1
|
Khinda R, Valecha S, Kumar N, Walia JPS, Singh K, Sethi S, Singh A, Singh M, Singh P, Mastana S. Prevalence and Predictors of Osteoporosis and Osteopenia in Postmenopausal Women of Punjab, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052999. [PMID: 35270692 PMCID: PMC8910053 DOI: 10.3390/ijerph19052999] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/02/2023]
Abstract
The prevalence and predictors of osteoporosis and osteopenia remain to be examined in the postmenopausal women of Punjab, India. The present cross-sectional study screened 1628 postmenopausal women during September 2019 to March 2020. Osteoporosis and osteopenia were confirmed on the basis of T-scores using dual energy X-ray absorptiometry (DXA) at the hip (femoral neck) and lumbar spine regions (L1−L4 vertebrae). The prevalence of osteoporosis and osteopenia was observed to be 30.50% and 44.20%, respectively, in postmenopausal women of Punjab. In univariable and multivariable regression analysis, variables independently influencing the risk of osteoporosis and osteopenia were: higher systolic blood pressure (95%CI: 1.22−3.11 & 1.08−2.49), triglyceride levels (95%CI: 1.21−3.10 & 1.42−2.51), poor sleep quality (95%CI: 1.91−2.47 & 1.76−3.47) and C-reactive protein levels (95%CI: 2.18−3.56 & 1.03−2.18). Years since menopause >10 years was observed to be an independent predictor for the risk of osteopenia but not for osteoporosis. Higher body mass index (>30 kg·m−2) was observed to be a significant protective factor against the risk of osteoporosis (95%CI: 0.26−0.68) and osteopenia (95%CI: 0.19−0.52). The higher prevalence rates of osteoporosis and osteopenia in postmenopausal women of Punjab are alarming, which solicits awareness and earlier testing of those women who are approaching menopause.
Collapse
Affiliation(s)
- Rubanpal Khinda
- Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India; (R.K.); (S.V.); (N.K.); (M.S.)
| | - Srishti Valecha
- Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India; (R.K.); (S.V.); (N.K.); (M.S.)
| | - Nitin Kumar
- Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India; (R.K.); (S.V.); (N.K.); (M.S.)
| | - J. P. S. Walia
- Department of Orthopedics, Aggarsain Charitable Hospital, Patiala 147002, Punjab, India;
| | - Kuldeep Singh
- Department of Orthopedics, Government Medical College and Hospital, Patiala 147002, Punjab, India;
| | - Sudhir Sethi
- Department of Orthopedics, Mata Kaushalya Hospital, Patiala 147002, Punjab, India;
| | - Avtar Singh
- Department of Orthopedics, Amandeep Hospital, Amritsar 143001, Punjab, India;
| | - Monica Singh
- Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India; (R.K.); (S.V.); (N.K.); (M.S.)
| | - Puneetpal Singh
- Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India; (R.K.); (S.V.); (N.K.); (M.S.)
- Correspondence: (P.S.); (S.M.)
| | - Sarabjit Mastana
- Human Genomics Lab, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- Correspondence: (P.S.); (S.M.)
| |
Collapse
|
2
|
Rahman IA, Nusaly IF, Syahrir S, Nusaly H, Mansyur MA. Association between metabolic syndrome components and the risk of developing nephrolithiasis: A systematic review and bayesian meta-analysis. F1000Res 2021; 10:104. [PMID: 34804491 PMCID: PMC8577060 DOI: 10.12688/f1000research.28346.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is increasing evidence that nephrolithiasis is a systemic disease, as opposed to an isolated urinary metabolic problem, after considerable links were found between nephrolithiasis and systemic diseases such as hypertension, obesity, dyslipidemia, and insulin resistance. The interplay between these four factors defines metabolic syndrome (MetS). In this review we aim to clarify the associations of MetS and its components to kidney stone incident. Methods: Online databases of EMBASE, MEDLINE, and Google Scholar were searched from January 1998 up to October 2020 to identify observational studies examining the association between metabolic syndrome components and kidney stone incident. Bayesian random-effects meta-analysis and meta-regression were performed to observe the association. Linear dose-response analysis was conducted to shape the direction of the association. Data analysis was performed using STATA, and R statistics. Results: A total of 25 potentially relevant studies (n = 934,588 participants) were eventually identified. The pooled results suggested that metabolic syndrome was associated with an increased risk of nephrolithiasis with an odds ratio (OR) of 1.769 (95% CI: 1.386 - 2.309). The summary OR of hypertension and dyslipidemia for developing nephrolithiasis were 1.613 (95% CI: 1.213 - 2.169) and 1.586 (95% CI: 1.007 - 2.502) respectively. The presence of diabetes mellitus and obesity had an OR of 1.552 (95% CI: 1.027 - 2.344) and 1.531 (95% CI: 1.099 - 2.109) respectively. Our results revealed that the increasing number of MetS traits will increase the risk of developing nephrolithiasis, the higher the fasting plasma glucose, and body mass index, the higher the risk of kidney stones incident. Conclusions: Our results suggest that hypertension, diabetes, obesity and dyslipidemia are associated with increased risk of developing nephrolithiasis. Linear significant association between MetS components and nephrolithiasis were revealed in our study which reinforced the notion that should be considered a systemic disorder.
Collapse
Affiliation(s)
- Ilham Akbar Rahman
- Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90222, Indonesia
| | - Ilham Fauzan Nusaly
- Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90222, Indonesia
| | - Syakri Syahrir
- Department of Urology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia
| | - Harry Nusaly
- Department of Urology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia
| | - Makbul Aman Mansyur
- Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia
| |
Collapse
|
3
|
Zhang B, Xie H, Liu C. Risk factors of calculi in upper urinary tract after radical cystectomy with urinary diversion. Actas Urol Esp 2019; 43:568-572. [PMID: 31358300 DOI: 10.1016/j.acuro.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/10/2019] [Accepted: 04/13/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND OBJECTIVES The study was conducted to identify the risk factors of upper tract stone formation in patients with diversions after radical cystectomy (RC). MATERIALS AND METHODS All patients with diversion after RC were collected in our center from January 2005 to December 2013. Three different common diversions were included: Orthotopic neobladder (ON: 168 patients), Ileal Conduit (IC: 93 patients) or Ureterocutaneostomy (UC: 104 patients). Univariable and multivariable logistic regression analysis were conducted to identify the independent predictors of stone formation in the upper tract. RESULTS A total of 365 consecutive patients (316 males, 49 females) were included. At a median follow-up of 48 months (range 12-65 months), 36 patients (9.9%) developed upper tract stone. Among them, 26 (72.2%), 5 (13.9%) and 5 (13.9%) patients underwent ON, IC and UC, respectively. 25 patients had renal stone and 11 ureter stone. Minimally invasive operations (endoscopic laser lithotripsy via the anterograde or retrograde approach in 24 cases, percutaneous nephrolithotomy in 9 cases and shock wave lithotripsy in 3 cases) were carried out successfully in all stone cases. On univariable and multivariable logistic regression analysis, diabetes mellitus, hypertension, urinary tract infection (UTI), anastomotic stenosis and types of diversions (P<.05) were positively associated with upper tract stone formation. CONCLUSIONS The variable predictors of upper tract stone may contain diabetes mellitus, hypertension, UTI, anastomotic stenosis and types of diversion.
Collapse
|
4
|
McKissack HM, Viner GC, Jha AJ, Wilson JT, Anderson MC, McGwin G, Shah AB. Comparison of risk factors for postoperative complications across age groups in patients undergoing ORIF of the ankle. Injury 2019; 50:2116-2122. [PMID: 31547967 DOI: 10.1016/j.injury.2019.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/09/2019] [Accepted: 09/08/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Risk factors associated with various adverse outcomes for patients undergoing open reduction and internal fixation (ORIF) of the ankle, and how these risks differ between younger and older patient populations, has not been clearly established. Objective quantitative data may aid physicians in surgical decision making, individualizing postoperative management, and targeting interventions for reducing postoperative comorbidity. The purpose of this study is to compare the incidence of and risk factors for adverse postoperative outcomes following ORIF of ankle fractures across patient age groups. MATERIALS AND METHODS Charts of patients age 18 years and older who underwent open reduction and internal fixation (ORIF) for any closed, non-polytraumatic, non-pilon ankle fracture at a single institution between the years 2008 and 2018 were reviewed. Demographic information, comorbidities, and postoperative outcomes were collected. Relative risks for adverse outcomes were calculated and compared between patients younger than 50 and patients 50 years and older. RESULTS A total of 886 patients were included, 375 (42.3%) of which were over age 50. In both age groups, risk of infection was significantly increased among patients with hypertension, although risk among older patients (RR = 3.52, p = 0.004) was greater than that among younger patients (RR = 2.46, p = 0.017). In patients younger than 50, significant risk of wound dehiscence was associated with tobacco use (RR = 3.39, p = 0.022), substance use (RR = 3.07, p = 0.020), and CHF (RR = 12.77, p < 0.001). Risk of implant failure was significantly increased among younger patients with HIV (RR = 4.33, p = 0.026), CHF (RR = 10.54, p < 0.001), and CKD (RR = 10.54, p < 0.001), and among older patients with HTN (RR = 4.51, p = 0.006), CHF (RR = 5.83, p < 0.001), and tobacco use (RR = 3.82, P = 0.001). CONCLUSION Patients undergoing ORIF of the ankle should be well-informed of the potential risks of surgery as they pertain to specific comorbidities. Multidisciplinary approaches are warranted for appropriate management of patients with multiple comorbidities.
