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Wang S, Wu J, Wang Q, Zhang Y, Yuan H, Wang J, Wu Y, Xu Y, Ji N, Quan B, Wang H, Shen Q. Evaluation of a miniature mass spectrometer based point-of-care-test method for direct analysis of amlodipine and benazepril in whole blood. J Pharm Biomed Anal 2024; 245:116194. [PMID: 38704878 DOI: 10.1016/j.jpba.2024.116194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 05/07/2024]
Abstract
A miniature mass spectrometer (mMS) based point-of-care testing (POCT) method was evaluated for on-site detecting the hypertension drugs, amlodipine and benazepril. The instrument parameters, including voltage, ISO1, ISO2, and CID, were optimized, under which the target compounds could be well detected in MS2. When these two drugs were injected simultaneously, the mutual ionization inhibition and mutual reduction between amlodipine and benazepril were evaluated. This phenomenon was severe on the precursor ions but had a small impact on the product ions, thus making this POCT method suitable for analysis using product ions. Finally, the method was validated and applied. The blood samples from patients were tested one hour after oral administration of the drugs (20 mg), and the benazepril was quantitatively analyzed using a standard curve, with detected concentrations ranging from 190.6 to 210 μg L-1 and a relative standard deviation (RSD) of 8.6 %. In summary, amlodipine has low sensitivity and can only be detected at higher concentrations, while benazepril has high sensitivity, good linearity, and even meets semi-quantitative requirements. The research results of this study are of great clinical significance for monitoring blood drug concentrations during hypertension medication, predicting drug efficacy, and customizing individualized medication plans.
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Affiliation(s)
- Shiqi Wang
- Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo 315000, China
| | - Jiahui Wu
- Laboratory of Food Nutrition and Clinical Research, Institute of Seafood, Zhejiang Gongshang University, Hangzhou, China
| | - Qingcheng Wang
- Hangzhou Linping Hospital of Traditional Chinese Medicine, Linping, Zhejiang 311106, China
| | - Yunfeng Zhang
- Institute of Forensic Science, Ministry of Public Security, Beijing 100038, China
| | - Hong Yuan
- First People's Hospital of Linping District, Hangzhou, China
| | - Jianding Wang
- Hangzhou Linping Hospital of Traditional Chinese Medicine, Linping, Zhejiang 311106, China
| | - Yonghui Wu
- Hangzhou Linping Hospital of Traditional Chinese Medicine, Linping, Zhejiang 311106, China
| | - Yaxi Xu
- Central Hospital of Haining, Haining 314408, China
| | - Na Ji
- Hangzhou Linping Hospital of Traditional Chinese Medicine, Linping, Zhejiang 311106, China
| | - Bin Quan
- Hangzhou Linping Hospital of Traditional Chinese Medicine, Linping, Zhejiang 311106, China.
| | - Haixing Wang
- Key Laboratory of Drug Monitoring and Control of Zhejiang Province, National Anti-Drug Laboratory Zhejiang Regional Center, Hangzhou, China.
| | - Qing Shen
- Panvascular Diseases Research Center, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou 324000, China; Laboratory of Food Nutrition and Clinical Research, Institute of Seafood, Zhejiang Gongshang University, Hangzhou, China.
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Nyame S, Boateng D, Heeres P, Gyamfi J, Gafane-Matemane LF, Amoah J, Iwelunmor J, Ogedegbe G, Grobbee D, Asante KP, Klipstein-Grobusch K. Community-Based Strategies to Improve Health-Related Outcomes in People Living With Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Glob Heart 2024; 19:51. [PMID: 38883258 PMCID: PMC11177843 DOI: 10.5334/gh.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/18/2024] [Indexed: 06/18/2024] Open
Abstract
Background Individuals living with hypertension are at an increased risk of cardiovascular- and cerebrovascular-related outcomes. Interventions implemented at the community level to improve hypertension control are considered useful to prevent cardiovascular and cerebrovascular events; however, systematic evaluation of such community level interventions among patients living in low- and middle-income countries (LMICs) is scarce. Methods Nine databases were searched for randomized controlled trials (RCTs) and cluster randomized control trials (cRCTs) implementing community level interventions in adults with hypertension in LMICs. Studies were included based on explicit focus on blood pressure control. Quality assessment was done using the Revised Cochrane Risk of Bias tool for randomized trials (ROBS 2). Results were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Fixed-effect meta-analyses were conducted for studies that reported continuous outcome measures. Results We identified and screened 7125 articles. Eighteen studies, 7 RCTs and 11 cRCTs were included in the analysis. The overall summary effect of blood pressure control was significant, risk ratio = 1.48 (95%CI = 1.40-1.57, n = 12). Risk ratio for RCTs was 1.68 (95%CI = 1.40-2.01, n = 5), for cRCTs risk ratio = 1.46 (95%CI = 1.32-1.61, n = 7). For studies that reported individual data for the multicomponent interventions, the risk ratio was 1.27 (95% CI = 1.04-1.54, n = 3). Discussion Community-based strategies are relevant in addressing the burden of hypertension in LMICs. Community-based interventions can help decentralize hypertension care in LMIC and address the access to care gap without diminishing the quality of hypertension control.
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Affiliation(s)
- Solomon Nyame
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
- Kintampo Health Research Centre, Ghana
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Pauline Heeres
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Joyce Gyamfi
- Department of Global Health, New York University School of Global Public Health, New York University, New York, NY, USA
| | - Lebo F. Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, North-West Province, South Africa
| | | | - Juliet Iwelunmor
- Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
| | - Diederick Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | | | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Dzau VJ, Hodgkinson CP. Precision Hypertension. Hypertension 2024; 81:702-708. [PMID: 38112080 DOI: 10.1161/hypertensionaha.123.21710] [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] [Indexed: 12/20/2023]
Abstract
Hypertension affects >1 billion people worldwide. Complications of hypertension include stroke, renal failure, cardiac hypertrophy, myocardial infarction, and cardiac failure. Despite the development of various antihypertensive drugs, the number of people with uncontrolled hypertension continues to rise. While the lack of compliance associated with frequent side effects to medication is a contributory issue, there has been a failure to consider the diverse nature of hypertensive populations. Instead, we propose that hypertension can only be truly managed by precision. A precision medicine approach would consider each patient's unique factors. In this review, we discuss the progress toward precision medicine for hypertension with more predictiveness and individualization of treatment. We will highlight the advances in data science, omics (genomics, metabolomics, proteomics, etc), artificial intelligence, gene therapy, and gene editing and their application to precision hypertension.
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Affiliation(s)
- Victor J Dzau
- Mandel Center for Hypertension and Atherosclerosis, the Duke Cardiovascular Research Center, Duke University Medical Center, Durham, NC (V.J.D., C.P.H.)
- National Academy of Medicine, Washington, DC (V.J.D.)
| | - Conrad P Hodgkinson
- Mandel Center for Hypertension and Atherosclerosis, the Duke Cardiovascular Research Center, Duke University Medical Center, Durham, NC (V.J.D., C.P.H.)
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Du T, Huang J, Xu X, Xiong S, Zhang L, Xu Y, Zhao X, Huang T, Xiao M, Xiong T, Xie M. Effects of fermentation with Lactiplantibacillus plantarum NCU116 on the antihypertensive activity and protein structure of black sesame seed. Int J Biol Macromol 2024; 262:129811. [PMID: 38302018 DOI: 10.1016/j.ijbiomac.2024.129811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 02/03/2024]
Abstract
Effects of fermentation by Lactobacillus Plantarum NCU116 on the antihypertensive potential of black sesame seed (BSS) and structure characteristics of fermented black sesame seed protein (FBSSP) were investigated. Angiotensin-I-converting enzyme (ACE) inhibition and zinc chelating ability of fermented black sesame seed hydrolysate (FBSSH) reached the highest of 60.78 ± 3.67 % and 2.93 ± 0.04 mg/mL at 48 h and 60 h of fermentation, respectively. Additionally, the antioxidant activities of FBSSH and surface hydrophobicity of FBSSP were increased noticeably by fermentation. The α-helix and β-rotation of FBSSP tended to decrease and increase, respectively, during fermentation. Correlation analysis indicated strong positive relationships between β-turn and ACE inhibition activity as well as zinc chelating ability with correlation coefficients r of 0.8976 and 0.8932. Importantly, novel ACE inhibitory peptides LLLPYY (IC50 = 12.20 μM) and ALIPSF (IC50 = 558.99 μM) were screened from FBSSH at 48 h using in silico method. Both peptides showed high antioxidant activities in vitro. Molecular docking analysis demonstrated that the hydrogen bond connected with zinc ions of ACE mainly attributed to the potent ACE inhibitory activity of LLLPYY. The findings indicated that fermentation by Lactobacillus Plantarum NCU116 is an effective method to enhance the antihypertensive potential of BSS.
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Affiliation(s)
- Tonghao Du
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China
| | - Jinqing Huang
- Institute of Agricultural Products Processing, Jiangxi Academy of Agricultural Sciences, No. 602 Nanlian Road, Nanchang 330200, China
| | - Xiaoyan Xu
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China
| | - Shijin Xiong
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China
| | - Linli Zhang
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China
| | - Yazhou Xu
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China
| | - Xueting Zhao
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China
| | - Tao Huang
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China; International Institute of Food Innovation, Nanchang University, Luozhu Road, Xiaolan Economic and Technological Development Zone, Nanchang 330052, China
| | - Muyan Xiao
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China; International Institute of Food Innovation, Nanchang University, Luozhu Road, Xiaolan Economic and Technological Development Zone, Nanchang 330052, China
| | - Tao Xiong
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China; State Key Laboratory of Food Science and Resources, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, China.
| | - Mingyong Xie
- School of Food Science and Technology, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, PR China; State Key Laboratory of Food Science and Resources, Nanchang University, No. 235 Nanjing East Road, Nanchang, Jiangxi 330047, China
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5
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Nilsson G, Lindam A. A comparative trial of blood pressure monitoring in a self-care kiosk, in office, and with ambulatory blood pressure monitoring. BMC Cardiovasc Disord 2024; 24:27. [PMID: 38172659 PMCID: PMC10765747 DOI: 10.1186/s12872-023-03701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Automated measurement of blood pressure (BP) in designated BP kiosks have in recent years been introduced in primary care. If kiosk blood pressure (BP) monitoring provides results equivalent to in-office BP or daytime ambulatory BP monitoring (ABPM), follow-up of adult patients could be managed primarily by self-checks. We therefore designed a comparative trial and evaluated the diagnostic performance of kiosk- and office-based BP (nurse- versus physician-measured) compared with daytime ABPM. METHODS A trial of automated BP monitoring in three settings: a designated BP kiosk, by nurses and physicians in clinic, and by ABPM. The primary outcome was systolic and diastolic BP, with respective diagnostic thresholds of ≥135 mmHg and/or ≥ 85 mmHg for daytime ABPM and kiosk BP and ≥ 140 mmHg and/or ≥ 90 mmHg for office BP (nurse- and physician-measured). RESULTS Compared with daytime ABPM, mean systolic kiosk BP was higher by 6.2 mmHg (95% confidence interval [CI] 3.8-8.6) and diastolic by 7.9 mmHg (95% CI 6.2-9.6; p < 0.001). Mean systolic BP taken by nurses was similar to daytime ABPM values (+ 2.0 mmHg; 95% CI - 0.2-4.2; p = 0.071), but nurse-measured diastolic values were higher, by 7.2 mmHg (95% CI 5.9-9.6; p < 0.001). Mean systolic and diastolic physician-measured BPs were higher compared with daytime ABPM (systolic, by 7.6 mmHg [95% CI 4.5-10.2] and diastolic by 5.8 mmHg [95% CI 4.1-7.6]; p < 0.001). Receiver operating characteristic curves of BP monitoring across pairs of systolic/diastolic cut-off levels among the three settings, with daytime ABPM as reference, demonstrated overall similar diagnostic performance between kiosk and nurse-measured values and over the curve performance for physician-measured BP. Accuracy with nurse-measured BP was 69.2% (95% CI 60.0-77.4%), compared with 65.8% (95% CI 56.5-74.3%) for kiosk BP. CONCLUSIONS In this study kiosk BP monitoring was not comparable to daytime ABPM but could be an alternative to in-office BP monitoring by trained nurses. The diagnostic performance of kiosk and nurse-measured BP monitoring was similar and better than that of physician-measured BP. TRIAL REGISTRATION ClinicalTrials.gov (NCT04488289) 27/07/2020.
