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Gafane-Matemane LF, Craig A, Kruger R, Alaofin OS, Ware LJ, Jones ESW, Kengne AP. Hypertension in sub-Saharan Africa: the current profile, recent advances, gaps, and priorities. J Hum Hypertens 2024:10.1038/s41371-024-00913-6. [PMID: 38698111 DOI: 10.1038/s41371-024-00913-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024]
Abstract
Recent global and regional reports consistently confirm the high and increasing prevalence of hypertension in sub-Saharan Africa (SSA), with poor detection, treatment, and control rates. This narrative review summarises the burden of hypertension in SSA and recent findings from community-based hypertension management strategies. We further outline prominent risk factors according to recent data and associated underlying mechanisms for hypertension development. An extensive review of literature showed that most countries have reported on the prevalence of hypertension during 2017-2023, despite limitations linked to the lack of nationally representative studies, heterogeneity of sampling and data collection methods. Task-shifting approaches that assign roles to model patients and community health workers reported improved linkage to healthcare services and adherence to medication, with inconsistent findings on blood pressure (BP)-lowering effects over time. The regularly reported risk factors include unhealthy diet, sedentary lifestyle, increased adiposity and underweight, ageing, level of education, and/or income as well as psychosocial factors. Newer data on the pathophysiological mechanisms leading to hypertension and potential areas of intervention are reported from children and adults and include, among others, salt-handling and volume overload, endothelial function, BP dipping patterns and the role of human immunodeficiency virus . To conclude, significant strides have been made in data reporting from SSA on the burden of hypertension in the region as well as biomarker research to improve understanding and identification of areas of intervention. However, gaps remain on linkage between knowledge generation, translation, and implementation research. Coordinated studies addressing both discovery science and public health are crucial to curb hypertension development and improve management in SSA.
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Affiliation(s)
- Lebo F Gafane-Matemane
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520, South Africa.
- SAMRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, South Africa.
| | - Ashleigh Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Soweto, 1864, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520, South Africa
- SAMRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, South Africa
| | - Omotayo S Alaofin
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520, South Africa
| | - Lisa J Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Soweto, 1864, South Africa
| | - Erika S W Jones
- Division of Nephrology and Hypertension, Groote Schuur Hospital and Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa
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Craig A, Kruger R, Gafane-Matemane LF, Louw R, Mels CMC. Early vascular ageing phenotypes and urinary targeted metabolomics in children and young adults: the ExAMIN Youth SA and African-PREDICT studies. Amino Acids 2023; 55:1049-1062. [PMID: 37328631 PMCID: PMC10514129 DOI: 10.1007/s00726-023-03293-2] [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: 11/22/2022] [Accepted: 06/08/2023] [Indexed: 06/18/2023]
Abstract
Some individuals are susceptible to accelerated biological ageing, resulting in premature alterations in arterial structure and function. Identifying early-onset vascular ageing characterised by arterial stiffening is vital for intervention and preventive strategies. We stratified and phenotyped healthy children (5-9 yrs) and young adults (20-30 yrs) into their vascular ageing extremes established by carotid-femoral pulse wave velocity (cfPWV) percentiles (i.e., healthy vascular ageing (HVA) and early vascular ageing (EVA)). We compared anthropometric, cardiovascular, and metabolomic profiles and explored associations between cfPWV and urinary metabolites. Children and adults in the EVA groups displayed higher levels of adiposity, cardiovascular, and lifestyle risk factors (adults only) (all p ≤ 0.018). In adults, several urinary metabolites were lower in the EVA group (all q ≤ 0.039) when compared to the HVA group, with no differences observed in children. In multiple regression analysis (adults only), we found inverse associations between cfPWV with histidine (adj. R2 = 0.038; β = -0.192; p = 0.013) and beta-alanine (adj. R2 = 0.034; β = -0.181; p = 0.019) in the EVA group, but with arginine (adj. R2 = 0.021; β = -0.160; p = 0.024) in the HVA group. The inverse associations of beta-alanine and histidine with cfPWV in the EVA group is suggestive that asymptomatic young adults who present with an altered metabolomic and less desired cardiovascular profile in combination with unfavourable lifestyle behaviours may be predisposed to early-onset vascular ageing. Taken together, screening on both a phenotypic and metabolic level may prove important in the early detection, prevention, and intervention of advanced biological ageing.