Collapse
Affiliation(s)
- Haley M McKissack
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| | - Gean C Viner
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| | - Aaradhana J Jha
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| | - John T Wilson
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| | - Matthew C Anderson
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| | - Gerald McGwin
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| | - Ashish B Shah
- Division of Orthopaedic Surgery, Department of Surgery, University of Alabama, Birmingham, School of Medicine, 1313 13th Street South, Suite 226, Birmingham, Alabama, 35205, USA.
| |
Collapse
|
5
|
Association of abnormal serum electrolyte levels with hypertension in a population with high salt intake. Public Health Nutr 2019; 22:1635-1645. [DOI: 10.1017/s1368980019000260] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractObjectiveThe present epidemiological study aimed to evaluate the association of serum electrolyte levels with hypertension in a population with a high-salt diet.DesignSecondary analysis of epidemiology data from the Northeast China Rural Cardiovascular Health Study conducted in 2012–2013. Blood pressure and hypertension status were analysed for association with serum sodium, potassium, chloride, total calcium, phosphate and magnesium levels using regression models.SettingHigh-salt diet, rural China.ParticipantsAdult residents in Liaoning, China.ResultsIn total 10 555 participants were included, of whom 3287 had incident hypertension (IH) and 1655 had previously diagnosed hypertension (PDH). Fifty-six per cent of participants had electrolyte disturbance. Sixty-two per cent of hypercalcaemic participants had hypertension, followed by hypokalaemia (56 %) and hypernatraemia (54 %). Only hypercalcaemia showed significant associations with both IH (OR=1·70) and PDH (OR=2·25). Highest serum calcium quartile had higher odds of IH (OR=1·58) and PDH (OR=1·64) than the lowest quartile. Serum sodium had no significant correlation with hypertension. Serum potassium had a U-shaped trend with PDH. Highest chloride quartile had lower odds of PDH than the lowest chloride quartile (OR=0·65). Highest phosphate quartile was only associated with lower odds of IH (OR=0·75), and the higher magnesium group had significantly lower odds of IH (OR=0·86) and PDH (OR=0·77).ConclusionsWe have shown the association of serum calcium, magnesium and chloride levels with IH and/or PDH. In the clinical setting, patients with IH may have concurrent electrolyte disturbances, such as hypercalcaemia, that may indicate other underlying aetiologies.
Collapse
|
6
|
|
7
|
Bislev LS, Langagergaard Rødbro L, Bech JN, Pedersen EB, Kjaergaard AD, Ladefoged SA, Rolighed L, Sikjaer T, Rejnmark L. The effect of vitamin D3 supplementation on markers of cardiovascular health in hyperparathyroid, vitamin D insufficient women: a randomized placebo-controlled trial. Endocrine 2018; 62:182-194. [PMID: 30043092 DOI: 10.1007/s12020-018-1659-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 06/19/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Emerging data supports an association between parathyroid hormone (PTH) and aldosterone. It has been speculated, that potential adverse cardiovascular effects of vitamin D insufficiency may partly be caused by the development of secondary hyperparathyroidism with increased activity of the renin-angiotensin-aldosterone system (RAAS). We aimed to investigate the effect of normalizing vitamin D status and/or reducing PTH levels on RAAS activity and other markers of cardiovascular health. METHODS In a double-blinded study during wintertime, we randomized 81 healthy postmenopausal women with secondary hyperparathyroidism (PTH > 6.9 pmol/l) and 25-hydroxy-vitamin D (25(OH)D) levels < 50 nmol/l to 12 weeks of treatment with vitamin D3 70 µg/day (2800 IU/day) or identical placebo. Markers of cardiovascular health were defined as changes in the plasma RAAS, glycated hemoglobin, lipids, and lipoproteins, blood pressure, vascular stiffness, heart rate, and cardiac conductivity. RESULTS Compared to placebo, vitamin D3 treatment significantly increased plasma levels of 25(OH)D and 1,25(OH)2D by 230% (95% CI: 189-272%) and 58% (190-271%), respectively. Vitamin D3 treatment reduced PTH by 17% (11-23%), but did not reduce RAAS activity. Compared to placebo, vitamin D3 treatment increased plasma levels of high-density lipoproteins (HDL) by 4.6% (0.12-9.12%), but did not affect other measured indices. CONCLUSIONS Vitamin D3 supplementation normalized vitamin D levels and reduced PTH. The supplement increased levels of HDL, but had no effects on RAAS activity or other indices of cardiovascular health.
Collapse
Affiliation(s)
- Lise Sofie Bislev
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | | | - Jesper Nørgaard Bech
- University Clinic in Nephrology and Hypertension, Hospital Unit West: Holstebro Hospital, Aarhus University, Holstebro, Denmark
| | - Erling Bjerregaard Pedersen
- University Clinic in Nephrology and Hypertension, Hospital Unit West: Holstebro Hospital, Aarhus University, Holstebro, Denmark
| | - Alisa D Kjaergaard
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lars Rolighed
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Otolaryngology, Aarhus University Hospital, 8000, Aarhus C, Denmark
| | - Tanja Sikjaer
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
8
|
Shang W, Li Y, Ren Y, Yang Y, Li H, Dong J. Nephrolithiasis and risk of hypertension: a meta-analysis of observational studies. BMC Nephrol 2017; 18:344. [PMID: 29187160 PMCID: PMC5708110 DOI: 10.1186/s12882-017-0762-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 11/17/2017] [Indexed: 11/30/2022] Open
Abstract
Background Observational studies have demonstrated an association between nephrolithiasis and hypertension. The aim of this meta-analysis was to summarize all available evidence. Methods PubMed, EMBASE, the Cochrane Central Register of Controlled Trials databases, and the reference lists of relevant articles were searched to identify observational studies that reported study-specific risk estimates comparing the risk of hypertension in patients with nephrolithiasis. We used a random-effect model to pool the study-specific risk estimates. We also assessed the potential heterogeneity by subgroup analyses, meta-regression analyses, and sensitivity analyses. Results A total of 7 articles including 9 studies (n = 313,222 participants) were eventually identified in this meta-analysis. In comparison with the patients who did not have nephrolithiasis, nephrolithiasis significantly increased the risk of hypertension (OR, 1.43; 95% CI, 1.30–1.56), with significant heterogeneity between these studies (I2 = 83.5%, P <0.001). The heterogeneity reduced in subgroups of cohort studies, USA, large sample size trials, men, and adjustment for confounding factors ≥ 5. Sensitivity analysis further demonstrated the results to be robust. Conclusions Nephrolithiasis is associated with increased risk of hypertension. Future randomized, high-quality clinical trials are encouraged to definitively clarify the relationship between nephrolithiasis and hypertension, which may influence clinical management and primary prevention of hypertension in nephrolithiasis patients. Electronic supplementary material The online version of this article (10.1186/s12882-017-0762-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Weifeng Shang
- Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yuanyuan Li
- Department of Respiratory Medicine, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yali Ren
- Department of Medical Affaires, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Yi Yang
- Department of Nephrology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hua Li
- Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Junwu Dong
- Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
| |
Collapse
|
9
|
Li C, Zeng Y, Tao L, Liu S, Ni Z, Huang Q, Wang Q. Meta-analysis of hypertension and osteoporotic fracture risk in women and men. Osteoporos Int 2017; 28:2309-2318. [PMID: 28447105 DOI: 10.1007/s00198-017-4050-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED The present meta-analysis synthesized evidence from 10 articles encompassing 28 independent studies to verify the association between hypertension and osteoporotic fracture risk in women and men. Our results indicate that the risk of osteoporotic fracture among individuals with hypertension was higher than that among individuals without hypertension. INTRODUCTION Epidemiological studies have suggested that hypertension is related to osteoporotic fracture. However, discrepancies exist in the reported findings. In this study, a systematic review of relevant published articles was conducted to verify the association between hypertension and osteoporotic fracture risk in women and men. METHODS PubMed (1953_October 5th, 2016) and Embase (1974_October 5th, 2016) were systematically searched for relevant articles. Odds ratios (ORs) and confidence intervals (CIs) were derived using random effect models. Categorical, subgroup, heterogeneity, publication bias, and meta-regression analyses were conducted. RESULTS We analyzed 10 articles encompassing 28 independent studies, 1,430,431 participants, and 148,048 osteoporotic fracture cases. The risk of osteoporotic fracture among individuals with hypertension was higher (pooled OR = 1.33, 95% CI 1.25-1.40; I 2 = 72.3%, P < 0.001) than that among individuals without hypertension. The association between hypertension and fracture risk was slightly stronger in women (pooled OR = 1.52, 95% CI 1.30-1.79) than in men (pooled OR = 1.35, 95% CI 1.26-1.44). Studies conducted in Asia revealed results that were consistent with those of studies performed in Europe. CONCLUSIONS Hypertension is associated with osteoporotic fracture risk. However, the biological mechanisms underlying the effect of hypertension on osteoporotic fracture remain to be elucidated.
Collapse
Affiliation(s)
- C Li
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Y Zeng
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - L Tao
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - S Liu
- Hospital Infection Management Office, PUAI Hospital, Wuhan, 430032, China
| | - Z Ni
- Women and Children Medical Center of Jiang-an District, Wuhan, 430017, China
| | - Q Huang
- Department of Medical Rehabilitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Q Wang
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
10
|
Nikolis L, Seideman C, Palmer LS, Singer P, Chorny N, Frank R, Infante L, Sethna CB. Blood pressure and urolithiasis in children. J Pediatr Urol 2017; 13:54.e1-54.e6. [PMID: 27720363 DOI: 10.1016/j.jpurol.2016.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/01/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Urolithiasis is a condition that is most commonly found in adults, but is becoming increasingly prevalent in children. Little is known about the relationship between blood pressure (BP) and urolithiasis in children. OBJECTIVES The aim was to evaluate the relationship between urolithiasis and BP, and to determine the association of BP with 24-h urine parameters in children. METHODS We retrospectively analyzed BP and 24-h urine data from children <18 years with and without urolithiasis from 2004 to 2015 at a single tertiary center. Children with a diagnosis of non-glomerular hematuria without history of urolithiasis were chosen as the control group. Non-stone formers were excluded if they presented with any abnormal 24-h urine data or kidney disease. Casual BP, BP index (BPi), and 24-h urine parameters were compared between groups using t-tests. Multiple regression analyses adjusting for age, sex and body mass index (BMI) z-score evaluated the association of BP with urolithiasis and urine electrolytes. RESULTS The urolithiasis group (N = 71) was significantly older, taller and heavier than the non-stone former group (N = 53) (Table). Systolic BP and diastolic BP in stone formers were significantly greater than in non-stone formers, respectively (p = 0.019). Additionally, systolic BPi was significantly higher in the urolithiasis group (p = 0.03) but there was no significant difference in diastolic BPi (p = 0.45). Urolithiasis was a significant predictor of systolic BPi in the adjusted model (β = 0.04, 95% CI 0.001-0.07). In stone formers, systolic BP and systolic BPi were directly associated with 24-h urine sodium, oxalate/1.73 m2, and uric acid (all p < 0.05). Urine calcium was not associated with any BP parameter. DISCUSSION The findings are consistent with previous studies in adults that examined the correlation between blood pressure and kidney stones. The results of this study also showed that blood pressure was positively associated with urine sodium, oxalate, and uric acid. Interestingly, contrary to adult literature, our hypothesis which postulated that blood pressure would be associated with an increase in urine calcium was not supported by our findings. The small sample size is a study limitation and the use of healthy controls as a comparison would have been ideal. CONCLUSIONS Blood pressure was directly associated with urolithiasis children. Greater BP values were also associated with abnormalities in 24-h urine oxalate, uric acid, and sodium values. Interestingly, BP was not associated with urine calcium in this population.
