like cell phenotypes, which may contribute to vascular calcification and other pathological processes like the formation of atherosclerotic plaques. This provides discusses the mechanisms that regulate VSMC phenotypic switching and its role in the development of vascular diseases. A better understanding of these processes is essential for the development of effective diagnostic and therapeutic strategies.
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Affiliation(s)
- Mohamed Elmarasi
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ibrahim Elmakaty
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Basel Elsayed
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Abdelrahman Elsayed
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Jana Al Zein
- Faculty of Medical Sciences, Lebanese University, Hadath, Beirut, Lebanon
| | - Ammar Boudaka
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ali H Eid
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Wang S, Wang Q, Yan X. Association between triglyceride-glucose index and hypertension: a cohort study based on the China Health and Nutrition Survey (2009-2015). BMC Cardiovasc Disord 2024; 24:168. [PMID: 38504161 PMCID: PMC10949779 DOI: 10.1186/s12872-024-03747-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/23/2024] [Indexed: 03/21/2024] Open
Abstract
AIM Insulin resistance (IR) may participate in the pathogenesis of hypertension by mediating low-grade systemic inflammation. The triglycerides-glucose (TyG) index has recently been suggested as a reliable alternative biochemical marker of IR compared with traditional methods. Herein, we speculated TyG index may also be associated with hypertension. METHODS Data of adults were extracted from the China Health and Nutrition Survey (CHNS) in 2009-2015 in this retrospective cohort study. The TyG index was calculated using the formula: TyG = Ln [fasting triglycerides (mg/dL) ×fasting glucose (mg/dL)/2]. Associations between TyG index and hypertension were evaluated by univariate and multivariate logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age and gender were also performed. In addition, we assessed the interaction effect between TyG index and body mass index (BMI) on hypertension in participants with different age and gender. RESULTS Among 3,413 eligible participants, 1,627 (47.67%) developed hypertension. The average TyG index in hypertension group and non-hypertension group was 8.58 and 8.39 respectively. After adjusting for covariates, we found that compared with participants with TyG index ≤ 8.41 (median value), those who had higher TyG index seemed to have higher odds of hypertension [OR = 1.17, 95%CI: (1.01-1.37)]. Similarly, this association was also discovered in participants who aged ≤ 65 years old [OR = 1.19, 95%CI: (1.01-1.39)] or were female [OR = 1.35, 95%CI: (1.10-1.65)]. Additionally, there was a potential additive interaction effect between obesity and TyG index on hypertension. CONCLUSION High TyG index was associated with high odds of hypertension in general population in China, but the causal relationship between them needed further exploration.
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Affiliation(s)
- Su Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
| | - Qian Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - Xianliang Yan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
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Cui L, Liu X, Li Y, Jing T, Liu D, Ren C, Yin T, Wang Y, Zhao Z, Wang J, Han X, Wang L. Chinese patent medicine combined with calcium channel blockers in the treatment of essential hypertension:a Bayes network meta-analysis and systematic review. Front Pharmacol 2024; 15:1321405. [PMID: 38560355 PMCID: PMC10978809 DOI: 10.3389/fphar.2024.1321405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
Backgroud: The co-administration of Chinese patent medicine with calcium channel blockers (CCBs) is a prevalent practice in China for treating essential hypertension (EH). However, robust evidence supporting the efficacy and safety of tailored combinations of different Chinese patent medicines with CCBs, according to individual patient conditions, is still limited. This study sought to elucidate the efficacy and safety of these combinations using a systematic review and network meta-analysis. Materials and methods: Relevant studies were sourced from established databases, incorporating randomized controlled trials published up to 1 February 2023. The ROB2 tool from the Cochrane Collaborative Network was employed to independently assess and cross-verify the quality of the included literature. A network meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 and PRISMA-Network Meta-Analyses (PRISMA-NMA) guidelines. A Bayesian network meta-analysis was utilized to gauge the efficacy and safety of distinct integrations of Chinese patent medicine and CCBs. Primary outcomes were interpreted using a paired fixed-effect meta-analysis. Publication bias was appraised through Egger's test and represented with funnel plots. All statistical analyses were executed within the R statistical framework. Results: Following rigorous selection, data extraction, and bias evaluation, 36 articles were incorporated. Tianma Gouteng Granule, when combined with CCBs, displayed superior efficacy in reducing systolic blood pressure (SBP). In terms of diastolic blood pressure (DBP) reduction, Songling Xuemaikang Capsule combined with CCBs emerged as the most effective. Regarding enhancement of antihypertensive effective rates, Qinggan Jiangya Capsule paired with CCBs demonstrated optimal results. For diminishing Traditional Chinese Medicine syndrome scores, the Qiangli Dingxuan Tablet and CCBs combination proved most beneficial. When aiming to reduce total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels, Tianma Gouteng Granule and CCBs showcased superior results. In contrast, the combination of Songling Xuemaikang Capsule and CCBs was more effective in reducing LDL-C, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Conclusion: This study underscores variability in outcomes from combining Chinese patent medicine and CCBs for hypertension, emphasizing the importance of personalized medicinal combinations, especially Tianma Gouteng Granule and Songling Xuemaikang Capsule. The results offer robust evidence to inform clinical guidelines for essential hypertention and significantly aid clinician in seleting appropriate Chinese patent medicines for treatment.
