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Xie H, Fan XF, Shuai WH, Zhong GY. The association between serum folate and elderly diastolic hypertension: results from the NHANES (2007-2018). Blood Press 2024; 33:2380002. [PMID: 39018205 DOI: 10.1080/08037051.2024.2380002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/09/2024] [Indexed: 07/19/2024]
Abstract
AIM To explore the association between serum folate concentration and the prevalence of elderly diastolic hypertension. This study aims to identify potential relationships that could inform further research into the mechanisms underlying hypertension management. METHODS Data from six NHANES cycles (2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018) were analysed for individuals aged over 60. Weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and restricted cubic spline (RCS) regression explored the serum folate concentration and elderly diastolic hypertension relationship. RESULTS This study included 9,419 participants (4,734 females and 4,685 males) with a mean age of 70.0 ± 7.0 years. Among them, 360 were diagnosed with diastolic hypertension. In the fully adjusted model, there was a negative correlation between serum folate concentration and the prevalence of diastolic hypertension (OR 0.65; 95% CI: 0.52-0.82). When serum folate concentration levels were divided into quartiles (in μg/dL), the ORs for diastolic hypertension corresponding to Q2 (1.29-1.98), Q3 (1.99-3.08), and Q4 (3.09-5.56) levels compared to Q1 (0.18-1.28) were 1.41 (95% CI: 0.60-3.33), 0.48(95% CI: 0.20-1.16), and 0.35 (95% CI: 0.16-0.74), respectively, with a P for trend <.05. Restricted cubic spline plots showed a negative correlation between serum folate concentration and the prevalence of diastolic hypertension (non-linearity: p = .495). Subgroup analysis indicated that the negative correlation between serum folate concentration and the prevalence of diastolic hypertension was more significant in female participants (interaction p = .009). CONCLUSION Higher serum folate concentration is associated with a lower prevalence of diastolic hypertension in the elderly.
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Affiliation(s)
- Hong Xie
- Department of General Medicine, Zigong Fourth People's Hospital, Zigong, Sichuan, P.R. China
| | - Xiao-Feng Fan
- Department of Cardiology, Zigong Fourth People's Hospital, Zigong, Sichuan, P.R. China
| | - Wen-Huan Shuai
- Department of Cardiology, Zigong Fourth People's Hospital, Zigong, Sichuan, P.R. China
| | - Gui-You Zhong
- Department of Cardiology, Zigong Fourth People's Hospital, Zigong, Sichuan, P.R. China
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Juraschek SP, Vyavahare M, Cluett JL, Turkson-Ocran RA, Mukamal KJ, Ishak AM. Comparison of Home and Office Blood Pressure Devices in the Clinical Setting. Am J Hypertens 2024; 37:342-348. [PMID: 38150380 PMCID: PMC11016832 DOI: 10.1093/ajh/hpad120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/02/2023] [Accepted: 12/17/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Self-measured blood pressure (SMBP) monitoring is increasingly used for remote hypertension management, but the real-world performance of home blood pressure (BP) devices is unknown. We examined BP measurements from patients' home devices using the American Medical Association's (AMA) SMBP Device Accuracy Test tool. METHODS Patients at a single internal medicine clinic underwent up to five seated, same-arm BP readings using a home device and an automated BP device (Omron HEM-907XL). Following the AMA's three-step protocol, we used the patient's home device for the first, second, and fourth measurements and the office device for the third and fifth (if needed) measurements. Device agreement failure was defined as an absolute difference in systolic BP >10 mm Hg between the home and office devices in either of two confirmatory steps. Performance was examined by brand (Omron vs. non-Omron). Moreover, we examined patient factors associated with agreement failure via logistic regression models adjusted for demographic characteristics. RESULTS We evaluated 152 patients (mean age 60 ± 15 years, 58% women, 31% Black) seen between October 2020 and November 2021. Device agreement failure occurred in 22.4% (95% CI: 16.4%, 29.7%) of devices tested, including 19.1% among Omron devices and 27.6% among non-Omron devices (P = 0.23). No patient characteristics were associated with agreement failure. CONCLUSIONS Over one-fifth of home devices did not agree based on the AMA SMBP device accuracy protocol. These findings confirm the importance of office-based device comparisons to ensure the accuracy of home BP monitoring.