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Affiliation(s)
- Gunnar Nilsson
- Department of Public Health and Clinical Medicine, Umeå University, 905 81, Umeå, Sweden.
| | - Anna Lindam
- Department of Public Health and Clinical Medicine, Unit of Research, Education, and Development, Östersund Hospital, Umeå University, Umeå, Sweden
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Kim KJ, Hwang MJ, Shim WG, Youn YN, Yoon SD. Sustained drug release behavior of captopril-incorporated chitosan/carboxymethyl cellulose biomaterials for antihypertensive therapy. Int J Biol Macromol 2024; 255:128087. [PMID: 37979743 DOI: 10.1016/j.ijbiomac.2023.128087] [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: 07/03/2023] [Revised: 10/21/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
Captopril (CTP) is an oral drug widely used to treat high blood pressure and congestive heart failure. In this study, CTP-incorporated biomaterials for antihypertensive therapy were synthesized from chitosan, carboxymethyl cellulose, and plasticizers. The physicochemical properties of the prepared biomaterials were characterized using FE-SEM, FT-IR analysis, and physical properties. CTP release experiments were carried out in buffer solutions at various pH values and temperatures. Results indicated that above 99.0 % of CTP was released within 180 min. Optimization of the experimental conditions for CTP release was analyzed by using response surface methodology (RSM). Results of CTP release through artificial skin indicated that CTP was continuously released above 95.0 % from the prepared biomaterials for 36.0 h. The CTP release mechanisms into a buffer and through artificial skin followed pseudo-Fickian diffusion mechanism and non-Fickian diffusion mechanisms, respectively. Moreover, angiotensin-converting enzyme (ACE) inhibition (related to cardiovascular disease) via the released CTP clearly reveals that the prepared biomaterials have a high potential as a transdermal drug delivery agent in antihypertensive therapy.
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Affiliation(s)
- Kyeong-Jung Kim
- Department of Chemical and Biomolecular Engineering, Chonnam National University, Yeosu 59626, Republic of Korea
| | - Min-Jin Hwang
- Department of Environmental System Engineering, Chonnam National University, Yeosu 59626, Republic of Korea; Smart Plant Reliability Center, Chonnam National University, Yeosu 59626, Republic of Korea
| | - Wang-Geun Shim
- Department of Chemical Engineering, Sunchon National University, Suncheon, Jeollanam-do 57922, Republic of Korea
| | - Young-Nam Youn
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, YONSEI University College of Medicine, Seoul 03722, Republic of Korea.
| | - Soon-Do Yoon
- Department of Chemical and Biomolecular Engineering, Chonnam National University, Yeosu 59626, Republic of Korea.
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7
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Singh S, Choudhury A, Hazelhurst S, Crowther NJ, Boua PR, Sorgho H, Agongo G, Nonterah EA, Micklesfield LK, Norris SA, Kisiangani I, Mohamed S, Gómez-Olivé FX, Tollman SM, Choma S, Brandenburg JT, Ramsay M. Genome-wide association study meta-analysis of blood pressure traits and hypertension in sub-Saharan African populations: an AWI-Gen study. Nat Commun 2023; 14:8376. [PMID: 38104120 PMCID: PMC10725455 DOI: 10.1038/s41467-023-44079-0] [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: 01/31/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023] Open
Abstract
Most hypertension-related genome-wide association studies (GWASs) focus on non-African populations, despite hypertension (a major risk factor for cardiovascular disease) being highly prevalent in Africa. The AWI-Gen study GWAS meta-analysis for blood pressure (BP)-related traits (systolic and diastolic BP, pulse pressure, mean-arterial pressure and hypertension) from three sub-Saharan African geographic regions (N = 10,775), identifies two novel genome-wide significant signals (p < 5E-08): systolic BP near P2RY1 (rs77846204; intergenic variant, p = 4.95E-08) and pulse pressure near LINC01256 (rs80141533; intergenic variant, p = 1.76E-08). No genome-wide signals are detected for the AWI-Gen GWAS meta-analysis with previous African-ancestry GWASs (UK Biobank (African), Uganda Genome Resource). Suggestive signals (p < 5E-06) are observed for all traits, with 29 SNPs associating with more than one trait and several replicating known associations. Polygenic risk scores (PRSs) developed from studies on different ancestries have limited transferability, with multi-ancestry PRS providing better prediction. This study provides insights into the genetics of BP variation in African populations.
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Affiliation(s)
- Surina Singh
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Ananyo Choudhury
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Scott Hazelhurst
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Electrical and Information Engineering, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Palwendé R Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso
| | - Hermann Sorgho
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Sante, Ouagadougou, Burkina Faso
| | - Godfred Agongo
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C.K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Engelbert A Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Lisa K Micklesfield
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Health and Human Development, University of Southampton, Southampton, UK
| | | | - Shukri Mohamed
- African Population and Health Research Center, Nairobi, Kenya
| | - Francesc X Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen M Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Solomon Choma
- Department of Medical Science, Public Health and Health Promotion, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - J-T Brandenburg
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Strengthening Oncology Services, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Jobe M, Mactaggart I, Hydara A, Kim MJ, Bell S, Badjie O, Bittaye M, Perel P, Prentice AM, Burton MJ. Evaluating the hypertension care cascade in middle-aged and older adults in The Gambia: findings from a nationwide survey. EClinicalMedicine 2023; 64:102226. [PMID: 37767194 PMCID: PMC10520336 DOI: 10.1016/j.eclinm.2023.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Background Hypertension is a major public health problem in sub-Saharan Africa with poor treatment coverage and high case-fatality rates. This requires assessment of healthcare performance to identify areas where intervention is most needed. To identify areas where health resources should be most efficiently targeted, we assessed the hypertension care cascade i.e., loss and retention across the various stages of care, in Gambian adults aged 35 years and above. Methods This study was embedded within the nationally representative 2019 Gambia National Eye Health Survey of adults ≥35 years. We constructed a hypertension care cascade with four categories: prevalence of hypertension (defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of medication prescribed for hypertension); those aware of their diagnosis; those treated; and those with a controlled blood pressure (defined as blood pressure <140/90 mmHg). Analyses were age- and sex-standardised to the population structure of The Gambia. Logistic regression was used to assess the socio-demographic factors associated with prevalence, awareness, treatment and control of hypertension. Findings Of 9171 participants with data for blood pressure, the prevalence of hypertension was 47.0%. Among people with hypertension, the prevalence of awareness was 54.7%, the prevalence of hypertension treatment was 32.5%, and prevalence of control was 10.0% with little difference between urban and rural residence. The cascade of care performance was better in women. However, there was no difference in achieving blood pressure control between men and women who were receiving treatment. Female sex, older age and higher body mass index were associated with higher hypertension awareness whilst having an occupation compared to being unemployed was associated with higher odds of being treated. Patients in the underweight category had higher odds of achieving blood pressure control. Interpretation There is a high prevalence of hypertension and low performance of the health care system that impact on the hypertension care cascade among middle-aged and older adults in The Gambia. Addressing the full cascade will be paramount especially in reducing the mounting prevalence and improving diagnosis of patients with hypertension, where the greatest dividends will be gained. Funding The Queen Elizabeth Diamond Jubilee Trust, Wellcome Trust.
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Affiliation(s)
- Modou Jobe
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, UK
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia
| | - Min J. Kim
- International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Suzannah Bell
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Omar Badjie
- Directorate of Health Promotion & Education, Ministry of Health, The Gambia
| | - Mustapha Bittaye
- Directorate of Health Services, Ministry of Health, The Gambia
- Department of Obstetrics and Gynaecology, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Pablo Perel
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK
| | - Andrew M. Prentice
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Belay GJ, Fentanew M, Belay M, Gobezie M, Bekele G, Getie K, Shiferaw KB, Takele MD, Cherkos K, Zemariam AB. Physical Activity and Its Associated Factors among Patients with Hypertension at Amhara Region Comprehensive Specialised Hospitals, Northwest Ethiopia: An Institutional Based Cross-Sectional Study. BMJ Open 2023; 13:e073018. [PMID: 37666550 PMCID: PMC10481733 DOI: 10.1136/bmjopen-2023-073018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Accurate evaluation of physical activity for patients with hypertension is important to determine patients' health outcomes and intervention measures. Information about physical activity among patients with hypertension in Ethiopia is not well known. OBJECTIVE This study was aimed to assess the physical activity and associated factors among patients with hypertension. STUDY DESIGN An institution-based cross-sectional study was conducted. STUDY SETTING The study was conducted at the Tertiary Hospital Northwest, Ethiopia. OUTCOME MEASURES Physical activity was assessed by Global Physical Activity Questionnaire as the primary outcome and factors significantly associated with physical activity were secondary outcomes. PARTICIPANTS Four hundred and twenty patients with hypertension took part in the study; among those 233 were men and 187 were women. The study participants were chosen using a systematic random sampling method. SPSS V.20 statistical software was used to analyse the data. In the multivariable logistic regression analysis model, adjusted OR (AOR) with a 95% CI and p value<0.05 were used to identify the associated factors with physical activities. RESULTS Our study showed that 19.1% of study participants had inadequate physical activity, being old age with AOR: 10.27 (3.21 to 33.01), low or poor self-efficacy with AOR: 10.34 (4.89 to 21.84), poor self-rated health with AOR: 5.91 (1.73 to 20.13) and lack of adequate facilities with AOR: 4.07 (1.72 to 9.66) were significantly associated with inadequate physical activity. CONCLUSION Inadequate physical activity was detected in one-fifth of the study participants, according to our research. Being elderly, having low self-efficacy, having inadequate facilities and having poor self-rated health were all linked to inadequate physical activity.
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Affiliation(s)
- Gashaw Jember Belay
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Molla Fentanew
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Misganaw Belay
- Department of Physiotherapy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melese Gobezie
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebremariam Bekele
- Department of Physiotherapy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kassaw Belay Shiferaw
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mihret Dejen Takele
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kassahun Cherkos
- Department of Physiotherapy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
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10
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Quan Y, Wang C, Wang L, Li G. Geriatric sarcopenia is associated with hypertension: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2023; 25:808-816. [PMID: 37594142 PMCID: PMC10497027 DOI: 10.1111/jch.14714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/19/2023]
Abstract
This meta-analysis aimed to explore the potential relationship between senile sarcopenia and hypertension in older people. A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library, up to November 2022. Ten studies comprising 14 804 participants were enrolled. The odds ratio (OR) and 95% confidence interval (CI) was pooled to evaluate the correlation between sarcopenia and hypertension in older people utilizing a random-effects model. Subgroup and sensitivity analyses were then carried out to explore the potential sources of heterogeneity. The results revealed a substantial correlation between sarcopenia and hypertension among older people (OR = 1.39, 95% CI: 1.15-1.67, p < .01). Further subgroup analysis revealed an association between sarcopenic obesity and hypertension (OR = 1.49, 95% CI: 1.37-1.62, p < .01). In conclusions, our findings highlighted a significant relationship between sarcopenia and hypertension among older people, with sarcopenic obesity amplifying this risk.
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Affiliation(s)
- Yawen Quan
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
- Graduate School of Hebei Medical UniversityShijiazhuangHebeiChina
| | - Chang Wang
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
- Graduate School of North China University of TechnologyTangshanHebeiChina
| | - Linfeng Wang
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
- Graduate School of Hebei North CollegeZhangjiakouHebeiChina
| | - Gang Li
- Department of Geriatric Cardiovascular DiseasesHebei General HospitalShijiazhuangHebeiChina
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11
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Jadhav P, Selvaraju V, Sathian SP, Swaminathan R. Use of Multiple Fluid Biomarkers for Predicting the Co-occurrence of Diabetes and Hypertension Using Machine Learning Approaches. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083584 DOI: 10.1109/embc40787.2023.10340163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The co-existence of diabetes and hypertension can complicate and affect the management of these diseases. The early detection of these comorbidities can help in developing personalized preventive treatments and thereby, reduce the healthcare burden. The inclusion of readily available fluid biomarkers from different body fluids can be used as diagnostic tools and can facilitate in the designing of treatment strategies. In this work, an attempt has been made using multiple fluid biomarkers to differentiate diabetic from diabetic and hypertensive comorbid (DHC) condition. The fluid biomarkers are obtained from a publicly available dataset for diabetic (N=105) and DHC (N=57) conditions. The features, such as systolic blood pressure, fasting blood glucose, diastolic blood pressure, and total cholesterol are extracted and statistically analyzed. Data balancing technique namely synthetic minority oversampling technique is applied on the minority class to balance the dataset. Machine learning techniques namely, linear discriminant analysis, random forest, K-nearest neighbor, and linear support vector machine are used to perform the classification between the two groups. The results show that systolic blood pressure, diastolic blood pressure, and total cholesterol are elevated in the comorbid condition. These features also exhibit a statistical significance (p<0.001) between the two groups. This study also addresses the data imbalance issue, which is resolved by using an oversampling technique to mitigate the bias resulting from imbalanced data. The LDA classifier achieves a maximum accuracy of 61.2% in distinguishing between the two conditions. Machine learning based approaches may help in the prediction of comorbid conditions. This can act as a guideline for future studies on the progression of diseases and the identification of fluid biomarkers.