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Affiliation(s)
- Ashleigh Craig
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Lebo F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Roan Louw
- Human Metabolomics, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
| | - Carina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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Grosicki GJ, Flatt AA, Cross BL, Vondrasek JD, Blumenburg WT, Lincoln ZR, Chall A, Bryan A, Patel RP, Ricart K, Linder BA, Sanchez SO, Watso JC, Robinson AT. Acute beetroot juice reduces blood pressure in young Black and White males but not females. Redox Biol 2023; 63:102718. [PMID: 37120928 PMCID: PMC10172749 DOI: 10.1016/j.redox.2023.102718] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/08/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023] Open
Abstract
A complex interplay of social, lifestyle, and physiological factors contribute to Black Americans having the highest blood pressure (BP) in America. One potential contributor to Black adult's higher BP may be reduced nitric oxide (NO) bioavailability. Therefore, we sought to determine whether augmenting NO bioavailability with acute beetroot juice (BRJ) supplementation would reduce resting BP and cardiovascular reactivity in Black and White adults, but to a greater extent in Black adults. A total of 18 Black and 20 White (∼equal split by biological sex) young adults completed this randomized, placebo-controlled (nitrate (NO3-)-depleted BRJ), crossover design study. We measured heart rate, brachial and central BP, and arterial stiffness (via pulse wave velocity) at rest, during handgrip exercise, and during post-exercise circulatory occlusion. Compared with White adults, Black adults exhibited higher pre-supplementation resting brachial and central BP (Ps ≤0.035; e.g., brachial systolic BP: 116(11) vs. 121(7) mmHg, P = 0.023). Compared with placebo, BRJ (∼12.8 mmol NO3-) reduced resting brachial systolic BP similarly in Black (Δ-4±10 mmHg) and White (Δ-4±7 mmHg) adults (P = 0.029). However, BRJ supplementation reduced BP in males (Ps ≤ 0.020) but not females (Ps ≥ 0.299). Irrespective of race or sex, increases in plasma NO3- were associated with reduced brachial systolic BP (ρ = -0.237, P = 0.042). No other treatment effects were observed for BP or arterial stiffness at rest or during physical stress (i.e., reactivity); Ps ≥ 0.075. Despite young Black adults having higher resting BP, acute BRJ supplementation reduced systolic BP in young Black and White adults by a similar magnitude, an effect that was driven by males.