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Affiliation(s)
- Liangyu Cui
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xingfang Liu
- Research Department, Swiss University of Traditional Chinese Medicine, Bad Zurzach, Switzerland
| | - Yukun Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tianyue Jing
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dasheng Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Cong Ren
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tong Yin
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhiwei Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiaheng Wang
- Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xuejie Han
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liying Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Ordunez P, Campbell NRC, DiPette DJ, Jaffe MG, Rosende A, Martínez R, Gamarra A, Lombardi C, Parra N, Rodríguez L, Rodríguez Y, Brettler J. [HEARTS in the Americas: targeting health system change to improve population hypertension controlHEARTS nas Américas: impulsionar mudanças no sistema de saúde para melhorar o controle da hipertensão arterial na população]. Rev Panam Salud Publica 2024; 48:e17. [PMID: 38464870 PMCID: PMC10924616 DOI: 10.26633/rpsp.2024.17] [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: 11/08/2023] [Accepted: 12/02/2023] [Indexed: 03/12/2024] Open
Abstract
Purpose of review HEARTS in the Americas is the regional adaptation of Global Hearts, the World Health Organization initiative for cardiovascular disease (CVD) prevention and control. Its overarching goal is to drive health services to change managerial and clinical practice in primary care settings to improve hypertension control and CVD risk management. This review describes the HEARTS in the Americas initiative. First, the regional epidemiological situation of CVD mortality and population hypertension control trends are summarized; then the rationale for its main intervention components: the primary care-oriented management system and the HEARTS Clinical Pathway are described. Finally, the key factors for accelerating the expansion of HEARTS are examined: medicines, team-based care, and a system for monitoring and evaluation. Recent findings Thus far, 33 countries in Latin America and the Caribbean have committed to integrating this program across their primary healthcare network by 2025. The increase in hypertension coverage and control in primary health care settings compared with the traditional model is promising and confirms that the interventions under the HEARTS umbrella are feasible and acceptable to communities, patients, providers, decision-makers, and funders. This review highlights some cases of successful implementation. Summary Scaling up effective treatment for hypertension and optimization of CVD risk management is a pragmatic way to accelerate the reduction of CVD mortality while strengthening primary healthcare systems to respond effectively, with quality, and equitably, to the challenge of non-communicable diseases, not only in low-middle income countries but in all communities globally.
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Affiliation(s)
- Pedro Ordunez
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Norm R. C. Campbell
- Departamento de MedicinaInstituto Cardiovascular LibinUniversidad de CalgaryCalgaryAB T2N 1N4CanadáDepartamento de Medicina, Instituto Cardiovascular Libin, Universidad de Calgary, Calgary, AB T2N 1N4, Canadá.
| | - Donald J. DiPette
- Universidad de Carolina del SurFacultad de Medicina de la Universidad de Carolina del SurColumbiaEstados Unidos de AméricaUniversidad de Carolina del Sur y Facultad de Medicina de la Universidad de Carolina del Sur, Columbia, Estados Unidos de América.
| | - Marc G. Jaffe
- Departamento de EndocrinologíaThe Permanente Medical GroupCentro Médico de San Francisco de Kaiser PermanenteSan FranciscoEstados Unidos de AméricaDepartamento de Endocrinología, The Permanente Medical Group, Centro Médico de San Francisco de Kaiser Permanente, San Francisco, Estados Unidos de América.
| | - Andrés Rosende
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Ramón Martínez
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Angelo Gamarra
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Cintia Lombardi
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Natalia Parra
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Libardo Rodríguez
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Yenny Rodríguez
- Departamento de Enfermedades no Transmisibles y Salud MentalOrganización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaDepartamento de Enfermedades no Transmisibles y Salud Mental, Organización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Jeffrey Brettler
- Southern California Permanent Medical GroupDepartamento de Ciencias de Sistemas de SaludPrograma Regional de Hipertensión, Facultad de Medicina Bernard J. Tyson de Kaiser PermanentePasadenaEstados Unidos de AméricaSouthern California Permanent Medical Group, Departamento de Ciencias de Sistemas de Salud, Programa Regional de Hipertensión, Facultad de Medicina Bernard J. Tyson de Kaiser Permanente, Pasadena, Estados Unidos de América.