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12
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Swed S, Alibrahim H, Bohsas H, Hafez W, Surma S, Rais MA, Abuelsaoud HM, Elshazly RM, Shoib S, Sawaf B, Farwati A, Seijari MN, Battikh N, Sleman S, Mourad D, Sakkour KJ, Alklani T, Rakab A. Assessment the awareness toward hypertension and diabetes mellitus: Syrian cross sectional study. BMC Public Health 2023; 23:789. [PMID: 37118706 PMCID: PMC10142391 DOI: 10.1186/s12889-023-15666-z] [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: 11/20/2022] [Accepted: 04/13/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Diabetes and arterial hypertension are the two most common types of non-communicable diseases (NCDs) impacting people globally. There is no prior research on the Syrian population's knowledge and treatment of hypertension and diabetes. It is crucial to investigate how the Syrian public understands and perceives these disorders in order to address the increased incidence and prevalence of hypertension and diabetes. This research intends to assess the level of hypertension and diabetes-related awareness, knowledge, attitude, and practices among Syrian individuals. METHODS A cross-sectional survey was conducted online between 1 August and 25 August 2022. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were Syrian residents older than 18 who presently live in Syria. The survey consisted four sections: sociodemographics information, WHO STEPS survey instrument on knowledge of and lifestyle determinants for hypertension and diabetes, respondents' knowledge of and comprehension of hypertension and diabetes, and respondents' awareness of these disorders. RESULTS Among 976 participants, 65.8% were females. the most common causes for hypertension from the perspective of participants were (90.1%) for stress, (87%) High salt consumption, (82.1%) genetics, (78.2%) old age, (78%) obesity (69%) anxiety, and (38.6%) for drug usage. Primary and middle school educational status participants had greater hypertension knowledge (92.3%) than other educational levels. There was a statistical significant difference between the knowledge toward the hypertension and the drinking alcohol, which the nonalcoholic knowledgeable persons were the most common (819 / 976)(P < 0.05). Participants whose lifestyles did not include alcohol use had a higher hypertension knowledge level (90.3%). Participants who do not consume alcohol have shown better hypertension knowledge (90.3%) than those who do (81.9%). Almost age groups have shown good knowledge of diabetes, especially participants aged above 55 (93.8%). However, most individuals have examined blood pressure (82.3%), whereas fewer than half had screened for blood sugar (64.4%). About 82.2% of individuals check their blood pressure frequently, whereas 6.2% monitor their blood sugar. There were significant associations between hypertension knowledge and gender, education, employment, and economic position (P value < 0.05). Men (mean = 8.39, SD = 2.02, P-value < 0.05) have a higher hypertension knowledge than females, and knowledge of hypertension among participants was shown to be higher among those in good income status than other economic levels (mean = 8.34, SD = 1.98). Age, gender, education, employment, and marital status were all associated with diabetes knowledge. Participants between the ages of 40 and 55 showed better knowledge of diabetes compared to other age groups (mean = 11.32, SD = 2.54); also, men demonstrated greater knowledge of diabetes than females (mean = 10.76, SD = 2.79). CONCLUSION We indicated that the Syrian population has a good to moderate understanding of hypertension and diabetes. However, there is still a shortage of standardized, regular screening practices. Since individuals remain involved in unhealthy lifestyle habits, it is vital to provide accurate information about hypertension and diabetes to encourage them to make healthy changes.
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Affiliation(s)
- Sarya Swed
- Faculty of medicine, Aleppo University, Aleppo, Syria.
| | | | | | - Wael Hafez
- NMC Royal Hospital, Khalifa city, abu Dhabi, Khalifa City, Abu Dhabi, UAE
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
| | - Stanisław Surma
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | | | | | | | - Sheikh Shoib
- JLNM Hospital, Rainawari, Srinagar, India
- Directorate of Health Services, J&K, India
| | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Amr Farwati
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Naim Battikh
- John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Soulaf Sleman
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Danya Mourad
- Faculty of Medicine, Al-Hawash Private University, Homs, Syria
| | | | - Temaa Alklani
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Amine Rakab
- Clinical Medicine, Weill Cornell Medical College, Medicine, Qatar
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Hatakenaka T, Kato T, Okamoto K. In Vitro and In Silico Studies on Angiotensin I-Converting Enzyme Inhibitory Peptides Found in Hydrophobic Domains of Porcine Elastin. Molecules 2023; 28:molecules28083337. [PMID: 37110571 PMCID: PMC10140934 DOI: 10.3390/molecules28083337] [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: 03/14/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
One of the most striking aspects of the primary structure in the hydrophobic domains of the tropoelastin molecule is the occurrence of the VAPGVG repeating sequence. Since the N-terminal tripeptide VAP of VAPGVG showed a potent ACE inhibitory activity, the ACE inhibitory activity of various derivatives of VAP was examined in vitro. The results showed that VAP derivative peptides VLP, VGP, VSP, GAP, LSP, and TRP exhibited potent ACE inhibitory activities, while the non-derivative peptide APG showed only weak activity. In in silico studies, the docking score S value showed that VAP derivative peptides VLP, VGP, VSP, LSP, and TRP had stronger docking interactions than APG. Molecular docking in the ACE active pocket showed that TRP, the most potent ACE inhibitory peptide among the VAP derivatives, had a larger number of interactions with ACE residues in comparison with APG and that the TRP molecule appeared to spread widely in the ACE pocket, while the APG molecule appeared to spread closely. Differences in molecular spread may be a reason why TRP exhibits more potent ACE inhibitory activity than APG. The results suggest that the number and strength of interactions between the peptide and ACE are important for the ACE- inhibitory potency of the peptide.
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Affiliation(s)
- Toshiya Hatakenaka
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Kitakyushu 808-0196, Japan
- Vital Resources Applied Laboratory, Inc., Iizuka 820-0067, Japan
| | - Tamaki Kato
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Kitakyushu 808-0196, Japan
| | - Kouji Okamoto
- Vital Resources Applied Laboratory, Inc., Iizuka 820-0067, Japan
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14
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Costello HM, Crislip GR, Cheng KY, Lynch IJ, Juffre A, Bratanatawira P, Mckee A, Thelwell RS, Mendez VM, Wingo CS, Douma LG, Gumz ML. Adrenal-Specific KO of the Circadian Clock Protein BMAL1 Alters Blood Pressure Rhythm and Timing of Eating Behavior. FUNCTION 2023; 4:zqad001. [PMID: 36778748 PMCID: PMC9909366 DOI: 10.1093/function/zqad001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 01/11/2023] Open
Abstract
Brain and muscle ARNT-like 1 (BMAL1) is a core circadian clock protein and transcription factor that regulates many physiological functions, including blood pressure (BP). Male global Bmal1 knockout (KO) mice exhibit ∼10 mmHg reduction in BP, as well as a blunting of BP rhythm. The mechanisms of how BMAL1 regulates BP remains unclear. The adrenal gland synthesizes hormones, including glucocorticoids and mineralocorticoids, that influence BP rhythm. To determine the role of adrenal BMAL1 on BP regulation, adrenal-specific Bmal1 (ASCre/+ ::Bmal1) KO mice were generated using aldosterone synthase Cre recombinase to KO Bmal1 in the adrenal gland zona glomerulosa. We confirmed the localization and efficacy of the KO of BMAL1 to the zona glomerulosa. Male ASCre/+ ::Bmal1 KO mice displayed a shortened BP and activity period/circadian cycle (typically 24 h) by ∼1 h and delayed peak of BP and activity by ∼2 and 3 h, respectively, compared with littermate Cre- control mice. This difference was only evident when KO mice were in metabolic cages, which acted as a stressor, as serum corticosterone was increased in metabolic cages compared with home cages. AS Cre/+ ::Bmal1 KO mice also displayed altered diurnal variation in serum corticosterone. Furthermore, these mice have altered eating behaviors where they have a blunted night/day ratio of food intake, but no change in overall food consumed compared with controls. Overall, these data suggest that adrenal BMAL1 has a role in the regulation of BP rhythm and eating behaviors.
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Affiliation(s)
- Hannah M Costello
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32610, USA
| | - G Ryan Crislip
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32610, USA
| | - Kit-Yan Cheng
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
| | - I Jeanette Lynch
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Research, North Florida/South Georgia Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL 32608, USA
| | - Alexandria Juffre
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL 32610, USA
| | - Phillip Bratanatawira
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
| | - Annalisse Mckee
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
| | - Ryanne S Thelwell
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
| | - Victor M Mendez
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
| | - Charles S Wingo
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Research, North Florida/South Georgia Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL 32608, USA
| | - Lauren G Douma
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32610, USA
| | - Michelle L Gumz
- Department of Physiology and Aging, University of Florida, Gainesville, FL 32610, USA
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32610, USA
- Research, North Florida/South Georgia Malcolm Randall Veterans Affairs Medical Center, Gainesville, FL 32608, USA
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL 32610, USA
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Cao X, Zhao Z, Kang Y, Tian Y, Song Y, Wang L, Zhang L, Wang X, Chen Z, Zheng C, Tian L, Yin P, Fang Y, Zhang M, He Y, Zhang Z, Weintraub WS, Zhou M, Wang Z, Cao X, Zhao Z, Kang Y, Tian Y, Song Y, Wang L, Zhang L, Wang X, Chen Z, Zheng C, Tian L, Chen L, Cai J, Hu Z, Zhou H, Gu R, Huang Y, Yin P, Fang Y, Zhang M, He Y, Zhang Z, Weintraub WS, Zhou M, Wang Z. The burden of cardiovascular disease attributable to high systolic blood pressure across China, 2005–18: a population-based study. THE LANCET PUBLIC HEALTH 2022; 7:e1027-e1040. [DOI: 10.1016/s2468-2667(22)00232-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/26/2022] [Accepted: 09/05/2022] [Indexed: 12/05/2022] Open
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16
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Association between Antihypertensive Therapy and Risk of Acute Lower Respiratory Infections (ALRI): A Retrospective Cohort Study. Healthcare (Basel) 2022; 10:healthcare10112318. [PMID: 36421642 PMCID: PMC9690450 DOI: 10.3390/healthcare10112318] [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: 09/13/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose: The aim of this study was to analyze the association between antihypertensive drugs and the incidence of acute lower respiratory infections in patients treated in general practices in Germany. Methods: After propensity score matching of five antihypertensive drug classes, a total of 377,470 patients aged ≥18 years were available for analysis. The association between each antihypertensive drug class and ALRI incidence as compared to all other antihypertensive drug classes (as a group) was studied using conditional Cox regression analyses. Because of multiple comparisons and large patient samples, findings were clinically considered relevant when the hazard ratio was <0.85 or >1.15. Results: The regression analyses applied found no clinically relevant associations between antihypertensive drugs and the incidence of acute lower respiratory infections, as all hazard ratios were between 0.85 and 1.15. Conclusion: In the present study, only slight and not clinically relevant increases or decreases in the ALRI incidence were observed. Additional studies are necessary to further explore the risks associated with antihypertensive agents that are widely embedded in today’s clinical practice.
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Shams M, Pariani A, Raeisi A, Maleki M, Shariatinia S, Jamalizadeh A, Poorkarami A, Ostovar A. The Iranian National Blood Pressure Measurement Campaign: What Do the Process and Output Evaluation say? ARCHIVES OF IRANIAN MEDICINE 2022; 25:718-724. [PMID: 37543895 PMCID: PMC10685855 DOI: 10.34172/aim.2022.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/29/2021] [Indexed: 08/08/2023]
Abstract
BACKGROUND The Iranian National Blood Pressure Measurement Campaign (INBPMC) was conducted all over the country to raise awareness in different groups of people regarding the importance of blood pressure and persuading them to manage their blood pressure. The present research aimed at assessing the process and output of this campaign. METHODS For process evaluation, 31 universities/faculties were selected. Experts from the Ministry of Health and Medical Education assessed the documentation of the campaign implementation using the designed checklist. The output was assessed by including 8274 people and through a telephone survey using the designed instructions. RESULTS The response rate of the telephone interviews was 82.74% (8274 people). It was found that 79% of the selected groups were aware of the INBPMC. Among them, 64% remembered the messages, 99% of the participants who remembered the messages agreed with those messages, and 89% of the participants who agree with the messages went for a measurement of their blood pressure. In the telephone interviews, 30% of the participants stated that they were diagnosed with hypertension, 97% of these participants received the required consultations for subsequent care, and 86% of them went to the health service centers to receive care. The process evaluation of the INBPMC indicated that the universities of medical sciences obtained 97% of the score of the checklist. CONCLUSION The INBPMC was successful and accomplished its objectives.
