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Cheung SWY, Chamley LW, Barrett CJ, Lau SYS. Extracellular vesicles and their effect on vascular haemodynamics: a systematic review. Hypertens Res 2024; 47:1588-1606. [PMID: 38600279 PMCID: PMC11150158 DOI: 10.1038/s41440-024-01659-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 02/03/2024] [Accepted: 03/13/2024] [Indexed: 04/12/2024]
Abstract
Extracellular vesicles (EVs) are released from all cell types studied to date and act as intercellular communicators containing proteins, nucleic acids and lipid cargos. They have been shown to be involved in maintaining homoeostasis as well as playing a role in the development of pathology including hypertension and cardiovascular disease. It is estimated that there is 109-1010 circulating EVs/mL in the plasma of healthy individuals derived from various sources. While the effect of EVs on vascular haemodynamic parameters will be dependent on the details of the model studied, we systematically searched and summarized current literature to find patterns in how exogenously injected EVs affected vascular haemodynamics. Under homoeostatic conditions, evidence from wire and pressure myography data demonstrate that injecting isolated EVs derived from cell types found in blood and blood vessels resulted in the impairment of vasodilation in blood vessels ex vivo. Impaired vasodilation was also observed in rodents receiving intravenous injections of human plasma EVs from cardiovascular diseases including valvular heart disease, acute coronary syndrome, myocardial infarction and end stage renal disease. When EVs were derived from models of metabolic syndromes, such as diabetes, these EVs enhanced vasoconstriction responses in blood vessels ex vivo. There were fewer publications that assessed the effect of EVs in anaesthetised or conscious animals to confirm whether effects on the vasculature observed in ex vivo studies translated into alterations in vascular haemodynamics in vivo. In the available conscious animal studies, the in vivo data did not always align with the ex vivo data. This highlights the importance of in vivo work to determine the effects of EVs on the integrative vascular haemodynamics.
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Affiliation(s)
- Sharon W Y Cheung
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lawrence W Chamley
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Hub for Extracellular Vesicle Investigations, The University of Auckland, Auckland, New Zealand
| | - Carolyn J Barrett
- Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sien Yee S Lau
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
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Sixtus RP, Gray C, Berry MJ, Dyson RM. Preterm-born individuals: a vulnerable population at risk of cardiovascular morbidity and mortality during thermal extremes? Exp Physiol 2023; 108:1011-1025. [PMID: 37084061 PMCID: PMC10988436 DOI: 10.1113/ep091152] [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: 02/01/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
NEW FINDINGS What is the topic of this review? Thermal extremes disproportionately affect populations with cardiovascular conditions. Preterm birth, across all gestational age ranges below 37 weeks, has been identified as a non-modifiable risk factor for cardiovascular disease. The hypothesis is presented that individuals born preterm are at an increased risk of cardiovascular morbidity and mortality during thermal extremes. What advances does it highlight? Cardiovascular stress tests performed in preterm-born populations, from infancy through adulthood, highlight a progression of cardiovascular dysfunction accelerating through adolescence and adulthood. This dysfunction has many similarities with populations known to be at risk in thermal extremes. ABSTRACT Preterm-born individuals are a uniquely vulnerable population. Preterm exposure to the extrauterine environment and the (mal)adaptations that occur during the transitional period can result in alterations to their macro- and micro-physiological state. The physiological adaptations that increase survival in the short term may place those born preterm on a trajectory of lifelong dysfunction and later-life decompensation. Cardiovascular compensation in children and adolescents, which masks this trajectory of dysfunction, is overcome under stress, such that the functional cardiovascular capacity is reduced and recovery impaired following physiological stress. This has implications for their response to thermal stress. As the Anthropocene introduces greater changes in our environment, thermal extremes will impact vulnerable populations as yet unidentified in the climate change context. Here, we present the hypothesis that individuals born preterm are a vulnerable population at an increased risk of cardiovascular morbidity and mortality during thermal extremes.
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Affiliation(s)
- Ryan Phillip Sixtus
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Clint Gray
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Mary Judith Berry
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
| | - Rebecca Maree Dyson
- Department of Paediatrics and Child HealthUniversity of OtagoWellingtonNew Zealand
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Khan SA, Hafeez A, Zaka A, Khan SA, Ahmed A, Pervaiz F, Siddiqui AH. A Randomized Controlled Trial of Blood Pressure Reduction Based on Disease Control Priorities 3 in Pakistan to Manage and Control Hypertension. High Blood Press Cardiovasc Prev 2023:10.1007/s40292-023-00589-y. [PMID: 37493898 DOI: 10.1007/s40292-023-00589-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/10/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION According to American Heart Association standards, hypertension is classified into three stages based on blood pressure measurements: essential hypertension, stage 1 hypertension, and stage 2 hypertension. The global target is to reduce the prevalence of high blood pressure by 25% by the year 2025. Worldwide, the prevalence of high blood pressure among men and women aged 18 and above reported to be 24% and 20%, respectively. AIM The aim of this study was to overall reduce high blood pressure of hypertensive patients to the recommended level of 140/90 mm of Hg through implementing a non-pharmacological and multi-component intervention based on Disease Control Priorities (3rd edition). METHODS A randomized controlled trial in which a multi-component intervention for lowering high blood pressure was tested. This was pilot-tested for its acceptance, appropriateness, and relevance, explored through an earlier formative research and desk review conducted from the available evidence. A total of 240 study participants were enrolled after obtaining informed consent. Ethical approval was obtained from the Institutional Review Board of Health Services Academy and the trial was registered in clinicaltrials.gov number NCT04336631. SPSS software version 21 was used to enter and analyze the data. RESULTS High blood pressure of hypertensive patients in a hospital setting during 03 months yielded -23.9 mm Hg of systolic blood pressure reduction (95% confidence interval, p ≤ 0.005). A significant reduction was observed in intervention group after delivering the intervention. Compared to patients in the usual care group, improved health outcomes were achieved for diet control, reducing salt intake and increased physical exercise. In the intervention group, the mean blood pressure among male hypertensive patients was 145/90 mm Hg and in female hypertensive patients, the mean blood pressure was recorded as 140/100 mm Hg. CONCLUSION High blood pressure was significantly reduced in hypertensive patients who adhered to a low salt diet, weight loss measures, and increased physical activity.
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Affiliation(s)
- Subhana Akber Khan
- Department of Public Health, Health Services Academy, Islamabad, Pakistan.
| | - Assad Hafeez
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Arif Zaka
- Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, Pakistan
| | - Shahzad Ali Khan
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Ahsen Ahmed
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Farrah Pervaiz
- Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, Pakistan
| | - Abdul Hameed Siddiqui
- Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, Pakistan
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Premature Cardiovascular Misdiagnosis of Senior Endurance-Trained Athletes. HEARTS 2023. [DOI: 10.3390/hearts4010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
A mature Caucasian patient, an endurance-trained triathlete (age group), had a routine ECG. The patient was immediately referred to Emergency based on supposed ECG abnormalities indicating a heart attack. This diagnosis was quickly dismissed based on no symptoms, heart rate of 50 BPM, athletic status, excellent health, and no prior cardiovascular problems. The patient had a history of severe white coat hypertension and underwent a further stress test and echocardiogram. The stress test showed exaggerated systolic blood pressures (over 225 mmHg) and high in-clinic basal blood pressures (160/90 mmHg), and the patient was diagnosed as hypertensive with exercise blood pressure close to stroke territory. He was told to stop racing, reduce training, and was prescribed antihypertensive drugs (which he did not take). Subsequent at-home 24 h (values close to 120/80 mmHg) and stress blood pressure measurements reversed that decision when considered in combination with an excellent echocardiogram result. The literature clearly describes endurance-trained athletes with systolic pressures over 225 mmHg Hg as being conditioned with no pathological aspects. Endurance-trained athletes should be examined as special cases in the field of cardiovascular medicine as trained physiological responses often present as cardiac abnormalities, and misdiagnosis can inappropriately change the athlete’s life.
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Dewau R, Addisu E, Dessie T, Birhane T, Tadesse SE, Muche A, Feleke YW, Akele B, Yalew M, Seid KA, Damtie Y, Kefale B, Asfaw ZA, Adane B, Mebratu W, Ademas A, Cherie N, Andargie A, Genetu Chanie M, Molla A, Adane M. Covid-19 Vaccine Side Effects and Its Associated Factors Among Healthcare Workers at Dessie Hospital, Ethiopia. J Multidiscip Healthc 2023; 16:363-376. [PMID: 36785578 PMCID: PMC9921431 DOI: 10.2147/jmdh.s384423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/27/2023] [Indexed: 02/10/2023] Open
Abstract
Background Vaccines are a powerful choice to stop disease outbreaks, including covid-19. However, people are hesitant to take vaccinations due to uncertainty about side effects. So, this study aimed to assess covid-19 vaccine side-effect and its associated factors among healthcare workers in Dessie comprehensive specialized hospital, in Ethiopia. Methods An institution-based cross-sectional study was conducted at Dessie Comprehensive and Specialized Hospital among 351 vaccinated healthcare workers from April 25 to May 25, 2021. Self-administrated questionnaires were used by consented health workers. Variance inflation factor (VIF) was used to assess the multicollinearity of independent variables. Bivariable and multivariable binary logistic regression were used to identify significant factors of vaccine side effects. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported as the effect size. Statistical significance was considered at p-value <0.05. Results Overall, of vaccinated healthcare workers, 56.98% (95% CI, 50.86-61.26%) experienced at least one side effect. The majority of the side effects were fever (44.44%), headache (39.03%), fatigue (27.35%), injection site pain (25.93%), and nausea (24.22%). Healthcare workers with (≥10 years) of work experience (AOR: 3.74, 95% CI, 1.32-10.59), Hesitancy to take the first dose of the Covid-19 vaccine (AOR: 3.01, 95% CI, 1.82-4.99), underlying chronic disease (AOR: 14.41, 95% CI, (5.07-40.92)), being on antihypertensive medication (AOR: 0.15; 95% CI (0.02-0.93)), and unsafe perception of vaccine safety (AOR:3.50; 95% CI, 1.43-8.57) were independent factors of Covax vaccine side effect development. Conclusion Overall, common vaccine side effects were identified in healthcare workers who have taken the Covax vaccine. Healthcare workers with (≥10 years) of work experience, Hesitancy to take the first dose, unsafe perception of vaccine safety, and underlined chronic disease were predictors of vaccine side effect occurrence. So, providing vaccine-related information to the community to be vaccinated is mandatory to reduce hesitancy and flaws regarding vaccine safety.