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Affiliation(s)
- Gregory J. Grosicki
- Biodynamics and Human Performance Center, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Andrew A. Flatt
- Biodynamics and Human Performance Center, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Brett L. Cross
- Biodynamics and Human Performance Center, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Joseph D. Vondrasek
- Biodynamics and Human Performance Center, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Wesley T. Blumenburg
- Biodynamics and Human Performance Center, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Zoe R. Lincoln
- Biodynamics and Human Performance Center, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Amy Chall
- Department of Diagnostic and Therapeutic Services, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Anna Bryan
- Department of Diagnostic and Therapeutic Services, Georgia Southern University, Armstrong Campus, Savannah, GA, USA
| | - Rakesh P. Patel
- Department for Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karina Ricart
- Department for Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Braxton A. Linder
- Neurovascular Physiology Laboratory, Auburn University, Auburn, AL, USA
| | - Sofia O. Sanchez
- Neurovascular Physiology Laboratory, Auburn University, Auburn, AL, USA
| | - Joseph C. Watso
- Cardiovascular and Applied Physiology Laboratory, Florida State University, Tallahassee, FL, USA
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Mehanna M, McDonough CW, Smith SM, Gong Y, Gums JG, Chapman AB, Johnson JA, Cooper-DeHoff RM. Influence of Genetic West African Ancestry on Metabolomics among Hypertensive Patients. Metabolites 2022; 12:metabo12090783. [PMID: 36144188 PMCID: PMC9506508 DOI: 10.3390/metabo12090783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
Patients with higher genetic West African ancestry (GWAA) have hypertension (HTN) that is more difficult to treat and have higher rates of cardiovascular diseases (CVD) and differential responses to antihypertensive drugs than those with lower GWAA. The mechanisms underlying these disparities are poorly understood. Using data from 84 ancestry-informative markers in US participants from the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) and PEAR-2 trials, the GWAA proportion was estimated. Using multivariable linear regression, the baseline levels of 886 metabolites were compared between PEAR participants with GWAA < 45% and those with GWAA ≥ 45% to identify differential metabolites and metabolic clusters. Metabolites with a false discovery rate (FDR) < 0.2 were used to create metabolic clusters, and a cluster analysis was conducted. Differential clusters were then tested for replication in PEAR-2 participants. We identified 353 differential metabolites (FDR < 0.2) between PEAR participants with GWAA < 45% (n = 383) and those with GWAA ≥ 45% (n = 250), which were used to create 24 metabolic clusters. Of those, 13 were significantly different between groups (Bonferroni p < 0.002). Four clusters, plasmalogen and lysoplasmalogen, sphingolipid metabolism and ceramide, cofactors and vitamins, and the urea cycle, were replicated in PEAR-2 (Bonferroni p < 0.0038) and have been previously linked to HTN and CVD. Our findings may give insights into the mechanisms underlying HTN racial disparities.
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Affiliation(s)
- Mai Mehanna
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Caitrin W. McDonough
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Steven M. Smith
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - John G. Gums
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Arlene B. Chapman
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Rhonda M. Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
- Correspondence: ; Tel.: +1-(352)-273-6184
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Unusual Derivatization of Methylmalonic Acid with Pentafluorobenzyl Bromide to a Tripentafluorobenzyl Derivative and Its Stable-Isotope Dilution GC-MS Measurement in Human Urine. Molecules 2022; 27:molecules27165202. [PMID: 36014446 PMCID: PMC9416772 DOI: 10.3390/molecules27165202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Methylmalonic acid (MMA) is a very short dicarboxylic acid (methylpropanedioic acid; CH3CH(COOH)2; pKa1, 3.07; pKa2, 5.76) associated with vitamin B12 deficiency and many other patho-physiological conditions. In this work, we investigated several carboxylic groups-specific derivatization reactions and tested their utility for the quantitative analysis of MMA in human urine and plasma by gas chromatography-mass spectrometry (GC-MS). The most useful derivatization procedure was the reaction of unlabeled MMA (d0-MMA) and trideutero-methyl malonic acid (d3-MMA) with 2,3,4,5,6-pentafluorobenzyl bromide (PFB-Br) in acetone. By heating at 80 °C for 60 min, we observed the formation of the dipentafluorobenzyl (PFB) ester of MMA (CH3CH(COOPFB)2). In the presence of N,N-diisopropylamine, heating at 80 °C for 60 min resulted in the formation of a tripentafluorobenzyl derivative of MMA, i.e., CH3CPFB(COOPFB)2). The retention time was 5.6 min for CH3CH(COOPFB)2 and 7.3 min for CH3CPFB(COOPFB)2). The most intense ions in the negative-ion chemical ionization (NICI) GC-MS spectra of CH3CH(COOPFB)2 were mass-to-charge (m/z) 233 for d0-MMA and m/z 236 for d3-MMA. The most intense ions in the NICI GC-MS spectra of CH3CPFB(COOPFB)2 were mass-to-charge (m/z) 349 for d0-MMA and m/z 352 for d3-MMA. These results indicate that the H at C atom at position 2 is C-H acidic and is alkylated by PFB-Br only in the presence of the base N,N-diisopropylamine. Method validation and quantitative analyses in human urine and plasma were performed by selected ion monitoring (SIM) of m/z 349 for d0-MMA and m/z 352 for the internal standard d3-MMA in the NICI mode. We used the method to measure the urinary excretion rates of MMA in healthy black (n = 39) and white (n = 41) boys of the Arterial Stiffness in Offspring Study (ASOS). The creatinine-corrected excretion rates of MMA were 1.50 [0.85–2.52] µmol/mmol in the black boys and 1.34 [1.02–2.18] µmol/mmol in the white boys (P = 0.85; Mann–Whitney). The derivatization procedure is highly specific and sensitive for MMA and allows its accurate and precise measurement in 10-µl of human urine by GC-MS.