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Affiliation(s)
- Stephen P Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Healthcare Associates, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Medha Vyavahare
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer L Cluett
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Healthcare Associates, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Ruth-Alma Turkson-Ocran
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Healthcare Associates, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Anthony M Ishak
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Healthcare Associates, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Pizano-Zarate ML, Torres-Ramos YD, Morales-Hernandez RM, Ramirez-Gonzalez MC, Hernandez-Trejo M. Are Overweight and Obesity Risk Factors for Developing Metabolic Syndrome or Hypertension after a Preeclamptic Event? Healthcare (Basel) 2023; 11:2872. [PMID: 37958016 PMCID: PMC10650089 DOI: 10.3390/healthcare11212872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE To identify the determinants and risks associated with developing hypertension and metabolic syndrome in the first year postpartum in women who experienced preeclampsia. METHODS A cohort study was conducted, involving women who had experienced preeclampsia (PE) recently. The control group was women with the same characteristics but a healthy pregnancy. The variables analyzed were somatometry, disease history, pre-pregnancy body mass index (Pre-BMI), and Third Adult Treatment Panel updated (ATP III) metabolic syndrome (MS) data (blood pressure, obesity, triglycerides, high-density lipoproteins, and fasting glucose). These variables were measured at 3, 6, and 12 months postpartum. RESULTS Women with a history of PE exhibited higher systolic and diastolic blood pressure than women without PE. The risk of developing isolated diastolic arterial hypertension at 3 and 12 months of follow-up was two to eight times greater in women with a history of PE. Factors associated with having higher blood pressure levels were preeclampsia, insulin resistance, age, and BMI. Neither the pre-BMI index nor gestational weight gain (GWG) had any effect on blood pressure in any of the three assessments. Women with preeclampsia had a 5- to 8-fold increased risk of developing MS (which could be explained not only by the history of preeclampsia but also by the history of pre-pregnancy obesity). However, PE was not identified as a risk factor at the six-month evaluation and was only explained by pre-pregnancy obesity and overweight. CONCLUSIONS Obesity and overweight, as well as preeclampsia, were strongly associated with the development of hypertension and metabolic syndrome during the first year following childbirth.
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Affiliation(s)
- Maria Luisa Pizano-Zarate
- Department of Nutrition and Bio-Programming, Instituto Nacional de Perinatologia, Montes Urales 800, Ciudad de Mexico 11000, Mexico
| | - Yessica Dorin Torres-Ramos
- Immunobiochemistry Department, Instituto Nacional de Perinatologia, Montes Urales 800, Ciudad de Mexico 11000, Mexico
| | - Rosa Maria Morales-Hernandez
- Department of Nutrition and Bio-Programming, Instituto Nacional de Perinatologia, Montes Urales 800, Ciudad de Mexico 11000, Mexico
| | - Maria Cristina Ramirez-Gonzalez
- Department of Nutrition and Bio-Programming, Instituto Nacional de Perinatologia, Montes Urales 800, Ciudad de Mexico 11000, Mexico
| | - Maria Hernandez-Trejo
- Department of Developmental Neurobiology, Instituto Nacional de Perinatologia, Montes Urales 800, Ciudad de Mexico 11000, Mexico