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Affiliation(s)
- Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia,Correspondence: Elsabeth Addisu, Email
| | - Tilahun Dessie
- Department of Paediatrics, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tesfaye Birhane
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitbarek Wasihun Feleke
- Department of Health Education, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Baye Akele
- Department of Clinical Laboratory, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Yalew
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kemal Ahmed Seid
- Department of Infectious Disease, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zinet Abegaz Asfaw
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Wondwosen Mebratu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ayechew Ademas
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Niguss Cherie
- Department of Reproductive health, School of Public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Assefa Andargie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Muluken Genetu Chanie
- Department of Health Service Management, School of public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Asnakew Molla
- Department of Health Service Management, School of public health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Ahmad M, Ahmad T, Irfan HM, Noor N. Blood pressure-lowering and cardiovascular effects of plumbagin in rats: An insight into the underlying mechanisms. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2022; 3:100139. [PMID: 36568266 PMCID: PMC9780077 DOI: 10.1016/j.crphar.2022.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/17/2022] [Accepted: 11/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background Plumbagin, a natural phenolic compound is investigated for response against blood pressure and vascular reactivity. Methodology Blood pressure lowering effects were observed by in-vivo invasive evaluation in normotensive rats, and in-vitro experimentation to measure changes of tension in isolated rat aorta and contractility in atria. Results The percentage decrease in mean arterial pressure (MAP) observed with plumbagin intravenously at doses of 0.1, 0.5, 1, 5, 10 μg/kg in normotensive rats was 7.16 ± 2.35, 15.5 ± 5.62, 19.5 ± 5.27, 26 ± 6.67, 34.33 ± 8.80, respectively. Plumbagin exerted vasorelaxant effects in rat aorta, unaffected by the removal of vascular endothelium, and L-NAME and methylene blue pretreatment. Plumbagin completely inhibited phenylephrine (1 μM) and High K+ (80 mM) induced contractions. Similar to a Ca+2 channel antagonist, plumbagin caused a rightward shift in the Ca+2 concentration-response-curves (CRCs), resembling nifedipine. Pre-incubation with plumbagin, significantly suppressed contractions induced by phenylephrine in Ca+2-free medium via disrupting Ca+2 release from intracellular stores. No change in vasorelaxant response was observed with the addition of potassium channel blockers, TEA and BaCl2. In rat atrial strips, plumbagin exerted significant negative inotropic and chronotropic effects. No significant change was observed with atropine and atenolol pretreatment, so the effect appeared independent of muscarinic and beta-adrenergic receptors. Conclusion This study suggests the blood pressure lowering effects of plumbagin. That could be contributed by a decrease in vascular resistance via calcium antagonism, interferences in calcium efflux, and depressive effects on the rate and force of cardiac contraction. Further studies would be necessary to probe deeper into the underlying mechanisms.
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Long Y, Li Y, Zhang L, Tao L, Xiao H, Li Y, Zhou C. Plasma D-dimer levels are correlated with disease severity among hypertensive patients: A comparative cross-sectional study. Medicine (Baltimore) 2022; 101:e30281. [PMID: 36086694 PMCID: PMC9646652 DOI: 10.1097/md.0000000000030281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
It has been reported that inappropriate acute thrombus formation is the pathophysiological substrate underlying increased risk and severity of target organ damage in hypertension (HTN). However, the relationship between severity of HTN and D-dimer has not been well characterized. The study was aimed to assess plasma D-dimer level and its correlation with disease severity among hypertensives. A comparative cross-sectional study was conducted at Wuhan Asia Heart Hospital among 100 participants (60 hypertensives and 40 controls). The correlation between variables were determined using correlation coefficients, regression analysis, and also using different parametric and nonparametric tests. We observed higher D-dimer levels among hypertensives compared to the healthy controls (P < .001). The D-dimer levels were found to be increased significantly with the severity of HTN (P < .001). D-dimer was found to have a diagnostic power of 86.9% in differentiating complicated from uncomplicated HTN at 0.83 mg/L cutoff value. This study suggests that D-dimer level was higher among hypertensives than control groups and it was also increasing significantly with the severity of HTN. This suggests that hypercoagulability of fibrin plays a role in the occurrence of thromboembolic complications of hypertensive patients.
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Affiliation(s)
- Yanli Long
- Heart Center, Wuhan Asia Heart Hospital Affiliated Wuhan University of Science and Technology, Wuhan, China
| | - Yi Li
- Heart Center, Wuhan Asia Heart Hospital Affiliated Wuhan University of Science and Technology, Wuhan, China
| | - Litao Zhang
- Department of Pathology and Clinical Laboratory (DPCL), Wuhan Asia Heart Hospital (WAHH), Wuhan University of Science and Technology, Wuhan, China
| | - Liang Tao
- Heart Center, Wuhan Asia Heart Hospital Affiliated Wuhan University of Science and Technology, Wuhan, China
| | - Hongyan Xiao
- Heart Center, Wuhan Asia Heart Hospital Affiliated Wuhan University of Science and Technology, Wuhan, China
| | - Ying Li
- Heart Center, Wuhan Asia Heart Hospital Affiliated Wuhan University of Science and Technology, Wuhan, China
| | - Chunyou Zhou
- Department of Pharmacy,The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
- * Correspondence: Chunyou Zhou, MD, Department of Pharmacy, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Huaihai Road 100, 230012, China (e-mail: )
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Jankūnas R, Rinkūnienė D, Stakišaitis D. Over-Prescription of the Imidazoline Receptor Agonists: Evidence for Restriction of the Therapeutic Indication. Ther Innov Regul Sci 2022; 56:859-866. [PMID: 35908005 DOI: 10.1007/s43441-022-00434-9] [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: 06/29/2021] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Major antihypertensive drug classes (but not Imidazoline Receptor Agonists) have been demonstrated to reduce cardiovascular morbidity and mortality. In 2017, Latvia and Lithuania had the highest cardiovascular mortality among the Eastern, Central, Northern, and Western Member States of the European Union (EU). Cardiovascular mortality in Estonia is much lower than in Lithuania and Latvia. OBJECTIVE To evaluate the consumption of Imidazoline Receptor Agonists in the Baltic States and its potential implications. MATERIALS AND METHODS The study included data on the sales of Imidazoline Receptor Agonists in Lithuania, Latvia, and Estonia; the marketing authorization databases of the competent authorities; the guidelines on the treatment of hypertension, and the reimbursement conditions. RESULTS The study showed a very high consumption of the Imidazoline Receptor Agonists in Lithuania and Latvia. From 2016 to 2019, the average consumption of Imidazoline Receptor Agonists in Lithuania was 15.5 times higher than in Estonia; in Latvia, it was 8.9 times higher than in Estonia. The guidelines recommend the use of the Imidazoline Receptors Agonists as one of the last options in hypertension therapy, but the marketing authorizations do not restrict their line of therapy. CONCLUSIONS Consumption of IRAs in Lithuania and Latvia is very high. The authorized use of the IRAs in the EU Member States is not in line with the guidelines on the management of arterial hypertension and therefore patients might be deprived of therapies that reduce the cardiovascular risk. The drug regulatory authorities of the EU should review the data on the safety and efficacy of the IRAs and restrict their therapeutic indications if necessary.
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Affiliation(s)
- Rimas Jankūnas
- Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, 44307, Kaunas, Lithuania.
| | - Diana Rinkūnienė
- Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, 44307, Kaunas, Lithuania
| | - Donatas Stakišaitis
- Scientific Research Center, National Cancer Institute, 08660, Vilnius, Lithuania.,Department of Histology and Embryology, Medical Academy, Lithuanian University of Health Sciences, 44307, Kaunas, Lithuania
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Effects of the self-management training program on self-management behavior and blood pressure levels among elderly people with hypertension. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure (BP) levels among elderly people with hypertension (HT).
Methods
This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT. Simple random sampling was applied to two sampling groups, an experimental group and a control group. However, the experimental group had been on the Self-Management Training Program based on the Creer concept. The Program's contents included small-group health-education sessions and the patients’ manual, Self-Management Training Skills for Self-Management Behavior. Small group discussions were held for self-reflection, to stimulate follow-up for self-management behavior training during home visits. The Self-Management Training Program was compared with programs involving the more usual care. Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests. Data were analyzed using a descriptive statistic, chi-square test, pair t-test, repeated-measures Analysis of Variance (ANOVA), and repeated-measures Analysis Covariance (ANCOVA).
Results
It was found that at 13 weeks after entering the program, the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance (P < 0.005), and that at the 4th week and the 13th week, there was a decrease in BP in the experimental group. The experimental group also had above-baseline self-management behavior scores that were higher than in the control group (P < 0.01).
Conclusions
Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.
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Bae E, Rocco MV, Lee J, Park JY, Kim YC, Yoo KD, Kim EY, Park DJ, Lim CS, Kim YS, Lee JP. Impact of DBP on all-cause and cardiovascular mortality: results from the National Health and Nutrition Examination survey, 1999-2014. J Hypertens 2022; 40:108-116. [PMID: 34857704 DOI: 10.1097/hjh.0000000000002983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Hypertension is common and has a significant effect on cardiovascular morbidity and death. However, despite the development of several guidelines to manage SBP, there is little research or guidance on the evaluation and management of DBP or isolated diastolic hypertension (IDH). METHOD To determine the association of DBP with all-cause and cardiovascular mortality, we used NHANES data from 1999 to 2014 and included adults aged at least 18 years. The relationship between DBP, IDH and all-cause, cardiovascular mortality was evaluated. RESULTS Of the 35 109 participants, all-cause death occurred in 10.6%, and cardiovascular death occurred in 2.1% over a median follow-up of 7.2 years. Multivariate Cox regression analysis revealed that the risk of all-cause mortality was significantly higher in the lowest (≤56.9 mmHg) DBP groups than in the reference group (DBP 74-76.9 mmHg). However, the risk of cardiovascular mortality was significantly higher in the lowest and highest (≥83 mmHg) DBP group than in the reference group. The risk of all-cause mortality was higher for most groups with SBP at least 140 mmHg than for the reference group with DBP 74-76.9 mmHg and SBP 100-139.9 mmHg. Both the 2018 ESC/NICE and the 2017 AHA/ACC-defined IDH was not significantly associated with all-cause mortality. CONCLUSION DBP and all-cause mortality had an inverse relationship, whereas DBP and cardiovascular mortality had a U-shaped relationship, with the DBP reference group having the lowest risk for all-cause and cardiovascular mortality. There was no significant relationship between IDH and death.
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Affiliation(s)
- Eunjin Bae
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
- Department of Internal Medicine, College of Medicine
- Institute of Health Science, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Michael V Rocco
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jeonghwan Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center
| | - Jae Yoon Park
- Department of Internal Medicine, Dongguk University School of Medicine
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul
| | - Kyung Don Yoo
- Department of Internal Medicine, Ulsan University Hospital, Ulsan
| | - Eun Young Kim
- Mental Health Center, Seoul National University Healthcare Center, Gwanak-gu
- Department of Psychiatry
| | - Dong Jun Park
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
- Department of Internal Medicine, College of Medicine
- Institute of Health Science, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University Boramae Medical Center
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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The Prevalence of Uncontrolled Hypertension among Patients Taking Antihypertensive Medications and the Associated Risk Factors in North Palestine: A Cross-Sectional Study. Adv Med 2022; 2022:5319756. [PMID: 36062140 PMCID: PMC9436595 DOI: 10.1155/2022/5319756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/02/2022] [Accepted: 08/06/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Uncontrolled hypertension (HTN) is a challenge for public health professionals all over the world. It is the leading and most important modifiable risk factor for coronary artery disease, congestive heart failure, stroke, renal diseases, and retinopathy. The aim of the present study was to estimate the prevalence of uncontrolled HTN among Palestinian hypertensive patients on treatment. In addition, the study aimed to explore the relationship between socio-demographic and clinical factors with HTN control as well as establish a comprehensive literature review for similar studies. METHODS A cross-sectional study was conducted. 218 hypertensive patients who met the inclusion criteria were included in the study. RESULTS HTN is not adequately controlled in over 60% of treated patients. Factors that were linked to uncontrolled HTN and were statistically significant as per this study were diabetes (p=0.010), high BMI (p=0.009), smoking (p < 0.0001), lower educational level (p=0.002), and monotherapy (p=0.004). CONCLUSION The results suggest that effective efforts on improving HTN control are strongly needed. The efforts need to target hypertensive patients who are also smokers, diabetics, having a low education level, and have a higher-than-normal BMI.