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Akopyan AA, Strazhesko ID, Klyashtorny VG, Orlova IA. Biological vascular age and its relationship with cardiovascular risk factors. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-2877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study of the relationship between cardiovascular risk factors and biological vascular age.Material and methods. The biological vascular age was estimated using models based on the arterial wall parameters. Using multiple logistic and linear regression, we studied the relationship between the biological vascular age and cardiovascular risk factors in 143 people without cardiovascular disease (CVD). Persons with a positive difference between the vascular and chronological age were assigned to the “old” vascular group, and persons with no or negative difference between the vascular and chronological age were assigned to the “young” vascular group.Results. Linear regression in the “young” vascular group showed an inverse relationship between the difference between the vascular and chronological age with the levels of low-density lipoprotein cholesterol (p=0,001; β±SE=-1,67±0,47), triglycerides (p=0,017; β±SE=-1,66±0,68), urea (p=0,025; β±SE=-0,89±0,39) and insulin resistance index (p=0,001; β±SE=-1,22±0,36). In the “old” vascular group, a direct relationship was found between the difference between the vascular and chronological age and central systolic blood pressure (p=0,015; β±SE=0,10±0,04). According to logistic regression, the likelihood of having “old” vessels increased by 1,23 times with an increase in blood glucose levels by 0,5 mmol/l (p=0,044; odds ratio (OR)=1,23; 95% confidence interval (CI): 1,011,51), the presence of hypertension (p=0,034; OR=3,11; 95% CI: 1,09-8,86) and type 2 diabetes (p=0,025; OR=3,61; 95% CI: 1,1711,09), as well as decreased by 2 times with an increase in high-density lipoprotein cholesterol by 0,3 mmol/l (p=0,003; OR=0,5; 95% CI: 0,32-0,79).Conclusion. The difference between the biological vascular age and chronological age is associated with traditional CVD risk factors.
