The distribution and epidemic characteristics of cerebrovascular disease in followed-up hypertension patients

Associations of MTHFR gene polymorphism with lipid metabolism and risk of cerebral infarction in the Northwest Han Chinese population

Objective

Genetic variation in the methylenetetrahydrofolate reductase (MTHFR) gene may contribute to the development of cerebral infarction (CI); however, results have been inconsistent across studies with different populations, including studies of the Chinese population. The aim of this study was to analyze the effect of MTHFR gene polymorphism on serum lipid and homocysteine levels among patients with CI in the Northwest Chinese Han population.

Patients and methods

A total of 521 CI patients and 524 non-CI controls were enrolled in the study. Polymerase chain reaction and hybridization were utilized to identify MTHFR gene polymorphisms. Multivariate logistic regression analysis was used to assess the associations of MTHFR gene polymorphism with risk of CI.

Results

Frequencies of the TT genotype and the T allele were markedly higher among CI patients than among controls. After stratifying our data by sex and age, we determined that these differences in frequency of the TT genotype and the T allele were statistically significant among participants of two different age brackets and among men, but not among women (i.e., there were no statistically significant differences between female patients and female controls). CI patients and control participants with the CT or TT genotype had significantly higher homocysteine (Hcy) levels than those with the CC genotype. Among CI patients, CT/TT carriers showed significantly lower high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (ApoA-I) levels as compared with CC carriers, but there was no significant difference for control participants. Multivariable logistic regression analysis showed that drinking; smoking; diabetes mellitus; levels of Hcy, direct bilirubin (DB), indirect bilirubin (IB), ApoA-I, and total protein (TP); and TT genotype were significant independent risk factors for CI.

Conclusions

The results suggested that the TT genotype of the MTHFR C677T gene polymorphism, which is associated with hyperhomocysteinemia (HHcy), might be of great clinical significance in the identification of new biomarkers for CI and in the development of individualized preventive and therapeutic strategies.

Prognostic Factors of New-Onset Hypertension in New and Traditional Hypertension Definition in a Large Taiwanese Population Follow-up Study

The aim of this study was to determine the predictors of new-onset hypertension when the definition of hypertension is changed from the traditional definition (140/90 mmHg) to a new definition (130/80 mmHg). Using data from the Taiwan Biobank, a total of 17,072 and 21,293 participants in the new and traditional definition groups were analyzed, respectively. During a mean follow-up period of 3.9 years, 3641 and 3002 participants developed hypertension in the new and traditional definition groups, respectively. After multivariable analysis, older age (OR, 1.035; 95% CI, 1.030 to 1.039; p < 0.001), male sex (OR, 1.332; 95% CI, 1.194 to 1.486; p < 0.001), high systolic blood pressure (SBP) (OR, 1.067; 95% CI, 1.062 to 1.073; p < 0.001), high diastolic blood pressure (DBP) (OR, 1.048; 95% CI, 1.040 to 1.056; p < 0.001), high heart rate (OR, 1.007; 95% CI, 1.002 to 1.012; p = 0.004), high body mass index (BMI) (OR, 1.091; 95% CI, 1.077 to 1.106; p < 0.001), high fasting glucose (OR, 1.004; 95% CI, 1.001 to 1.006; p = 0.002), and high triglycerides (OR, 1.001; 95% CI, 1.000 to 1.001; p = 0.004) were significantly associated with new-onset hypertension in the new definition group. In the traditional definition group, the predictors of new-onset hypertension were older age (OR, 1.038; 95% CI, 1.032 to 1.043; p < 0.001), high SBP (OR, 1.078; 95% CI, 1.072 to 1.084; p < 0.001), high DBP (OR, 1.039; 95% CI, 1.031 to 1.046; p < 0.001), high heart rate (OR, 1.005; 95% CI, 1.000 to 1.010; p = 0.032), high BMI (OR, 1.072; 95% CI, 1.058 to 1.087; p < 0.001), high fasting glucose (OR, 1.003; 95% CI, 1.000 to 1.005; p = 0.020), low cholesterol (OR, 0.998; 95% CI, 0.997 to 0.999; p = 0.004), high triglycerides (OR, 1.001; 95% CI, 1.000 to 1.001; p = 0.001), and low estimated glomerular filtration rate (eGFR) (OR, 0.995; 95% CI, 0.993 to 0.997; p < 0.001). In conclusion, older age, high SBP and DBP, high heart rate, high BMI, high fasting glucose, and high triglycerides were useful predictors of new-onset hypertension in both the new and traditional definition groups. However, male sex was a significant predictor of new-onset hypertension only in the new definition group, and low cholesterol and low eGFR were significant predictors of new-onset hypertension only in the traditional definition group. Hence, changing the diagnostic cut-off value for hypertension may have a significant impact on the association of some clinical and laboratory parameters with new-onset hypertension.

Risk probability and influencing factors of stroke in followed-up hypertension patients

Objective

To explore the risk probability and main influencing factors of stroke in followed-up hypertension patients through the analysis of long-term followed-up cohort data.