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Zuraini NZA, Sekar M, Wu YS, Gan SH, Bonam SR, Mat Rani NNI, Begum MY, Lum PT, Subramaniyan V, Fuloria NK, Fuloria S. Promising Nutritional Fruits Against Cardiovascular Diseases: An Overview of Experimental Evidence and Understanding Their Mechanisms of Action. Vasc Health Risk Manag 2021; 17:739-769. [PMID: 34858028 PMCID: PMC8631183 DOI: 10.2147/vhrm.s328096] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/06/2021] [Indexed: 12/22/2022] Open
Abstract
Cardiovascular diseases (CVDs) are one of the leading causes of morbidity and mortality in both developed and developing countries, affecting millions of individuals each year. Despite the fact that successful therapeutic drugs for the management and treatment of CVDs are available on the market, nutritional fruits appear to offer the greatest benefits to the heart and have been proved to alleviate CVDs. Experimental studies have also demonstrated that nutritional fruits have potential protective effects against CVDs. The aim of the review was to provide a comprehensive summary of scientific evidence on the effect of 10 of the most commonly available nutritional fruits reported against CVDs and describe the associated mechanisms of action. Relevant literatures were searched and collected from several scientific databases including PubMed, ScienceDirect, Google Scholar and Scopus. In the context of CVDs, 10 commonly consumed nutritious fruits including apple, avocado, grapes, mango, orange, kiwi, pomegranate, papaya, pineapple, and watermelon were analysed and addressed. The cardioprotective mechanisms of the 10 nutritional fruits were also compiled and highlighted. Overall, the present review found that the nutritious fruits and their constituents have significant benefits for the management and treatment of CVDs such as myocardial infarction, hypertension, peripheral artery disease, coronary artery disease, cardiomyopathies, dyslipidemias, ischemic stroke, aortic aneurysm, atherosclerosis, cardiac hypertrophy and heart failure, diabetic cardiovascular complications, drug-induced cardiotoxicity and cardiomyopathy. Among the 10 nutritional fruits, pomegranate and grapes have been well explored, and the mechanisms of action are well documented against CVDs. All of the nutritional fruits mentioned are edible and readily accessible on the market. Consuming these fruits, which may contain varying amounts of active constituents depending on the food source and season, the development of nutritious fruits-based health supplements would be more realistic for consistent CVD protection.
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Affiliation(s)
- Nur Zulaikha Azwa Zuraini
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | - Yuan Seng Wu
- Centre for Virus and Vaccine Research, School of Medical and Life Sciences, Sunway University, Selangor, 47500, Malaysia
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Selangor, 47500, Malaysia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor Darul Ehsan, 47500, Malaysia
| | - Srinivasa Reddy Bonam
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherché des Cordeliers, Sorbonne Université, Université de Paris, Paris, France
| | - Nur Najihah Izzati Mat Rani
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | - M Yasmin Begum
- Department of Pharmaceutics, College of Pharmacy, King Khalid University (KKU), Asir-Abha, 61421, Saudi Arabia
| | - Pei Teng Lum
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, 30450, Malaysia
| | | | - Neeraj Kumar Fuloria
- Faculty of Pharmacy & Centre of Excellence for Biomaterials Engineering, AIMST University, Kedah, 08100, Malaysia
| | - Shivkanya Fuloria
- Faculty of Pharmacy & Centre of Excellence for Biomaterials Engineering, AIMST University, Kedah, 08100, Malaysia
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Durães AR. Helicobacter Pylori and High Blood Pressure. Arq Bras Cardiol 2021; 117:637-638. [PMID: 34709290 PMCID: PMC8528362 DOI: 10.36660/abc.20210629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Andre Rodrigues Durães
- Universidade Federal da BahiaSalvadorBABrasilUniversidade Federal da Bahia, Salvador, BA - Brasil
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Kij A, Bar A, Przyborowski K, Proniewski B, Mateuszuk L, Jasztal A, Kieronska-Rudek A, Marczyk B, Matyjaszczyk-Gwarda K, Tworzydlo A, Enggaard C, Hansen PBL, Jensen B, Walczak M, Chlopicki S. Thrombin Inhibition Prevents Endothelial Dysfunction and Reverses 20-HETE Overproduction without Affecting Blood Pressure in Angiotensin II-Induced Hypertension in Mice. Int J Mol Sci 2021; 22:ijms22168664. [PMID: 34445374 PMCID: PMC8395447 DOI: 10.3390/ijms22168664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/05/2021] [Accepted: 08/07/2021] [Indexed: 02/02/2023] Open
Abstract
Angiotensin II (Ang II) induces hypertension and endothelial dysfunction, but the involvement of thrombin in these responses is not clear. Here, we assessed the effects of the inhibition of thrombin activity by dabigatran on Ang II-induced hypertension and endothelial dysfunction in mice with a particular focus on NO- and 20-HETE-dependent pathways. As expected, dabigatran administration significantly delayed thrombin generation (CAT assay) in Ang II-treated hypertensive mice, and interestingly, it prevented endothelial dysfunction development, but it did not affect elevated blood pressure nor excessive aortic wall thickening. Dabigatran’s effects on endothelial function in Ang II-treated mice were evidenced by improved NO-dependent relaxation in the aorta in response to acetylcholine in vivo (MRI measurements) and increased systemic NO bioavailability (NO2− quantification) with a concomitant increased ex vivo production of endothelium-derived NO (EPR analysis). Dabigatran treatment also contributed to the reduction in the endothelial expression of pro-inflammatory vWF and ICAM-1. Interestingly, the fall in systemic NO bioavailability in Ang II-treated mice was associated with increased 20-HETE concentration in plasma (UPLC-MS/MS analysis), which was normalised by dabigatran treatment. Taking together, the inhibition of thrombin activity in Ang II-induced hypertension in mice improves the NO-dependent function of vascular endothelium and normalises the 20-HETE-depedent pathway without affecting the blood pressure and vascular remodelling.
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Affiliation(s)
- Agnieszka Kij
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Anna Bar
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Kamil Przyborowski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Bartosz Proniewski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Lukasz Mateuszuk
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Agnieszka Jasztal
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Anna Kieronska-Rudek
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Brygida Marczyk
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Karolina Matyjaszczyk-Gwarda
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Anna Tworzydlo
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
| | - Camilla Enggaard
- Department of Cardiovascular and Renal Research, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark; (C.E.); (P.B.L.H.); (B.J.)
| | - Pernille B. Lærkegaard Hansen
- Department of Cardiovascular and Renal Research, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark; (C.E.); (P.B.L.H.); (B.J.)
| | - Boye Jensen
- Department of Cardiovascular and Renal Research, University of Southern Denmark, J.B. Winsløws Vej 21, 5000 Odense, Denmark; (C.E.); (P.B.L.H.); (B.J.)
| | - Maria Walczak
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
- Chair and Department of Toxicology, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
| | - Stefan Chlopicki
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Bobrzynskiego 14, 30-348 Krakow, Poland; (A.K.); (A.B.); (K.P.); (B.P.); (L.M.); (A.J.); (A.K.-R.); (B.M.); (K.M.-G.); (A.T.); (M.W.)
- Chair of Pharmacology, Jagiellonian University Medical College, Grzegorzecka 16, 31-531 Krakow, Poland
- Correspondence:
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Enhanced purification protocol for the angiotensin-converting enzyme from bovine systems and investigation of the in vitro effect of some active substances. Chem Biol Interact 2021; 347:109604. [PMID: 34352275 DOI: 10.1016/j.cbi.2021.109604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
Angiotensin-converting enzyme (ACE, EC 3.4.15.1) synthesized by endothelial cells and responsible for the regulation of blood pressure was purified from the bovine lung with affinity chromatography method. The purification rate of the ACE of the bovine lung was calculated as 1748- fold. Optimum pH and optimum temperature for the purified ACE were found to be 7.6 and 35-40 °C, respectively. The purity and molecular weight of the ACE were designated with SDS-PAGE. The ACE was found to have three subunits with molecular weights of 57 kDa, 66 kDa, and 190 kDa. Then, the total molecular weight of the ACE was designated as 303 kDa with gel filtration chromatography. The effects of ACE inhibitors captopril, fosinopril, lisinopril, and beta-blockers propranolol, atenolol, and diuretic triamterene on ACE activity were studied. ACE inhibitors lisinopril, captopril, fosinopril, and diuretic triamterene demonstrated an inhibition effect on ACE activity. Beta-blockers indicated no effect on ACE. IC50 values of captopril, fosinopril, lisinopril, and triamterene from the graphical equation were calculated as 0.835 nM, 1.159 μM, 4.085 nM, and 227 μM, respectively. The inhibition type and Ki values of these compounds were determined from Lineweaver-Burk plots. Captopril, fosinopril, lisinopril, and triamterene demonstrated a non-competitive inhibition effect on ACE activity. Ki constants were found as 1.057 nM, 1.675 μM, 6.449 nM, and 419.5 μM, respectively. Captopril indicated the highest inhibitor effect with an IC50 value of 0.835 nM.
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Bokaba M, Modjadji P, Mokwena KE. Undiagnosed Hypertension in a Workplace: The Case of a Logistics Company in Gauteng, South Africa. Healthcare (Basel) 2021; 9:healthcare9080964. [PMID: 34442101 PMCID: PMC8394589 DOI: 10.3390/healthcare9080964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022] Open
Abstract
A large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular diseases in South Africa. A workplace may either mitigate or accentuate the risk factors for hypertension. A cross sectional study was conducted to determine the prevalence of undiagnosed hypertension and associated factors among 312 employees in a Logistics Company, South Africa. A modified, validated, self-administered WHO STEPwise questionnaire was used to collect data on demography, lifestyle factors, anthropometry and blood pressure (BP). Hypertension was defined at BP ≥ 140/90 mmHg. Data was analysed using STATA 14. Mean age of employees was 40 ± 10 years, with a 50% prevalence of undiagnosed hypertension. No significant association was observed between occupation and undiagnosed hypertension, except for high prevalence of undiagnosed hypertension among truck drivers and van assistants (43%), and general workers (27%), having higher odds of increased waist-to-height ratio. Hypertension was associated with age (OR = 2.3, 95%CI; 1.21–4.27), alcohol use (AOR = 1.8, 95%CI; 1.05–2.93), waist circumference (AOR = 2.3, 95%CI; 1.29–4.07) and waist-to-height-ratio (AOR = 3.7, 95%CI; 1.85–7.30). Improved and effective workplace health programs and policies are necessary for management of undiagnosed hypertension among employees. Longitudinal studies on mediation of occupation in association of demographic and lifestyle factors with hypertension in workplaces are needed.