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Ma S, Xie X, Yuan R, Xin Q, Miao Y, Leng SX, Chen K, Cong W. Vascular Aging and Atherosclerosis: A Perspective on Aging. Aging Dis 2024:AD.2024.0201-1. [PMID: 38502584 DOI: 10.14336/ad.2024.0201-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/01/2024] [Indexed: 03/21/2024] Open
Abstract
Vascular aging (VA) is recognized as a pivotal factor in the development and progression of atherosclerosis (AS). Although various epidemiological and clinical research has demonstrated an intimate connection between aging and AS, the candidate mechanisms still require thorough examination. This review adopts an aging-centric perspective to deepen the comprehension of the intricate relationship between biological aging, vascular cell senescence, and AS. Various aging-related physiological factors influence the physical system's reactions, including oxygen radicals, inflammation, lipids, angiotensin II, mechanical forces, glucose levels, and insulin resistance. These factors cause endothelial dysfunction, barrier damage, sclerosis, and inflammation for VA and promote AS via distinct or shared pathways. Furthermore, the increase of senescent cells inside the vascular tissues, caused by genetic damage, dysregulation, secretome changes, and epigenetic modifications, might be the primary cause of VA.
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Affiliation(s)
- Shudong Ma
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuena Xie
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- School of Pharmacy, Macau University of Science and Technology, Macau, China
| | - Rong Yuan
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiqi Xin
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Miao
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Sean Xiao Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Keji Chen
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weihong Cong
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- School of Pharmacy, Macau University of Science and Technology, Macau, China
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48
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Li Y, Jiang M, Ren X, Han L, Zheng X, Wu W. Hypertension combined with limitations in activities of daily living and the risk for cardiovascular disease. BMC Geriatr 2024; 24:225. [PMID: 38439007 PMCID: PMC10913420 DOI: 10.1186/s12877-024-04832-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE The aim of present study was to evaluate the combined effect of hypertension and activities of daily living (ADL)/instrumental activities of daily living (IADL) with the risk of CVD, stroke and cardiac events. METHODS A total of 14,083 participants aged 45 years or older from the China Health and Retirement longitudinal study were included in current study. Participants were divided into 4 groups according to hypertension and ADL/IADL status. Cox proportional hazards regression model was used to explore the associations between hypertension, ADL/IADL and new-onset CVD, stroke and cardiac events. RESULTS During the 7-year follow-up, a total of 2,324 respondents experienced CVD (including 783 stroke and 1,740 cardiac events). Individuals with limitations in ADL alone, or with hypertension alone, or with both limitations in ADL and hypertension were associated with increased risk of CVD, with the adjusted hazard ratios (95% confidence intervals) were 1.17(1.00-1.35), 1.36(1.24-1.49) and 1.44(1.23-1.68), respectively. Those with limitations in ADL and hypertension also had higher risk of stroke (hazard ratios = 1.64; 1.26-2.14) and cardiac events (hazard ratios = 1.37; 1.14-1.64). Similarly, individuals with both limitations in IADL and hypertension were associated with increased risk of CVD (hazard ratios = 1.34; 1.15-1.57), stroke (hazard ratios = 1.50; 1.17-1.95) and cardiac events (hazard ratios = 1.27; 1.06-1.53). CONCLUSION Hypertension and limitations in ADL/IADL jointly increased the risk of CVD, stroke and cardiac events.
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Affiliation(s)
- Yiqun Li
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Minglan Jiang
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Xiao Ren
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Longyang Han
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Xiaowei Zheng
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China.
| | - Wenyan Wu
- Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated Hospital of Jiangnan University, Jiangnan University , 214011, Wuxi, Jiangsu, China.
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Bao M, Song Y, Han X, Wu S, Li J. Comparison of BP variability, cumulative BP, and BP trajectory for predicting cardiovascular events in the general population. Hellenic J Cardiol 2024; 76:11-21. [PMID: 37532023 DOI: 10.1016/j.hjc.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE Systolic blood pressure variability (SBPV), cumulative systolic BP (cumSBP), and systolic blood pressure trajectory (trajSBP) are major indices describing characteristics of BP changes. The aim of this study was to compare their discrimination abilities for cardiovascular (CV) events. METHODS In 51698 subjects, associations were assessed using Cox regression in the overall cohort and Framingham risk score (FRS) stratified groups. Individuals with <10%, 10%-20%, and >20% 10-year CV risk were categorized into the low-, intermediate-, and high-risk group, respectively. Discrimination capabilities were evaluated using the area under curve (AUC), Harrell's C index, net reclassification index (NRI), and integrated discrimination index (IDI). RESULTS Within a mean follow-up of 6.83 ± 0.89 years, 2330 participants had CV events, and all three markers were significantly associated with CV events. TrajSBP provided the best additional discriminative value for CV events, with improvements of 1.54% in AUC%, 0.01 in Harrell's C, 37.52% in NRI%, and 0.59% in IDI%. CumSBP had good additional discriminative capability in the intermediate to high FRS groups, but the effect sizes were smaller than those of trajSBP. Although, SBPV improved the predictive capabilities in the low-to intermediate-risk groups, the effect sizes were much smaller than those of the other indices. Sensitivity analyses excluding patients who underwent antihypertensive therapy revealed similar patterns but higher effect sizes than in the overall population. CONCLUSION TrajSBP provides the best additional discrimination capabilities based on traditional risk profiles and may assist the risk stratification and individual prediction for future CV events.