Collapse
Affiliation(s)
- Louis Nikolis
- Department of Pediatrics, Division of Nephrology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Casey Seideman
- Department of Pediatrics, Division of Urology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Lane S Palmer
- Department of Pediatrics, Division of Urology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Pamela Singer
- Department of Pediatrics, Division of Nephrology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Nataliya Chorny
- Department of Pediatrics, Division of Nephrology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Rachel Frank
- Department of Pediatrics, Division of Nephrology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Lulette Infante
- Department of Pediatrics, Division of Nephrology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA
| | - Christine B Sethna
- Department of Pediatrics, Division of Nephrology, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA.
| |
Collapse
|
11
|
Abstract
Purpose Calcium, which is one the most abundant mineral elements in the body, has been suggested to be involved in blood pressure regulation. We aimed to assess the association of active serum calcium (which is the ionised and physiologically active form of serum calcium) with the future risk of hypertension. Methods The active serum calcium concentration was assessed at baseline in the Finnish Kuopio Ischemic Heart Disease population-based prospective cohort study of 1562 normotensive men aged 42-61 years at baseline. Cox proportional hazard models were used to assess the hazard ratios (95% confidence intervals (CIs)) for incident hypertension. Results During a median follow-up of 24.9 years, 247 men developed new-onset hypertension. Active serum calcium was inversely associated with incident hypertension in an approximately linear fashion. In age-adjusted analysis, the hazard ratio for hypertension per 1 standard deviation increase in active serum calcium was 0.86 (95% CI 0.76-0.98), which remained consistent after adjustment for several established risk factors and potential confounders 0.82 (0.71-0.94). In a comparison of extreme quintiles of active serum calcium levels, the corresponding adjusted hazard ratios were 0.59 (95% CI 0.39-0.90) and 0.54 (95% CI 0.35-0.82), respectively. Conclusion Active serum calcium is protective of future hypertension in a middle-aged male Caucasian population. Further research is needed to confirm these findings and help unravel the mechanistic pathways of calcium in the pathogenesis of hypertension.
Collapse
Affiliation(s)
| | - Jari A Laukkanen
- 2 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,3 Central Finland Central Hospital, Jyväskylä, Finland
| |
Collapse
|
12
|
Lind L, Lithell H, Wenglc B, Wrege U, Ljunghall S. A Pilot Study of Metabolic Effects of Intravenously Given Alpha-Calcidol In Patients With Chronicc Renal Failure. ACTA ACUST UNITED AC 2016; 22:219-22. [DOI: 10.1080/00365599.1988.11690415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Lars Lind
- Departments of Internal Medicine, Gävle County Hospital and the Institutions of Geriatrics and Internal Medicine, University Hospital, Uppsala, Sweden
| | - Hans Lithell
- Departments of Internal Medicine, Gävle County Hospital and the Institutions of Geriatrics and Internal Medicine, University Hospital, Uppsala, Sweden
| | - Bo Wenglc
- Departments of Internal Medicine, Gävle County Hospital and the Institutions of Geriatrics and Internal Medicine, University Hospital, Uppsala, Sweden
| | - Ulf Wrege
- Departments of Internal Medicine, Gävle County Hospital and the Institutions of Geriatrics and Internal Medicine, University Hospital, Uppsala, Sweden
| | - Sverker Ljunghall
- Departments of Internal Medicine, Gävle County Hospital and the Institutions of Geriatrics and Internal Medicine, University Hospital, Uppsala, Sweden
| |
Collapse
|
13
|
Wu X, Al-Abedalla K, Eimar H, Arekunnath Madathil S, Abi-Nader S, Daniel NG, Nicolau B, Tamimi F. Antihypertensive Medications and the Survival Rate of Osseointegrated Dental Implants: A Cohort Study. Clin Implant Dent Relat Res 2016; 18:1171-1182. [DOI: 10.1111/cid.12414] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/15/2016] [Accepted: 01/22/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Xixi Wu
- Department of Dentistry, Faculty of Dentistry; McGill University; Montreal QC Canada
| | - Khadijeh Al-Abedalla
- Department of Dentistry, Faculty of Dentistry; McGill University; Montreal QC Canada
| | - Hazem Eimar
- Department of Dentistry, Faculty of Dentistry; McGill University; Montreal QC Canada
| | | | - Samer Abi-Nader
- Department of Dentistry, Faculty of Dentistry; McGill University; Montreal QC Canada
| | - Nach G. Daniel
- Private practice, East Coast Oral Surgery; Moncton NB Canada
| | - Belinda Nicolau
- Department of Dentistry, Faculty of Dentistry; McGill University; Montreal QC Canada
| | - Faleh Tamimi
- Department of Dentistry, Faculty of Dentistry; McGill University; Montreal QC Canada
| |
Collapse
|
14
|
Kovshilovskaya B, Chi T, Miller J, Stoller ML. Systemic implications of urinary stone disease. Transl Androl Urol 2016; 1:89-96. [PMID: 26816692 PMCID: PMC4708212 DOI: 10.3978/j.issn.2223-4683.2012.06.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Urinary stone disease is the third most common condition affecting the urinary tract. It contributes to a great deal of morbidity for both men and women, and cost the United States (US) over 5.3 billion dollars in 2000 alone. Moreover, it is associated with systemic diseases such as hypertension, diabetes, and other components of the metabolic syndrome. Reciprocally, these systemic diseases may be contributing to the rising incidence in urinary stone disease. Previously described mechanisms of stone formation attribute stone development and growth to the urinary milieu. While this may partly influence the process, it cannot account for the associations between systemic diseases and stones observed in large community-based studies. Here we present a review of the evidence demonstrating a link between urinary stone disease and components of the metabolic syndrome. We believe a vascular etiology for the initiation of urinary stones may tie these processes together.
Collapse
Affiliation(s)
- Bogdana Kovshilovskaya
- University of California, San Francisco, Department of Urology, 400 Parnassus Ave, 6 Floor Urology Clinics, Box 0638, San Francisco, CA 94143, USA
| | - Thomas Chi
- University of California, San Francisco, Department of Urology, 400 Parnassus Ave, 6 Floor Urology Clinics, Box 0638, San Francisco, CA 94143, USA
| | - Joe Miller
- University of California, San Francisco, Department of Urology, 400 Parnassus Ave, 6 Floor Urology Clinics, Box 0638, San Francisco, CA 94143, USA
| | - Marshall L Stoller
- University of California, San Francisco, Department of Urology, 400 Parnassus Ave, 6 Floor Urology Clinics, Box 0638, San Francisco, CA 94143, USA
| |
Collapse
|
15
|
Bone Strength and Arterial Stiffness Impact on Cardiovascular Mortality in a General Population. J Osteoporos 2016; 2016:7030272. [PMID: 27047700 PMCID: PMC4800107 DOI: 10.1155/2016/7030272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/06/2016] [Accepted: 02/14/2016] [Indexed: 11/29/2022] Open
Abstract
Osteoporosis and increased arterial stiffness independently have been found to be associated with higher cardiovascular events rates in the general population (GP). We examined 558 patients from GP by dual-energy X-ray absorptiometry (DXA) and pulse wave velocity (PWV) measurements at baseline, with 36-month follow-up period. DXA assessed bone mineral density of femoral neck (BMD FN) and lumbar spine (BMD LS). Carotid-femoral PWV was assessed by pulsed-Doppler. The aim of our study is to find correlation between bone strength and arterial stiffness and their impact on cardiovascular mortality in GP. The mean ± SD of BMD FN, BMD LS, and PWV was 0.852 ± 0.1432 g/cm(2), 0.934 ± 0.1546 g/cm(2), and 9.209 ± 1.9815 m/s. In multiple regression analysis we found BMD FN (βst = -6.0094, p < 0.0001), hypertension (βst = 1.7340, p < 0.0091), and diabetes (βst = 0.4595, p < 0.0046). With Cox-regression analysis, after 17 cardiovascular events, the significant covariates retained by the backward model were BMD FN (b = -2.4129, p = 0.015) and PWV (b = 0.2606, p = 0.0318). The cut-off values were PWV = 9.4 m/s, BMD FN = 0.783 g/cm(2), and BMD LS = 0.992 g/cm(2). The results for BMD FN and PWV hazard ratio risk were 1.116 and 1.297, respectively. BMD FN as a measure of bone strength and PWV as a measure of arterial stiffness are strong independent predictors of cardiovascular mortality in GP.