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Czajka S, Putowski Z, Krzych ŁJ. Intraoperative hypotension and its organ-related consequences in hypertensive subjects undergoing abdominal surgery: a cohort study. Blood Press 2021; 30:348-358. [PMID: 34323131 DOI: 10.1080/08037051.2021.1947777] [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: 10/20/2022]
Abstract
Purpose. Intraoperative hypotension is associated with organ hypoperfusion, which is deleterious to vital organs. Little is known about the prevalence and consequences of intraoperative hypotension in subjects with arterial hypertension (AH). The primary goal of this study was to investigate the prevalence and determinants of hypoperfusion-related clinical consequences of intraoperative hypotension, taking into account the role of AH, in a homogeneous cohort of patients undergoing abdominal surgery.Materials and methods. We enrolled 508 patients (219 males, median age 62 years). Intraoperative hypotension was defined as systolic blood pressure (SBP) <90 mmHg for at least 10 min or mean arterial pressure (MAP) <65 mmHg for at least 10 min or a need for noradrenaline infusion of at least 0.05 μg/kg/min for ≥10 min or intraoperative MAP drop of at least 30% from the baseline value for at least 10 min, regardless of the time of surgery. Acute kidney injury, stroke or transient ischaemic attack, delirium, and myocardial infarction were considered as the outcome.Results. AH concerned 234 (46%) individuals. The prevalence of intraoperative hypotension varied from 19.9 to 59.4%. Patients with AH were more likely to experience MAP drop of >30% than non-hypertensive patients (OR = 1.53; 95%CI 1.07-2.19; p = 0.02). The outcome was diagnosed in 38 (7.5%) patients. AH was a significant predictor of hypoperfusion-related events, regardless of the intraoperative hypotension definition applied (logOR 2.80 ÷ 3.22; p < 0.05 for all). Only intraoperative hypotension defined as 'MAP < 65mmHg' was found to be a determinant of negative outcome (logOR = 2.85; 95%CI 1.35-5.98; p < 0.01), with AUROC = 0.83 (95%CI 0.0-0.86); p < 0.01.Conclusion. AH is a significant predictor of hypoperfusion-related events, regardless of the intraoperative hypotension definition applied. In hypertensive patients, hypoperfusion-related clinical consequences are more frequent in high-risk and long-lasting procedures. MAP < 65 mmHg lasting for >10 min during surgery was identified as most associated with the negative outcome.
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Affiliation(s)
- Szymon Czajka
- Department of Anaesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Putowski
- Department of Anaesthesiology and Intensive Care, School of Medicine in Katowice, Students' Scientific Society, Medical University of Silesia, Katowice, Poland
| | - Łukasz J Krzych
- Department of Anaesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Dorrington KL, Frise MC. Sir George Johnson FRCP (1818-96), high blood pressure and the continuing altercation about its origins. Exp Physiol 2021; 106:1886-1896. [PMID: 34184351 DOI: 10.1113/ep089627] [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: 05/10/2021] [Accepted: 06/23/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the topic of this review? The review takes a historical approach to examining where in the body it might be possible to identify the most common cause, or causes, of long-term hypertension. It gathers evidence from histology, human and animal physiology, and computational modelling. The burden of decades of controversy is noted. What advances does it highlight? The review highlights the distinctive pathology of the afferent renal circulation and what its consequences are for the widespread view that essential hypertension is caused by elevated peripheral vascular resistance. ABSTRACT The widely promulgated notion that long-term elevation in mean arterial blood pressure (MAP) can be caused by raised peripheral vascular resistance remains a subject of vigorous debate. According to the 1967 mathematical model of Guyton and Coleman, such a causal relationship is impossible, kidney function being the determining factor. We explore this altercation starting with Sir George Johnson's 19th-century renal vascular histological observations in patients with Bright's disease. We note the striking physiological measurements in hypertensives by Gómez and Bolomey in the 1950s, moving on to the mathematical modelling of the circulation from the 1960s up to the ∼100-parameter computer models of the present day. Confusion has been generated by the fact that peripheral resistance is raised in hypertension in close proportion to MAP whilst cardiac output often stays normal, an apparent autoregulation, the mechanism of which is poorly understood. All models allowing for the circulation to be an open system show that isolated changes in peripheral resistance cannot lead to long-term hypertension, but models fail so frequently to account for results from experiments such as salt loading that their credibility with regard to this key finding is compromised. Laboratory animal models of adrenergic renal actions resonate with a contemporary emphasis on the sympathetic nerve supply to the kidney as contributing to the characteristically markedly elevated renal afferent resistance that appears to be the most common cause of hypertension. Remarkably, there remains no account of the way in which the fixed structural changes in vessels observed by Johnson relate to this sympathetic overactivity, which can itself be modified by drugs in the medium term. In this account, we seek to locate the crime scene and identify a smoking gun.
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Affiliation(s)
- Keith L Dorrington
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, UK
| | - Matthew C Frise
- Department of Physiology, Anatomy & Genetics, University of Oxford, Oxford, UK
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Dereje R, Hassen K, Gizaw G. Evaluation of Anthropometric Indices for Screening Hypertension Among Employees of Mizan Tepi University, Southwestern Ethiopia. Integr Blood Press Control 2021; 14:99-111. [PMID: 34295187 PMCID: PMC8291801 DOI: 10.2147/ibpc.s317018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Globally, hypertension is becoming a serious problem affecting the health and wellbeing of the adult population. Anthropometric indices like body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) have long been utilized to screen hypertension; in contrast, other evidence indicates the superior utility of waist-to-height ratio (WHtR) to screen hypertension. There are inconclusive results from different studies done in different settings regarding the best screening index for hypertension. In addition, there is a paucity of information on the evaluation of anthropometric indices for screening hypertension in the study area. Therefore, this study evaluates the utility of anthropometric indices for screening hypertension among Mizan Tepi University employees, southwestern Ethiopia. METHODS An institution-based cross-sectional study was conducted among Mizan Tepi University employees. A gender-based stratified simple random sampling technique was used to select 585 employees. Logistic regression analysis was conducted to assess the association between anthropometric indices and hypertension. Receiver operating characteristic curve (ROC) was employed to evaluate anthropometric indices for screening hypertension, and optimal cutoff points were also developed based on Youden index (sensitivity + specificity - 1) and presented with sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV). RESULTS The overall prevalence of hypertension was 20.9%, which was 22.5% in males and 18.7% in females. Among males, WHtR, WHR, and BMI were significantly associated with hypertension, while, in females, only BMI was associated with hypertension. WHtR had a higher screening ability for hypertension followed by WC in both sexes. For males, the cutoff point for WHR, WC, BMI, and WHtR for screening hypertension was 0.897, 85.17cm, 24.6kg/m2, and 0.51, respectively. In females, the cutoff point developed for screening hypertension for WHR, WC, BMI, and WHtR were 0.92, 85.67cm, 24.8kg/m2, and 0.52, respectively. CONCLUSION The waist-to-height ratio was found to be the best obesity index to screen hypertension than BMI, WC, and WHR. The finding supports the use of WHtR for screening hypertension in resource-limited settings.
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Affiliation(s)
- Rahel Dereje
- Department of Nutrition and Dietetics, Institute of Health Science, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- School of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan Aman, Ethiopia
| | - Kalkidan Hassen
- Department of Nutrition and Dietetics, Institute of Health Science, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Getu Gizaw
- Department of Nutrition and Dietetics, Institute of Health Science, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Enzyme-Assisted Extraction to Obtain Phenolic-Enriched Wine Lees with Enhanced Bioactivity in Hypertensive Rats. Antioxidants (Basel) 2021; 10:antiox10040517. [PMID: 33810336 PMCID: PMC8065631 DOI: 10.3390/antiox10040517] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 02/06/2023] Open
Abstract
The antihypertensive effect of the soluble fraction of wine lees (WL) from Cabernet variety grapes was recently reported by our group. This blood pressure (BP)-lowering effect was attributed to the presence of flavanols and anthocyanins. In this context, phenolic-enriched wine lees (PWL) could potentially exhibit a stronger bioactivity. Therefore, the aim of this study was to obtain a soluble fraction of WL with increased phenolic content and evaluate its functionality. The PWL were obtained using an enzyme-assisted extraction based on the hydrolysis of WL proteins with Flavourzyme®. They contained 57.20% more total phenolic compounds than WL, with anthocyanins and flavanols being the largest families present. In addition, PWL also showed greater angiotensin-converting enzyme inhibitory and antioxidant activities. Finally, the antihypertensive activity of the PWL was evaluated in spontaneously hypertensive rats. A single dose of 5 mL/kg body weight of PWL showed a greater BP-lowering effect than the one shown by WL. Moreover, this antihypertensive effect was more prolonged than the one produced by the antihypertensive drug Captopril. These results demonstrate that enzymatic protein hydrolysis is a useful method to maximize the extraction of phenolic compounds from WL and to obtain extracts with enhanced functionalities.
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Jayanthi R, Girijasivam SP, Gaur A. Association of blood pressure and BMI to corrected QT interval in young adults. Can J Physiol Pharmacol 2021; 99:894-899. [PMID: 33517855 DOI: 10.1139/cjpp-2020-0520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hypertension is often associated with obesity. Uncontrolled hypertension can lead to uncorrected cardiac dysautonomia that makes cardiac repolarization abnormally prolonged. Modern dietary habits, stress, and bad lifestyle habits make young adults vulnerable to hazards of health. We planned to study the association of body mass index (BMI) and blood pressure (BP) with corrected QT (QTc) intervals in young adults. After obtaining the written informed consent, 171 subjects were randomly selected in the age group of 18-35 years. A general history and physical examination were done before recording the BMI and BP. A 12-lead electrocardiogram was recorded and QTc calculated using Bazett's formula. The values obtained were compared and statistical analysis done. Of the 171 subjects 14.03% were hypertensive. The QTc interval was found to be prolonged in females and it is prolonged with age, BMI, and BP. QTc was significantly increased among the prehypertensive and hypertensive group and with the overweight and (or) obese BMI group compared with the normotensives and normal BMI group suggesting an altered autonomic homeostasis. This warrants lifestyle modification at a younger age to reduce the cardiovascular risk.
