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Meng Y, Mynard JP, Smith KJ, Juonala M, Urbina EM, Niiranen T, Daniels SR, Xi B, Magnussen CG. Pediatric Blood Pressure and Cardiovascular Health in Adulthood. Curr Hypertens Rep 2024; 26:431-450. [PMID: 38878251 PMCID: PMC11455673 DOI: 10.1007/s11906-024-01312-5] [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] [Accepted: 05/28/2024] [Indexed: 10/06/2024]
Abstract
PURPOSE OF REVIEW This review summarizes current knowledge on blood pressure in children and adolescents (youth), with a focus on primary hypertension-the most common form of elevated blood pressure in this demographic. We examine its etiology, progression, and long-term cardiovascular implications. The review covers definitions and recommendations of blood pressure classifications, recent developments in measurement, epidemiological trends, findings from observational and clinical studies, and prevention and treatment, while identifying gaps in understanding and suggesting future research directions. RECENT FINDINGS Youth hypertension is an escalating global issue, with regional and national variations in prevalence. While the principles of blood pressure measurement have remained largely consistent, challenges in this age group include a scarcity of automated devices that have passed independent validation for accuracy and a generally limited tolerance for ambulatory blood pressure monitoring. A multifaceted interplay of factors contributes to youth hypertension, impacting long-term cardiovascular health. Recent studies, including meta-analysis and sophisticated life-course modelling, reveal an adverse link between youth and life-course blood pressure and subclinical cardiovascular outcomes later in life. New evidence now provides the strongest evidence yet linking youth blood pressure with clinical cardiovascular events in adulthood. Some clinical trials have expanded our understanding of the safety and efficacy of antihypertensive medications in youth, but this remains an area that requires additional attention, particularly regarding varied screening approaches. This review outlines the potential role of preventing and managing blood pressure in youth to reduce future cardiovascular risk. A global perspective is necessary in formulating blood pressure definitions and strategies, considering the specific needs and circumstances in low- and middle-income countries compared to high-income countries.
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Affiliation(s)
- Yaxing Meng
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan P Mynard
- Heart Research Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, Australia
| | - Kylie J Smith
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, TAS, Hobart, Australia
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Elaine M Urbina
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Teemu Niiranen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Internal Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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Izaki T, Himichi T, Sakaki M. Cardiac cycle modulates social pain. Biol Psychol 2024; 192:108853. [PMID: 39116917 DOI: 10.1016/j.biopsycho.2024.108853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/22/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
Social pain is a painful feeling evoked by social rejection, exclusion, or the loss of other important people. Previous research suggests that physical pain is reduced by increased signals from baroreceptors that monitor blood pressure. This pre-registered study investigated whether social pain is attenuated by increased baroafferent signals, as observed in physical pain. Given that baroafferent signals increase during cardiac systole and decrease during diastole, we hypothesized that feelings of pain induced by social rejection would be lower when exclusion events are presented at the cardiac systole than when they are presented at the diastole. Participants completed the cyberball task, a computerized ball-tossing game involving two other players. In the rejection condition, the ball was rarely thrown to the participant, while the other players kept tossing it to each other. Throws between other players were defined as exclusion events and were presented either at the cardiac systole (a systole condition) or at the diastole (a diastole condition). We found that exclusion events evoked significantly less social pain in the systole condition than in the diastole condition. Furthermore, the effects of cardiac cycle were more pronounced in participants with higher heart rate variability than those with lower heart rate variability. Our results suggest that cardiac afferent signals contribute not only to physical pain but also to social pain.
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Affiliation(s)
- Tsubasa Izaki
- School of Economics & Management, Kochi University of Technology, Kochi, Japan.