Collapse
|
16
|
|
17
|
Ma ZP, Liao JC, Zhao C, Cai DZ. Effects of the 1, 4-dihydropyridine L-type calcium channel blocker benidipine on bone marrow stromal cells. Cell Tissue Res 2015; 361:467-76. [DOI: 10.1007/s00441-015-2115-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 01/05/2015] [Indexed: 12/22/2022]
|
18
|
Singh M, Singh P, Singh S, Juneja PK, Kaur T. A susceptibility haplotype within the endothelial nitric oxide synthase gene influences bone mineral density in hypertensive women. J Bone Miner Metab 2014; 32:580-7. [PMID: 24213141 DOI: 10.1007/s00774-013-0533-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/14/2013] [Indexed: 10/26/2022]
Abstract
The influence of the coordinated effect of various single-nucleotide polymorphisms (SNPs) within the endothelial nitric oxide synthase (eNOS) gene on the risk of osteoporosis in hypertension has remained undetermined. Four pertinent SNPs of the eNOS gene, rs2070774, rs1799983, rs1800780 and rs3918181, were examined for the risk of osteoporosis in 313 hypertensive postmenopausal women in Northwest India. All the hypertensive women were verified with dual energy X-ray absorptiometry and categorized as 150 with osteoporosis and 163 without osteoporosis. The minor allele (T) of rs1799983 exerts a statistically significant risk for osteoporosis both in dominant [odds ratio (OR) 3.71, 95 % confidence interval (CI) 2.12-6.49, P < 0.001] and recessive mode (OR 5.75, 95 % CI 1.24-26.69, P = 0.036) after Bonferroni correction. Bone mineral density (BMD) values (corrected for the effects of risk variables) according to eNOS SNP genotypes revealed a significant association with rs1799983 at both the lumbar spine (P = 0.001) and femoral neck (P = 0.023). Risk association analyses revealed a susceptibility haplotype TTAG which influences the risk of osteoporosis (OR 2.02, 95 % CI 1.05-3.39, P = 0.042) in hypertension after adjusting for the effects of risk factors. Furthermore, this haplotype was significantly associated with BMD at the lumbar spine (P = 0.029) and femoral neck (P = 0.021) in a dose-dependent manner. The results suggest that possession of the TTAG haplotype of the eNOS gene may increase the risk of osteoporosis two-fold in hypertensive postmenopausal women in Northwest India.
Collapse
Affiliation(s)
- Monica Singh
- Molecular Genetics Laboratory, Department of Human Genetics, Punjabi University, Patiala, 147002, Punjab, India
| | | | | | | | | |
Collapse
|
19
|
Yang S, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Association between hypertension and fragility fracture: a longitudinal study. Osteoporos Int 2014; 25:97-103. [PMID: 23892585 DOI: 10.1007/s00198-013-2457-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Hypertension is an independent risk factor for osteoporosis and osteoporotic fracture in postmenopausal women. INTRODUCTION Although hypertension has been suggested to be associated with increased fracture risk, it is not clear whether the association is independent of bone mineral density (BMD). The present study sought to examine the interrelationships between hypertension, BMD, and fracture risk. METHODS The study included 1,032 men and 1,701 women aged 50 years and older who were participants in the Dubbo Osteoporosis Epidemiology Study. BMD at the femoral neck and lumbar spine was measured by dual energy X-ray absorptiometry (GE-LUNAR Corp., Madison, WI, USA). The presence of hypertension was ascertained by direct interview and verification through clinical history. The incidence of fragility fractures was ascertained by X-ray report during the follow-up period (1989-2008). The Cox proportional hazards model was used to assess the association between hypertension and fracture risk. RESULTS Women with hypertension had lower BMD at the femoral neck (0.79 versus 0.82 g/cm(2), P = 0.02) than those without the disease. After adjusting for BMD and covariates, hypertension was an independent risk factor for fragility fracture [hazard ratio (HR), 1.49; 95% CI, 1.13-1.96]. In men, hypertension was associated with higher femoral neck BMD (0.94 versus 0.92 g/cm(2), P = 0.02), but the association between hypertension and fracture risk did not reach statistical significance. CONCLUSION Hypertension is associated with increased fracture risk in women, and the association is independent of BMD.
Collapse
Affiliation(s)
- S Yang
- Division of Musculoskeletal Diseases, Garvan Institute of Medical Research, 384 Victoria Street, Sydney, New South Wales, 2010, Australia
| | | | | | | | | |
Collapse
|
20
|
Abstract
The pathophysiology of the various forms of urinary stone disease remains a complex topic. Epidemiologic research and the study of urine and serum chemistries have created an abundance of data to help drive the formulation of pathophysiologic theories. This article addresses the associations of urinary stone disease with hypertension, cardiovascular disease, atherosclerosis, obesity, dyslipidemia, diabetes, and other disease states. Findings regarding the impact of dietary calcium and the formation of Randall's plaques are also explored and their implications discussed. Finally, further avenues of research are explored, including genetic analyses and the use of animal models of urinary stone disease.
Collapse
Affiliation(s)
- Herman Singh Bagga
- Department of Urology, University of California San Francisco, San Francisco, CA 94143-0738, USA.
| | | | | | | |
Collapse
|
21
|
Sashidhara KV, Kumar M, Khedgikar V, Kushwaha P, Modukuri RK, Kumar A, Gautam J, Singh D, Sridhar B, Trivedi R. Discovery of coumarin-dihydropyridine hybrids as bone anabolic agents. J Med Chem 2012; 56:109-22. [PMID: 23214410 DOI: 10.1021/jm301281e] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The concept of molecular hybridization led us to discover a novel series of coumarin-dihydropyridine hybrids that have potent osteoblastic bone formation in vitro and that prevent ovariectomy-induced bone loss in vivo. In this context, among all the compounds screened for alkaline phosphatase activity, four compounds 10, 14, 18, and 22 showed significant activity at picomolar concentrations. A series of other in vitro data strongly suggested compound 18 as the most promising bone anabolic agent, which was further evaluated for in vivo studies. From these studies compound 18 proved to be useful, which at low oral dose of 1 (mg/kg)/day body weight increased bone mass density and volume, expression of osteogenic genes (RUNX2, BMP-2, and ColI), bone formation rate (BFR), and mineral apposition rate (MAR), improved the trabecular microarchitecture, and decreased bone turn over markers in an ovariectomized rodent model for postmenopausal osteoporosis.
Collapse
Affiliation(s)
- Koneni V Sashidhara
- Medicinal and Process Chemistry Division, CSIR-Central Drug Research Institute-CSIR-CDRI, Lucknow 226001, India.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Javed F, Khan SA, Ayers EW, Aziz EF, Akram MS, Nadkarni GN, Sabharwal MS, Ahmad Z, Benjo AM, Herzog E. Association of hypertension and bone mineral density in an elderly African American female population. J Natl Med Assoc 2012; 104:172-8. [PMID: 22774384 DOI: 10.1016/s0027-9684(15)30140-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Recent studies have shown that hypertension is inversely correlated with bone mineral density (BMD) as determined by dual energy x-ray absorptiometery (DXA) in different ethnic groups. But in most published studies, either the sample size was small or the study was limited by different measurement methods. These limitations leave this association controversial and inconclusive. The current study utilizes a sample of African American females referred for clinical screening of osteoporosis in our center to find out if any association of high blood pressure and BMD in this ethnic group exists. The secondary endpoint was to determine the effect of thiazide diuretics on BMD of the elderly African American females because, theoretically, thiazides are considered to have a positive impact on BMD. METHODS In this retrospective, cross-sectional study, 10 years of data were reviewed from 1113 medical records of African American females aged 65 years and older whose BMD values were measured by DXA at the lumbar spine (L1-L4) and both femoral necks (the standard sites for BMD determination) along with their T scores and Z scores (used to determine osteopenia vs osteoporosis). Our exclusion criteria included patients who: (1) were current smokers, (2) had a previous oophorectomy, (3) had a history of corticosteroid use, (4) had a history of biphosphonate use, (5) were on hormone replacement therapy, and (6) were diabetic and taking either pioglitazones or roziglitazones. A total of 148 patients were excluded from the analysis due to either incomplete data or exclusion criteria. The remaining sample was then divided into 2 groups based on their hypertensive status. For the subanalysis, the hypertensive group was further divided into 2 additional groups based on their thiazide usage. RESULTS We had complete data on 965 participants, of which 631 (65.3%) had a history of hypertension and 334 (34.7%) did not. Out of 631 hypertensive patients, 173 were found to be using thiazide diuretics as antihypertensive medication, while 458 were without thiazide diurectic use. The proportion of patients with both osteopenia and osteoporosis was similar in those with and without hypertension (50% vs 50%, p = .95 for osteopenia; 18% vs 19%, p = .95 for osteoporosis). There was no significant difference between the BMD at the lumbar spine, and right and left femoral necks between patients with and without hypertension. This lack of association held true when comparing the mean T scores and Z scores at the above sites. Within patients with a history of hypertension, there were no significant differences in the BMD, T score or Z score at any site with and without a history of thiazide diuretic use. CONCLUSION Hypertension in elderly African American females aged at least 65 years was not found to be correlated with low BMD at either the lumbar spine (L1-L4) or both femoral necks when confounding factors were taken into consideration. Mean BMD of the hypertensive cohort taking thiazide diuretics was found lower at the lumbar spine as compared to the hypertensive patients not taking thiazide diuretics.
Collapse
Affiliation(s)
- Fahad Javed
- St Luke's-Roosevelt Hospital Center, University Hospital of Columbia University College of Physician and Surgeons, New York, NY 10025, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Sabanayagam C, Shankar A. Serum calcium levels and hypertension among U.S. adults. J Clin Hypertens (Greenwich) 2011; 13:716-21. [PMID: 21974758 DOI: 10.1111/j.1751-7176.2011.00503.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Serum calcium levels have been shown to be associated with cardiovascular disease (CVD); however, it is not clear whether serum calcium levels are related to hypertension, a risk factor for CVD. The authors examined the association between serum calcium and hypertension in a representative sample of US adults. A cross-sectional study of 12,405 third National Health and Nutrition Examination Survey participants 20 years and older was conducted. Serum total and ionized calcium levels were analyzed as quartiles. The main outcome of interest was hypertension (n=3437), defined as self-reported use of antihypertensive medication and/or systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg. Elevated serum total calcium levels were positively associated with hypertension, independent of potential confounders including C-reactive protein, estimated glomerular filtration rate, serum albumin, 25(OH)D, and phosphorous. Compared with the lowest quartile of serum total calcium (referent category), the multivariable odds ratio (95% confidence interval) of hypertension was 1.49 (1.15-1.93) for the highest quartile (P=.005). This association persisted in subgroup analyses stratified by sex, age, and race-ethnicity. In contrast, serum ionized calcium levels were not associated with hypertension. Higher serum total calcium levels are positively associated with hypertension in a representative sample of U.S. adults.