Methods

The method of followed-up observation cohort was used to collect the information of 168,417 followed-up hypertension patients from 2002 to 2020 in Jiading District in Shanghai. Kaplan–Meier method was used to analyze the risk probability of stroke complications in long-term followed-up HTN patients, and the influencing factors were analyzed by Cox proportional risk model.

Results

Among 168,417 followed-up hypertension patients, 11,143 cases had suffered stroke, and the cumulative incidence rate of stroke was 6.62% (male was 6.87%, female was 6.37%). With the extension of the hypertension years, the cumulative risk probability of stroke in HTN patients would continue to increase and the interval was not equidistant. The total cumulative risk probability of stroke in HTN patients was 78.9% (male was 91.0%, female was 70.7%). During the period of hypertension, the risk occurring probability of stroke was not fixed, but fluctuating. There were 4 onset peaks, which were in 8 years (probability was 4.2%), 15 years (probability was 14.0%), 22 years (probability was 6.0%) and 26 years (probability was 13.9%). The highest risk probability of male patients was in 26 years (probability was 23.1%), and the second peak was in 15 years (probability was 15.6%). The highest risk probability of female patients was in 15 years (probability was 12.9%), and the second peak was in 26 years (probability was 8.7%). The risk probability of different gender, BP grade and BMI was different, the male were at higher risk than the female, stage 3 HTN was higher than stage 2 and stage 1 HTN, obese people and underweight people were at higher risk than those who have normal weight. The main factors closely related to the occurrence of stroke complications were age (RR = 2.917, p < 0.001), body mass index (RR = 1.654, p < 0.001), family history of stroke (RR = 1.386, p < 0.001) and blood pressure grade (RR = 1.148, p < 0.001).

Conclusion

The risk probability of stroke among hypertension patients was high in followed-up hypertension patients (total 78.9%, male 91.0%, female 70.7%), and would continue to increase disproportionately during period of hypertension (4 different onset peaks). With the persistence of hypertension, the risk probability of stroke would increase continuously. Multivariate Cox regression analysis showed that male patients, patients with HBP, abnormal BMI and positive family history were main factors closely related to the occurrence of stroke complications.

Effect of om chanting and yoga nidra on blood pressure and lipid profile in hypertension - A randomized controlled trial

BACKGROUND

Hypertension (HTN) is a major public health concern, and elevated blood pressure (BP) is a distinct risk factor for all - causes of morbidity and mortality.

OBJECTIVES

Considering the growing evidence of yoga interventions in the management of hypertension, the objective of the current randomized controlled study is to assess the effect of OM chanting and Yoga nidra (Relaxation technique) on BP and lipid profile in individuals with HTN.

MATERIALS AND METHODS

Eighty patients with diagnosed HTN were recruited and randomized equally to either the experimental group or the control group. Patients in the experimental group received a combination of OM chanting and Yoga nidra, five days a week for a period of 2 months and patients in the control group continued with their regular conventional medications. BP and lipid profile parameters were assessed at baseline, 30th day and 60th day for both the groups.

RESULTS

After 2 months of intervention, a significant (p < 0.05) reduction in the BP and lipid profile was observed in the intervention group when compared to the control group. The reduction in systolic and diastolic BP and LDL were significantly (p < 0.001) higher in the experimental group. In addition, there is a significant increase in HDL levels in the experimental group. No adverse events were reported during the trial period.

CONCLUSION

The current study demonstrates the efficacy of Om chanting and Yoga nidra in reducing blood pressure and improving lipid profiles in patients with HTN. These particular yoga interventions could thus be considered a safer form of complementary therapy in the management of HTN, alongside conventional management.

REGISTRATION

Clinical trial identifier- CTRI/2020/02/023400.

Felodipine Determination by a CdTe Quantum Dot-Based Fluorescent Probe

In this work, a CdTe quantum dot-based fluorescent probe was synthesized to determine felodipine (FEL). The synthesis conditions, structure, and interaction conditions with FEL of CdTe quantum dots were analysed by fluorescence spectrophotometry, Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), UV–visible spectroscopy, and TEM. The CdTe QD concentration was 2.0 × 10⁻⁴ mol/L. The amount of quantum dots controlled in the experiment was 0.8 mL. The controlled feeding ratio of N (Cd²⁺):N (Te²⁻):N (TGA) was 2:1:4, the heating temperature was 140 °C, the heating time was 60 min, and the pH of the QD precursor was adjusted to 11 for subsequent experiments. The UV–visible spectrum showed that the emission wavelength of CdTe quantum dots at 545 nm was the strongest and symmetric. The particle size of the synthesized quantum dots was approximately 5 nm. In the interaction of CdTe quantum dots with FEL, the FEL dosage was 1.0 mL, the optimal pH value of Tris-HCl buffer was 8.2, the amount of buffer was 1.5 mL, and the reaction time was 20 min. The standard curve of FEL was determined under the optimal synthesis conditions of CdTe quantum dots and reaction of CdTe quantum dots with FEL. The linear equation was Y = 3.9448x + 50.068, the correlation coefficient R2 was 0.9986, and the linear range was 5 × 10⁻⁶–1.1 × 10⁻⁴ mol/L. A CdTe quantum dot-based fluorescent probe was successfully constructed and could be used to determine the FEL tablet content.