| | - Toshiyuki Himichi
- School of Economics & Management, Kochi University of Technology, Kochi, Japan
| | - Michiko Sakaki
- Hector Research Institute of Education Sciences and Psychology, University of Tübingen, Tübingen, Germany; Research Institute, Kochi University of Technology, Kochi, Japan
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Niepmann ST, Roderburg C, Luedde M, Nickenig G, Loosen SH, Kostev K. The Association between Aortic Valve Stenosis and a Subsequent Diagnosis of Depression in Germany. J Clin Med 2024; 13:5525. [PMID: 39337012 PMCID: PMC11432745 DOI: 10.3390/jcm13185525] [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: 08/06/2024] [Revised: 08/22/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: Aortic valve stenosis (AS) represents one of the most common valve diseases in the western world. It often leads to severe symptoms that can lead to a restriction of everyday life and thus to psychological stress. Therefore, we aimed to investigate the association between AS and depression in outpatients in Germany. Methods: The IQVIATM Disease Analyzer database was used to identify 14,681 individuals with non-rheumatic AS (ICD-10: I35.0 or I35.2). They were propensity score matched (1:1) based on age, sex, average yearly consultation frequency during the follow-up, and co-diagnoses to 14,681 patients without AS. Cox regression models were used to analyze the association between aortic stenosis and depression. Results: Within the follow-up period of up to 10 years, depression was diagnosed in 20.6% of AS patients compared to 20.0% in the matched cohort (p = 0.351). In the regression analysis, we were not able to discover an association between AS and a subsequent diagnosis of depression (HR: 1.03; 95% CI: 0.96-1.11). This effect was consistent among different age and sex groups. Conclusions: In the broad population of patients treated outside of hospital settings in Germany, AS was not associated with a higher incidence of depression.
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Affiliation(s)
- Sven Thomas Niepmann
- Heart Center Bonn, Clinic for Internal Medicine II, University Hospital Bonn, 53127 Bonn, Germany
| | - Christoph Roderburg
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, 40225 Duesseldorf, Germany
| | - Mark Luedde
- Department of Cardiology, Christian Albrechts University of Kiel, 24118 Kiel, Germany
| | - Georg Nickenig
- Heart Center Bonn, Clinic for Internal Medicine II, University Hospital Bonn, 53127 Bonn, Germany
| | - Sven H. Loosen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, 40225 Duesseldorf, Germany
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Zhang H, Xu Y, Xu Y. Association of diastolic and systolic blood pressure with depression: a cross-sectional study from NHANES 2005-2018. Front Psychiatry 2024; 15:1433990. [PMID: 39355374 PMCID: PMC11442334 DOI: 10.3389/fpsyt.2024.1433990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 08/29/2024] [Indexed: 10/03/2024] Open
Abstract
Background Many studies worldwide have reported the association between mental health and blood pressure, but the results are mixed, and even contradictory. We aim to investigate the relationship between systolic and diastolic blood pressure and depression in the entire US population. Methods This study analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. All adults completed 3-4 blood pressure measurements after sitting quietly for 5 minutes. Depression was diagnosed based on the Patient Health Questionnaire (PHQ-9), with a score ≥10 defined as depression. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the relationship between blood pressure and depression. Two-piecewise linear regression was used to determine the inflection point. Additionally, subgroup analyses and interaction tests were conducted to identify potential subgroups. Finally, two sensitivity analyses were conducted. Results A total of 26,581 American adults were included, with a mean age of 47.2 years, of whom 13,354 (49.54%) were male; 2,261 individuals were defined as depressed, with a weighted prevalence of 7.41%. All participants' mean systolic blood pressure (SBP) was 121.7 mmHg, and the mean diastolic blood pressure (DBP) was 70.9 mmHg. RCS showed a nonlinear association between SBP and depression, while DBP showed a positive linear association with depression. Two-piecewise linear regression showed that the inflection point of the association between SBP and depression was 129.7 mmHg. Weighted logistic regression showed that after fully adjusting for depression-related risk factors, there was a significant positive correlation between per 10 mmHg increase in DBP and depression (OR: 1.06, 95% CI: 1.00-1.12, P=0.04); however, only on the left side of the inflection point, SBP tended to decrease the odds of depression (P =0.09). Furthermore, interaction analysis showed that the association between DBP and depression was significantly stronger in cancer patients (P for interaction=0.02); on the left side of the inflection point (<129.7 mmHg), current smokers also significantly interacted with SBP (P for interaction=0.018). Finally, two sensitivity analyses also supported our findings. Conclusion In the adult population of the United States, there is a positive linear association between DBP and depression, while the association between SBP and depression exhibits a significant threshold effect, maintaining SBP at 129.7 mmHg is associated with the lowest prevalence of depression.
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Affiliation(s)
- Huifeng Zhang
- Department of Cardiovascular, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Ying Xu
- Department of Hematology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yaying Xu
- Department of Endocrinology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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Inoue T. Depressive symptoms and the development of hypertension. Hypertens Res 2024:10.1038/s41440-024-01856-8. [PMID: 39169152 DOI: 10.1038/s41440-024-01856-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Taku Inoue
- Department of Preventive Medicine and Public Health, School of Medicine, Fukuoka University, Fukuoka, Japan.