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Affiliation(s)
- Mohsen Shams
- School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
- Iranian Social Marketing Association, Health Technology Incubation Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Abbas Pariani
- Department of Non-Communicable Diseases Management, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alireza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Maleki
- Iranian Social Marketing Association, Health Technology Incubation Center, Yasuj University of Medical Sciences, Yasuj, Iran
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Shariatinia
- Iranian Social Marketing Association, Health Technology Incubation Center, Yasuj University of Medical Sciences, Yasuj, Iran
- School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Jamalizadeh
- Health Deputy, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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18
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Saei Ghare Naz M, Sheidaei A, Azizi F, Ramezani Tehrani F. Gestational diabetes mellitus and hypertensive disorder of pregnancy play as spouse-pair risk factors of diabetes and hypertension: Insights from Tehran Lipid and Glucose Study. J Diabetes Complications 2022; 36:108311. [PMID: 36201894 DOI: 10.1016/j.jdiacomp.2022.108311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/27/2022] [Accepted: 09/17/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Complicated pregnancies by gestational diabetes mellitus (GDM) and hypertensive disorder of pregnancy (HDP) are relatively common worldwide. The evidence is still inconclusive regarding the role of GDM and HDP as spousal risk factor of diabetes (DM) and hypertension (HTN). This study aimed to determine the spousal risk of development of DM and/or HTN in the context of GDM and/or HDP. METHODS This population-based cohort study involved couples who participated in Tehran Lipid and Glucose Study. A total of 3650 pairs of spouses were identified, and among them, 2820 met the inclusion criteria. Included participants, followed up 3-year intervals visits from 1999 to 2018. All pairs underwent standard data collection. GDM and HDP were the main exposure of interest in females, and DM and HTN were the main outcomes in both females and their spouses. Cox proportional hazard regression models were used for both females and their spouses, adjusting for age, consanguinity, waist-to-height ratio, physical activity, smoking, and parity. RESULTS Of 2820 females, 558 (19.79 %) had histories of GDM or HDP, and 72 (2.55 %) experienced both. Among females who experienced GDM and HDP, 24 (33 %) and 31 (33 %) developed DM and HTN during the follow-up. The corresponding numbers were 89 (16 %) and 191 (34 %) for those who experienced GDM or HPD, and 274 (13 %) and 623 (28 %) for the non-risk factors group. The incidences of DM were 9 (12 %), 100 (18 %), and 373 (17 %) for males whose spouses experienced both GDM and HDP, either one or none of them, respectively. Among males in these groups, 20 (28 %), 150 (27 %), and 630 (29 %) developed HTN, respectively. Females who never had history of GDM and HDP have 34 % (95 % CI: 21, 45) less hazard of being diabetic than their spouses if they have the same age and waist to hip ratio. In cases with histories of both GDM and HDP, the risk of females increases to 3.05 (95 % CI: 1.43, 6.52) times of their spouses. Also, females who had experienced GDM (HR: 3.51, 95 % CI: 2.23, 5.53), or HDP (HR: 2.80, 95 % CI: 1.72, 4.56) were at higher risk of developing DM compared with females who never had GDM or HDP. We found that females with neither GDM nor HDP were more likely than males to be hypertensive in the future by the hazard ratio of 1.21 (95 % CI: 1.06, 1.39). CONCLUSIONS Complicated pregnancies by GDM and/or HDP were associated with increased risk of development DM and HTN in later life of females and their spouses. Further studies are required to confirm these results. Preventive care programs should be considered pregnancy complications as couple-based risk factors for subsequent DM and HTN.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Liu B, Jiang X, Xie Y, Jia X, Zhang J, Xue Y, Qin S. The effect of a low dose hydrogen-oxygen mixture inhalation in midlife/older adults with hypertension: A randomized, placebo-controlled trial. Front Pharmacol 2022; 13:1025487. [PMID: 36278221 PMCID: PMC9585236 DOI: 10.3389/fphar.2022.1025487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/21/2022] [Indexed: 04/04/2024] Open
Abstract
Objective: To explore the effect of a low-dose hydrogen-oxygen (H2-O2) mixture inhalation in midlife/older adults with hypertension. Methods: This randomized, placebo-controlled trial included 60 participants with hypertension aged 50-70 years who were randomly divided into Air group (inhaled placebo air) or H2-O2 group [inhaled H2-O2 mixture (66% H2/33% O2)]. Participants in both groups were treated 4 h per day for 2 weeks. Four-limb blood pressure and 24-h ambulatory blood pressure were monitored before and after the intervention, and levels of plasma hormones related to hypertension were determined. Results: A total of 56 patients completed the study (27 in the Air group and 29 in the H2-O2 group). The right and left arm systolic blood pressure (SBP) were significantly decreased in H2-O2 group compared with the baseline levels (151.9 ± 12.7 mmHg to 147.1 ± 12.0 mmHg, and 150.7 ± 13.3 mmHg to 145.7 ± 13.0 mmHg, respectively; all p < 0.05). Meanwhile, the H2-O2 intervention significantly decreased diastolic nighttime ambulatory blood pressure by 2.7 ± 6.5 mmHg (p < 0.05). All blood pressures were unaffected in placebo group (all p > 0.05). When stratified by age (aged 50-59 years versus aged 60-70 years), participants in the older H2-O2 group showed a larger reduction in right arm SBP compared with that in the younger group (p < 0.05). In addition, the angiotensin II, aldosterone, and cortisol levels as well as the aldosterone-to-renin ratio in plasma were significantly lower in H2-O2 group compared with baseline (p < 0.05). No significant differences were observed in the Air group before and after the intervention. Conclusion: Inhalation of a low-dose H2-O2 mixture exerts a favorable effect on blood pressure, and reduces the plasma levels of hormones associated with hypertension on renin-angiotensin-aldosterone system and stress in midlife/older adults with hypertension.
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Affiliation(s)
- Boyan Liu
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
| | - Xue Jiang
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
- College of Nursing, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
| | - Yunbo Xie
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
| | - Xiubin Jia
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
| | - Jiashuo Zhang
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
| | - Yazhuo Xue
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
- College of Nursing, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
| | - Shucun Qin
- Taishan Institute for Hydrogen Biomedicine, the Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, Shandong, China
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Yan J, Honglei Y, Yun W, Sheng D, Yun H, Anhua Z, Na F, Min L, Dandan S, Jing W, Junming T, Wenjun Z, Xiju H. Puerarin ameliorates myocardial remodeling of spontaneously hypertensive rats through inhibiting TRPC6-CaN-NFATc3 pathway. Eur J Pharmacol 2022; 933:175254. [PMID: 36087696 DOI: 10.1016/j.ejphar.2022.175254] [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: 12/20/2021] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022]
Abstract
Puerarin (Pue) has been widely used in the treatment of hypertension and cardiovascular diseases, but the basic mechanism of Pue on myocardial remodeling (MR) of hypertension is not clear. The purpose of this study was to investigate the effect and mechanism of Pue on MR and provide the basis for the clinical application. Thirty male spontaneously hypertensive rats (SHR) and six male Wistar Kyoto rats (WKY) aged 3 months were used in this study, SHR rats were randomly divided into 5 groups, Pue (40 or 80 mg/kg/d, ip) and telmisartan (TELMI) (30 mg/kg/d, ig) were administrated for 12 weeks. We used Echocardiography to detect the cardiac function. Morphology and structure of myocardium were observed. H9C2 cells were subjected to 1 μM Ang Ⅱ in vitro, 100 μM Pue, 0.5 μM Calmodulin-dependent calcineurin (CaN) inhibitor Cyclosporin A (CsA) and 1 μM specific transient receptor potential channel 6 (TRPC6) inhibitor SAR7334 were used in H9C2 cells. Long-term administration of Pue could significantly improve cardiac function, improve morphology and structure of myocardium in vivo. Pue could reduce MR related proteins expression (ACTC1, TGF-β1, CTGF, β-MHC and BNP), attenuate ROS, restore MMP and decrease Ca2+-overload in vitro. Further study indicated that Pue could decrease TRPC6 expression and inhibit nuclear factor of activated T cells 3 (NFATc3) nuclear translocation in vitro. These results suggested that puerarin could ameliorate myocardial remodeling through inhibiting TRPC6-CaN-NFATc3 in spontaneously hypertensive rats.
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Affiliation(s)
- Jiang Yan
- Department of Ultrasound, Taihe Hospital, Jinzhou Medicical University Union Training Base, Shiyan, 442000, China
| | - Yu Honglei
- Department of Ultrasound, Taihe Hospital, Jinzhou Medicical University Union Training Base, Shiyan, 442000, China
| | - Wu Yun
- Department of Ultrasound, Wuhan Asia General Hospital, Wuhan, 430000, China
| | - Dong Sheng
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China
| | - He Yun
- Department of Ultrasound, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China
| | - Zhang Anhua
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China
| | - Feng Na
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China
| | - Lu Min
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China
| | - Shi Dandan
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China
| | - Wang Jing
- School of Public Health and Health, Hubei University of Medicine, Shiyan, 442000, China
| | - Tang Junming
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China
| | - Zhang Wenjun
- Department of Ultrasound, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.
| | - He Xiju
- Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, 442000, China; Department of Ultrasound, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.
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21
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Al-Kadi H. Prevalence of Prehypertension among Saudi Adults: A Narrative Review. Open Cardiovasc Med J 2022. [DOI: 10.2174/18741924-v16-e2206270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Prehypertension is a pre-disease state wherein an individual has a blood pressure (BP) measurement above normal (≥120/80 mmHg) but below the hypertensive range (<140/90 mmHg). Large population-based studies have shown that individuals with a BP in the prehypertensive range have an increased risk of developing hypertension and cardiovascular events. Despite these risks and high mortality rates associated with pre-hypertension, there are currently no reviews that define the prevalence of pre-hypertension in the Saudi population.
Objective:
To determine the magnitude of the pre-hypertension problem among Saudi adults and identify areas for future research based on the current gaps in the literature.
Methods:
This narrative review considers studies addressing the prevalence of pre-hypertension among Saudi adults; 8 studies were identified for this review.
Results:
In total, 14,782 men and women participated in these studies. The overall prevalence of pre-hypertension in both sexes ranged from 18.5-54.9%. Men had higher rates of pre-hypertension (24.7-66.1%) than women (7-48.1%).A modifiable risk factor reported in the majority of the studies was increased adiposity.
Conclusion:
Lifestyle changes to reduce weight may be effective in preventing or at least delaying the progression to hypertension and its associated cardiovascular events. Large, prospective, epidemiological studies are needed to estimate the risk of incident hypertension and cardiovascular events in pre-hypertension patients. Randomized clinical trials are also needed to evaluate the effectiveness of lifestyle modification and/or pharmacotherapy in reducing the risk of incident hypertension.
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Belay DG, Fekadu Wolde H, Molla MD, Aragie H, Adugna DG, Melese EB, Tarekegn GE, Gezahegn E, Kibret AA. Prevalence and associated factors of hypertension among adult patients attending the outpatient department at the primary hospitals of Wolkait tegedie zone, Northwest Ethiopia. Front Neurol 2022; 13:943595. [PMID: 36034276 PMCID: PMC9414034 DOI: 10.3389/fneur.2022.943595] [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: 05/13/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Hypertension, often known as increased blood pressure, is a worldwide public health concern. Globally, ~1 billion people have hypertension and 7.1 million die from this disease. It is disproportionately more prevalent in resource-poor nations, with inadequate health systems like Ethiopia. Moreover, information on the burden of disease from hypertension in the specific area, especially in the newly organized Wolkait Tegedie zone, is essential to develop effective prevention and control strategies. Therefore, this study aimed to assess the prevalence of hypertension and associated factors among adult patients evaluated at the outpatient department of the two district hospitals in the Wolkait Tegedie zone, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from September to October 2021. A systematic random sampling technique was used to select a total of 449 participants. The data were collected and then entered using EPI-INFO version 7 and exported to STATA 14 for analysis. Bivariable and multivariable binary logistic regression analyses were performed. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used as a measure of association. Variables having a p-value < 0.05 from the multivariable analysis were considered to have a significant association with the outcome. Results The prevalence of hypertension among adult patients in this study was 44.91% [95% CI: 40.26%, 49.65%], of which 63.92% were new diagnoses. Being >60 years [AOR = 1.81; 95% CI: 1.11, 3.20], having poor physical exercise [AOR = 1.74; 95% CI: 1.01, 3.15], consuming cruddy oil [AOR = 15.22; 95% CI: 3.86, 60.12], having a family history of hypertension [AOR = 13.02; 95% CI: 3.75, 45.16], and having a history of diabetes mellitus (DM) [AOR = 8.05; 95% CI: 1.24, 51.49] had a statistically significant association with having hypertension. Conclusion There is a relatively high prevalence of hypertension among adult patients in the outpatient department of the two primary hospitals, Northwest Ethiopia. Factors such as being of older age, having poor physical exercise behavior, cruddy oil consumption, and family history of DM and hypertension had a positive significant statistical association with being hypertensive. Community-based screening programs for hypertension should be designed and implemented to prevent this silent killer disease. Health education and promotion that focus on healthy nutrition and physical exercise should be delivered.
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Affiliation(s)
- Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- *Correspondence: Daniel Gashaneh Belay
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hailu Aragie
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagnew Getnet Adugna
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Belayneh Melese
- Department of Internal Medicine School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekegn
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Eleleta Gezahegn
- Department of Internal Medicine School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ho JH, Baskaran R, Wang MF, Mohammedsaleh ZM, Yang HS, Balasubramanian B, Lin WT. Dipeptide IF and Exercise Training Attenuate Hypertension in SHR Rats by Inhibiting Fibrosis and Hypertrophy and Activating AMPKα1, SIRT1, and PGC1α. Int J Mol Sci 2022; 23:ijms23158167. [PMID: 35897743 PMCID: PMC9330102 DOI: 10.3390/ijms23158167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 01/27/2023] Open
Abstract
Bioactive peptides are physiologically active peptides produced from proteins by gastrointestinal digestion, fermentation, or hydrolysis by proteolytic enzymes. Bioactive peptides are resorbed in their whole form and have a preventive effect against various disease conditions, including hypertension, dyslipidemia, inflammation, and oxidative stress. In recent years, there has been a growing body of evidence showing that physiologically active peptides may have a function in sports nutrition. The present study aimed to evaluate the synergistic effect of dipeptide (IF) from alcalase potato protein hydrolysates and exercise training in hypertensive (SHR) rats. Animals were divided into five groups. Bioactive peptide IF and swimming exercise training normalized the blood pressure and decreased the heart weight. Cardiac, hepatic, and renal functional markers also normalized in SHR rats. The combined administration of IF peptide and exercise offer better protection in SHR rats by downregulating proteins associated with myocardial fibrosis, hypertrophy, and inflammation. Remarkably, peptide treatment alongside exercise activates the PI3K/AKT cell survival pathway in the myocardial tissue of SHR animals. Further, the mitochondrial biogenesis pathway (AMPKα1, SIRT1, and PGC1α) was synergistically activated by the combinatorial treatment of IF and exercise. Exercise training along with IF administration could be a possible approach to alleviating hypertension.