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Affiliation(s)
- Ramkumar Jayanthi
- Department of Physiology, Chengalpattu Medical College, Chengalpattu, India
| | | | - Archana Gaur
- Department of Physiology, AIIMS Jodhpur, Jodhpur, India
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Assessment of Plasma Sodium to Potassium Ratio, Renal Function, Markers of Oxidative Stress, Inflammation, and Endothelial Dysfunction in Nigerian Hypertensive Patients. Int J Hypertens 2021; 2020:6365947. [PMID: 33489353 PMCID: PMC7803263 DOI: 10.1155/2020/6365947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/28/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022] Open
Abstract
Background This study investigated plasma sodium/potassium ratio, markers of oxidative stress, renal function, and endothelial dysfunction in hypertensive Nigerians. Materials and Methods Five hundred forty-nine volunteers consisting of three hundred and twenty-four hypertensive and two hundred twenty-five controls participated in this study. Blood samples were collected from the participants and were analyzed for electrolytes, markers of oxidative stress, endothelial dysfunction, renal function, and inflammation, using ion-selective electrodes, spectrophotometric, and enzyme-linked immunosorbent assay methods, respectively. Results The mean systolic blood pressure, mean diastolic blood pressure, mean arterial blood pressure, and body mass index (BMI) were significantly elevated among the hypertensive group when compared with control (p < 0.001). The mean sodium increased, while potassium and bicarbonate (HCO3−) decreased (p < 0.001) in hypertensive volunteers. The sodium-potassium ratio (Na+/K+) and urea were raised (p < 0.001) in the hypertensive group when compared with the control. Glutathione, superoxide dismutase, nitric oxide (NO), and catalase were significantly reduced (p < 0.001) while malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), and ferritin were raised significantly (p < 0.001) in hypertensive participants. The odds of hypertension and its complications increased (p < 0.001) with an increase in BMI, Na+/K+, hs-CRP, MDA, and ferritin and a decrease in estimated glomerular filtration rate (eGFR), glutathione, superoxide dismutase, and catalase. Conclusion An increase in Na+/K+, urea, hs-CRP, ferritin, MDA, and BMI and a decrease in eGFR, glutathione, and superoxide dismutase were associated with an increased risk of hypertension complication. Abnormal values of markers of oxidative stress, inflammation, and endothelial function could impact deleterious effects on the cardiovascular system among hypertensive Nigerians. A decreased bicarbonate possibly suggests an occult acid-base imbalance among hypertensive volunteers.
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Aryal D, Roy T, Chamcheu JC, Jackson KE. Chronic Metabolic Acidosis Elicits Hypertension via Upregulation of Intrarenal Angiotensin II and Induction of Oxidative Stress. Antioxidants (Basel) 2020; 10:antiox10010002. [PMID: 33374943 PMCID: PMC7821948 DOI: 10.3390/antiox10010002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Chronic metabolic acidosis (CMA) can be a consequence of persistent hypertension but could potentially play a role in invoking hypertension. Currently, there is a scarcity of studies examining the outcome of induced chronic acidosis on blood pressure regulation. This study investigates CMA as a cause of hypertension. Chronic acidosis was induced in Sprague Dawley rats (100–150 g) by providing a weak acid solution of 0.28 M ammonium chloride (NH4Cl) in tap water for 8 weeks. To determine whether the rats were acidotic, blood pH was measured, while blood pressure (BP) was monitored by tail-cuff plethysmography weekly. Rats were divided into five groups: control, CMA, CMA ± spironolactone, captopril, and tempol. Serum sodium and potassium; renal interstitial fluid (for Angiotensin II concentration); and kidney proximal tubules (for Na+/K+ ATPase- α1 concentration) were analyzed. Reactive oxygen species (ROS) were detected in renal cortical homogenates using electron paramagnetic resonance (EPR). In the CMA rats, a sustained elevation in mean arterial pressure (MAP) associated with a significant decrease in blood pH was observed compared to that of control over the 8 weeks. A significant decrease in MAP was observed in acidotic rats treated with captopril/tempol, whereas spironolactone treatment caused no decrease in MAP as compared to that of the CMA group. The interstitial angiotensin II was increased in the CMA group but decreased in the CMA with captopril and tempol groups. In addition, the urinary sodium was decreased, and the serum sodium levels increased significantly in the CMA groups as compared to that of control. However, the acidotic groups with captopril and tempol showed reduced levels of serum sodium and an elevation in urinary sodium as compared to that of the CMA group. In addition, there was a significant increase in plasma renin and no change in plasma aldosterone in the CMA group with no significant differences in plasma renin or aldosterone observed during spironolactone, captopril, or tempol treatments. The increased expression of Na+/K+ ATPase-α1 in the CMA group suggests that active transport of Na+ to the blood could be causative of the observed hypertension. Furthermore, the EPR analysis confirmed an elevation in superoxide (O2-) radical levels in the CMA group, but the tempol/captopril treated acidotic groups showed less (O2-) compared to that of either the CMA group or control. Taken together, our data suggest that induction of CMA could potentially be causative of hypertension, while the mechanisms underlying the increased BP could be through the activation of intrarenal Ang II and induction of oxidative stress.
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Affiliation(s)
- Dinesh Aryal
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71201, USA; (D.A.); (T.R.); (J.C.C.)
- Department of Biomedical Affairs, Edward Via College of Osteopathic Medicine, Monroe, LA 71203, USA
| | - Tithi Roy
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71201, USA; (D.A.); (T.R.); (J.C.C.)
| | - Jean Christopher Chamcheu
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71201, USA; (D.A.); (T.R.); (J.C.C.)
| | - Keith E. Jackson
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71201, USA; (D.A.); (T.R.); (J.C.C.)
- Correspondence: ; Tel.: +1-318-342-1390
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Kumar G, Dey SK, Kundu S. Functional implications of vascular endothelium in regulation of endothelial nitric oxide synthesis to control blood pressure and cardiac functions. Life Sci 2020; 259:118377. [PMID: 32898526 DOI: 10.1016/j.lfs.2020.118377] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/24/2020] [Accepted: 08/31/2020] [Indexed: 11/29/2022]
Abstract
The endothelium is the innermost vascular lining performing significant roles all over the human body while maintaining the blood pressure at physiological levels. Malfunction of endothelium is thus recognized as a biomarker linked with many vascular diseases including but not limited to atherosclerosis, hypertension and thrombosis. Alternatively, prevention of endothelial malfunctioning or regulating the functions of its associated physiological partners like endothelial nitric oxide synthase can prevent the associated vascular disorders which account for the highest death toll worldwide. While many anti-hypertensive drugs are available commercially, a comprehensive description of the key physiological roles of the endothelium and its regulation by endothelial nitric oxide synthase or vice versa is the need of the hour to understand its contribution in vascular homeostasis. This, in turn, will help in designing new therapeutics targeting endothelial nitric oxide synthase or its interacting partners present in the cellular pool. This review describes the central role of vascular endothelium in the regulation of endothelial nitric oxide synthase while outlining the emerging drug targets present in the vasculature with potential to treat vascular disorders including hypertension.
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Affiliation(s)
- Gaurav Kumar
- Department of Biochemistry, University of Delhi, South Campus, New Delhi 110021, India
| | - Sanjay Kumar Dey
- Department of Biochemistry, University of Delhi, South Campus, New Delhi 110021, India; Center for Advanced Biotechnology and Medicine, Rutgers University, NJ 08854, USA
| | - Suman Kundu
- Department of Biochemistry, University of Delhi, South Campus, New Delhi 110021, India.
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Hussain H, Fadel A. Malignant Hypertension Without End-Organ Damage Secondary to Stressful Condition in a Female. Cureus 2020; 12:e10109. [PMID: 33005527 PMCID: PMC7523541 DOI: 10.7759/cureus.10109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Malignant hypertension (hypertensive emergency), is an extreme elevation of blood pressure under certain conditions that can lead to organ damage and other serious consequences. It is a common condition that affects about one in three Americans, according to the Centers for Disease Control and Prevention. An elevation of systolic blood pressure above 180 mmHg and diastolic blood pressure above 120 mmHg is considered a hypertensive emergency. This article addresses the case of a 61-year-old female patient who presented to the ER with a semicomatose and gasping condition and response to painful stimuli with an unclear voice. She also had unstable vital signs, with a blood pressure of 370/200 mmHg, a pulse rate of 115, a respiratory rate of 22, and a pulse oximetry of 96%, but no fever. Her son provided a brief history and reported that a stressful condition had occurred at home one hour before; she had begun to scream and been brought to the ER by ambulance in the condition described above. Cardiac monitoring and an electrocardiograph were performed and indicated a normal condition besides the unstable vital signs. Oxygen was administered via a nasal cannula with 20 mg of intravenous hydralazine, and the patient’s blood pressure improved progressively. Moreover, she regained consciousness with no end-organ damage. A hypertensive emergency is usually associated with end-organ damage, such as heart, kidney, eye, or brain damage. However, in this case, despite the extreme elevation of her blood pressure, the patient suffered no organ damage. It is essential to manage the extreme elevation of blood pressure as soon as possible and monitor the patient for consequences.
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Affiliation(s)
| | - Aya Fadel
- Internal Medicine, Florida International University, Hialeah Hospital, Miami, USA
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26
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Matta EG, Rubini DA, Araújo NC. Effect of systemic arterial hypertension and use of antiproteinuric drug in induction therapy for lupus nephritis. EINSTEIN-SAO PAULO 2020; 18:eAO5322. [PMID: 36083852 PMCID: PMC7453831 DOI: 10.31744/einstein_journal/2020ao5322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 12/12/2019] [Indexed: 11/05/2022] Open
Abstract
Objective Methods Results Conclusion
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Masilela C, Pearce B, Ongole JJ, Adeniyi OV, Benjeddou M. Cross-sectional study of prevalence and determinants of uncontrolled hypertension among South African adult residents of Mkhondo municipality. BMC Public Health 2020; 20:1069. [PMID: 32631300 PMCID: PMC7339580 DOI: 10.1186/s12889-020-09174-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/28/2020] [Indexed: 01/01/2023] Open
Abstract
Background Achieving the blood pressure treatment target in individuals with hypertension is a serious global health challenge. Furthermore, the actual burden of uncontrolled hypertension is poorly understood, especially in the developing countries. Therefore, this study comprehensively examined the prevalence and factors associated with uncontrolled hypertension in individuals receiving care at the primary healthcare facilities in the rural areas of Mkhondo Municipality in the Mpumalanga Province, South Africa. Methods In this cross-sectional study, 329 individuals attending care for hypertension were recruited from January 2019 to June 2019 at three primary healthcare centres, namely, Piet Retief hospital, Mkhondo town clinic and Thandukukhanya community health centre. Uncontrolled hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg in accordance with the South African Hypertension Society guideline (2014). Multiple logistic regression (Forward LR method) analysis was used to identify the significant determinants of uncontrolled hypertension. Results The majority of the participants were 55 years old and above (69.0%), Zulus (81.2%), non-smokers (84.19%) and had been diagnosed with hypertension for more than a year prior to the study (72.64%). The overall prevalence of uncontrolled hypertension was 56.83% (n = 187) with no significant difference between sexes, 57.38% male versus 56.88% female, respectively. In the multiple logistic regression model analysis after adjusting for confounding variables, obesity (AOR = 2.90; 95% CI 1.66–5.05), physical activity (AOR = 4.79; 95% CI 2.15–10.65) and HDL-C (AOR = 5.66; 95% CI 3.33–9.60) were the significant and independent determinants of uncontrolled hypertension in the cohort. Conclusion The high prevalence of uncontrolled hypertension in the study setting can be largely attributed to obesity, physical activity and dyslipidaemia. Treatment will require the collaborative efforts of individuals, clinicians and health authorities. All these determinants should be addressed decisively so as to achieve the treatment blood pressure targets in the study population.