- Cardiovascular Medicine, Omoromachi Medical Center, Naha, Japan.
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Foguet-Boreu Q, Ayerbe García-Morzón L. [High blood pressure and depression, an underestimated comorbidity]. HIPERTENSION Y RIESGO VASCULAR 2024:S1889-1837(24)00088-6. [PMID: 39142907 DOI: 10.1016/j.hipert.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 08/16/2024]
Affiliation(s)
- Q Foguet-Boreu
- MFyC y Psiquiatría, Facultad de Medicina, Universitat de Vic-Universitat Central de Catalunya, Hospital Universitario de Vic, Vic, Barcelona, España; Multidiscisplinary Inflamation Research Group, Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Barcelona, España.
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Wesselbaum D. Association of Hypertension with Well-Being: Results from the Behavioral Risk Factor Surveillance System (BRFSS) Study. High Blood Press Cardiovasc Prev 2024; 31:401-404. [PMID: 38775926 PMCID: PMC11322268 DOI: 10.1007/s40292-024-00653-1] [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: 04/23/2024] [Accepted: 05/14/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION It remains unclear how hypertension affects subjective well-being, especially in light of its potential gender-specific impacts. AIM In this study, we aimed to study the association between hypertension and subjective well-being and the potential gender differences in this relationship as well as mediating factors. METHODS We use individual-level data from > 1 million Americans who participated in six waves of the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. We employ descriptive and regression analyses to determine the association between hypertension and subjective well-being while controlling for the usual well-being covariates identified from the related literature. RESULTS Hypertension was negative associated with subjective well-being (p < 0.001) and our results for covariates were in line with the findings in the related literature. The association between hypertension and subjective well-being was only found in males (p < 0.001) but not in females. The relationship is mediated by age and exercising but only for females. CONCLUSION Hypertension is negatively associated with well-being among males. The diagnosis of hypertension should not only lead to medical treatments but also involve a careful psychological management.
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Mogi M, Ikegawa Y, Haga S, Hoshide S, Kario K. Hypertension facilitates age-related diseases. ~ Is hypertension associated with a wide variety of diseases?~. Hypertens Res 2024; 47:1246-1259. [PMID: 38491107 DOI: 10.1038/s41440-024-01642-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/18/2024]
Abstract
Hypertension, a disease whose prevalence increases with age, induces pathological conditions of ischemic vascular disorders such as cerebral infarction and myocardial infarction due to accelerated arteriosclerosis and circulatory insufficiency of small arteries and sometimes causes hemorrhagic conditions such as cerebral hemorrhage and ruptured aortic aneurysm. On the other hand, as it is said that aging starts with the blood vessels, impaired blood flow associated with vascular aging is the basis for the development of many pathological conditions, and ischemic changes in target organs associated with vascular disorders result in tissue dysfunction and degeneration, inducing organ hypofunction and dysfunction. Therefore, we hypothesized that hypertension is associated with all age-related vascular diseases, and attempted to review the relationship between hypertension and diseases for which a relationship has not been previously well reported. Following our review, we hope that a collaborative effort to unravel age-related diseases from the perspective of hypertension will be undertaken together with experts in various specialties regarding the relationship of hypertension to all pathological conditions.
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Affiliation(s)
- Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
| | - Yasuhito Ikegawa
- Department of Pharmacology, Ehime University Graduate School of Medicine, Matsuyama, Japan
- Department of Ophthalmology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Shunsuke Haga
- Department of Pharmacology, Ehime University Graduate School of Medicine, Matsuyama, Japan
- Department of Urology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
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Li AKC, Nowrouzi-Kia B. Relationships between employment status with self-perceived mental and physical health in Canada. AIMS Public Health 2024; 11:236-257. [PMID: 38617416 PMCID: PMC11007413 DOI: 10.3934/publichealth.2024012] [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: 01/22/2024] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 04/16/2024] Open
Abstract
Background The annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health. Objective To explore the relationships between age, gender, income, and employment status on mental and physical health. Methods The 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data. Results The total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55-2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68-0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41-2.14) or retired (OR: 1.28; 95% CI: 1.12-1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income. Conclusion Our findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.