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Affiliation(s)
- Jou-Hsuan Ho
- Department of Food Science, Tunghai University, Taichung 407224, Taiwan; (J.-H.H.); (H.-S.Y.)
| | - Rathinasamy Baskaran
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413305, Taiwan;
| | - Ming-Fu Wang
- Department of Food and Nutrition, Providence University, Taichung 43301, Taiwan;
| | - Zuhair M. Mohammedsaleh
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Hong-Siang Yang
- Department of Food Science, Tunghai University, Taichung 407224, Taiwan; (J.-H.H.); (H.-S.Y.)
| | | | - Wan-Teng Lin
- Department of Hospitality Management, College of Agriculture, Tunghai University, Taichung 407224, Taiwan
- Correspondence: ; Tel.: +886-4-2359-0121 (ext. 37709)
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De Brandt E, Hillary T. Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management. PSORIASIS (AUCKLAND, N.Z.) 2022; 12:113-126. [PMID: 35651599 PMCID: PMC9149586 DOI: 10.2147/ptt.s293107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/30/2022] [Indexed: 11/26/2022]
Abstract
Purpose To review the literature on guidance on the follow-up of psoriasis and its comorbidities and to provide practical recommendations. Patients and Methods A PubMed search was conducted using MeSH terms and free text keywords related to "psoriasis", "obesity", "hypertension", "diabetes", "dyslipidemia", "metabolic syndrome" and "Psoriatic arthritis". The search was conducted between September 2021 and January 2022. References of selected articles were scanned to identify additional articles. Results Recommendations on the follow-up of hypertension, obesity, dyslipidemia, type 2 diabetes, metabolic syndrome, psoriatic arthritis, non-alcoholic fatty liver disease and inflammatory bowel disease in psoriasis patients were extracted from the included articles. These data are presented in summary tables for both adults and children. A practical and feasible approach for each comorbidity is discussed. Conclusion Awareness among dermatologists for relevant psoriasis-associated comorbidities is crucial. The dermatologist should function as gatekeeper and screen for comorbidities, in order to make timely referrals when indicated.
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Affiliation(s)
- Eveline De Brandt
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Tom Hillary
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
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Emamat H, Zahedmehr A, Asadian S, Nasrollahzadeh J. The effect of purple-black barberry (Berberis integerrima) on blood pressure in subjects with cardiovascular risk factors: a randomized controlled trial. JOURNAL OF ETHNOPHARMACOLOGY 2022; 289:115097. [PMID: 35150818 DOI: 10.1016/j.jep.2022.115097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/27/2021] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Berberis integerrima commonly known as "barberry" belongs to the Berberidaceae family and has been used as a medicinal plant in Iranian traditional medicine. AIM OF THE STUDY Our aim in this study was to investigate the effects of barberry consumption on blood pressure (BP). MATERIALS AND METHODS Eighty-four medicated hypertensive patients were selected and randomly allocated to barberry and placebo groups. The barberry group received 10 g/day dried purple-black barberry powder, once daily, for 2-months. Systolic, diastolic, and mean arterial BP was assessed through 24-h ambulatory BP monitoring before and after 2-month treatment. The estimation of sodium and potassium intake was done through measurement of sodium and potassium in 24-h urinary samples. Plasma and urinary nitrite, and nitrate (NOx) levels, as well as plasma angiotensin-converting enzyme (ACE) activity, were also determined. RESULTS Seventy-eight participants with an average age of 54.12 ± 10.32 years and BMI of 27.93 ± 2.22 kg/m2 completed the study. There was no significant difference in body weight, physical activity, and the 24-h urinary sodium and potassium excretion between the two groups before and after the study. After adjusting for baseline values and changes in sodium intake, systolic, and mean arterial BP decreased significantly in the barberry group compared to the placebo group (p = 0.015 and p = 0.008, respectively). Plasma NOx levels and ACE activity were not different between the two groups, but urinary NOx was increased significantly in the barberry group compared to the placebo group (p = 0.008). CONCLUSIONS In patients treated with antihypertensive drugs, daily consumption of purple-black barberry can be effective in improving systolic BP control.
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Affiliation(s)
- Hadi Emamat
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Sanaz Asadian
- Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Javad Nasrollahzadeh
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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26
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Islam SMS, Chow CK, Daryabeygikhotbehsara R, Subedi N, Rawstorn J, Tegegne T, Karmakar C, Siddiqui MU, Lambert G, Maddison R. Wearable cuffless blood pressure monitoring devices: a systematic review and meta-analysis. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2022; 3:323-337. [PMID: 36713001 PMCID: PMC9708022 DOI: 10.1093/ehjdh/ztac021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/11/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023]
Abstract
Aims High blood pressure (BP) is the commonest modifiable cardiovascular risk factor, yet its monitoring remains problematic. Wearable cuffless BP devices offer potential solutions; however, little is known about their validity and utility. We aimed to systematically review the validity, features and clinical use of wearable cuffless BP devices. Methods and results We searched MEDLINE, Embase, IEEE Xplore and the Cochrane Database till December 2019 for studies that reported validating cuffless BP devices. We extracted information about study characteristics, device features, validation processes, and clinical applications. Devices were classified according to their functions and features. We defined devices with a mean systolic BP (SBP) and diastolic BP (DBP) biases of <5 mmHg as valid as a consensus. Our definition of validity did not include assessment of device measurement precision, which is assessed by standard deviation of the mean difference-a critical component of ISO protocol validation criteria. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 tool. A random-effects model meta-analysis was performed to summarise the mean biases for SBP and DBP across studies. Of the 430 studies identified, 16 studies (15 devices, 974 participants) were selected. The majority of devices (81.3%) used photoplethysmography to estimate BP against a reference device; other technologies included tonometry, auscultation and electrocardiogram. In addition to BP and heart rate, some devices also measured night-time BP (n = 5), sleep monitoring (n = 3), oxygen saturation (n = 3), temperature (n = 2) and electrocardiogram (n = 3). Eight devices showed mean biases of <5 mmHg for SBP and DBP compared with a reference device and three devices were commercially available. The meta-analysis showed no statistically significant differences between the wearable and reference devices for SBP (pooled mean difference = 3.42 mmHg, 95% CI: -2.17, 9.01, I2 95.4%) and DBP (pooled mean = 1.16 mmHg, 95% CI: -1.26, 3.58, I2 87.1%). Conclusion Several cuffless BP devices are currently available using different technologies, offering the potential for continuous BP monitoring. The variation in standards and validation protocols limited the comparability of findings across studies and the identification of the most accurate device. Challenges such as validation using standard protocols and in real-life settings must be overcome before they can be recommended for uptake into clinical practice.
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Affiliation(s)
| | - Clara K Chow
- Westmead Applied Research Centre, University of Sydney, Sydney, Australia,The George Institute for Global Health, UNSW, Sydney, Australia,Department of Cardiology, Westmead Hospital, Sydney, Australia
| | | | - Narayan Subedi
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Jonathan Rawstorn
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Teketo Tegegne
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | | | - Muhammad U Siddiqui
- Marshfield Clinic Health System, Rice Lake, USA,George Washington University, Washington, DC, USA
| | - Gavin Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Vic, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
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27
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Jung J, Kim H. Shared genetic etiology and antagonistic relationship of plasma renin activity and systolic blood pressure in a Korean cohorts. Genomics 2022; 114:110334. [PMID: 35278618 DOI: 10.1016/j.ygeno.2022.110334] [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: 11/08/2021] [Revised: 02/11/2022] [Accepted: 03/06/2022] [Indexed: 01/14/2023]
Abstract
Despite extensive studies on blood pressure, its genetic risk factors remain uncertain. Even one of the most researched blood pressure-related traits - renin - is not fully understood genetically. Here, we determine the genetic relationship and associated predisposition between blood pressure and baseline renin. In 8840 Korean individuals, we observed a strong negative genome-wide genetic correlation (rg = -0.484) between systolic blood pressure (SBP) and plasma renin activity (PRA), suggesting that antagonistic genetic signals explain the variance in the two traits. We found 51 significant pleiotropic SNPs affecting the two traits, which could contribute to the Renin-Angiotensin-Aldosterone System (RAAS). Our findings provide insight into studies on RAAS by identifying the genome-wide relationship and susceptibility loci of SBP and PRA.
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Affiliation(s)
- Jaehoon Jung
- Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 151-742, Republic of Korea; eGnome, 26 Beobwon-ro, Songpa-gu, Seoul 05836, Republic of Korea.
| | - Heebal Kim
- Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 151-742, Republic of Korea; eGnome, 26 Beobwon-ro, Songpa-gu, Seoul 05836, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul 151-742, Republic of Korea.
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28
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Regensteiner JG, Reusch JEB. Sex Differences in Cardiovascular Consequences of Hypertension, Obesity, and Diabetes: JACC Focus Seminar 4/7. J Am Coll Cardiol 2022; 79:1492-1505. [PMID: 35422246 PMCID: PMC9503760 DOI: 10.1016/j.jacc.2022.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Abstract
It has long been recognized that there are significant differences between the sexes affecting prevalence, incidence, and severity over a broad range of diseases. Until the early 1990s, the limited research conducted on women's health focused primarily on diseases affecting fertility and reproduction, and women were excluded from most clinical trials. For these reasons, the prevention, diagnosis, and treatment of serious chronic diseases such as cardiovascular disease in women continue to be based primarily on findings in men, and sex-specific clinical guidelines are mostly lacking. Hypertension, obesity, and diabetes, interrelated risk factors for cardiovascular disease, differ by sex in terms of prevalence and adverse effects as well as by genetics and biology. Research is needed to understand sex differences in hypertension, obesity, and diabetes to optimally inform sex-specific prevention, diagnosis, and treatment strategies for women and men. In this way, sex-specific clinical guidelines can be developed where warranted.
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Affiliation(s)
- Judith G Regensteiner
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Ludeman Family Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
| | - Jane E B Reusch
- Ludeman Family Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Division of Endocrinology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Méndez-Albiñana P, Martínez-González Á, Camacho-Rodríguez L, Ferreira-Lazarte Á, Villamiel M, Rodrigues-Díez R, Balfagón G, García-Redondo AB, Prieto-Nieto MI, Blanco-Rivero J. Supplementation with the Symbiotic Formulation Prodefen® Increases Neuronal Nitric Oxide Synthase and Decreases Oxidative Stress in Superior Mesenteric Artery from Spontaneously Hypertensive Rats. Antioxidants (Basel) 2022; 11:antiox11040680. [PMID: 35453365 PMCID: PMC9029967 DOI: 10.3390/antiox11040680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/23/2022] Open
Abstract
In recent years, gut dysbiosis has been related to some peripheral vascular alterations linked to hypertension. In this work, we explore whether gut dysbiosis is related to vascular innervation dysfunction and altered nitric oxide (NO) production in the superior mesenteric artery, one of the main vascular beds involved in peripheral vascular resistance. For this purpose, we used spontaneously hypertensive rats, either treated or not with the commercial synbiotic formulation Prodefen® (108 colony forming units/day, 4 weeks). Prodefen® diminished systolic blood pressure and serum endotoxin, as well as the vasoconstriction elicited by electrical field stimulation (EFS), and enhanced acetic and butyric acid in fecal samples, and the vasodilation induced by the exogenous NO donor DEA-NO. Unspecific nitric oxide synthase (NOS) inhibitor L-NAME increased EFS-induced vasoconstriction more markedly in rats supplemented with Prodefen®. Both neuronal NO release and neuronal NOS activity were enhanced by Prodefen®, through a hyperactivation of protein kinase (PK)A, PKC and phosphatidylinositol 3 kinase-AKT signaling pathways. The superoxide anion scavenger tempol increased both NO release and DEA-NO vasodilation only in control animals. Prodefen® caused an increase in both nuclear erythroid related factor 2 and superoxide dismutase activities, consequently reducing both superoxide anion and peroxynitrite releases. In summary, Prodefen® could be an interesting non-pharmacological approach to ameliorate hypertension.
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Affiliation(s)
- Pablo Méndez-Albiñana
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (P.M.-A.); (Á.M.-G.); (L.C.-R.); (G.B.); (A.B.G.-R.)
- Group of Chemistry and Functionality of Carbohydrates and Derivatives, Food Science Research Institute (CIAL) (CSIC-UAM), 28049 Madrid, Spain; (Á.F.-L.); (M.V.)
| | - Ángel Martínez-González
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (P.M.-A.); (Á.M.-G.); (L.C.-R.); (G.B.); (A.B.G.-R.)
| | - Laura Camacho-Rodríguez
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (P.M.-A.); (Á.M.-G.); (L.C.-R.); (G.B.); (A.B.G.-R.)
| | - Álvaro Ferreira-Lazarte
- Group of Chemistry and Functionality of Carbohydrates and Derivatives, Food Science Research Institute (CIAL) (CSIC-UAM), 28049 Madrid, Spain; (Á.F.-L.); (M.V.)
| | - Mar Villamiel
- Group of Chemistry and Functionality of Carbohydrates and Derivatives, Food Science Research Institute (CIAL) (CSIC-UAM), 28049 Madrid, Spain; (Á.F.-L.); (M.V.)
| | - Raquel Rodrigues-Díez
- Department of Pharmacology and Therapeutics, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain;
- Research Institute University Hospital la Paz (IdIPaz), 28029 Madrid, Spain
- Center for Biomedical Research Network (CIBER) in Cardiovascular Diseases, 28029 Madrid, Spain
| | - Gloria Balfagón
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (P.M.-A.); (Á.M.-G.); (L.C.-R.); (G.B.); (A.B.G.-R.)