Collapse
Affiliation(s)
- Charumathi Sabanayagam
- Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV 26506-9190, USA
| | | |
Collapse
|
24
|
Yazici S, Yazici M, Korkmaz U, Engin Erkan M, Erdem Baki A, Erden I, Ozhan H, Ataoğlu S. Relationship between blood pressure levels and bone mineral density in postmenopausal Turkish women. Arch Med Sci 2011; 7:264-70. [PMID: 22291766 PMCID: PMC3258724 DOI: 10.5114/aoms.2011.22077] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Revised: 08/10/2010] [Accepted: 09/09/2010] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION We investigated the association between bone mineral density (BMD) detected by dual-energy X-ray absorptiometric (DXA) method and blood pressure (BP) in a large sample of postmenopausal women. MATERIAL AND METHODS The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 ±8.8 years, who were screened for osteopenia or osteoporosis by DXA. Patients with hypertension (HT, n= 306) were compared with normotensive (NT, n = 290) individuals. Bone mineral density results for the femur neck and spine were classified into 3 groups according to World Health Organization criteria: normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD) and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were grouped as having low bone mass (LBM). RESULTS There were no significant differences in femur T score, femur BMD, femur Z score, spinal T score, spinal BMD and spinal Z score between hypertensive and normotensive groups. The group of patients with low bone mass calculated from femur T scores had higher age, systolic BP, duration of hypertension and duration of menopause, but lower BMI. Similarly, patients with low spine BMD had higher age and duration of menopause, but lower BMI. Linear regression analysis showed a significant correlation between systolic BP and femur BMD and T score values. Furthermore, logistic regression analysis revealed that hypertension is an independent predictor of spinal osteopenia and osteoporosis. CONCLUSIONS The presence of hypertension is an independent predictor of spinal low bone density in Turkish women after menopause.
Collapse
Affiliation(s)
- Selma Yazici
- Department of Physical Medicine and Rehabilitation, Düzce University Medical Faculty, Düzce, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Schaeffer AJ, Feng Z, Trock BJ, Mathews RI, Neu AM, Gearhart JP, Matlaga BR. Medical comorbidities associated with pediatric kidney stone disease. Urology 2010; 77:195-9. [PMID: 20970831 DOI: 10.1016/j.urology.2010.06.062] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 06/25/2010] [Accepted: 06/29/2010] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To characterize the relationship between pediatric kidney stone disease and the presence of hypertension (HTN), diabetes mellitus (DM), and obesity. In adults, kidney stone disease has been associated with medical comorbidities such as HTN, DM, and obesity. Similar analyses have never been performed for the pediatric population. METHODS The 2003 and 2006 Kids' Inpatient Databases were queried to identify subjects treated for kidney stone disease ("International Classification of Diseases" codes 9592.0 and 592.1). The comorbidities of HTN, DM, and obesity were identified using the provided comorbidity software. The risk of kidney stone disease associated with age, sex, and comorbidity status was evaluated using multivariate logistic regression. RESULTS A total of 6,115,443 subjects were evaluated. Of these, 14,245 (0.2%) had a diagnosis of upper tract calculus (4092 boys and 10,045 girls, sex unavailable for 108). Age was the strongest independent predictor of stone risk (P < .0001). HTN was associated with a significantly increased risk of stone diagnosis in children ≤10 years old and DM for children ≤5 years old. Stone risk was not affected by obesity in any age group. CONCLUSIONS The results of our study have shown that kidney stone disease is significantly associated with age among all children and both HTN and DM for young children. Although exploratory, these findings are novel and suggest that kidney stone disease among young children might be associated with nonrenal, systemic disease states.
Collapse
Affiliation(s)
- Anthony J Schaeffer
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | | | | | | | | | | | | |
Collapse
|
26
|
Aribi M, Merzouk H, Haddouche M, Benyoucef M, Taleb A, Kendouci-Tani M, Merzouk SA, Meziane A. Clinical evaluation of lipids, lipoproteins and red blood cells sodium and potassium in patients with different grades of hypertension. Clin Biochem 2010; 43:942-7. [DOI: 10.1016/j.clinbiochem.2010.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 05/18/2010] [Accepted: 05/19/2010] [Indexed: 01/05/2023]
|
27
|
Marini F, Brandi ML. Genetic determinants of osteoporosis: common bases to cardiovascular diseases? Int J Hypertens 2010; 2010:394579. [PMID: 20948561 PMCID: PMC2949079 DOI: 10.4061/2010/394579] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 02/07/2010] [Indexed: 01/18/2023] Open
Abstract
Osteoporosis is the most common and serious age-related skeletal disorder, characterized by a low bone mass and bone microarchitectural deterioration, with a consequent increase in bone fragility and susceptibility to spontaneous fractures, and it represents a major worldwide health care problem with important implications for health care costs, morbidity and mortality. Today is well accepted that osteoporosis is a multifactorial disorder caused by the interaction between environment and genes that singularly exert modest effects on bone mass and other aspects of bone strength and fracture risk. The individuation of genetic factors responsible for osteoporosis predisposition and development is fundamental for the disease prevention and for the setting of novel therapies, before fracture occurrence. In the last decades the interest of the Scientific Community has been concentrated in the understanding the genetic bases of this disease but with controversial and/or inconclusive results. This review tries to summarize data on the most representative osteoporosis candidate genes. Moreover, since recently osteoporosis and cardiovascular diseases have shown to share common physiopathological mechanisms, this review also provides information on the current understanding of osteoporosis and cardiovascular diseases common genetic bases.
Collapse
Affiliation(s)
- Francesca Marini
- Department of Internal Medicine, University of Florence, Viale Pieraccini, 6, 50139 Florence, Italy
| | | |
Collapse
|
28
|
Tseng YH, Huang KC, Liu ML, Shu WT, Sheu WHH. Association between metabolic syndrome (MS) and bone mineral loss: a cross-sectional study in Puli Township in Taiwan. Arch Gerontol Geriatr 2009; 49 Suppl 2:S37-40. [DOI: 10.1016/s0167-4943(09)70011-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
29
|
Covi G, Corsato M, Paluani F, Marcolongo A, Minuz P, Lechi A. Reduced Urinary Excretion of Calcium in Pregnancy-Induced Hypertension: Relationship to Renal Prostaglandin Excretion. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/10641959009072252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
30
|
Lind L, Wengle B, Ljunghall S. Blood pressure is lowered by vitamin D (alphacalcidol) during long-term treatment of patients with intermittent hypercalcaemia. A double-blind, placebo-controlled study. ACTA MEDICA SCANDINAVICA 2009; 222:423-7. [PMID: 3321926 DOI: 10.1111/j.0954-6820.1987.tb10959.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
There is epidemiologic evidence of a relationship between calcium deficiency and hypertension. The present study evaluated the effects of alphacalcidol, a synthetic analogue of active vitamin D, given to 29 patients with marginal, intermittent hypercalcaemia. Before therapy there was an inverse relationship between serum calcium levels and diastolic blood pressure (p less than 0.02). Treatment with 1 microgram alphacalcidol raised the serum calcium by 0.07 mmol/l during a 6-month, double-blind, placebo-controlled trial and caused a significant reduction of diastolic blood pressure by 9.2 mmHg compared with placebo (p less than 0.01). The study extends previous observations, in normocalcaemic subjects, of inverse relationships between serum calcium and blood pressure indicating a primary disturbance of calcium homeostasis in hypertension. The observation that a physiologic amount of active vitamin D has hypotensive effects agrees with such a concept and suggests a new principle for the treatment of hypertension.
Collapse
Affiliation(s)
- L Lind
- Department of Internal Medicine, Gävle County Hospital, Uppsala, Sweden
| | | | | |
Collapse
|
31
|
Hvarfner A, Ljunghall S, Mörlin C, Wide L, Bergström R. Indices of mineral metabolism in relation to blood pressure in a sample of a healthy population. ACTA MEDICA SCANDINAVICA 2009; 219:461-8. [PMID: 3017054 DOI: 10.1111/j.0954-6820.1986.tb03340.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Indices of mineral metabolism in blood and urine were analysed in relation to blood pressure in 97 healthy subjects aged 16-82 years. In a multivariate analysis, after allowing for the effects of sex, body mass index (BMI) and age, there was an inverse relationship between plasma level of ionized calcium and mean blood pressure (MBP) (beta = -50.0 mmHg/mmol/l P-ionized calcium, p = 0.0005). In univariate analyses MBP also showed statistically significant inverse relationships with plasma ionized calcium, serum phosphate and renal threshold concentration of phosphate; positive relationships to MBP were found for fasting urinary excretion of calcium and cyclic adenosine monophosphate. However, when examined multivariately, only the relation between MBP and plasma ionized calcium persisted. This study supports previous findings of an inverse relationship between blood pressure and serum ionized calcium and extends the observations to the physiological range. It is further evident from this study that BMI and age should be taken into account in analyses of the relationship between blood pressure and mineral metabolism.