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Affiliation(s)
- Charity Masilela
- Department of Biotechnology, University of the Western Cape, 7535, Bellville, Cape Town, South Africa.
| | - Brendon Pearce
- Department of Biotechnology, University of the Western Cape, 7535, Bellville, Cape Town, South Africa
| | - Joven Jebio Ongole
- Department of Family Medicine, Center for Teaching and Learning, Piet Retief Hospital, Mkhondo, South Africa
| | | | - Mongi Benjeddou
- Department of Biotechnology, University of the Western Cape, 7535, Bellville, Cape Town, South Africa
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Plotnikov MB, Aliev OI, Shamanaev AY, Sidekhmenova AV, Anishchenko AM, Fomina TI, Rydchenko VS, Khlebnikov AI, Anfinogenova YJ, Schepetkin IA, Atochin DN. Antihypertensive activity of a new c-Jun N-terminal kinase inhibitor in spontaneously hypertensive rats. Hypertens Res 2020; 43:1068-1078. [PMID: 32382155 DOI: 10.1038/s41440-020-0446-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 11/09/2022]
Abstract
c-Jun N-terminal kinases (JNKs) are involved in the myocardial and aortic remodeling, increased arterial tone, and arterial blood pressure elevation associated with hypertension. The aim of the present study was to investigate the antihypertensive effect of a new JNK inhibitor, 1H-indeno[1,2-b]quinoxalin-11-one oxime sodium salt (IQ-1S), on spontaneously hypertensive rats (SHRs). Experiments were performed using normotensive Wistar-Kyoto (WKY) rats and SHRs. Experimental groups of SHRs received IQ-1S intragastrically for 6 weeks in daily doses of 5 and 50 mg/kg; experimental groups of WKY rats received 50 mg/kg IQ-1S according to the same regimen. The IQ-1S administration regimen induced decreases in systolic blood pressure, mean arterial blood pressure, total peripheral resistance, blood viscosity, hematocrit, myocardial cell cross-sectional area, and aortic wall thickness in SHRs vs untreated SHRs. There were no significant differences in systolic blood pressure values between the control and experimental groups of WKY rats during the treatment period. A concentration-dependent decrease in the tone of carotid arterial rings isolated from SHRs was observed after JNK inhibitor application in vitro. Application of the JNK inhibitor diminished endothelin-1 secretion by human umbilical vein endothelial cells in vitro. The main mechanisms of the antihypertensive effect of IQ-1S included the attenuation of blood viscosity due to decreased hematocrit, a vasodilatory effect on arterial smooth muscle cells, and a decrease in endothelin-1 production by endothelial cells.
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Affiliation(s)
- Mark B Plotnikov
- Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, 3 Lenin Av., Tomsk, 634028, Russia. .,National Research Tomsk State University, Tomsk, Russia.
| | - Oleg I Aliev
- Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, 3 Lenin Av., Tomsk, 634028, Russia
| | - Aleksandr Y Shamanaev
- Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, 3 Lenin Av., Tomsk, 634028, Russia
| | - Anastasia V Sidekhmenova
- Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, 3 Lenin Av., Tomsk, 634028, Russia
| | - Anna M Anishchenko
- Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, 3 Lenin Av., Tomsk, 634028, Russia.,Department of Pharmacology, Siberian State Medical University, 2 Moskovsky Trakt, Tomsk, 634050, Russia
| | - Tatiana I Fomina
- Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, 3 Lenin Av., Tomsk, 634028, Russia
| | - Victoria S Rydchenko
- Department of Biophysics, Siberian State Medical University, 2 Moskovsky Trakt, Tomsk, 634050, Russia
| | - Andrei I Khlebnikov
- Kizhner Research Center, Tomsk Polytechnic University, Tomsk, 634050, Russia.,Research Institute of Biological Medicine, Altai State University, Barnaul, 656049, Russia
| | - Yana J Anfinogenova
- Kizhner Research Center, Tomsk Polytechnic University, Tomsk, 634050, Russia.,Cardiology Research Institute, Tomsk National Research Medical Center, 111a Kievskaya St., Tomsk, 634012, Russia
| | - Igor A Schepetkin
- Kizhner Research Center, Tomsk Polytechnic University, Tomsk, 634050, Russia.,Department of Microbiology and Immunology, Montana State University, Bozeman, MT, 59717, USA
| | - Dmitriy N Atochin
- Kizhner Research Center, Tomsk Polytechnic University, Tomsk, 634050, Russia.,Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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Amin AR, Kassab RB, Abdel Moneim AE, Amin HK. Comparison Among Garlic, Berberine, Resveratrol,Hibiscus sabdariffa, GenusZizyphus, Hesperidin, Red Beetroot,Catha edulis,Portulaca oleracea, and Mulberry Leaves in the Treatment of Hypertension and Type 2 DM: A Comprehensive Review. Nat Prod Commun 2020. [DOI: 10.1177/1934578x20921623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Diabetes mellitus (DM) and hypertension are 2 of the most prevalent diseases with poor impact on health status worldwide. In most cases, they coexist with other metabolic disorders as well as cardiac, micro- and macrovascular complications. Many plants are known for their hypotensive, cardioprotective, and/or antidiabetic activities. Their active ingredients either identified and isolated or still utilized as herbal preparations of certain plant parts. The use of medicinal plants comprises the main basis for most of the traditional medicine (TM) systems and procedures. As conventional medicines seem insufficient to control such progressive diseases, herbal agents from TM could be used as adjuvant with good impact on disease control and progression as well as other concomitant health conditions. The aim of this study is to compare the efficacy of 10 different herbal medicines of botanical origin or herbal preparations in the management of hypertension and its cardiovascular complications and type 2 DM along with various coexisting health disorders. These herbal medicines are garlic, berberine, resveratrol, Hibiscus sabdariffa, Zizyphus ( oxyphylla, mucronate, jujube, rugosa), hesperidin, red beetroot, Catha edulis, mulberry leaves, and Portulaca oleracea.
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Affiliation(s)
- Amira R. Amin
- Cardiology and Oncology Section, Nasser Institute for Research and Treatment, Cairo, Egypt
| | - Rami B. Kassab
- Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo, Egypt
| | - Ahmed E. Abdel Moneim
- Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo, Egypt
| | - Hatem K. Amin
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Egypt
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Psara E, Pentieva K, Ward M, McNulty H. Critical review of nutrition, blood pressure and risk of hypertension through the lifecycle: do B vitamins play a role? Biochimie 2020; 173:76-90. [PMID: 32289470 DOI: 10.1016/j.biochi.2020.03.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/17/2022]
Abstract
Hypertension is the leading cause of preventable mortality worldwide, contributing to over 9 million deaths per annum, predominantly owing to cardiovascular disease. The association of obesity, physical inactivity and alcohol with elevated blood pressure (BP) is firmly established. Weight loss or other dietary strategies, such as the Dietary Approaches to Stop Hypertension (DASH) diet, have been shown to be effective in lowering BP. Additionally, specific nutrients are recognised to contribute to BP, with higher sodium intake linked with an increased risk of hypertension, while potassium is associated with a reduced risk of hypertension. Of note, emerging evidence has identified a novel role for one-carbon metabolism and the related B vitamins, particularly riboflavin, in BP. Specifically in adults genetically at risk of developing hypertension, owing to the common C677T polymorphism in MTHFR, supplemental riboflavin (co-factor for MTHFR) was shown in randomised trials to lower systolic BP by up to 13 mmHg. A BP response to intervention of this magnitude could have important clinical impacts, given that a reduction in systolic BP of 10 mmHg is estimated to decrease stroke risk by 40%. This review aims to explore the factors contributing to hypertension across the lifecycle and to critically evaluate the evidence supporting a role for nutrition, particularly folate-related B vitamins, in BP and risk of hypertension. In addition, gaps in our current knowledge that warrant future research in this area, will be identified.
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Affiliation(s)
- Elina Psara
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, BT52 1SA, United Kingdom
| | - Kristina Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, BT52 1SA, United Kingdom
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, BT52 1SA, United Kingdom
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, BT52 1SA, United Kingdom.
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Abstract
Nitrite, an anion produced from the oxidative breakdown of nitric oxide (NO), has traditionally been viewed as an inert molecule. However, this dogma has been challenged with the findings that nitrite can be readily reduced to NO under pathological conditions, hence representing a physiologically relevant storage reservoir of NO either in the blood or tissues. Nitrite administration has been demonstrated to improve myocardial function in subjects with heart failure and to lower the blood pressure in hypertensive subjects. Thus, extensive amount of work has since been carried out to investigate the therapeutic potential of nitrite in treating cardiovascular diseases, especially hypertension. Studies done on several animal models of hypertension have demonstrated the efficacy of nitrite in preventing and ameliorating the pathological changes associated with the disease. This brief review of the current findings aims to re-evaluate the use of nitrite for the treatment of hypertension and in particular to highlight its role in improving endothelial function.
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Affiliation(s)
- Wei Chih Ling
- Department of Pre-clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor; and
| | - Mohd Rais Mustafa
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Dharmani Devi Murugan
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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CaSR participates in the regulation of vascular tension in the mesentery of hypertensive rats via the PLC‑IP3/AC‑V/cAMP/RAS pathway. Mol Med Rep 2019; 20:4433-4448. [PMID: 31485595 PMCID: PMC6797953 DOI: 10.3892/mmr.2019.10620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/12/2019] [Indexed: 12/20/2022] Open
Abstract
Hypertension is a cardiovascular disease that severely impairs human health; however, its specific etiology and pathogenesis are complex. The present study investigated the effects of the calcium sensing receptor (CaSR) on vascular tone in spontaneously hypertensive rats (SHRs), and clarified the role and mechanism of CaSR in regulating this property with respect to the phospholipase C (PLC)-inositol 1,4,5-triphosphate (IP3)/adenylate cyclase-V(AC-V)/cyclic adenosine monophosphate (cAMP)/renin-angiotensin system (RAS) pathway in these animals. CaSR protein expression in the mesenteric artery (MA) of rats and CaSR protein expression in SHRs were significantly reduced. Based on wire myography studies, vasoconstriction was significantly augmented and vasodilatation was attenuated in SHRs, and this effect was endothelium-independent. The CaSR calcimimetic NPSR568 and inhibitor NPS2143 reduced vasoconstriction and enhanced vasodilation in SHRs. Furthermore, pretreatment with PLC-IP3/AC-V/cAMP/RAS pathway blockers significantly reduced the vasoconstriction response and enhanced the vasodilator response in SHRs and Wistar-Kyoto rats (WKY), and these effects were partially dependent on the endothelium. Additionally, pretreatment with CaSR inhibitors were determined to cooperate with the PLC-IP3/AC-V/cAMP/RAS pathway inhibitors to significantly reduce vasoconstriction and enhance vasodilation in SHRs and WKY. Our results demonstrated that CaSR is functionally expressed in the MA of SHRs, and that CaSR expression is decreased in SHRs. Additionally, vasoconstriction was enhanced while vasodilatation was attenuated in SHRs; these processes were determined to be endothelium-independent. CaSR is involved in the regulation of blood pressure and vascular tension in SHRs and WKYs. In association with mechanistic differences, this effect was proposed to be partially endothelium-dependent and mediated by the PLC-IP3/AC-V/cAMP/RAS pathway.