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Affiliation(s)
- Anson Kwok Choi Li
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, Canada M5T 3M6
- Department of Biology, University of Western Ontario, 1151 Richmond Street, London, ON, Canada N6A 3K7
- ReSTORE Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, ON, Canada M5G 1V7
| | - Behdin Nowrouzi-Kia
- ReSTORE Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, ON, Canada M5G 1V7
- Krembil Research Institute-University Health Network, 60 Leonard Ave, Toronto, ON, Canada, M5T 0S8
- Centre for Research in Occupational Safety & Health, Laurentian University, 935 Ramsey Lake Rd, Sudbury, ON, Canada P3E 2C
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Braun J, Patel M, Kameneva T, Keatch C, Lambert G, Lambert E. Central stress pathways in the development of cardiovascular disease. Clin Auton Res 2024; 34:99-116. [PMID: 38104300 DOI: 10.1007/s10286-023-01008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Mental stress is of essential consideration when assessing cardiovascular pathophysiology in all patient populations. Substantial evidence indicates associations among stress, cardiovascular disease and aberrant brain-body communication. However, our understanding of the flow of stress information in humans, is limited, despite the crucial insights this area may offer into future therapeutic targets for clinical intervention. METHODS Key terms including mental stress, cardiovascular disease and central control, were searched in PubMed, ScienceDirect and Scopus databases. Articles indicative of heart rate and blood pressure regulation, or central control of cardiovascular disease through direct neural innervation of the cardiac, splanchnic and vascular regions were included. Focus on human neuroimaging research and the flow of stress information is described, before brain-body connectivity, via pre-motor brainstem intermediates is discussed. Lastly, we review current understandings of pathophysiological stress and cardiovascular disease aetiology. RESULTS Structural and functional changes to corticolimbic circuitry encode stress information, integrated by the hypothalamus and amygdala. Pre-autonomic brain-body relays to brainstem and spinal cord nuclei establish dysautonomia and lead to alterations in baroreflex functioning, firing of the sympathetic fibres, cellular reuptake of norepinephrine and withdrawal of the parasympathetic reflex. The combined result is profoundly adrenergic and increases the likelihood of cardiac myopathy, arrhythmogenesis, coronary ischaemia, hypertension and the overall risk of future sudden stress-induced heart failure. CONCLUSIONS There is undeniable support that mental stress contributes to the development of cardiovascular disease. The emerging accumulation of large-scale multimodal neuroimaging data analytics to assess this relationship promises exciting novel therapeutic targets for future cardiovascular disease detection and prevention.
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Affiliation(s)
- Joe Braun
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia.
| | - Mariya Patel
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Tatiana Kameneva
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Charlotte Keatch
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Gavin Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
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Di Giacomo D, Ranieri J, Guerra F, Cilli E, Sciarra L, Romano S. Cardiovascular risk and biopsychosocial interplay: Association among hypertension, anxiety, and emotional dysregulation-observational study in primary care setting for efficient self-care. Clin Cardiol 2024; 47:e24152. [PMID: 37771169 PMCID: PMC10765995 DOI: 10.1002/clc.24152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Aim of the study was to explore the relationship between emotional dimensions of hypertensive patients and the self-care skills; we tried to draw the psychological aspects could impact the health management in hypertension analyzing the effect of emotional regulation on self-care skills: our scope was to highlight the psychological dynamics into behavioral medicine approach. METHODS In an observational study design, patients were collected. Patients with diagnosis of hypertension were recruited in primary care setting. Inclusion criteria included patients older than 18 years, with known and medically treated primary hypertension undergoing antihypertensive medication. RESULTS Statistical analysis was carried out based on the data of 28 primary hypertensive patients (seven females, 21 males, mean age ± SD: 49.8 ± 7.8 years mean; clinic blood pressure: mean systolic blood pressure: 137.2 ± 13.1 mmHg, mean diastolic blood pressure: 82.1 ± 9.9 mmHg). Mean duration of hypertension in the sample was 13.1 years (±8.2 years). Correlations among the main variables of interest showed a positive and significant relationship between emotional dysregulation indexes, psychological distress, and self-care domains: awareness resulted negatively and significantly correlated to self-efficacy; nonacceptance, goals and impulse indexes seemed positively and significantly correlated to anxiety and depression; finally, stress was correlated positively and significantly to awareness and impulse. CONCLUSIONS Evidencing the role of emotion dysregulation on self-care skills and psychological outcomes, and specifically highlighting the impact of emotion dysregulation on self-care, our findings could inform the development and implementation of psychological interventions aimed at promoting psychological well-being and healthy behavior by focusing on the promotion of emotion regulation strategies, to reduce the risk for co-morbidity and/or severe cardiovascular diseases.