Collapse
|
32
|
Vestergaard P, Rejnmark L, Mosekilde L. Hypertension is a risk factor for fractures. Calcif Tissue Int 2009; 84:103-11. [PMID: 19067019 DOI: 10.1007/s00223-008-9198-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2008] [Accepted: 11/07/2008] [Indexed: 10/21/2022]
Abstract
To study the effects of hypertension and other cardiovascular risk factors on risk of fractures, we carried out a case-control study including 124,655 fracture cases and 373,962 age- and gender-matched controls. The main exposure was hypertension, stroke, acute myocardial infarction, ischemic heart disease, atrial fibrillation, peripheral arterial disease, and deep venous thromboembolism, and the main confounders were use of diuretics, antihypertensive drugs, organic nitrates, vitamin K antagonists, and cholesterol lowering drugs along with other confounders. Hypertension and stroke were the only significant risk factors in both the short-term (OR = 1.27, 95% CI = 1.20-1.34 and 1.24, and 95% CI = 1.16-1.31 for < or = 3 years since diagnosis of hypertension and stroke, respectively) and the long-term (OR = 1.11, 95% CI = 1.00-1.23 and 1.09, and 95% CI = 1.02-1.18 for > 6 years since diagnosis of hypertension and stroke, respectively) perspective. Acute myocardial infarction, atrial fibrillation, and deep venous thromboembolism were all associated with a transient increase in the risk of fractures within the first 3 years following diagnosis. Peripheral arterial disease and ischemic heart disease were not associated with an increased risk of fractures. In conclusion, hypertension and stroke seem to be the major cardiovascular risk factors for fractures, whereas acute myocardial infarction, atrial fibrillation, and deep venous thromboembolism seem to be only minor risk factors. The fracture risk in hypertension may explain why antihypertensive drugs as a class effect are associated with a decreased risk of fractures. These drugs may counter some of the deleterious effects of high blood pressure.
Collapse
Affiliation(s)
- Peter Vestergaard
- Department of Endocrinology and Metabolism C, The Osteoporosis Clinic, Aarhus Amtssygehus, Aarhus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, Denmark.
| | | | | |
Collapse
|
33
|
Effect of successful parathyroidectomy on 24-hour ambulatory blood pressure in patients with primary hyperparathyroidism. Int J Cardiol 2008; 142:15-21. [PMID: 19117619 DOI: 10.1016/j.ijcard.2008.12.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 12/06/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The pathogenesis of hypertension in patients with primary hyperparathyroidism (PHPT) is unclear, and the prevailing opinion is that parathyroidectomy does not affect the blood pressure (BP). Most previous studies have been based on BP measurements at rest in a clinical setting. The aim of this study was to get additional information by 24-hour ambulatory measurements. DESIGN AND PATIENTS Forty-nine consecutive patients with PHPT (age 63+/-12 years, 44 women) were examined before and 6 months after curative parathyroid surgery. MEASUREMENTS Serum concentrations of calcium and PTH, and 24-hour ambulatory mean, minimum, and maximum systolic (S) and diastolic BP, and mean arterial BP. RESULTS On average, the patients showed no BP change after parathyroidectomy. However, those with a history of hypertension (n=20) showed generally increased BP values after parathyroidectomy, with significantly increased minimum and average SBP (P=0.02 and P=0.04, respectively), whereas patients without a history of hypertension (n=29) showed unchanged or slightly reduced BP values after parathyroidectomy, with significantly decreased maximum SBP (P=0.04). Serum concentrations of PTH and calcium were not significantly related to any of the BP variables measured. CONCLUSIONS The novel finding that patients with both PHPT and hypertension may show increased BP after parathyroidectomy warrants intensified BP control postoperatively in these patients, and motivates early treatment of PHPT in order to prevent the development of complicating hypertension.
Collapse
|
34
|
Abstract
PURPOSE OF REVIEW Nephrolithiasis is a prominent public health issue. It imposes a substantial burden on human health and is a considerable financial expenditure for the nation. Numerous epidemiologic studies have shown a significant association between nephrolithiasis, obesity, hypertension and chronic kidney disease. The review highlights many of those emerging studies and sheds light on the importance of our recognition of kidney stones as a systemic illness. RECENT FINDINGS Several cross-sectional retrospective studies have investigated the relationship between kidney stones and the metabolic syndrome. The various silent features of the metabolic syndrome, including type 2 diabetes, increased BMI, hypertension and dyslipidemia, are becoming progressively more recognized and independently associated with an increased risk of kidney stone formation. SUMMARY Our further understanding of the underlying mechanisms in the connection between nephrolithiasis and the metabolic syndrome will stimulate the development of more effective preventive and therapeutic measures.
Collapse
|
35
|
Obligado SH, Goldfarb DS. The association of nephrolithiasis with hypertension and obesity: a review. Am J Hypertens 2008; 21:257-64. [PMID: 18219300 DOI: 10.1038/ajh.2007.62] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Kidney stones affect hypertensive patients disproportionately compared to normotensive individuals. On the other hand, some prospective data suggest that a history of nephrolithiasis was associated with a greater tendency to develop hypertension. Newer epidemiologic data also link obesity and diabetes, features of the metabolic syndrome, with nephrolithiasis. In this review, the association of hypertension, diabetes, and obesity with nephrolithiasis is reviewed, and possible pathogenic mechanisms are discussed. Patients with hypertension may have abnormalities of renal calcium metabolism, but data confirming this hypothesis are inconsistent. Higher body mass index and insulin resistance (i.e., the metabolic syndrome) may be etiologic in uric acid nephrolithiasis as increasing body weight is associated with decreasing urinary pH. The possibility that common pathophysiologic mechanisms underly these diseases is intriguing, and if better understood, could potentially lead to better therapies for stone prevention. Both hypertension and stones might be addressed through lifestyle modification to prevent weight gain. Adoption of a lower sodium diet with increased fruits and vegetables and low-fat dairy products, (for example, the dietary approaches to stop hypertension(DASH) diet), may be useful to prevent both stones and hypertension. In those patients in whom dietary modification and weight loss are ineffective, thiazide diuretics are likely to improve blood pressure control and decrease calciuria.
Collapse
|
36
|
Halici Z, Borekci B, Ozdemir Y, Cadirci E, Suleyman H. Protective effects of amlodipine and lacidipine on ovariectomy-induced bone loss in rats. Eur J Pharmacol 2008; 579:241-5. [DOI: 10.1016/j.ejphar.2007.09.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Accepted: 09/26/2007] [Indexed: 10/22/2022]
|
37
|
Abstract
Based on the premise that elevated blood pressure and low bone mass have both been associated with poor Ca nutriture and disturbances in Ca metabolism, a cross-sectional study was employed to determine if blood pressure and dietary Ca intake were significantly related to bone mass. Forty-seven men between 24–77 years of age with blood pressure values ranging from normal to mildly elevated comprised the study group. Blood pressure was measured with a random-zero sphygmomanometer. Bone mineral content (BMC) and density (BMD) of the hip, spine and total body were measured with dual-photon absorptiometry. Dietary intake and physical activity were also assessed. Multiple linear regression analysis was used for statistical analysis. After adjusting for known confounding variables (age, BMI, Ca intake, and others) diastolic blood pressure was negatively related to BMC (P ≤ 0·05) and BMD (P ≤ 0·01) of the total body, trochanteric region (P < 0·01) and Ward's triangle (P < 0·05), and to BMC of the femoral neck (P < 0·05) and lumbar spine, although the latter was just shy of statistical significance (P = 0·058). Systolic blood pressure was negatively related to trochanteric BMD (P = 0·04) and BMC (P = 0·06). Ca intake was positively related to total body BMD (P = 0·005), and BMC of the lumbar spine (P = 0·05). In this population of men, Ca intake was a positive predictor, and blood pressure was a negative predictor of regional measures of bone mass. These findings support the concept that independent of age, BMI and Ca intake, elevated blood pressure varies indirectly with bone mass and density, known predictors of osteoporotic fractures. Future studies are needed to determine whether elevated blood pressure is causally related to the development of low bone mass, and what role dietary Ca plays in that pathway.
Collapse
|
38
|
Afghani A, Goran MI. Lower bone mineral content in hypertensive compared with normotensive overweight Latino children and adolescents. Am J Hypertens 2007; 20:190-6. [PMID: 17261466 PMCID: PMC1852456 DOI: 10.1016/j.amjhyper.2006.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Revised: 07/21/2006] [Accepted: 07/27/2006] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND In adults, hypertension has been shown to be inversely correlated with bone mineral content (BMC); however, the association between blood pressure (BP) and BMC has not been studied in pediatrics. METHODS Total body BMC of 187 overweight (mean BMI = 28.7 kg/m(2)) Latino children and adolescents (mean age = 11.2 years) were measured using dual-energy x-ray absorptiometry. Seated systolic BP (SBP) and diastolic BP (DBP) were measured using a standard mercury sphygmomanometer. Hypertension was defined by SBP or DBP above the 90(th) percentile for height, age, and sex. RESULTS Partial correlations revealed an inverse association between SBP and BMC (r = -0.24, P = 0.02) in boys (n = 105); results were nonsignificant (P = 0.27) in girls (n = 82). There were no significant correlations between DBP and BMC. When BMI and insulin sensitivity were adjusted for, hypertensive boys (n = 21) had lower BMC (1435 v 1636 g; P = 0.03) than normotensive boys (n = 84); similarly, hypertensive girls (n = 25) had lower BMC (1438 v 1618 g; P = 0.02) than normotensive girls (n = 57). In postpubertal adolescents (Tanner stage 4-5; n = 48), inverse correlations were stronger (r = -0.40, P = 0.007); results were nonsignificant in prepubertal and pubertal children (Tanner stage 1-3; n = 139, P = 0.57). In postpubertal girls (n = 37), there were no significant correlations (P = 0.14); inverse correlations in postpubertal boys (n = 11) became markedly stronger (r = -0.80, P = 0.02). CONCLUSION Based on the study findings, SBP is inversely correlated with BMC in overweight adolescents; additionally, hypertensive subjects have lower adjusted means of BMC than normotensive subjects. These promising new findings suggest that hypertension may be a risk factor for osteopenia in overweight children and adolescents; this risk may be exacerbated in postpubertal boys.