- Research Institute University Hospital la Paz (IdIPaz), 28029 Madrid, Spain
- Center for Biomedical Research Network (CIBER) in Cardiovascular Diseases, 28029 Madrid, Spain
| | - Ana B. García-Redondo
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (P.M.-A.); (Á.M.-G.); (L.C.-R.); (G.B.); (A.B.G.-R.)
- Research Institute University Hospital la Paz (IdIPaz), 28029 Madrid, Spain
- Center for Biomedical Research Network (CIBER) in Cardiovascular Diseases, 28029 Madrid, Spain
| | - Mª Isabel Prieto-Nieto
- Research Institute University Hospital la Paz (IdIPaz), 28029 Madrid, Spain
- Department of General and Digestive Surgery, Hospital Universitario la Paz, 28046 Madrid, Spain
- Correspondence: (M.I.P.-N.); (J.B.-R.); Tel.: +34-91-497-5446 (J.B.-R.)
| | - Javier Blanco-Rivero
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (P.M.-A.); (Á.M.-G.); (L.C.-R.); (G.B.); (A.B.G.-R.)
- Research Institute University Hospital la Paz (IdIPaz), 28029 Madrid, Spain
- Center for Biomedical Research Network (CIBER) in Cardiovascular Diseases, 28029 Madrid, Spain
- Correspondence: (M.I.P.-N.); (J.B.-R.); Tel.: +34-91-497-5446 (J.B.-R.)
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Adherence Clubs to Improve Hypertension Management in Nigeria: Clubmeds, a Feasibility Study. Glob Heart 2022; 17:21. [PMID: 35342700 PMCID: PMC8932363 DOI: 10.5334/gh.1109] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Hypertension control remains a significant challenge in reducing the cardiovascular disease burden worldwide. Community peer-support groups have been identified as a promising strategy to improve medication adherence and blood pressure (BP) control. Objectives: The study aimed to evaluate the feasibility and impact of adherence clubs to improve BP control in Southeast Nigeria. Methods: This was a mixed-methods research involving a formative (pre-implementation) research, pilot study and process evaluation. Hypertensive patients in two communities were recruited into peer-support adherence clubs under the leadership of role-model patients to motivate and facilitate medication adherence, BP monitoring, and monthly medication delivery for six months. The primary outcome was medication adherence measured using visual analogue scale (VAS), with BP level at six months as a key secondary outcome. Results: We recruited a total of 104 participants. The mean age was 56.8 (SD–10.7) years, 72 (69.2%) were women, mean BP was 146.7 (SD–20.1)/86.9 (SD–11.2) mmHg, and the mean percentage of medication adherence on the VAS was 41.4% (SD–11.9%). At six months, 67 patients were assessed; self-reported adherence on the VAS increased to 57.3% (SD–25.3%) (mean difference between baseline and follow-up of 15.5%, p < 0.0001), while the mean BP decreased to 132.3 (SD–22.0)/82.9 (SD–12.2) mmHg (mean difference of 13.0 mmHg in systolic BP, p < 0.0001 and of 3.6 mmHg in diastolic BP, p = 0.02). Five in-depth interviews and four focus groups discussions were conducted as part of the qualitative analyses of the study. The participants saw hypertension as a big issue, with many unaware of the diagnosis, and they accepted the CLUBMEDS differential service delivery (DSD) model concept in hypertension. Conclusions: The study demonstrates that the implementation of adherence clubs for hypertension control is feasible and led to a statistically significant and clinically meaningful improvement in self-reported medication adherence, resulting in BP reduction. Upscaling the intervention may be needed to confirm these findings.
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Hamzeh B, Pasdar Y, Moradi S, Darbandi M, Rahmani N, Shakiba E, Najafi F. Metabolically healthy versus unhealthy obese phenotypes in relation to hypertension incidence; a prospective cohort study. BMC Cardiovasc Disord 2022; 22:106. [PMID: 35287586 PMCID: PMC8922873 DOI: 10.1186/s12872-022-02553-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although obesity increases the risk of hypertension, the effect of obesity based on metabolic status on the incidence of hypertension is not known. This study aimed to determine the association between obesity phenotypes including metabolically unhealthy obesity (MUO) and metabolically healthy obesity (MHO) and the risk of hypertension incidence. Methods We conducted a prospective cohort study on 6747 adults aged 35–65 from Ravansar non-communicable diseases (RaNCD) study. Obesity was defined as body mass index above 30 kg/m2 and metabolically unhealthy was considered at least two metabolic disorders based on the International Diabetes Federation criteria. Obesity phenotypes were categorized into four groups including MUO, MHO, metabolically unhealthy non obesity (MUNO), and metabolically healthy non obesity (MHNO). Cox proportional hazards regression models were applied to analyze associations with hypertension incidence. Results The MHO (HR: 1.37; 95% CI: 1.03–1.86) and MUO phenotypes (HR: 2.44; 95% CI: 1.81–3.29) were associated with higher hypertension risk compared to MHNO. In addition, MUNO phenotype was significantly associated with risk of hypertension incidence (HR: 1.65; 95% CI: 1.29–2.14). Conclusions Both metabolically healthy and unhealthy obesity increased the risk of hypertension incidence. However, the increase in metabolically unhealthy phenotype was higher.
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Affiliation(s)
- Behrooz Hamzeh
- Health Education and Promotion, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Department of Nutrition Sciences, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Department of Nutrition Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Rahmani
- Julius Maximillian University of Wuerzburg, Wuerzburg, Germany
| | - Ebrahim Shakiba
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Epidemiology, School of Public Health, Communing Developmental and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Punia S, Singh V, Joshi S, Saini M. Comparison of different types of exercise training on resting blood pressure in 30-45 years old adults: a randomised controlled trial. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep210012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hypertension is the most metastasizing non-communicable disease, which has affected more than 1.4 billion people, worldwide. Exercise is the core management strategy for hypertensive individuals. Extensive literature is available for each kind of exercise that is isometric hand grip training (IHGT), resistance training (RT), and aerobic training (AT). However, the comparison between these exercise regimens has not been done in a single trial. The trial was conducted on 126 subjects in Hisar, an urban area of Haryana (INDIA), from July 2017 to December 2018. Subjects were randomly assigned to four groups: control (n=33), IHGT (n=32), RT (n=31), and AT (n=30). Study variables were measured at baseline, 2nd week, 4th week, 6th week, and also after the 8th week of intervention. Experimental groups showed significant reduction in all the components of blood pressure in comparison to control group. The RT group showed maximum reduction in blood pressure in comparison to other regimens (systolic blood pressure: RT > IHGT > AT; diastolic blood pressure: RT > AT > IHGT). However, the difference between the groups is not statistically significant (P>0.05). The study findings reveal that different kind of exercise regimens are equally effective in lowering blood pressure among pre hypertensive and stage 1 hypertension adults.
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Affiliation(s)
- S. Punia
- Guru Jambheshwar University of Science and Technology, Hisar 125001, India
| | - V. Singh
- Guru Jambheshwar University of Science and Technology, Hisar 125001, India
| | - S. Joshi
- Guru Jambheshwar University of Science and Technology, Hisar 125001, India
| | - M. Saini
- Mother Teresa Saket College of Physiotherapy, Panchkula 13410, Haryana, India
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Cavalcanti ALDM, Rocha PKL, Zhuge Z, Paulo LL, Mendes-Júnior LDG, Brandão MCR, Athayde-Filho PF, Lundberg JO, Weitzberg E, Carlström M, Braga VDA, Montenegro MF. Cardiovascular characterization of the novel organic mononitrate NDIBP in rats. Nitric Oxide 2022; 119:50-60. [PMID: 34958954 DOI: 10.1016/j.niox.2021.12.007] [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: 06/30/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022]
Abstract
Organic nitrates are widely used to restore endogenous nitric oxide (NO) levels reduced by endothelial nitric oxide synthase dysfunction. However, these drugs are associated with undesirable side effects, including tolerance. This study aims to investigate the cardiovascular effects of the new organic nitrate 1,3-diisobutoxypropan-2-yl nitrate (NDIBP). Specifically, we assessed its effects on blood pressure, vascular reactivity, acute toxicity, and the ability to induce tolerance. In vitro and ex vivo techniques showed that NDIBP released NO both in a cell-free system and in isolated mesenteric arteries preparations through a process catalyzed by xanthine oxidoreductase. NDIBP also evoked endothelium-independent vasorelaxation, which was significantly attenuated by 2-phenyl-4,4,5,5,-tetramethylimidazoline-1-oxyl 3-oxide (PTIO, 300 μM), a nitric oxide scavenger; 1-H-[1,2,4] oxadiazolo-[4,3-a]quinoxalin-1-one (ODQ, 10 μM), a soluble guanylyl cyclase inhibitor; tetraethylammonium (TEA, 3 mM), a potassium channel blocker; febuxostat (500 nM), a xanthine oxidase inhibitor; and proadifen (10 μM), an inhibitor of cytochrome P450 enzyme. Furthermore, this organic nitrate did not induce tolerance in isolated vessels and presented low toxicity following acute oral administration. In vivo changes on cardiovascular parameters were assessed using normotensive and renovascular hypertensive rats. NDIBP evoked a reduction of blood pressure that was significantly higher in hypertensive animals. Our results suggest that NDIBP acts as a NO donor, inducing blood pressure reduction without having the undesirable effects of tolerance. Those effects seem to be mediated by activation of NO-sGC-cGMP pathway and positive modulation of K+ channels in vascular smooth muscle.
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Affiliation(s)
| | - Patrícia Keytth Lins Rocha
- Biotechnology Center, Federal University of Paraíba, Cidade Universitária, 58051970, João Pessoa, PB, Brazil
| | - Zhengbing Zhuge
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Luciano Leite Paulo
- Biotechnology Center, Federal University of Paraíba, Cidade Universitária, 58051970, João Pessoa, PB, Brazil
| | | | | | - Petrônio F Athayde-Filho
- Department of Chemistry, Federal University of Paraíba, Cidade Universitária, 58059900, João Pessoa, PB, Brazil
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Mattias Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 65, Stockholm, Sweden
| | - Valdir de Andrade Braga
- Biotechnology Center, Federal University of Paraíba, Cidade Universitária, 58051970, João Pessoa, PB, Brazil.
| | - Marcelo F Montenegro
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 65, Stockholm, Sweden
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Effects of Long-Term Regular Continuous and Intermittent Walking on Oxidative Stress, Metabolic Profile, Heart Rate Variability, and Blood Pressure in Older Adults with Hypertension. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:5942947. [PMID: 35140794 PMCID: PMC8820939 DOI: 10.1155/2022/5942947] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
It is documented that regular exercise is beneficial for improving the antioxidant system, metabolic system, cardiac autonomic function, and blood pressure in those with hypertension. In this regard, low-intensity exercise is recommended for older adults, particularly those with chronic diseases. This study aimed to compare the effects of long-term regular continuous walking with intermittent walking on oxidative stress, metabolic profile, heart rate variability, and blood pressure in older adults with hypertension. Forty-three participants with hypertension aged 60–80 years were randomly divided into the continuous or intermittent walking (CON or INT) groups. Participants in the CON group walked for 30 min, 3 days/week for 12 weeks. Participants in the INT group split 30 min walking into 3 identical sessions punctuated by a 1 min rest after each session, 3 days/week for 12 weeks. Antioxidant and oxidative stress markers, metabolic markers, heart rate variability, and blood pressure were evaluated before and after the exercise program. Glutathione (GSH), GSH to GSH disulfide (GSSG) ratio, and total GSH increased significantly, and GSSG and malondialdehyde decreased significantly in both groups (
) without significant differences between groups. Triglycerides, ratio of total cholesterol to high-density lipoprotein cholesterol, and atherosclerogenic index were significantly lower in the CON group than those in the INT group (
). The standard deviation of the NN intervals and root mean square of the successive differences were significantly higher, and low-frequency power was significantly lower in the INT group than that in the CON group (
). No significant changes in blood pressure were noted in both groups, and nor were there any significant differences between groups. Long-term regular continuous and intermittent walking may comparably increase antioxidants, reduce oxidative stress, and be beneficial for improving important blood pressure-related outcomes, including metabolic profile or cardiac autonomic function in older adults with hypertension.