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Affiliation(s)
- Dina Di Giacomo
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Jessica Ranieri
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Federica Guerra
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Eleonora Cilli
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
| | - Luigi Sciarra
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
- Di Lorenzo ClinicAvezzanoItaly
| | - Silvio Romano
- Life, Health and Environmental Sciences DepartmentUniversity of L'AquilaL'AquilaItaly
- Heart Failure ClinicASL Avezzano‐SulmonaL'AquilaItaly
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Zhang X, Zhou Y, Yang J, Wang Y, Xiang Y, Ma H, Lu W. Trend of blood pressure changes among children from 2012 to 2022: findings from student health surveillance in Eastern China. J Hypertens 2023; 41:1821-1830. [PMID: 37682062 DOI: 10.1097/hjh.0000000000003554] [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: 09/09/2023]
Abstract
OBJECTIVES The primary objective of this study is to examine the secular trends in blood pressure levels from 2012 to 2022 in eastern China. Additionally, to compare two standards [International Blood Pressure Reference for Children and Adolescents (ICBP) and the National Blood Pressure Reference for Chinese Han Children and Adolescents (CCBP)], we calculate the 95th percentile of blood pressure levels for students in developed regions (ECCBP). Secondly, the study aims to investigate potential contributors to elevated blood pressure, including sex, age, behaviors, and mental health. Lastly, the study seeks to estimate the total population aged 7-18 years with elevated blood pressure in Eastern China based on three references. METHODS The data used in this study were obtained from the Student Health Surveillance program in Jiangsu Province, which has been collecting data since 2012. Trained project members, skilled nurses, and doctors measured anthropometric variables. Additionally, online student questionnaires were administered in 2017, 2019, and 2021 to collect personal information behavior patterns, and mental health. RESULTS The study examined blood pressure changes in 123 013 children and adolescents in Eastern China from 2012 to 2022. Significant increases were observed in systolic blood pressure (SBP) and pulse pressure difference. Prevalence of elevated blood pressure followed a similar trend with ECCBP and CCBP, ranging from 17.2%/16.3% (2012-2015) to 11.6%/14.6% (2020-2022). Notably, BP with ICBP showed a significant increase in both prevalence and population, from 12.6% [6 713 679, 95% confidence interval (CI): 6 708 931 to 6 718 427] to 14.5% (7 004 208, 95% CI: 6 999 411 to 7 009 004). The study further emphasizes the significant impact of various risk factors on elevated blood pressure among children and adolescents, particularly the detrimental effect of depression on blood pressure, with the odds ratios (OR) in 2021 being 1.310 (95% CI, 1.290-1.330) for ECCBP, 1.239 (95% CI, 1.223-1.255) for CCBP, and 1.189 (95% CI, 1.176-1.202) for ICBP. CONCLUSION The study revealed significant changes in the population and prevalence of elevated blood pressure in Eastern China from 2012 to 2022. The findings indicate a decline in the prevalence of elevated blood pressure (referred to as CCBP or ECCBP), while highlighting an increasing trend in elevated blood pressure (referred to as ICBP). Untreated high blood pressure can lead to serious cardiovascular diseases in adulthood, underscoring the importance of early prevention and management, particularly through nonpharmacological methods and regular monitoring for students in Eastern China. Raising awareness among educators, parents, and healthcare providers about the association between mental health and elevated blood pressure is essential.