Collapse
Affiliation(s)
- Afrooz Afghani
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
| | | |
Collapse
|
39
|
Taylor EN, Mount DB, Forman JP, Curhan GC. Association of prevalent hypertension with 24-hour urinary excretion of calcium, citrate, and other factors. Am J Kidney Dis 2006; 47:780-9. [PMID: 16632016 DOI: 10.1053/j.ajkd.2006.01.024] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2005] [Accepted: 01/31/2006] [Indexed: 02/02/2023]
Abstract
BACKGROUND The relation between hypertension and the urinary excretion of calcium, citrate, and other factors is unclear. It has been proposed that increased urinary calcium excretion is a central feature of essential hypertension. Metabolic acidosis also may be associated with hypertension and decreases urinary citrate levels. METHODS To compare the urine composition of individuals with and without hypertension, we studied 24-hour urinary excretion of calcium, citrate, oxalate, uric acid, sodium, magnesium, potassium, phosphorus, and creatinine and pH in a subset of participants with and without nephrolithiasis in the Nurses' Health Study I (older women; N = 1,284), Nurses' Health Study II (younger women; N = 952), and the Health Professionals Follow-up Study (men; N = 788). Logistic regression models adjusted for age, weight, dietary intake, and urinary factors. RESULTS In participants with and without nephrolithiasis, citrate was the only urinary factor consistently related to hypertension. Compared with those in the lowest quartile of urinary citrate excretion, multivariate odds ratios of prevalent hypertension in the highest quartile were 0.37 (95% confidence interval [CI], 0.24 to 0.55; P trend < 0.001) for older women, 0.54 (95% CI, 0.32 to 0.92; P trend = 0.03) for younger women, and 0.27 (95% CI, 0.16 to 0.45; P trend < 0.001) for men. Urinary calcium levels were not related consistently to hypertension. Excluding participants with single 24-hour urine collections and those administered thiazide diuretics or angiotensin-converting enzyme inhibitors did not change the results. CONCLUSION Lower urinary citrate excretion is associated independently with prevalent hypertension. Factors that regulate urinary citrate excretion may play a role in hypertension.
Collapse
Affiliation(s)
- Eric N Taylor
- Renal Division, Department of Medicine, Brigham Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | | | | | | |
Collapse
|
40
|
Gillen DL, Coe FL, Worcester EM. Nephrolithiasis and increased blood pressure among females with high body mass index. Am J Kidney Dis 2005; 46:263-9. [PMID: 16112044 DOI: 10.1053/j.ajkd.2005.04.030] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Accepted: 04/18/2005] [Indexed: 11/11/2022]
Abstract
BACKGROUND We hypothesized that one reason for the heterogeneity in previously reported links between kidney stones and blood pressure (BP) was the differential effects of nephrolithiasis among subgroups of individuals. In particular, we hypothesized that the association between stone history and BP may vary with respect to sex and body size. METHODS Data from the Third National Health and Nutrition Examination Survey were used to estimate the association between history of stone disease and odds of prior diagnosis of hypertension and mean difference in systolic BP, diastolic BP, and pulse pressure. Nine hundred nineteen persons with a history of stones and 19,120 persons without stones were available for analysis. RESULTS In women, it was estimated that stone formers (SFs) experienced a 69% increase in odds of self-reported hypertension (95% confidence interval [CI], 1.33 to 2.17; P < 0.001). No significant difference was found in men. The estimated difference in mean systolic and diastolic BP comparing SFs with non-SFs increased with body mass index in both sexes, but was more pronounced in women. Mean systolic BPs in women SFs in quintiles 4 and 5 of body mass index were 7.62 mm Hg (95% CI, 1.04 to 14.2; P = 0.024) and 4.36 mm Hg (95% CI, 0.30 to 8.42; P = 0.036) greater than those in similar women non-SFs, respectively. CONCLUSION Our findings not only support the link between kidney stone disease and BP, but also suggest that overweight women SFs may be at significantly increased risk for hypertension.
Collapse
Affiliation(s)
- Daniel L Gillen
- Department of Statistics, University of California, Irvine, CA 92697-1250, USA.
| | | | | |
Collapse
|
41
|
Thierry-Palmer M, Cephas S, Sayavongsa P, Doherty A, Arnaud SB. Dahl salt-sensitive rats develop hypovitaminosis D and hyperparathyroidism when fed a standard diet. Bone 2005; 36:645-53. [PMID: 15784187 DOI: 10.1016/j.bone.2005.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2004] [Revised: 01/19/2005] [Accepted: 01/24/2005] [Indexed: 11/29/2022]
Abstract
The Dahl salt-sensitive rat (S), a model for salt-sensitive hypertension, excretes protein-bound 25-hydroxyvitamin D (25-OHD) into urine when fed a low salt diet. Urinary 25-OHD increases during high salt intake. We tested the hypothesis that continuous loss of 25-OHD into urine would result in low plasma 25-OHD concentration in mature S rats raised on a standard diet. Dahl S and salt-resistant (R) male rats were raised to maturity (12-month-old) on a commercial rat diet (1% salt) and switched to 0.3% (low) or 2% (high) salt diets 3 weeks before euthanasia. Urine (24 h) was collected at the end of the dietary treatments. Urinary 25-OHD and urinary 25-OHD binding activity of S rats were three times that of R rats, resulting in lower plasma 25-OHD and 24,25-dihydroxyvitamin D concentrations in S rats than in R rats (P < 0.001). Plasma parathyroid hormone concentrations of S rats were twice that of R rats. S rats fed 2% salt had higher plasma 1,25-dihydroxyvitamin D concentrations than those fed 0.3% salt (P = 0.002). S rats excreted more calcium into urine than R rats (P < 0.001) and did not exhibit the expected calciuric response to salt. Proteinuria of the S rats was three times that of the R rats, suggesting kidney damage in the S rats. Low plasma 25-OHD and 24,25-dihydroxyvitamin D and high plasma 1,25-dihydroxyvitamin D and PTH concentrations seen in the mature S rats have also been reported for elderly patients with low-renin (salt-induced) hypertension. An implication of this study is that low vitamin D status may occur with age in salt-sensitive individuals, even when salt intake is normal.
Collapse
Affiliation(s)
- Myrtle Thierry-Palmer
- Department of Biochemistry, Morehouse School of Medicine, Atlanta, GA 30310-1495, USA.
| | | | | | | | | |
Collapse
|
42
|
McCarron DA, Reusser ME. Diet: Micronutrients. Hypertension 2005. [DOI: 10.1016/b978-0-7216-0258-5.50132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
43
|
Gotoh M, Mizuno K, Ono Y, Takahashi M. High Blood Pressure, Bone-Mineral Loss and Insulin Resistance in Women. Hypertens Res 2005; 28:565-70. [PMID: 16335884 DOI: 10.1291/hypres.28.565] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Increasing evidence indicates that high blood pressure is associated with abnormalities in calcium metabolism. Sustained calcium loss may lead to increased bone-mineral loss in subjects with elevated blood pressure. Furthermore, recent findings indicate a possible linkage between abnormal calcium metabolism and insulin resistance. In the present study, we investigated the relationship(s) among bone-mineral density (BMD), blood pressure, calcium-related and bone metabolic parameters (plasma intact parathyroid hormone (I-PTH), 1,25-dihydroxyvitamin D [1,25(OH)2D], osteocalcin, and urinary deoxypyridinoline), and insulin resistance, as assessed by a conventional homeostasis model (HOMA-R). We compared non-diabetic women with essential hypertension (WHT, n=34) with age-, body mass index- and menopause (yes or no)-matched normotensive, non-diabetic women (WNT, n=34). The BMD for WHT was significantly lower than that for WNT (0.596+/-0.019 vs. 0.666+/-0.024 g/cm2, p<0.05). The BMD was correlated inversely with systolic blood pressure in all subjects examined (r=-0.385, p<0.05). The 24-h urinary calcium/sodium excretion ratio (Ux-Ca/Na) was significantly greater in WHT compared with WNT (p<0.01). In addition, a negative relationship was apparent between Ux-Ca/Na and BMD (r=-0.58, p<0.05). The plasma levels of PTH and 1,25(OH)2D, and HOMA-R were significantly higher in WHT compared with WNT (p<0.01, p<0.05, and p<0.05, respectively), whereas the serum ionized calcium was lower in WHT compared with WNT (p<0.05). There were no significant differences in serum total calcium, inorganic phosphorus, osteocalcin, or urinary deoxypyridinoline between the two groups. These results indicate that high blood pressure is associated with abnormalities in calcium metabolism and insulin resistance in WHT.
Collapse
Affiliation(s)
- Mitsuhiro Gotoh
- From the Department of Internal Medicine, Fukushima Rosai Hospital, Iwaki, Japan.
| | | | | | | |
Collapse
|
44
|
Larijani B, Bekheirnia MR, Soltani A, Khalili-Far A, Adibi H, Jalili RB. Bone mineral density is related to blood pressure in men. Am J Hum Biol 2004; 16:168-71. [PMID: 14994316 DOI: 10.1002/ajhb.20005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to determine the relationships between bone mineral density (BMD) and blood pressure in 214 men, age 20-76. BMD measurements were done by dual X-ray absorptiometry using a Lunar DPXMD densitometer at the lumbar spine (L2-L4) and different femoral regions. Systolic (SBP) and diastolic (DBP) blood pressure were measured using an MPC-350 sphygmomanometer. Physicians gathered demographic data and participants' dietary intake of calcium were determined by using food frequency questionnaires. After adjusting for age, body mass index, dietary calcium, and exercise history, multiple linear regression models showed that DBP was negatively related to femoral neck BMD (beta = -0.145, P = 0.032) and just shy of significant association with femoral neck BMC (beta = -0.114, P = 0.079). SBP was correlated with femoral neck (r = -0.171, P = 0.012) and Ward's (r = -0.186, P = 0.006) BMD but not after adjusting for possible confounders. Further studies are needed to determine whether elevated blood pressure is causally related to the development of low bone mass.