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Katsi V, Didagelos M, Skevofilax S, Armenis I, Kartalis A, Vlachopoulos C, Karvounis H, Tousoulis D. GUT Microbiome-GUT Dysbiosis-Arterial Hypertension: New Horizons. Curr Hypertens Rev 2019; 15:40-46. [PMID: 29895255 DOI: 10.2174/1573402114666180613080439] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 01/18/2023]
Abstract
Arterial hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. The human microbiome refers to the community of microorganisms that live in or on the human body. They influence human physiology by interfering in several processes such as providing nutrients and vitamins in Phase I and Phase II drug metabolism. The human gut microbiota is represented mainly by Firmicutes and Bacteroidetes and to a lesser degree by Actinobacteria and Proteobacteria, with each individual harbouring at least 160 such species. Gut microbiota contributes to blood pressure homeostasis and the pathogenesis of arterial hypertension through production, modification, and degradation of a variety of microbial-derived bioactive metabolites. Animal studies and to a lesser degree human research has unmasked relative mechanisms, mainly through the effect of certain microbiome metabolites and their receptors, outlining this relationship. Interventions to utilize these pathways, with probiotics, prebiotics, antibiotics and fecal microbiome transplantation have shown promising results. Personalized microbiome-based disease prediction and treatment responsiveness seem futuristic. Undoubtedly, a long way of experimental and clinical research should be pursued to elucidate this novel, intriguing and very promising horizon.
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Affiliation(s)
- Vasiliki Katsi
- 1st Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Matthaios Didagelos
- 1st Cardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Iakovos Armenis
- Cardiology Department, Skylitseio General Hospital, Chios, Greece
| | | | - Charalambos Vlachopoulos
- 1st Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Haralambos Karvounis
- 1st Cardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Tousoulis
- 1st Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Bravo FI, Mas‐Capdevila A, Margalef M, Arola‐Arnal A, Muguerza B. Novel Antihypertensive Peptides Derived from Chicken Foot Proteins. Mol Nutr Food Res 2019; 63:e1801176. [PMID: 30924597 PMCID: PMC6617776 DOI: 10.1002/mnfr.201801176] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/15/2019] [Indexed: 12/26/2022]
Abstract
SCOPE Chicken foot proteins have recently been demonstrated by the group to be a great source of hydrolysates with antihypertensive properties. The aim of this study was to isolate and identify angiotensin I-converting enzyme inhibitory (ACEI) peptides from chicken foot hydrolysate Hpp11 and to test their antihypertensive properties. METHODS AND RESULTS Peptides are separated into fractions according to their molecular size and hydrophobicity by ultrafiltration and RP-HPLC, respectively. Subsequent peptide identification in the two fractions that present the highest ACEI activities is carried out by HPLC-MS. Ten of the identified peptides are synthesized and five of them show ACEI (IC50 ) values lower than 100 µm. The antihypertensive effects of these ACEI peptides after oral administration is evaluated in spontaneously hypertensive rats. The peptides AVFQHNCQE and QVGPLIGRYCG exhibit antihypertensive activity when administered at an oral dose of 10 mg kg-1 body weight. The maximal decrease in systolic blood pressure is recorded 6 h after their administration (-25.07 ± 4.21 and -10.94 ± 1.96 mmHg, respectively). CONCLUSION These results suggest that AVFQHNCQE and QVGPLIGRYCG could be used as functional ingredients with antihypertensive effects, although it would be necessary to perform bioavailability and clinical studies to demonstrate their efficiency in humans.
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Affiliation(s)
- Francisca I. Bravo
- Universitat Rovira i VirgiliDepartment of Biochemistry and BiotechnologyNutrigenomics Research GroupC/ Marcel.lí Domingon 1Tarragona43007Spain
| | - Anna Mas‐Capdevila
- Universitat Rovira i VirgiliDepartment of Biochemistry and BiotechnologyNutrigenomics Research GroupC/ Marcel.lí Domingon 1Tarragona43007Spain
| | - Maria Margalef
- Universitat Rovira i VirgiliDepartment of Biochemistry and BiotechnologyNutrigenomics Research GroupC/ Marcel.lí Domingon 1Tarragona43007Spain
| | - Anna Arola‐Arnal
- Universitat Rovira i VirgiliDepartment of Biochemistry and BiotechnologyNutrigenomics Research GroupC/ Marcel.lí Domingon 1Tarragona43007Spain
| | - Begoña Muguerza
- Universitat Rovira i VirgiliDepartment of Biochemistry and BiotechnologyNutrigenomics Research GroupC/ Marcel.lí Domingon 1Tarragona43007Spain
- EURECAT‐Technology Centre of CataloniaTechnological Unit of Nutrition and HealthAvda. Universitatn 1Reus43204Spain
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Martin M, Hagemann D, Nguyen TT, Schwarz L, Khedr S, Moskopp ML, Henle T, Deussen A. Plasma concentrations and ACE-inhibitory effects of tryptophan-containing peptides from whey protein hydrolysate in healthy volunteers. Eur J Nutr 2019; 59:1135-1147. [DOI: 10.1007/s00394-019-01974-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/17/2019] [Indexed: 12/19/2022]
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Cilhoroz BT, Schifano ED, Panza GA, Ash GI, Corso L, Chen M, Deshpande V, Zaleski A, Farinatti P, Santos LP, Taylor BA, O'Neill RJ, Thompson PD, Pescatello LS. FURIN variant associations with postexercise hypotension are intensity and race dependent. Physiol Rep 2019; 7:e13952. [PMID: 30706700 PMCID: PMC6356167 DOI: 10.14814/phy2.13952] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 12/16/2022] Open
Abstract
FURIN is a proprotein convertase subtilisin/kexin enzyme important in pro-renin receptor processing, and FURIN (furin, paired basic amino acid cleaving enzyme) variants are involved in multiple aspects of blood pressure (BP) regulation. Therefore, we examined associations among FURIN variants and the immediate blood pressure (BP) response to bouts of aerobic exercise, termed postexercise hypotension (PEH). Obese (30.9 ± 3.6 kg m-2 ) Black- (n = 14) and White- (n = 9) adults 42.0 ± 9.8 year with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous (VIGOROUS) and moderate (MODERATE) intensity cycling and control. Subjects were then attached to an ambulatory BP monitor for 19 h. We performed deep-targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. FURIN genotypes were coded as the number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini-Yekutieli multiple testing corrected P-values under time-adjusted linear models for 19 hourly BP measurements. After VIGOROUS over 19 h, as FURIN #MA increased in rs12917264 (P = 2.4E-04) and rs75493298 (P = 6.4E-04), systolic BP (SBP) decreased 30.4-33.7 mmHg; and in rs12917264 (P = 1.6E-03) and rs75493298 (P = 9.7E-05), diastolic BP (DBP) decreased 17.6-20.3 mmHg among Blacks only. In addition, after MODERATE over 19 h in FURIN rs74037507 (P = 8.0E-04), as #MA increased, SBP increased 20.8 mmHg among Blacks only. Whereas, after MODERATE over the awake hours in FURIN rs1573644 (P = 6.2E-04), as #MA increased, DBP decreased 12.5 mmHg among Whites only. FURIN appears to exhibit intensity and race-dependent associations with PEH that merit further exploration among a larger, ethnically diverse sample of adults with hypertension.
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Affiliation(s)
| | | | - Gregory A. Panza
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | | | - Lauren Corso
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
| | - Ming‐Hui Chen
- Department of StatisticsUniversity of ConnecticutStorrsConnecticut
| | - Ved Deshpande
- Department of StatisticsUniversity of ConnecticutStorrsConnecticut
| | - Amanda Zaleski
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | - Paulo Farinatti
- Department of Physical Activity SciencesRio de Janeiro State UniversityRio de JaneiroBrazil
| | - Lucas P. Santos
- Department of Medical SciencesFederal University of Rio Grande do SulPorto AlegreBrazil
| | - Beth A. Taylor
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | - Rachel J. O'Neill
- Institute for Systems GenomicsUniversity of ConnecticutStorrsConnecticut
- Department of Molecular and Cell BiologyUniversity of ConnecticutStorrsConnecticut
| | - Paul D. Thompson
- Department of Preventive CardiologyHartford HospitalHartfordConnecticut
| | - Linda S. Pescatello
- Department of KinesiologyUniversity of ConnecticutStorrsConnecticut
- Institute for Systems GenomicsUniversity of ConnecticutStorrsConnecticut
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Molani Gol R, Rafraf M, Asghari Jafarabadi M. Evaluation of cardiovascular risk factors in women referring to health centers in Tabriz, Iran, 2017. Health Promot Perspect 2018; 8:315-322. [PMID: 30479987 PMCID: PMC6249489 DOI: 10.15171/hpp.2018.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/11/2018] [Indexed: 01/25/2023] Open
Abstract
Background: Cardiovascular disease (CVD) is the leading cause of mortality among men and women around the world. The aim of this study was to investigate major cardiovascular risk factors in women living in the Tabriz petrochemical region, Iran during spring 2017. Methods: In this cross-sectional study, a sample of 152 women aged 30-55 years was selected from who attended health center in Tabriz, Iran. Anthropometric measurements, blood pressure,daily dietary intakes and fasting serum lipid profile, oxidized LDL (ox-LDL) and high sensitivity C-reactive protein (hs-CRP) were evaluated. Results: The prevalence of overweight, general and abdominal obesity (based on Body mass index [BMI] and waist circumference [WC]) was 34.2%, 52.6%, and 73.7%, respectively. Eleven point two percent and 4.6% of women had pre-hypertension based on systolic blood pressure (SBP)and diastolic blood pressure (DBP). High serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C)were determined in 32.5%, 25.7%, 17.8% and 56.6% of subjects, respectively. The median of serum ox-LDL concentration was 3181.5 ng/L. Sixty-five point eight percent of participants hadhigh hs-CRP levels. In the multiple-adjusted quintile regression analysis, significant relationships were found between serum ox-LDL and age (B = 96.7, P = 0.003) and between serum hs-CRP with diastolic blood pressure (B = 0.1, P = 0.083) and TG (B = 0.01, P = 0.088). Conclusion: The high prevalence of cardiovascular risk factors in the studied women warrants more public health attention. The results also suggest that aging was associated with high serumox-LDL and increased serum hs-CRP levels, which may reflect enhanced DBP and serum TG.