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Affiliation(s)
- Xiyan Zhang
- Jiangsu Provincial Center for Disease Control and Prevention
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yonglin Zhou
- Jiangsu Provincial Center for Disease Control and Prevention
| | - Jie Yang
- Jiangsu Provincial Center for Disease Control and Prevention
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yan Wang
- Jiangsu Provincial Center for Disease Control and Prevention
| | - Yao Xiang
- Jiangsu Provincial Center for Disease Control and Prevention
| | - Hongxia Ma
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wei Lu
- Jiangsu Provincial Center for Disease Control and Prevention
- School of Public Health, Nanjing Medical University, Nanjing, China
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Romankiewicz L, Schaare HL, Nestler S, Villringer A, Blöchl M. Mediation of the Association Between Vascular Risk Factors and Depressive Symptoms by C-Reactive Protein. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:642-650. [PMID: 37881535 PMCID: PMC10593949 DOI: 10.1016/j.bpsgos.2023.04.008] [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: 01/13/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 10/27/2023] Open
Abstract
Background This study examined whether C-reactive protein (CRP), a marker of low-grade systemic inflammation, mediates the association between vascular risk factor (VRF) burden and depressive symptoms. Methods We drew on the prospective design of the UK Biobank to include participants with longitudinal data on VRF burden, CRP, and depressive symptoms. Total, direct, and indirect effects were estimated using regression-based mediation models while controlling for confounding by sociodemographic factors, baseline CRP, and baseline depression. Sensitivity analyses probed the robustness of results to unmeasured confounding. Results We analyzed data from 10,470 participants from the UK Biobank (mean age = 56.75 years at baseline). Net of covariates, VRFs at baseline were associated with higher depressive symptoms at follow-up (total effect = 0.099; 95% CI, 0.002-0.163). CRP mediated this association (indirect effect = 0.010; 95% CI, 0.004-0.017), accounting for 10.0% (95% CI, 0.3%-30.0%) of the total effect of VRF burden on depressive symptoms. Exploratory analyses suggested that the total and indirect effects pertained to somatic depressive symptoms (tiredness and appetite). Conclusions These results suggest that inflammation-promoting effects of VRFs may contribute to depressive symptoms in mid- and later life. However, the mediating pathway via CRP explains only a small part of the association between VRFs and depression after accounting for important covariates and may pertain to specific depressive symptoms. Future studies leveraging similar longitudinal designs are needed to further disentangle the time-varying effects between VRFs, inflammation, and certain depressive symptoms while addressing important confounders.
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Affiliation(s)
| | - H. Lina Schaare
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour) Research Centre, Jülich, Germany
| | - Steffen Nestler
- Department of Psychology, University of Münster, Münster, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Clinic Leipzig, Leipzig, Germany
- Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Blöchl
- Department of Psychology, University of Münster, Münster, Germany
- International Max Planck Research School: Neuroscience of Communication: Structure, Function, and Plasticity, Leipzig, Germany
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Oshchepkov DY, Makovka YV, Ponomarenko MP, Redina OE, Markel AL. Age-Dependent Changes in the Relationships between Traits Associated with the Pathogenesis of Stress-Sensitive Hypertension in ISIAH Rats. Int J Mol Sci 2023; 24:10984. [PMID: 37446162 DOI: 10.3390/ijms241310984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Hypertension is one of the most significant risk factors for many cardiovascular diseases. At different stages of hypertension development, various pathophysiological processes can play a key role in the manifestation of the hypertensive phenotype and of comorbid conditions. Accordingly, it is thought that when diagnosing and choosing a strategy for treating hypertension, it is necessary to take into account age, the stage of disorder development, comorbidities, and effects of emotional-psychosocial factors. Nonetheless, such an approach to choosing a treatment strategy is hampered by incomplete knowledge about details of age-related associations between the numerous features that may contribute to the manifestation of the hypertensive phenotype. Here, we used two groups of male F2(ISIAHxWAG) hybrids of different ages, obtained by crossing hypertensive ISIAH rats (simulating stress-sensitive arterial hypertension) and normotensive WAG rats. By principal component analysis, the relationships among 21 morphological, physiological, and behavioral traits were examined. It was shown that the development of stress-sensitive hypertension in ISIAH rats is accompanied not only by an age-dependent (FDR < 5%) persistent increase in basal blood pressure but also by a decrease in the response to stress and by an increase in anxiety. The plasma corticosterone concentration at rest and its increase during short-term restraint stress in a group of young rats did not have a straightforward relationship with the other analyzed traits. Nonetheless, in older animals, such associations were found. Thus, the study revealed age-dependent relationships between the key features that determine hypertension manifestation in ISIAH rats. Our results may be useful for designing therapeutic strategies against stress-sensitive hypertension, taking into account the patients' age.
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Affiliation(s)
- Dmitry Yu Oshchepkov
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (SB RAS), Novosibirsk 630090, Russia
| | - Yulia V Makovka
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (SB RAS), Novosibirsk 630090, Russia
- Department of Natural Sciences, Novosibirsk State University, Novosibirsk 630090, Russia
| | - Mikhail P Ponomarenko
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (SB RAS), Novosibirsk 630090, Russia
| | - Olga E Redina
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (SB RAS), Novosibirsk 630090, Russia
| | - Arcady L Markel
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (SB RAS), Novosibirsk 630090, Russia
- Department of Natural Sciences, Novosibirsk State University, Novosibirsk 630090, Russia
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