Collapse
Affiliation(s)
- Bagher Larijani
- Endocrinology and Metabolism Research Center, Division of Bone Metabolism, Tehran, Iran.
| | | | | | | | | | | |
Collapse
|
45
|
|
46
|
Tisler A, Pierratos A, Honey JD, Bull SB, Rosivall L, Logan AG. High urinary excretion of uric acid combined with high excretion of calcium links kidney stone disease to familial hypertension. Nephrol Dial Transplant 2002; 17:253-9. [PMID: 11812875 DOI: 10.1093/ndt/17.2.253] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Past studies identified an association between kidney stone disease (KSD) and hypertension. We recently reported a high occurrence of hypertension in families of patients with hyperuricosuric KSD. As hypercalciura frequently coexists with hyperuricosuria and high urinary excretion of calcium is found in patients with hypertension, we hypothesized that hyperuricosuria that is accompanied by hypercalciuria better describes the familial association between KSD and hypertension. METHODS Four hundred and eighty-six KSD patients, aged 18-50 years, attending a lithotripsy unit collected a 24-h urine sample for metabolic analysis and provided information on family history of hypertension. The familial occurrence of hypertension was compared among four groups of patients: those who had combined elevation of both urinary calcium and uric acid excretions ("combined" abnormality, n=56), those who had hyperuricosuria without concomitant hypercalciuria ("pure" hyperuricosuria, n=67), those who had hypercalciuria without concomitant hyperuricosuira ("pure" hypercalciuria, n=52), and a control KSD patient group ("other" abnormality, n=311). The prevalence of treated hypertension in patients from the four groups was 16%, 12%, 2%, 10%, respectively. RESULTS Thirty-four per cent of the patients with the "combined" abnormality had a positive family history of hypertension, defined as two or more first-degree relatives with treated hypertension, that was significantly higher than in patients with either "pure" hyperuricosuira (15%, P<0.02), "pure" hypercalciuria (8%, P<0.001), or patients with "other" abnormality (10%, P<0.001). The adjusted OR for positive family history of hypertension in the "combined" abnormality group compared to the control KSD patient group was 5.6 (2.39-13.30). The prevalence of hypertension in siblings of patients with the "combined" abnormality (13%) was significantly higher than in siblings of patients with either "pure" hyperuricosuria (3%, P<0.001), "pure" hypercalciuria (1%, P<0.001), or siblings of control patients with "other" abnormality (4%, P<0.001). The adjusted OR for hypertension in siblings of a patient with "combined" abnormality compared to a control KSD patient was 3.4 (1.97-5.91). Patients in the "combined" abnormality group were also characterized by significantly elevated urinary sodium, phosphorus, citrate and potassium excretions. CONCLUSIONS Our data suggest that there is a strong, independent association between familial occurrence of hypertension and the phenotype characterized by combined elevation of both urinary uric acid and calcium excretions. The association is not present in those with "pure" hyperuricosuria or "pure" hypercalciuria. Ascertainment of patients based on this phenotype may identify more homogeneous populations for genetic analysis of hypertension.
Collapse
Affiliation(s)
- Andras Tisler
- First Department of Medicine, Semmelweis University, 2/a Koranyi S.u., H-1083 Budapest, Hungary.
| | | | | | | | | | | |
Collapse
|
47
|
Strazzullo P, Barba G, Vuotto P, Farinaro E, Siani A, Nunziata V, Galletti F, Mancini M, Cappuccio FP. Past history of nephrolithiasis and incidence of hypertension in men: a reappraisal based on the results of the Olivetti Prospective Heart Study. Nephrol Dial Transplant 2001; 16:2232-5. [PMID: 11682673 DOI: 10.1093/ndt/16.11.2232] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND We have previously reported that in the Olivetti Prospective Heart Study cohort the incidence of nephrolithiasis was higher in hypertensive participants than in normotensive ones. As the time sequence and the mechanisms underlying the association between nephrolithiasis and hypertension remain controversial, we further tested the hypothesis that in a cohort of normotensive males a history of nephrolithiasis predicts the development of future hypertension. METHODS The analysis was conducted in 381 male workers at Olivetti who were normotensive at the baseline examination and who were re-examined 8 years later. RESULTS A past history of nephrolithiasis is associated with an increased risk of hypertension of 1.96 (95% CI=1.25-3.07) relative to subjects with a negative history, after adjusting for age. CONCLUSION In this 8-year follow-up study, a history of nephrolithiasis resulted in an increased risk of developing hypertension in the future. As the reverse was also true, as previously reported, a clear-cut time sequence, as well as the mechanisms linking these two conditions, remain to be identified.
Collapse
Affiliation(s)
- P Strazzullo
- Department of Clinical and Experimental Medicine, Unit of Clinical Genetics and Pharmacology, Hypertension and Mineral Metabolism, Federico II University Medical School, Naples, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Nishiya Y, Sugimoto S. Effects of various antihypertensive drugs on the function of osteoblast. Biol Pharm Bull 2001; 24:628-33. [PMID: 11411549 DOI: 10.1248/bpb.24.628] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several studies have suggested that high blood pressure is associated with the risk of bone loss. Since various antihypertensive drugs are in wide use for the treatment of hypertension, it is important to investigate the influences of these drugs on bone metabolism. Osteoblasts play a pivotal role in the regulation of bone formation. During differentiation, they sequentially express type I collagen, alkaline phosphatase (ALP), other bone matrix proteins, and finally undergo mineral deposition. In this study, we examined the effects of various antihypertensive drugs on the function of osteoblast using clonal MC3T3-E1 cells. Drugs examined include dihydropyridine-type calcium channel blockers (benidipine, amlodipine, and nifedipine), angiotensin-converting enzyme (ACE) inhibitors (captopril, lisinopril, and enalapril), and angiotensin II receptor type1 (AT1) antagonists (TCV-116 and KW-3433). None of the ACE inhibitors or AT1 antagonists affected ALP activity or cellular DNA content significantly. In contrast, benidipine, amlodipine, and nifedipine increased ALP activity when used in amounts 1 pM, 100 nM, and 100 nM, respectively. Benidipine blocked calcium influx through the L-type voltage dependent calcium channel of MC3T3-E1 more potently than amlodipine or nifedipine. These calcium channel blockers did not change collagen accumulation. Benidipine significantly increased in vitro mineralization at a concentration of 1 nM and higher, while amlodipine did so at 1 microM and nifedipine did not. Comparison of the effective concentration of each calcium channel blocker in our study with the reported maximum serum concentration of each drug suggests that benidipine, but not amlodipine or nifedipine, promotes mineral deposition in human.
Collapse
Affiliation(s)
- Y Nishiya
- Tokyo Research Laboratories, Kyowa Hakko Kogyo Co., Ltd., Machida, Japan
| | | |
Collapse
|
49
|
Haenni A, Reneland R, Lind L, Lithell H. Serum aldosterone changes during hyperinsulinemia are correlated to body mass index and insulin sensitivity in patients with essential hypertension. J Hypertens 2001; 19:107-12. [PMID: 11204289 DOI: 10.1097/00004872-200101000-00014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To measure the effects of hyperinsulinemia on serum electrolyte status and associated hormones, and on serum free fatty acid (FFA) concentrations, in patients with essential hypertension. DESIGN AND METHODS The serum electrolyte status (Na, K, Ca, ionized Ca, Mg, P, pH) and associated hormones [plasma renin activity (PRA), serum parathyroid hormone (PTH) and aldosterone concentrations], and FFA were measured during an euglycemic hyperinsulinemic clamp test in 49 patients with untreated essential hypertension. RESULTS Serum potassium, phosphate, PTH, and FFA concentrations decreased during hyperinsulinemia, while serum ionized calcium concentration, pH, and PRA increased significantly (P < 0.05). The changes in serum potassium and magnesium were both inversely related to the insulin-mediated glucose uptake (r= -0.62, P< 0.0001; r= -0.31, P< 0.05, respectively). Both body mass index (BMI) and insulin-mediated glucose disposal were significantly correlated to the changes in serum aldosterone concentration during hyperinsulinemia (r = 0.41, P < 0.01; r = -0.40, P < 0.01, respectively). The change in serum aldosterone during the clamp test was not significantly related to the change in PRA, but tended to correlate to the change in potassium concentration (r= 0.25, P= 0.10). A less pronounced reduction in FFA during induced hyperinsulinemia was associated with low insulin sensitivity (r= -0.35, P< 0.05). CONCLUSION Hypertensive patients with normal BMI and a more pronounced glucose uptake showed a larger serum potassium decline and lowered aldosterone concentrations during induced euglycemic hyperinsulinemia. Insulin-resistant patients showed a less pronounced reduction in FFA during hyperinsulinemia. The observations in the present study may indicate that alterations in aldosterone and FFA metabolism might be linked to the insulin resistance metabolic syndrome.
Collapse
Affiliation(s)
- A Haenni
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Sweden.
| | | | | | | |
Collapse
|
50
|
Abstract
The dietary guidelines established under the auspices of public health policy are intended to promote healthy diets in the general public. The current recommendations for sodium intake stem from studies and publications that are older than much of the public they are designed to benefit. The past 2 decades have seen a dramatic increase in our knowledge of nutritional science, particularly our understanding of the role of sodium in blood pressure regulation. With a myriad of data from observational studies and randomized, controlled trials, we have the information to finally put sodium into its correct context in terms of its role in the regulation of blood pressure and hypertension. Not the sole and pervasive dietary villain it was once believed to be, sodium is but one factor in the complex interplay of multiple, inextricably related regulatory systems of which hypertension is the end result. With the data now available concerning dietary sodium, including the minimal and specific blood pressure effects of sodium in normotensive adults and both the benefits and risks of sodium reduction, future public health recommendations can be based on carefully acquired, consistent, and rational science.
Collapse
Affiliation(s)
- D A McCarron
- Divisions of Nephrology, Hypertension, and Clinical Pharmacology, the Department of Medicine, Oregon Health Sciences University, Portland, USA.
| |
Collapse
|