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Affiliation(s)
- Roghayeh Molani Gol
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
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Yeo QM, Hammond DA, Li C, Olsen KM. Impact of chronic hypertension on time to goal mean arterial pressure and clinical outcomes in critically ill patients with septic shock requiring vasopressors. J Crit Care 2018; 49:143-148. [PMID: 30428412 DOI: 10.1016/j.jcrc.2018.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 09/23/2018] [Accepted: 10/28/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Mean arterial pressure (MAP) reflects the adequacy of tissue perfusion. In septic shock, vasopressors are recommended to target MAP ≥65 mmHg. The impact of chronic hypertension (HTN) on MAP achievement and outcomes are uncertain. MATERIALS AND METHODS This retrospective, cohort study compared time to goal MAP in critically ill patients with septic shock admitted between May 2014 and July 2016. Between-group differences of patients with and without HTN were compared using appropriate statistical tests. To adjust for imbalances in baseline characteristics, inverse probability of treatment weighting (IPTW) procedure was performed. RESULTS Of the 133 included patients, 75 (56.4%) had a history of HTN. Baseline characteristics were mostly similar. Patients with HTN had higher in-hospital (49.3 vs. 31.0%, p = .035) and 28-day mortality (53.3 vs. 31.0%, p = .011). After weighting and adjustment for imbalanced variables, patients with HTN achieved goal MAP more rapidly than those without (HR: 1.84, 95% CI: 1.14-2.96; p = .012). However, they also have higher odds of dying within 28 days of discharge (OR: 3.04, 95% CI: 1.11-8.38; p = .031). CONCLUSIONS Patients with HTN achieved goal MAP more rapidly but had higher odds of mortality.
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Affiliation(s)
- Qiu Min Yeo
- Changi General Hospital, 2 Simei Street 3, 529889, Singapore.
| | | | - Chenghui Li
- College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W. Markham, #522, Little Rock, AR 72205, USA.
| | - Keith M Olsen
- College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W. Markham, #522, Little Rock, AR 72205, USA.
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Liao W, Jahandideh F, Fan H, Son M, Wu J. Egg Protein-Derived Bioactive Peptides: Preparation, Efficacy, and Absorption. ADVANCES IN FOOD AND NUTRITION RESEARCH 2018; 85:1-58. [PMID: 29860972 DOI: 10.1016/bs.afnr.2018.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The hen's egg is an important protein source of human diet. On average one large egg contains ~6g protein, which contributes to ~11% of daily protein intake. As a high-quality protein, egg proteins are well recognized as excellent sources of bioactive peptides. The objectives of this chapter are to introduce generation, bioactivities, and absorption of egg protein-derived bioactive peptides. Research on egg protein-derived bioactive peptides has been progressed during the past decades. Enzymatic hydrolysis is the major technique to prepare bioactive peptides from egg protein. Quantitative structure-activity relationships-aided in silico prediction is increasingly applied as a promising tool for efficient prediction of novel bioactive peptides. A number of bioactive peptides from egg proteins have been characterized for antioxidant, immunomodulatory, antihypertensive, antidiabetic, anticancer, and antimicrobial activities. Egg protein-derived peptides that can improve bone health have been reported as well. However, molecular mechanisms of many peptides are not fully understood. The stability and absorption routes, bioavailability, safety, and production of bioactive peptides await further investigation.
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Affiliation(s)
- Wang Liao
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Forough Jahandideh
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Hongbing Fan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Myoungjin Son
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Jianping Wu
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada; Cardiovascular Research Centre, University of Alberta, Edmonton, AB, Canada.
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Enawgaw B, Adane N, Terefe B, Asrie F, Melku M. A comparative cross-sectional study of some hematological parameters of hypertensive and normotensive individuals at the university of Gondar hospital, Northwest Ethiopia. BMC HEMATOLOGY 2017; 17:21. [PMID: 29209503 PMCID: PMC5704458 DOI: 10.1186/s12878-017-0093-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022]
Abstract
Background Hypertension is a major health problem worldwide. It can lead to cardiovascular disease and also leads to functional disturbances including hematological parameters. The abnormalities of haematological parameters may enhance an end-organ damage. Therefore, the aim of this study was to assess some hematological parameters of hypertensive individuals in comparison with normotensive individuals at University of Gondar hospital, northwest Ethiopia. Methods A cross sectional comparative study was conducted from October to November 2015 on a total of 126 hypertensive and 126 normotensive individuals at University of Gondar Hospital. All participants after taking informed consent were interviewed for detailed history and 3 ml of blood was collected for hematological test analysis. Independent t-test and the Mann Whitney u-test were used to find out significant difference and Pearson’s and Spearman’s correlation were used for correlation test. P values less than 0.05 was considered the level of significance. Result From a total of 252 study subjects, about 67.5% were females. The mean age of study subjects was 50.3 ± 11 years for hypertensive individuals and 49.8 ± 11.6 years for normotensive individuals with range of 18–65 years. In the present study, the median (IQR) value of WBC, RBC, Hgb, HCT, MCV and the mean value of MCHC, RDW, MPV and PDW were significantly higher in hypertensive group compared to apparently healthy normotensive groups. Additionally, WBC, RBC, Hgb, HCT and PLT showed statistically significant positive correlations with blood pressure indices. Platelet count and MCH did not show statistically significant difference between the two groups. Conclusion Hypertension has impact on hematological parameters. In this study, the mean and median values of haematological parameters in hypertensive individuals were significantly different compared to apparently healthy normotensive individuals. Hence, hematological parameters can be used to monitor the prognosis of the disease and manage hypertensive related complications, and it is important to assess hematological parameters for hypertensive individuals which may help to prevent complications associated hematological disorders. Electronic supplementary material The online version of this article (doi: 10.1186/s12878-017-0093-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bamlaku Enawgaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigist Adane
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Betelihem Terefe
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Wu J, Liao W, Udenigwe CC. Revisiting the mechanisms of ACE inhibitory peptides from food proteins. Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2017.07.011] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Lowe FJ, Luettich K, Talikka M, Hoang V, Haswell LE, Hoeng J, Gaca MD. Development of an Adverse Outcome Pathway for the Onset of Hypertension by Oxidative Stress-Mediated Perturbation of Endothelial Nitric Oxide Bioavailability. ACTA ACUST UNITED AC 2017. [DOI: 10.1089/aivt.2016.0031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Frazer J. Lowe
- British American Tobacco (Investments) Ltd., Group Research and Development, Southampton, United Kingdom
| | - Karsta Luettich
- Philip Morris International R&D, Philip Morris Products S.A. (part of Philip Morris International group of companies), Neuchatel, Switzerland
| | - Marja Talikka
- Philip Morris International R&D, Philip Morris Products S.A. (part of Philip Morris International group of companies), Neuchatel, Switzerland
| | - Vy Hoang
- Selventa, One Alewife Center, Cambridge, Massachusetts
| | - Linsey E. Haswell
- British American Tobacco (Investments) Ltd., Group Research and Development, Southampton, United Kingdom
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A. (part of Philip Morris International group of companies), Neuchatel, Switzerland
| | - Marianna D. Gaca
- British American Tobacco (Investments) Ltd., Group Research and Development, Southampton, United Kingdom
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Khedr S, Deussen A, Kopaliani I, Zatschler B, Martin M. Effects of tryptophan-containing peptides on angiotensin-converting enzyme activity and vessel tone ex vivo and in vivo. Eur J Nutr 2017; 57:907-915. [PMID: 28102435 DOI: 10.1007/s00394-016-1374-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 12/22/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE Over-activation of the renin-angiotensin axis and worsening of vascular function are critical contributors to the development of hypertension. Therefore, inhibition of angiotensin-converting enzyme (ACE), a key factor of the renin-angiotensin axis, is a first line treatment of hypertension. Besides pharmaceutical ACE inhibitors, some natural peptides have been shown to exert ACE-inhibiting properties with antihypertensive effects and potentially beneficial effects on vascular function. In this study, the ACE-inhibiting potential and effects on vascular function of tryptophan-containing peptides were evaluated. METHODS The ACE inhibitory action and stability of tryptophan-containing peptides was tested in endothelial cells-a major source of whole body ACE activity. Furthermore, the efficacy of peptides on vascular ACE activity, as well as vessel tone was assessed both ex vivo and in vivo. RESULTS In human umbilical vein endothelial cells (HUVEC), isoleucine-tryptophan (IW) had the highest ACE inhibitory efficacy, followed by glutamic acid-tryptophan (EW) and tryptophan-leucine (WL). Whereas none of the peptides affected basal vessel tone (rat aorta), angiotensin I-induced vasoconstriction was blocked. IW effectively inhibited aortic ACE activity ex vivo taken from SHRs after 14-weeks of oral treatment with IW. Furthermore, IW treated SHRs showed better endothelium-dependent vessel relaxation compared to placebo. CONCLUSION This study shows strong ACE-inhibiting effects of IW, EW and WL in HUVECs and aorta. The peptides effectively counteract angiotensin-induced vasoconstriction and preserve endothelium-dependent vessel relaxation. Thus, tryptophan-containing peptides and particularly IW may serve as innovative food additives with the goal of protection from angiotensin II-induced worsening of vascular function.
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Affiliation(s)
- Sherif Khedr
- Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Germany
| | - Andreas Deussen
- Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Germany
| | - Irakli Kopaliani
- Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Germany
| | - Birgit Zatschler
- Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Germany
| | - Melanie Martin
- Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, Germany.
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Peach H, Gaultney JF, Reeve CL. Sleep characteristics, body mass index, and risk for hypertension in young adolescents. J Youth Adolesc 2015; 44:271-84. [PMID: 25001215 DOI: 10.1007/s10964-014-0149-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/25/2014] [Indexed: 12/17/2022]
Abstract
Inadequate sleep has been identified as a risk factor for a variety of health consequences. For example, short sleep durations and daytime sleepiness, an indicator of insufficient sleep and/or poor sleep quality, have been identified as risk factors for hypertension in the adult population. However, less evidence exists regarding whether these relationships hold within child and early adolescent samples and what factors mediate the relationship between sleep and risk for hypertension. Using data from the Study of Early Child Care and Youth Development, the present study examined body mass index (BMI) as a possible mediator for the effects of school-night sleep duration, weekend night sleep duration, and daytime sleepiness on risk for hypertension in a sample of sixth graders. The results demonstrated gender-specific patterns. Among boys, all three sleep characteristics predicted BMI and yielded significant indirect effects on risk for hypertension. Oppositely, only daytime sleepiness predicted BMI among girls and yielded a significant indirect effect on risk for hypertension. The findings provide clarification for the influence of sleep on the risk for hypertension during early adolescence and suggest a potential need for gender-specific designs in future research and application endeavors.
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Affiliation(s)
- Hannah Peach
- Health Psychology Program, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223-0001, USA,
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Jang DJ, Bae SK, Oh E. Coated dextrin microcapsules of amlodipine incorporable into orally disintegrating tablets for geriatric patients. Biomed Pharmacother 2014; 68:1117-24. [DOI: 10.1016/j.biopha.2014.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 10/16/2014] [Indexed: 11/27/2022] Open
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