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Zhang X, Wang X, Wang M, Qu H, Hu B, Li Q. Prevalence, awareness, and treatment of isolated diastolic hypertension in the United States. Eur J Intern Med 2023; 112:93-99. [PMID: 37002149 DOI: 10.1016/j.ejim.2023.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Isolated diastolic hypertension (IDH) is recognized as a risk factor for cardiovascular disease, yet its clinical epidemiology remains poorly understood due to insufficient recognition. This study aims to describe the trend in the prevalence, awareness, and treatment of IDH in the United States from 2001 to 2018. METHODS This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in nine consecutive two-year cycles from 2001-2002 to 2017-2018, comprising a sample of 48,742 adults aged over 18 years. IDH was defined as a diastolic blood pressure ≥ 80 mm Hg with a systolic BP < 130 mm Hg by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. RESULTS In the nationally representative dataset, 8.9% of participants had IDH in 2017-2018, a decreased of 3.6% (95% confidence interval [CI], -2.6% to -5.0%, P<0.0002) since 2001-2002. IDH prevalence was highest among Mexican American (10.5%), individuals aged 40-59 (12.3%), increased with body mass index (BMI) (11.2% among those BMI ≥30.0 kg/m2), and tended to be higher in men (12.3%). A multiple regression analysis showed that men, white race/ethnicity, young and middle-aged people (aged 18-59), and increasing BMI were independently associated with increased risks of IDH. Among IDH patients, there was a modest increase in awareness (P<0.0002), from 22.4% (95%CI, 18.4% to 27.1%) in 2001-2002 to 35.0% (95%CI, 28.2% to 42.5%) in 2017-2018, with the largest percentage increases among non-Hispanic white and men. IDH treatment increased by 7.6% (95%CI, 3.1% to 12.1%) between 2001-2002 and 2017-2018, with the greatest increases occurring in Mexican American and men. CONCLUSION IDH prevalence is decreasing from 2001-2002 to 2017-2018 in the United States. Despite the significantly increased in both awareness and treatment, they remain below 50%.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Miaoran Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | | | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Sheng Z, Lou S, Cao J, Sun W, Shen Y, Xu Y, Ren Z, Liu W, Yi Q, Song P. The associations of obesity phenotypes with the risk of hypertension and its transitions among middle-aged and older Chinese adults. Epidemiol Health 2023; 45:e2023043. [PMID: 37054724 PMCID: PMC10593582 DOI: 10.4178/epih.e2023043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/14/2023] [Indexed: 04/15/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the associations of obesity phenotypes with hypertension stages, phenotypes, and transitions among middle-aged and older Chinese. METHODS Using the 2011-2015 waves of the China Health and Retirement Longitudinal Study, we conducted a cross-sectional analysis included 9,015 subjects and a longitudinal analysis included 4,961 subjects, with 4,872 having full data on the hypertension stage and 4,784 having full data on the hypertension phenotype. Based on body mass index and waist circumstance, subjects were categorized into 4 mutually exclusive obesity phenotypes: normal weight with no central obesity (NWNCO), abnormal weight with no central obesity (AWNCO), normal weight with central obesity (NWCO), and abnormal weight with central obesity (AWCO). Hypertension stages were classified into normotension, pre-hypertension, stage 1 hypertension, and stage 2 hypertension. Hypertension phenotypes were categorized as normotension, pre-hypertension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). The association between obesity phenotypes and hypertension was estimated by logistic regression. A comparison between different sexes was conducted by testing the interaction effect of sex. RESULTS NWCO was associated with normal→stage 2 (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.11 to 3.42), maintained stage 1 (OR, 1.62; 95% CI, 1.14 to 2.29), and normal→ISH (OR, 1.39; 95% CI, 1.05 to 1.85). AWCO was associated with normal→stage 1 (OR, 1.75; 95% CI, 1.40 to 2.19), maintained stage 1 (OR, 2.77; 95% CI, 2.06 to 3.72), maintained stage 2 (OR, 2.80; 95% CI, 1.50 to 5.25), normal→ISH (OR, 1.56; 95% CI, 1.20 to 2.02), and normal→SDH (OR, 2.54; 95% CI, 1.72 to 3.75). An interaction effect of sex existed in the association between obesity phenotypes and hypertension stages. CONCLUSIONS This study highlights the importance of various obesity phenotypes and sex differences in hypertension progression. Tailored interventions for different obesity phenotypes may be warranted in hypertension management, taking into account sex-specific differences to improve outcomes.