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Affiliation(s)
- A. A. Akopyan
- Medical Research and Educational Center, Lomonosov Moscow State University
| | - I. D. Strazhesko
- Medical Research and Educational Center, Lomonosov Moscow State University; Pirogov Russian National Research Medical University, Russian Clinical and Research Center of Gerontology
| | - V. G. Klyashtorny
- Pirogov Russian National Research Medical University, Russian Clinical and Research Center of Gerontology
| | - I. A. Orlova
- Medical Research and Educational Center, Lomonosov Moscow State University
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Pettersson-Pablo P, Nilsson TK, Breimer LH, Hurtig-Wennlöf A. IGFBP-1 and IGFBP-2 are associated with a decreased pulse-wave velocity in young, healthy adults. BMC Cardiovasc Disord 2021; 21:131. [PMID: 33706704 PMCID: PMC7949246 DOI: 10.1186/s12872-021-01914-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/01/2021] [Indexed: 12/27/2022] Open
Abstract
Background and aims In healthy, young adults we analyzed a panel of cardiovascular disease related proteins in plasma and compared them with the vascular health of the subjects. The aim was to identify proteins with a relationship to the early atherosclerotic process in healthy individuals. Methods We employed the proximity extension assay from OLINK proteomics to analyze 92 cardiovascular disease (CVD) related proteins on 833 subjects (men and women, ages 18–26). The women were further divided into an estrogen-using group and non-users. Protein expression was analyzed using principal component analysis (PCA). The following vascular examinations were performed: Pulse-wave velocity (PWV), augmentation index (AIX), carotid-intima media thickness (cIMT). Results Three principal components were obtained using PCA to analyze the protein expression. None of the obtained principal components correlated significantly with AIX or cIMT. One of the components, explaining 6% of the total variance of the data, was significantly correlated with PWV. Upon examination of the proteins with the highest factor loadings on this component independently in a multivariable model, adjusting for established CVD risk biomarkers, insulin-like growth factor-binding protein 1 (IGFBP-1) and insulin-like growth factor-binding protein 2 (IGFBP-2) were found to independently, negatively correlate with PWV. Among the established risk factors included in the multivariable model, age was significantly and adversely correlated with all vascular measurements. Conclusions In this population of healthy, young adults, groups of CVD related proteins correlate with PWV, but not AIX or cIMT. This group of proteins, of which IGFBP-1 and IGFBP-2 were independently, negatively correlated in a multivariable model with PWV, could have benificial effects on vascular stiffness. The robust association between age and PWV, AIX and cIMT provide insight into the impact of aging on the vasculature, which is detectable even in a population of young, healthy, non-smoking individuals of ages spanning only 8 years. Supplementary information The online version contains supplementary material available at 10.1186/s12872-021-01914-w.
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Affiliation(s)
- Paul Pettersson-Pablo
- Department of Laboratory Medicine, Clinical Chemistry, Faculty of Medicine and Health, Örebro University Hospital, Södra Grevrosengatan 1, 703 62, Örebro, Sweden. .,School of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. .,Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden.
| | - Torbjörn K Nilsson
- Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Lars H Breimer
- Department of Laboratory Medicine, Clinical Chemistry, Faculty of Medicine and Health, Örebro University Hospital, Södra Grevrosengatan 1, 703 62, Örebro, Sweden.,School of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anita Hurtig-Wennlöf
- School of Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,The Biomedical platform, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Matjuda EN, Engwa GA, Sewani-Rusike CR, Nkeh-Chungag BN. An Overview of Vascular Dysfunction and Determinants: The Case of Children of African Ancestry. Front Pediatr 2021; 9:769589. [PMID: 34956981 PMCID: PMC8709476 DOI: 10.3389/fped.2021.769589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022] Open
Abstract
The balance between dilatory and constrictive factors is important as it keeps blood vessels in a homeostatic state. However, altered physiological processes as a result of obesity, hypertension, oxidative stress, and other cardiovascular risk factors may lead to vascular damage, causing an imbalance of vasoactive factors. Over time, the sustained imbalance of these vasoactive factors may lead to vascular dysfunction, which can be assessed by non-invasive methods, such as flow-mediated dilation, pulse wave velocity, flow-mediated slowing, retinal vessel analysis, peripheral vascular reactivity, and carotid intima-media thickness assessment. Although there is increasing prevalence of cardiovascular risk factors (obesity and hypertension) in children in sub-Saharan Africa, little is known about how this may affect vascular function. This review focuses on vasoactive factors implicated in vascular (dys)function, highlighting the determinants and consequences of vascular dysfunction. It further describes the non-invasive methods used for vascular (dys)function assessments and, last, describes the impact of cardiovascular risk factors on vascular dysfunction in children of African ancestry.
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Affiliation(s)
- Edna N Matjuda
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
| | - Godwill Azeh Engwa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
| | - Constance R Sewani-Rusike
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
| | - Benedicta N Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
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