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Górska A, Paczosa-Bator B, Szlósarczyk M, Piech R. Highly sensitive voltammetric determination of captopril on renewable amalgam film electrode. Talanta 2022; 237:122937. [PMID: 34736668 DOI: 10.1016/j.talanta.2021.122937] [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: 07/31/2021] [Revised: 09/27/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
New highly sensitive voltammetric method for captopril (CPT) determination was developed. The main novelty of the work was the application of a renewable amalgam film electrode (Hg(Ag)FE) for this purpose. During the research instrumental parameters of the developed method were optimized and were as follows: tw = ts = 5 ms, Es = 5 mV, ΔE = 100 mV. Preconcentration potential and time were equal to 100 mV and 20 s, respectively. All measurements were conducted in electrolyte consisted of 0.1 M HClO4. Limit of detection was calculated and was equal to 1.9 nM (0.39 ng mL-1) for 20 s preconcentration time and Hg(Ag)FE surface area approximately 11.2 mm2. Linearity was achieved in the concentration range 0.05-1 μM. Repeatability of the method expressed as variation coefficient was estimated at 3.5% (0.15 μM CPT, n = 10). Applicability of the method was confirmed by analysis of tablets containing CPT and urine. Recoveries were in the range from 95 to 109% suggesting that the method might be assumed as accurate. Obtained results were also in good agreement with the producer declaration.
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Affiliation(s)
- Anna Górska
- Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059, Kraków, Poland
| | - Beata Paczosa-Bator
- Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059, Kraków, Poland
| | - Marek Szlósarczyk
- Jagiellonian University Medical College, Department of Inorganic and Analytical Chemistry, Medyczna 9, 30-688, Kraków, Poland
| | - Robert Piech
- Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059, Kraków, Poland.
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Ghasemihamedani F, Habibisaravi R, Assadi T, Gholami G, Hasani M, Pourmand S, Navaie R. Flood and hypertension: A systematic review. Res Cardiovasc Med 2022. [DOI: 10.4103/rcm.rcm_59_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Potassium Effects on NCC Are Attenuated during Inhibition of Cullin E3-Ubiquitin Ligases. Cells 2021; 11:cells11010095. [PMID: 35011657 PMCID: PMC8750104 DOI: 10.3390/cells11010095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 01/02/2023] Open
Abstract
The thiazide-sensitive sodium chloride cotransporter (NCC) plays a vital role in maintaining sodium (Na+) and potassium (K+) homeostasis. NCC activity is modulated by with-no-lysine kinases 1 and 4 (WNK1 and WNK4), the abundance of which is controlled by the RING-type E3 ligase Cullin 3 (Cul3) and its substrate adapter Kelch-like protein 3. Dietary K+ intake has an inverse correlation with NCC activity, but the mechanism underlying this phenomenon remains to be fully elucidated. Here, we investigated the involvement of other members of the cullin family in mediating K+ effects on NCC phosphorylation (active form) and abundance. In kidneys from mice fed diets varying in K+ content, there were negative correlations between NCC (phosphorylated and total) and active (neddylated) forms of cullins (Cul1, 3, 4, and 5). High dietary K+ effects on phosphorylated NCC were attenuated in Cul3 mutant mice (CUL3-Het/Δ9). Short-term (30 min) and long-term (24 h) alterations in the extracellular K+ concentration did not affect cullin neddylation levels in ex vivo renal tubules. In the short term, the ability of high extracellular K+ to decrease NCC phosphorylation was preserved in the presence of MLN4924 (pan-cullin inhibitor), but the response to low extracellular K+ was absent. In the long term, MLN4924 attenuated the effects of high extracellular K+ on NCC phosphorylation, and responses to low extracellular K+ were absent. Our data suggest that in addition to Cul3, other cullins are involved in mediating the effects of K+ on NCC phosphorylation and abundance.
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Hypertension Control and Guideline-Recommended Target Blood Pressure Goal Achievement at an Early Stage of Hypertension in the UAE. J Clin Med 2021; 11:jcm11010047. [PMID: 35011789 PMCID: PMC8745633 DOI: 10.3390/jcm11010047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 01/13/2023] Open
Abstract
(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m2 was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07–1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08–1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03–1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.
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Mohamed SF, Uthman OA, Mutua MK, Asiki G, Abba MS, Gill P. Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa: a systematic review and meta-analysis. BMJ Open 2021; 11:e045880. [PMID: 34903530 PMCID: PMC8671923 DOI: 10.1136/bmjopen-2020-045880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The burden of uncontrolled hypertension in sub-Saharan Africa (SSA) is high and hypertension is known to coexist with other chronic diseases such as kidney disease, diabetes among others. This is the first systematic review and meta-analysis to determine the burden of uncontrolled hypertension among patients with comorbidities in SSA. METHODS A comprehensive search was conducted on MEDLINE, Excerpta Medica Database (Embase) and Web of Science to identify all relevant articles published between 1 January 2000 and 17 June 2021. We included studies that reported on the prevalence of uncontrolled hypertension among people in SSA who report taking antihypertensive treatment and have another chronic condition. A random-effects meta-analysis was performed to obtain the pooled estimate of the prevalence of uncontrolled hypertension among patients with comorbid conditions while on treatment across studies in SSA. RESULTS In all, 20 articles were included for meta-analyses. Eleven articles were among diabetic patients, five articles were among patients with HIV, two were among patients with stroke while chronic kidney disease and atrial fibrillation had one article each. The pooled prevalence of uncontrolled hypertension among patients with comorbidities was 78.6% (95% CI 71.1% to 85.3%); I² 95.9%, varying from 73.1% in patients with stroke to 100.0% in patients with atrial fibrillation. Subgroup analysis showed differences in uncontrolled hypertension prevalence by various study-level characteristics CONCLUSION: This study suggests a high burden of uncontrolled hypertension in people with comorbidities in SSA. Strategies to improve the control of hypertension among people with comorbidities are needed. PROSPERO REGISTRATION NUMBER CRD42019108218.
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Affiliation(s)
- Shukri F Mohamed
- Academic Unit of Primary Care (AUPC) and the NIHR Global Health Research Unit on Improving Health in Slums, University of Warwick, Coventry, UK
- Health and Systems for Health, African Population and Health Research Center, Nairobi, Kenya
- Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Olalekan A Uthman
- Warwick-Centre for Applied Health Research and Delivery (WCAHRD), University of Warwick, Coventry, West Midlands, UK
| | - Martin K Mutua
- Data, Measurement and Evaluation unit, African Population and Health Rsearch Center, Nairobi, Kenya
| | - G Asiki
- Health and Systems for Health, African Population and Health Research Center, Nairobi, Kenya
| | - Mustapha S Abba
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
| | - Paramjit Gill
- Academic Unit of Primary Care (AUPC) and the NIHR Global Health Research Unit on Improving Health in Slums, University of Warwick, Coventry, UK
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PTML modeling for peptide discovery: in silico design of non-hemolytic peptides with antihypertensive activity. Mol Divers 2021; 26:2523-2534. [PMID: 34802116 DOI: 10.1007/s11030-021-10350-z] [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] [Received: 09/14/2021] [Accepted: 11/05/2021] [Indexed: 01/19/2023]
Abstract
Hypertension is a medical condition that affects millions of people worldwide. Despite the high efficacy of the current antihypertensive drugs, they are associated with serious side effects. Peptides constitute attractive options for chemical therapy against hypertension, and computational models can accelerate the design of antihypertensive peptides. Yet, to the best of our knowledge, all the in silico models predict only the antihypertensive activity of peptides while neglecting their inherent toxic potential to red blood cells. In this work, we report the first sequence-based model that combines perturbation theory and machine learning through multilayer perceptron networks (SB-PTML-MLP) to enable the simultaneous screening of antihypertensive activity and hemotoxicity of peptides. We have interpreted the molecular descriptors present in the model from a physicochemical and structural point of view. By strictly following such interpretations as guidelines, we performed two tasks. First, we selected amino acids with favorable contributions to both the increase of the antihypertensive activity and the diminution of hemotoxicity. Then, we assembled those suitable amino acids, virtually designing peptides that were predicted by the SB-PTML-MLP model as antihypertensive agents exhibiting low hemotoxicity. The potentiality of the SB-PTML-MLP model as a tool for designing potent and safe antihypertensive peptides was confirmed by predictions performed by online computational tools reported in the scientific literature. The methodology presented here can be extended to other pharmacological applications of peptides.
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Chen L, Wang L, Li J, Shu G. Antihypertensive potential of fermented milk: the contribution of lactic acid bacteria proteolysis system and the resultant angiotensin-converting enzyme inhibitory peptide. Food Funct 2021; 12:11121-11131. [PMID: 34657947 DOI: 10.1039/d1fo02435c] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hypertension has become an increasing health concern given that it is a major risk for cardiovascular disease. Synthetic antihypertensive drugs, including angiotensin-converting enzyme (ACE) inhibitors, effectively control high blood pressure but are associated with unpleasant side effects. Milk fermented by certain lactic acid bacteria (LAB) provides energetic contributions to the management of hypertension, especially the regulation of ACE. LAB are important food-grade microbial organisms that release ACE inhibitory peptides through their unique proteolysis system, which consists of cell-envelope proteinases (CEPs), transporter systems, and intracellular peptidases. Thus, the description of LAB proteolysis system genes and their contributions to ACE inhibitory peptide production is a challenging but promising study. This review provides a survey of LABs with potential ACE inhibitory activity and investigates the research progress of LAB proteolytic systems with an emphasis on the correlation of their components and ACE inhibitory activity. Subsequently, a depiction of the ACE inhibitory peptide action mechanism, structure-activity relationship and bioavailability is presented. The improved functional annotation of LAB proteolytic system genes will provide an excellent framework for future experimental validations of predicted ACE inhibitory activity in fermented milk.
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Affiliation(s)
- Li Chen
- College of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an 710119, P. R. China.
| | - Linlin Wang
- College of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an 710119, P. R. China.
| | - Jianke Li
- College of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi'an 710119, P. R. China.
| | - Guowei Shu
- School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi'an 710021, P. R. China.
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Abstract
Accumulating evidence suggests that the molecular circadian clock is crucial in blood pressure (BP) control. Circadian rhythms are controlled by the central clock, which resides in the suprachiasmatic nucleus of the hypothalamus and peripheral clocks throughout the body. Both light and food cues entrain these clocks but whether these cues are important for the circadian rhythm of BP is a growing area of interest. The peripheral clocks in the smooth muscle, perivascular adipose tissue, liver, adrenal gland, and kidney have been recently implicated in the regulation of BP rhythm. Dysregulation of the circadian rhythm of BP is associated with adverse cardiorenal outcomes and increased risk of cardiovascular mortality. In this review, we summarize the most recent advances in peripheral clocks as BP regulators, highlight the adverse outcomes of disrupted circadian BP rhythm in hypertension, and provide insight into potential future work in areas exploring the circadian clock in BP control and chronotherapy. A better understanding of peripheral clock function in regulating the circadian rhythm of BP will help pave the way for targeted therapeutics in the treatment of circadian BP dysregulation and hypertension.
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Affiliation(s)
- Hannah M. Costello
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL 32610
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32610
| | - Michelle L. Gumz
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL 32610
- Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32610
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Cocoa ( Theobroma cacao L.) Seed-Derived Peptides Reduce Blood Pressure by Interacting with the Catalytic Site of the Angiotensin-Converting Enzyme. Foods 2021; 10:foods10102340. [PMID: 34681387 PMCID: PMC8534856 DOI: 10.3390/foods10102340] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022] Open
Abstract
This study aimed at determining the effect of cocoa proteins (CP) on the blood pressure, using in silico, in vitro and in vivo approaches. The in silico assay showed 26 Criollo cocoa peptides with alignment in the Blast® analysis. Peptide sequences ranged from 6 to 16 amino acids, with molecular weight ranging from 560.31 to 1548.76 Da. The peptide sequences LSPGGAAV, TSVSGAGGPGAGR, and TLGNPAAAGPF showed the highest theoretical affinity with −8.6, −5.0, and −10.2 kcal/mol, for the angiotensin-converting enzyme (ACE), renin, and angiotensin II type 1 receptor (AT1-R), respectively. The Criollo CP hydrolysates (CPH) presented in vitro ACE inhibitory activity with an IC50 value of 0.49 mg/mL. Furthermore, the orogastric administration of 150 mg CP/kg/day in rats fed a high-fat (HF) diet (HF + CP group) showed a significant decrease in systolic blood pressure (SBP) by 5% (p < 0.001) and diastolic blood pressure (DBP) by 7% (p < 0.001) compared with the HF group. The human equivalent dose (HED) of CP for an adult (60 kg) is 1.45 g per day. These results suggest that the consumption of CP could reduce blood pressure by blocking ACE, and could be used as an ingredient in the elaboration of antihypertensive functional foods.
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Omidi N, Arabloo J, Rezapour A, Alaeddini F, Bragazzi NL, Pourasghari H, Behzadifar M, Salarifar M, Khorgami M, Ghorashi SM, Azari S. Burden of Hypertensive Heart Disease in Iran during 1990-2017: Findings from the Global Burden of Disease study 2017. PLoS One 2021; 16:e0257617. [PMID: 34551003 PMCID: PMC8457465 DOI: 10.1371/journal.pone.0257617] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/06/2021] [Indexed: 01/01/2023] Open
Abstract
Background Hypertension and its consequent end-organ damage including Hypertensive Heart Disease (HHD) are a major concern that impact health, resulting into impairment and reduced quality of life (QOL). The purpose of this study was to describe the burden of HHD in Iran and comparing it with the World Bank upper middle-income countries (UMICs) in terms of disability-adjusted life years (DALY), mortality and prevalence. Methods Using data from the Global Burden of Disease study 2017, we compared the number of DALYs, deaths and prevalence trends for HHD from 1990 to 2017 in all age groups for both sex in Iran, and compared the epidemiology and trends with UMICs and globally. Results The age-standardized DALY rate for HHD increased by 51.6% for men (95% uncertainty interval [UI] 305.8 to 436.7 per 100,000) and 4.4% for women (95% UI 429.4 to 448.7 per 100,000) in Iran. The age-standardized prevalence of HHD in Iran was almost twice times higher than globally and 1.5-times more than the World Bank UMICs. The age-standardized death rate for HDD increased by 60.1% (95% UI 17.3 to 27.7% per 100,000) for men and by 21.7% (95% UI 25.85 to 31.48 per 100,000) for women from 1990 to 2017. Age-standardized death rate in Iran was 2.4 and 1.9 times higher than globally and UMICs, respectively. Conclusions The higher prevalence and death rate in Iran in comparison with UMICs and globally should encourage health care provider to perform intensive screening activities in at risk population to prevent HHD and mitigate its mortality.