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Affiliation(s)
- Ziyue Sheng
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shang Lou
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Cao
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weidi Sun
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaojia Shen
- School of Public Health, Department of Maternal and Child Health, Health Science Centre, Peking University, Beijing, China
| | - Yunhan Xu
- School of Public Health, Department of Maternal and Child Health, Health Science Centre, Peking University, Beijing, China
| | - Ziyang Ren
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Liu
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Lv S, Li Z, Li H, Liu M, Wu Z, Yu S, Wu B, Gao B, Tao L, Luo Y, Li X, Guo X, Liu X. Long-term effects of PM 2.5 components on hypertension: A national analysis in China. ENVIRONMENTAL RESEARCH 2023; 222:115323. [PMID: 36681144 DOI: 10.1016/j.envres.2023.115323] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Evidence is less about the associations between fine particulate matter (PM2.5) components and hypertension. We aimed to examine the long-term effects of PM2.5 components on prevalence of hypertension, diastolic blood pressure (DBP) and systolic blood pressure (SBP). METHODS We included participants between March 1, and July 31, 2021, from 13 provinces in China. Geocoded residential address was used for exposure assignment. Mixed-effect regression was used to assess 3-year average concentrations of PM2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) on prevalence of hypertension, DBP and SBP with covariate-adjusted. SHapley Additive exPlanation was used to compare the contribution of PM2.5 components to hypertension, DBP, and SBP. Sex and age subgroup were also analyzed. RESULTS We enrolled a total of 113,159 participants aged ≥18 years. Long-term exposure to PM2.5 and its components (black carbon, organic matter, nitrate, ammonium, and sulfate) had associations with prevalence of hypertension, with the Odds Ratios and 95% confidence interval (CI) of 1.06 (95%CI: 1.03-1.09), 1.07 (95%CI: 1.04-1.09), 1.07 (95%CI: 1.04-1.10), 1.05 (95%CI: 1.01-1.08), 1.03 (95%CI: 1.00-1.06), and 1.03 (95%CI: 1.00-1.04), respectively. Effects of that except for black carbon on DBP with per interquartile upticks of concentration were 0.23 (95%CI: 0.11-0.35), 0.17 (95%CI: 0.04-0.29), 0.35 (95%CI: 0.21-0.48), 0.40 (95%CI: 0.28-0.52), and 0.25 (95%CI: 0.13-0.26), respectively. Ammonium was associated with SBP, corresponding to an increase of 0.18 (95%CI: 0.01-0.35). Males had higher risks of DBP (Z = 2.54-6.08, P < 0.001). Older people were substantially more affected by PM2.5 and its components. Nitrate showed the highest contribution to hypertension, DBP and SBP compared with other components. CONCLUSIONS Long-term exposure to PM2.5 and its components had adverse consequences on prevalence of hypertension, DBP and SBP, especially for males and older people. Nitrate contributed the highest to hypertension, DBP and SBP. Findings may have implications for pollution and hypertension control.
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Affiliation(s)
- Shiyun Lv
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhiwei Li
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Haibin Li
- Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Mengmeng Liu
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing, China
| | - Zhiyuan Wu
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Siqi Yu
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Binqiang Wu
- School of Public Health, Capital Medical University, Beijing, China
| | - Bo Gao
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lixin Tao
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yanxia Luo
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing, China.
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Chuang HH, Cherng WJ, Lin CH, Lee LA, Hsu KH, Lin RH. Physical fitness mediates and predicts for high blood pressure among children in relation to weight status. Front Public Health 2023; 11:1157351. [PMID: 37143976 PMCID: PMC10151579 DOI: 10.3389/fpubh.2023.1157351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/16/2023] [Indexed: 05/06/2023] Open
Abstract
Background Pediatric hypertension contributes to adulthood hypertension and target organ damage. Obesity is a well-known predictor for pediatric hypertension; however, the relationship between physical fitness and blood pressure (BP) is unclear among children. This study aimed to compare the differences in demographics, anthropometrics, and physical fitness across BP subgroups and investigate whether physical fitness was related to pediatric hypertension independent of weight status. Methods This quantitative, cross-sectional study investigated demographic, anthropometric, physical fitness, and BP measures among 360 healthy school-aged children. Continuous variables were compared across BP subgroups with the one-way analysis of variance. Mediation and moderation analyses were used to explore the mechanism. Multivariable regression models were used to assess independent associations for hypertension. Results There were 177 (49.2%), 37 (10.3%), and 146 (40.6%) children in the normotensive, elevated BP, and hypertensive subgroups, respectively. The hypertensive subgroup had higher body mass index (BMI) and waist/height ratio percentiles and performed worse in 800-m run, standing long jump (SLJ), and 1-min sit-ups than the normotensive subgroup. Furthermore, the 800-m run percentile (total effect: β = 0.308, standard error = 0.044, p < 0.001) and sit and reach percentile (total effect: β = 0.308, standard error = 0.044, p < 0.001) mediated the relationship between the BMI percentile and systolic BP percentile; the SLJ percentile was directly associated with the diastolic BP percentile (β,-0.197, 95% confidence interval,-0.298-0.097; p < 0.001). The parsimonious model of multivariable regression models revealed that the SLJ percentile (adjusted exp (β), 0.992, 95% confidence interval, 0.985-0.999; p = 0.042) and BMI percentile (adjusted exp (β), 1.024, 95% confidence interval, 1.016-1.032; p < 0.001) were two independent predictors for pediatric hypertension. Conclusion Physical fitness mediates the relationship between anthropometric and BP measures. The SLJ percentile is associated with pediatric hypertension independent of the BMI percentile. Proactive screening and health promotion for not only healthy weight status but also good physical fitness may be beneficial for BP control among school-aged students.