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Affiliation(s)
- Minghui Bao
- Department of Cardiology, Peking University First Hospital, Peking University, Beijing, China.
| | - Yongjian Song
- Department of Cardiology, Zhangjiakou First Hospital, Hebei, China
| | - Xu Han
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Peking University, Beijing, China
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Prado JP, Castro AE, Carvalho J, Pereira D, Faccioli LH, Sorgi C, Novaes R, Silva S, Galdino G. Investigation of the involvement of platelet-activating factor in the control of hypertension by aerobic training. A randomized controlled trial. Biol Sport 2024; 41:163-174. [PMID: 38524817 PMCID: PMC10955738 DOI: 10.5114/biolsport.2024.131819] [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: 06/15/2023] [Revised: 07/03/2023] [Accepted: 09/18/2023] [Indexed: 03/26/2024] Open
Abstract
Although studies have demonstrated the effectiveness of exercise in controlling systemic arterial hypertension (SAH), the mechanisms involved in this effect are still poorly understood. Thus, this study investigated the impact of aerobic training on the relationship between platelet-activating factor (PAF) circulating levels and blood pressure in hypertensives. Seventy-seven hypertensive subjects were enrolled in this randomized controlled trial (age 66.51 ± 7.53 years, body mass 76.17 ± 14.19 kg). Participants were randomized to two groups: the intervention group (IG, n = 36), composed of hypertensive individuals submitted to an aerobic training protocol, and the control group (CG, n = 41), composed of non-exercised hypertensives. Body mass index, arterial blood pressure, quality of life, respiratory muscle strength, and functional capacity were assessed before and after 12 weeks. PAF and plasma cytokine levels were also evaluated respectively by liquid chromatography coupled with mass spectrometry and enzyme-linked immunosorbent assay. Aerobic training promoted a significant reduction in blood pressure while functional capacity, expiratory muscle strength, and quality of life, PAFC16:0 and PAFC18:1 plasma levels were increased in comparison to the CG (p < 0.05). In addition, multiple correlation analysis indicated a positive correlation [F (3.19) = 6.322; p = 0.001; R2adjusted = 0.499] between PAFC16:0 levels and expiratory muscle strength after aerobic training. Taken together, our findings indicate that PAF may be involved in the indirect mechanisms that control SAH, being mainly associated with increased respiratory muscle strength in hypertensive subjects undergoing aerobic training.
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Affiliation(s)
- João Paulo Prado
- Institute of Motricity of Sciences, Federal University of Alfenas, 2600 Jovino Fernandes Sales Ave, Alfenas, MG 37133-550, Brazil
| | - Ana Emilia Castro
- Institute of Motricity of Sciences, Federal University of Alfenas, 2600 Jovino Fernandes Sales Ave, Alfenas, MG 37133-550, Brazil
| | - Jonatan Carvalho
- Department of Chemistry, Faculty of Philosophy, Sciences, and Letters of Ribeirao Preto, Univer-sity of Sao Paulo, Ribeirao Preto, Brazil
| | - Daniele Pereira
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lúcia Helena Faccioli
- Faculty of Pharmaceutical Sciences of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Carlos Sorgi
- Department of Chemistry, Faculty of Philosophy, Sciences, and Letters of Ribeirao Preto, Univer-sity of Sao Paulo, Ribeirao Preto, Brazil
| | - Rômulo Novaes
- Department of Structural Biology, Institute of Biomedical Sciences, Federal University of Alfenas, 700 Gabriel Monteiro Silva St, Alfenas, MG 37130-001, Brazil
| | - Silvia Silva
- Faculty of Medicine, Federal University of Juiz de Fora, MG, Brazil
| | - Giovane Galdino
- Institute of Motricity of Sciences, Federal University of Alfenas, 2600 Jovino Fernandes Sales Ave, Alfenas, MG 37133-550, Brazil
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