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Affiliation(s)
- Negar Omidi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshid Alaeddini
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of mathematics and statistics, York University, Toronto, Canada
| | - Hamid Pourasghari
- Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mojtaba Salarifar
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - MohammdRafie Khorgami
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Samad Azari
- Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
- * E-mail:
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Egbi OG, Ahmed SD, Madubuko R. Prevalence and biosocial determinants of hypertension in a rural population in Edo State, Southern Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e7. [PMID: 34212744 PMCID: PMC8335784 DOI: 10.4102/phcfm.v13i1.2833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 11/07/2022] Open
Abstract
Background Hypertension is a public health threat of global concern with increasing prevalence in many countries, including Nigeria. Aim The aim of the study was to determine the prevalence and determinants of hypertension in a rural agrarian community in Edo North, Nigeria. Setting The study was carried out in Ayua, a community in Edo North, southern Nigeria. Methods This cross-sectional descriptive study involved the use of a structured interviewer-administered questionnaire to obtain relevant data. Body mass index (BMI), blood pressure and glucose were recorded. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Results Two hundred and nineteen participants aged > 15 years completed the study with a mean age of 54.03 ± 16.61 years and females comprising 159 (72.6%) of the total. The prevalence of hypertension was 27.9% (in 61 participants). Twenty-one (9.8%) respondents gave a family history of hypertension. The mean BMI amongst respondents was 27.10 ± 6.61 kg/m2. Obesity and pre-obesity were found in 58 (26.5%) and 71(32.4%) respondents, respectively. The determinants of hypertension were age and BMI. Compared with those who were less than 40 years old, those aged 40–65 years and > 65 years had 1.9 and 4.2 times increased odds of developing hypertension, respectively. Similarly, compared with the non-obese, obese participants had 2.3 times increased odd of having hypertension. Conclusion Hypertension was highly prevalent in this rural community. Health sensitisation and intervention programmes are recommended in rural communities for early detection and management of hypertension, especially amongst older and obese adults.
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Affiliation(s)
- Oghenekaro G Egbi
- Department of Internal Medicine, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria; and, Department of Internal Medicine, Faculty of Clinical Sciences, Niger Delta University, Amassoma, Bayelsa State.
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Dzudie A, Njume E, Mfekeu LK, Djomou A, Ba H, Ndom MS, Nkoke C, Ndongo S, Boombhi J, Kamdem F, Mouandjo JPD, Mouliom SA, Kouam CK, Meli H, Monkam Y, Awungia A, Serah A, Tantchou C, Ndjebet J, Menanga A, Beaney T, Clarke J, Poulter NR, Kengne AP, Kingue S. May Measurement Month 2019: an analysis of blood pressure screening results from Cameroon. Eur Heart J Suppl 2021; 23:B33-B36. [PMID: 34248429 PMCID: PMC8263083 DOI: 10.1093/eurheartj/suab056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The multi-country May Measurement Month (MMM) screening campaign aims to raise awareness on blood pressure (BP) and hypertension in individuals and communities, and measure BP, ideally, of those who had no BP measurement in the preceding year. We here report key findings from the Cameroon arm of MMM 2019. An opportunistic sample of adults (≥18 years) was included from 5 May to 5 June 2019 across 15 sites (markets, churches, homes, motor parks, workplaces, and hospitals/clinics). Data collection, cleaning, the definition of hypertension, and statistical analysis followed the standard protocol. The mean age of the 30 187 participants screened was 36.9 (SD: 14.9) years, 50.4% were female (5% of whom were pregnant), and 94.4% were screened out of the hospital/clinic settings. After multiple imputation of missing data, 6286 (20.8%) had hypertension, 24.0% were taking antihypertensive medication, and 705 (11.2%) of all participants with hypertension had controlled BP. In linear regression models adjusted for age, sex, and antihypertensive medicines use, a previous diagnosis of hypertension, a history of stroke, and use of antihypertensive medicines were significant predictors of systolic and diastolic BP levels. BPs were also significantly higher when measured in public outdoors, public indoors (diastolic BP only), workplaces, and other unspecified areas compared to hospitals/clinic settings. MMM19 is the largest ever BP screening campaign in a single month, in Cameroon and despite the limitations resulting from non-random sample selection, the opportunistic screening allows access to awareness and screening for hypertension out of the hospital/clinic settings.
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Affiliation(s)
- Anastase Dzudie
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon.,Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon
| | - Epie Njume
- Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon
| | - Liliane Kuate Mfekeu
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Armel Djomou
- Fondation Coeur et Vie, Carrefour Zachman, Ndogbong, Douala, Cameroon
| | - Hamadou Ba
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Marie Solange Ndom
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Clovis Nkoke
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon.,Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon
| | - Sylvie Ndongo
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Jerome Boombhi
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Felicite Kamdem
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | | | | | - Charles Kouam Kouam
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Herve Meli
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Yves Monkam
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Alexis Awungia
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Ambang Serah
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Cabral Tantchou
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Jules Ndjebet
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Alain Menanga
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Jonathan Clarke
- Department of Mathematics, Huxley Building, South Kensington Campus, Imperial College London, London SW7 2AZ, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Andre Pascal Kengne
- Clinical Research Education, Networking and Consultancy, Carrefour Tam-Tam, Opposite Neptune Station, PO Box 3787, Yaounde, Cameroon.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Samuel Kingue
- Cameroon Cardiac Society, Hôpital Général de Yaoundé, PO Box 1364, Yaoundé, Cameroon
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Razavi MA, Bazzano LA, Nierenberg J, Huang Z, Fernandez C, Razavi AC, Whelton SP, He J, Kelly TN. Advances in Genomics Research of Blood Pressure Responses to Dietary Sodium and Potassium Intakes. Hypertension 2021; 78:4-15. [PMID: 33993724 DOI: 10.1161/hypertensionaha.121.16509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
More than half of US adults have hypertension by 40 years of age and a subsequent increase in atherosclerotic cardiovascular disease risk. Dietary sodium and potassium are intricately linked to the pathophysiology of hypertension. However, blood pressure responses to dietary sodium and potassium, phenomena known as salt and potassium sensitivity of blood pressure, respectively, are heterogenous and normally distributed in the general population. Like blood pressure, salt and potassium sensitivity are complex phenotypes, and previous research has shown that up to 75% of individuals experience a blood pressure change in response to such dietary minerals. Previous research has also implicated both high salt sensitivity and low salt sensitivity (or salt resistance) of blood pressure to an increased risk of hypertension and potentially atherosclerotic cardiovascular disease risk. Given the clinical challenges required to accurately measure the sodium and potassium response phenotypes, genomic characterization of these traits has become of interest for hypertension prevention initiatives on both the individual and population levels. Here, we review advances in human genomics research of blood pressure responses to dietary sodium and potassium by focusing on 3 main areas, including the phenotypic characterization of salt sensitivity and resistance, clinical challenges in diagnosing such phenotypes, and the genomic mechanisms that may help to explain salt and potassium sensitivity and resistance. Through this process, we hope to further underline the value of leveraging genomics and broader multiomics for characterizing the blood pressure response to sodium and potassium to improve precision in lifestyle approaches for primordial and primary atherosclerotic cardiovascular disease prevention.
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Affiliation(s)
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.A.B., Z.H., C.F., A.C.R., J.H., T.N.K.)
| | - Jovia Nierenberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine (J.N.)
| | - Zhijie Huang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.A.B., Z.H., C.F., A.C.R., J.H., T.N.K.)
| | - Camilo Fernandez
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA (C.F., A.C.R., J.H.).,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.A.B., Z.H., C.F., A.C.R., J.H., T.N.K.)
| | - Alexander C Razavi
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA (C.F., A.C.R., J.H.).,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.A.B., Z.H., C.F., A.C.R., J.H., T.N.K.)
| | - Seamus P Whelton
- The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD (S.P.W.)
| | - Jiang He
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA (C.F., A.C.R., J.H.).,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.A.B., Z.H., C.F., A.C.R., J.H., T.N.K.)
| | - Tanika N Kelly
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (L.A.B., Z.H., C.F., A.C.R., J.H., T.N.K.)
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Hong D, Shan W. Improvement in Hypertension Management with Pharmacological and Non- Pharmacological Approaches: Current Perspectives. Curr Pharm Des 2021; 27:548-555. [PMID: 32962608 DOI: 10.2174/1381612826666200922153045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Improving hypertension management is still one of the biggest challenges in public health worldwide. Existing guidelines do not reach a consensus on the optimal Blood Pressure (BP) target. Therefore, how to effectively manage hypertension based on individual characteristics of patients, combined with the pharmacological and non-pharmacological approach, has become a problem to be urgently considered. METHODS Reports published in PubMed that covered Pharmacological and Non-Pharmacological Approaches in subjects taking hypertension management were reviewed by the group independently and collectively. Practical recommendations for hypertension management were established by the panel. RESULTS Pharmacological mechanism, action characteristics, and main adverse reactions varied across different pharmacological agents, and patients with hypertension often require a combination of antihypertensive medications to achieve the target BP range. Non-pharmacological treatment provides an additional effective method for improving therapy adherence and long-term BP control, thus reducing the risk of cardiovascular diseases, and slowing down the progression of the disease. CONCLUSION This review summarizes the available literature on the most convincing guideline principles, pharmacological treatment, biotechnology interference, interventional surgical treatment, managing hypertension with technical means of big data, Artificial Intelligence and Behavioral Intervention, as well as providing future directions, for facilitating Current and Developing knowledge into clinical implementation.
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Affiliation(s)
- Dongsheng Hong
- Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Wenya Shan
- Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Simonsson O, Hendricks PS, Carhart-Harris R, Kettner H, Osika W. Association Between Lifetime Classic Psychedelic Use and Hypertension in the Past Year. Hypertension 2021; 77:1510-1516. [PMID: 33677982 DOI: 10.1161/hypertensionaha.120.16715] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Otto Simonsson
- Department of Sociology, University of Oxford, United Kingdom (O.S.)
| | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham (P.S.H.)
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, United Kingdom (R.C.-H., H.K.)
| | - Hannes Kettner
- Centre for Psychedelic Research, Department of Brain Science, Imperial College London, United Kingdom (R.C.-H., H.K.)
| | - Walter Osika
- Department of Clinical Neuroscience, Center for Psychiatry Research (W.O.), Karolinska Institute, Sweden.,Department of Neurobiology, Center for Social Sustainability, Care Sciences and Society (W.O.), Karolinska Institute, Sweden.,Northern Stockholm Psychiatry, Stockholm Health Care Services, Region Stockholm, Sweden (W.O.)
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50
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Anyanti J, Akuiyibo SM, Fajemisin O, Idogho O, Amoo B. Assessment of the level of knowledge, awareness and management of hypertension and diabetes among adults in Imo and Kaduna states, Nigeria: a cross-sectional study. BMJ Open 2021; 11:e043951. [PMID: 34006029 PMCID: PMC7942260 DOI: 10.1136/bmjopen-2020-043951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and Kaduna states, Nigeria. DESIGN A descriptive cross-sectional study. SETTING Selected communities across 14 local government areas in Imo and Kaduna states were included. PARTICIPANTS In total, 824 adults, aged 35 years or older and resident in selected communities where the Access-N project was being implemented in Imo and Kaduna states participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES The study assessed the level of hypertension and diabetes knowledge among the participants. Regular blood pressure (BP) and glucose screening practices were also examined as outcome measures. RESULTS The mean age of the respondents was 48.32 years. In total, 778 (94.4%) and 746 (90.5%) of the respondents were aware of hypertension and diabetes, respectively. The mean hypertension and diabetes knowledge scores (±SD) were 4.99 (±1.99) and 8.02 (±2.61), respectively. A total of 326 (41.9%) respondents aware of hypertension had a good knowledge of hypertension while 477 (63.9%) of those aware of diabetes had a good knowledge of diabetes. Levels of hypertension and diabetes knowledge were found to be associated with physical activity and the level of education of the respondents. About two-thirds (62.6%) and less than half (41.5%) of the respondents, respectively check their BP and blood glucose (BG) levels regularly (at least once yearly). Statistically significant associations were observed between age and regular BP and BG level checks. CONCLUSIONS Despite the high awareness rate of hypertension and diabetes observed in this study and a relatively good knowledge about the two conditions, unhealthy lifestyle practices and non-regular routine screening abounds among the respondents. Thus, there is a need to improve access to quality information about hypertension and diabetes aimed at motivating adoption of healthy behaviours.
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