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Affiliation(s)
- Hai-Hua Chuang
- Department of Family Medicine, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Wen-Jin Cherng
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Chih-Hung Lin
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Linkou Main Branch, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Ang Lee
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
- Departments of Otorhinolaryngology-Head and Neck Surgery, Linkou Main Branch, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuang-Hung Hsu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Rong-Ho Lin
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan
- *Correspondence: Rong-Ho Lin
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Cheng H, Li G, Dai J, Zhang K, Xu T, Wei L, Zhang X, Ding D, Hou J, Li J, Zhuang J, Tan K, Guo R. A fluid-structure interaction model accounting arterial vessels as a key part of the blood-flow engine for the analysis of cardiovascular diseases. Front Bioeng Biotechnol 2022; 10:981187. [PMID: 36061431 PMCID: PMC9438578 DOI: 10.3389/fbioe.2022.981187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
According to the classical Windkessel model, the heart is the only power source for blood flow, while the arterial system is assumed to be an elastic chamber that acts as a channel and buffer for blood circulation. In this paper we show that in addition to the power provided by the heart for blood circulation, strain energy stored in deformed arterial vessels in vivo can be transformed into mechanical work to propel blood flow. A quantitative relationship between the strain energy increment and functional (systolic, diastolic, mean and pulse blood pressure) and structural (stiffness, diameter and wall thickness) parameters of the aorta is described. In addition, details of blood flow across the aorta remain unclear due to changes in functional and other physiological parameters. Based on the arterial strain energy and fluid-structure interaction theory, the relationship between physiological parameters and blood supply to organs was studied, and a corresponding mathematical model was developed. The findings provided a new understanding about blood-flow circulation, that is, cardiac output allows blood to enter the aorta at an initial rate, and then strain energy stored in the elastic arteries pushes blood toward distal organs and tissues. Organ blood supply is a key factor in cardio-cerebrovascular diseases (CCVD), which are caused by changes in blood supply in combination with multiple physiological parameters. Also, some physiological parameters are affected by changes in blood supply, and vice versa. The model can explain the pathophysiological mechanisms of chronic diseases such as CCVD and hypertension among others, and the results are in good agreement with epidemiological studies of CCVD.
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Affiliation(s)
- Heming Cheng
- Department of Mechanics, Kunming University of Science and Technology, Kunming, China
- *Correspondence: Heming Cheng, ; Ke Zhang,
| | - Gen Li
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Jifeng Dai
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Ke Zhang
- Department of Mechanics, Kunming University of Science and Technology, Kunming, China
- Department of Hydraulic Engineering, Kunming University of Science and Technology, Kunming, China
- *Correspondence: Heming Cheng, ; Ke Zhang,
| | - Tianrui Xu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Liuchuang Wei
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Xue Zhang
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Dongfang Ding
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Jie Hou
- Department of Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Jianyun Li
- Department of Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Jiangping Zhuang
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Kaijun Tan
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, Kunming, China
| | - Ran Guo
- Department of Mechanics, Kunming University of Science and Technology, Kunming, China
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Huang M, Long L, Tan L, Shen A, Deng M, Peng Y, Yang W, Li H, Wei Y, Li M, Liao F, Liu C, Lu A, Qu H, Fu C, Chen K. Isolated Diastolic Hypertension and Risk of Cardiovascular Events: A Systematic Review and Meta-Analysis of Cohort Studies With 489,814 Participants. Front Cardiovasc Med 2022; 8:810105. [PMID: 35071370 PMCID: PMC8766994 DOI: 10.3389/fcvm.2021.810105] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/03/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The association between isolated diastolic hypertension (IDH) and cardiovascular events has been inconsistently reported. This meta-analysis of cohort studies was designed to investigate the effect of the 2018 European Society of Cardiology (ESC) definition of IDH on the risk of composite cardiovascular events, cardiovascular mortality, all-cause mortality, and all strokes including ischemic stroke (IS) and hemorrhagic stroke (HS). Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to July 6, 2021. Cohort studies that investigated the association between IDH and cardiovascular events risk, compared to normotension, were included. Pooled hazard ratios (HRs) and 95% CIs were calculated using a random-effects models and heterogeneity was evaluated using Q-test and I 2 statistic. The robustness of the associations was identified using sensitivity analysis. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale. Publication bias was assessed using funnel plot, trim-and-fill method, Begg's test, and Egger's test. Results: A total of 15 cohort studies (13 articles) including 489,814 participants were included in this meta-analysis. The follow-up period ranged from 4.3 to 29 years. IDH was significantly associated with an increased risk of composite cardiovascular events (HR 1.28, 95% CI: 1.07-1.52, p = 0.006), cardiovascular mortality (HR 1.45, 95% CI: 1.07-1.95, p = 0.015), all strokes (HR 1.44, 95% CI: 1.04-2.01, p = 0.03), and HS (HR 1.64, 95% CI: 1.18-2.29, p = 0.164), but not associated with all-cause mortality (HR 1.20, 95% CI: 0.97-1.47, p = 0.087) and IS (HR 1.56, 95% CI: 0.87-2.81, p = 0.137). Subgroup analysis further indicated that IDH in the younger patients (mean age ≤ 55 years) and from Asia were significantly associated with an increased risk of composite cardiovascular events, while the elderly patients (mean age ≥ 55 years), Americans, and Europeans were not significantly associated with an increased risk of composite cardiovascular events. Conclusion: This meta-analysis provides evidence that IDH defined using the 2018 ESC criterion is significantly associated with an increased risk of composite cardiovascular events, cardiovascular mortality, all strokes and HS, but not significantly associated with all-cause death and IS. These findings also emphasize the importance for patients with IDH to have their blood pressure within normal, especially in the young adults and Asians. Trial Registration: PROSPERO, Identifier: CRD42021254108.
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Affiliation(s)
- Mingyan Huang
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China.,Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Linzi Long
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ling Tan
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Aling Shen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Mi Deng
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Yuxuan Peng
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China.,Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Wenwen Yang
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Hongzheng Li
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China.,Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Wei
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Meng Li
- Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Feifei Liao
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China.,Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Chao Liu
- Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Aimei Lu
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China.,Beijing University of Traditional Chinese Medicine Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Hua Qu
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China.,National Medical Products Administration (NMPA) Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
| | - Changgeng Fu
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
| | - Keji Chen
- Department of Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.,National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine, Beijing, China
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10
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Romero CA, Tabares AH, Orias M. Is Isolated Diastolic Hypertension an Important Phenotype? Curr Cardiol Rep 2021; 23:177. [PMID: 34657205 DOI: 10.1007/s11886-021-01609-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Isolated diastolic hypertension (IDH) is a frequent hypertension phenotype. We review IDH pathophysiology, risk stratification, and therapeutic decisions. RECENT FINDINGS Recent guidelines lowering blood pressure cutoff levels have increased IDH prevalence and likely decreased associated cardiovascular risk. Long-term cardiovascular risk and pharmacological intervention in IDH are controversial. Narrow pulse pressure and other physiological and epidemiological characteristics are shared with a systodiastolic hypertension (SDH) subgroup. We propose that IDH be incorporated into a broader category, predominantly diastolic hypertension (PDH), defined by pulse pressure ≤ 45 mmHg and includes IDH and SDH with a narrow pulse pressure. IDH-PDH is associated with cardiovascular risk in the long term, especially in young patients. Standardization of the IDH definition and population may contribute to future research to understand genetics, pathophysiology, and eventually therapy in this important subgroup of hypertensive patients.
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Affiliation(s)
- Cesar A Romero
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Marcelo Orias
- Section of Nephrology, Yale University, 25 Glenbrook Rd, Stamford, CT, 06902, USA.
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11
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Lee SR, Han KD, Choi EK, Ahn HJ, Oh S, Lip GYH. Risk of Atrial Fibrillation in Young Adults With Isolated Diastolic, Isolated Systolic, and Systolic-Diastolic Hypertension. Hypertension 2021; 78:1248-1258. [PMID: 34538103 DOI: 10.1161/hypertensionaha.121.17399] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- So-Ryoung Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea (S.-R.L., E.-K.C., H.-J.A., S.O.)
| | - Kyung-Do Han
- Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (K.-D.H.)
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea (S.-R.L., E.-K.C., H.-J.A., S.O.).,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)
| | - Hyo-Jeong Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea (S.-R.L., E.-K.C., H.-J.A., S.O.)
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea (S.-R.L., E.-K.C., H.-J.A., S.O.).,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)
| | - Gregory Y H Lip
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea (E.-K.C., S.O., G.Y.H.L.).,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest and Heart Hospital, Liverpool, United Kingdom (G.Y.H.L.).,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (G.Y.H.L.)
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