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Day CA, Berkowsky RS, Zaleski AL, Chen MH, Taylor BA, Wu Y, Parducci PM, Zhang Y, Fernhall B, Fernandez AB, Pescatello LS. The influence of vigorous physical exertion on cardiac demand under conditions of daily living among firefighters with elevated blood pressure. Heart Lung 2024; 68:208-216. [PMID: 39047646 DOI: 10.1016/j.hrtlng.2024.07.008] [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: 04/12/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Firefighters have a high prevalence of cardiovascular disease. The poor heart health of firefighters is implicated in their increased risk of sudden cardiac death (SCD). Exercise may be protective against SCD partially due to the immediate blood pressure (BP) reductions of 5-8 mmHg following exercise, termed postexercise hypotension (PEH) OBJECTIVES: To examine PEH under ambulatory conditions after a maximal cardiopulmonary exercise test (CPET) among career firefighters METHODS: Firefighters (n = 19) completed a maximal CPET and non-exercise control (CONTROL) in random order on separate non-workdays and left the laboratory instrumented to an ambulatory BP (ABP) monitor. Ambulatory systolic BP (ASBP), diastolic BP (ADBP), and heart rate (AHR) were recorded at hourly intervals over 19hr. The ambulatory rate pressure product (ARPP) was calculated as ASBPxAHRx10-3 at each hourly interval. Repeated measures ANCOVA tested if the ABP, AHR, and ARPP responses differed after CPET vs CONTROL over 19hr RESULTS: Firefighters were middle-aged (39.5 ± 8.9 yr), overweight (29.2 ± 4.0 kg/m2) men with elevated BP (123.1 ± 9.6/79.8 ± 10.4 mmHg), while resting HR (67.7 ± 11.3 bpm) and RPP (8.4 ± 1.7mmHg*bpm*10-3) were in normal ranges. ASBP (16.6 ± 5.7 mmHg) and ADBP (3.1 ± 4.6 mmHg) increased after the CPET vs CONTROL over 19hr (ps<0.01), as did AHR (9.4 ± 7.9 bpm, p = 0.02) and ARPP (2.5 ± 1.1mmHg*bpm*10-3, p < 0.01). CONCLUSIONS Unexpectedly, the firefighters exhibited postexercise hypertension rather than PEH. The increases in ABP and AHR we observed indicated a sustained increase in cardiac demand. Further investigation is needed to confirm our findings and determine whether the adverse hemodynamic responses we observed contribute to the high prevalence of SCD that firefighters experience on the job.
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Affiliation(s)
- Christina A Day
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
| | - Rachel S Berkowsky
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA.
| | - Amanda L Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA; Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06102, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT 06268, USA
| | - Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA; Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06102, USA
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
| | - Paul M Parducci
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
| | - Yiming Zhang
- Department of Statistics, University of Connecticut, Storrs, CT 06268, USA
| | - Bo Fernhall
- Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA 02125, USA
| | - Antonio B Fernandez
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06102, USA
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
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Cuffee YL, Wang M, Geyer NR, Saxena S, Akuley S, Jones L, Wilson RT. Vitamin D and family history of hypertension in relation to hypertension status among college students. J Hum Hypertens 2022; 36:839-845. [PMID: 34285353 PMCID: PMC9467912 DOI: 10.1038/s41371-021-00577-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 12/01/2022]
Abstract
Hypertension and vitamin D concentrations have heritable components, although these factors remain uninvestigated in young adults. The objective of this study was to investigate hypertension risk among young adults with respect to family history of hypertension, adjusting for vitamin D status. Resting blood pressure (BP) was measured in 398 individuals aged 18-35 and classified according to the 2017 American Heart Association criteria. Plasma vitamin D metabolite (25(OH)D3; 24,25(OH)2D3; 1,25(OH)2D3) concentrations were determined using liquid chromatography tandem mass spectrometry (LC-MS/MS). Stepwise logistic regression was used to select covariates. Participants' mean age was 21, 30.3% had hypertension, and nearly all unaware of their hypertensive status (90.7%). Compared with no parental history, the adjusted odds ratio (AOR) for hypertension was elevated among participants with two parents having hypertension (AOR = 4.5, 95% CI: 1.70-11.76), adjusting for sex, body mass index, physical activity, and plasma 25(OH)D3. Results for systolic hypertension (SH) were similar but more extreme (two parents AOR = 7.1, 95% CI: 2.82, 17.66), although dihydroxy metabolites (1,25(OH)2D3 and 24,25(OH)2D3) were significant. There was a strong, independent association with dual parental history and hypertension status, regardless of vitamin D status. Hypertension was prevalent in nearly one-third of the sample and underscores the need for targeted prevention for young adults.
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Affiliation(s)
- Yendelela L Cuffee
- Epidemiology Program, College of Health Sciences, University of Delaware, Newark, DE, USA.
| | - Ming Wang
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Nathaniel R Geyer
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Sangeeta Saxena
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Suzanne Akuley
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, USA
| | - Lenette Jones
- University of Michigan, School of Nursing, Ann Arbor, MI, USA
| | - Robin Taylor Wilson
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA
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Rupasinghe CD, Shahbaz U, Huang E, Patel A, Mohammed Saeed Muthanna F, Basta M, Narawish C, Karim S, Rahim A. Determinants of Hypertension Among Patients With Type 2 Diabetes Mellitus in Karachi, Pakistan: A Cross-Sectional Study. Cureus 2022; 14:e22157. [PMID: 35340479 PMCID: PMC8920824 DOI: 10.7759/cureus.22157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/05/2022] Open
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Sane AH, Mekonnen MS, Tsegaw MG, Zewde WC, Mesfin EG, Beyene HA, Ashine TM, Tiruneh KG, Mengistie MA. New Onset of Diabetes Mellitus and Associated Factors among COVID-19 Patients in COVID-19 Care Centers, Addis Ababa, Ethiopia 2022. J Diabetes Res 2022; 2022:9652940. [PMID: 36420090 PMCID: PMC9678479 DOI: 10.1155/2022/9652940] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/22/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION New onset of diabetes mellitus was noted as the commonest comorbidity in the COVID-19 pandemic, which contributed to a worse prognosis. Existing evidence showed that new-onset diabetes is associated with increased mortality compared to nondiabetic and known diabetic patients in the COVID-19 era. SARS-CoV-2 virus can worsen existing diabetes; at the same time, it can trigger new-onset diabetes that eventually worsens patient outcomes. Thus, this study is aimed at determining the prevalence and factors associated with new onset of diabetes mellitus among COVID-19 patients. METHODS Institution-based retrospective cross-sectional study design was conducted by reviewing 244 patient's records in the Addis Ababa COVID-19 care center. Descriptive statistics and binary logistic regression were used. During bivariate analysis, variables with p ≤ 0.25 were transferred into multivariate analysis. Adjusted odds ratios to determine the strength and presence of the association with a 95% confidence interval and p value ≤ 0.05 were considered, respectively. RESULTS The mean age of the study participants was 53.2 years with (SD = 13.35). The study findings showed that 31.1% (CI: 25.4-37.4) of COVID-19 patients had new onset of diabetes mellitus; of those, 11.8% had type 1 and 88.2% had type 2 diabetes. Being male (aOR = 2.9; 95% CI: 1.2, 7.1), family history of hypertension (aOR = 3.7; 95% CI: 1.3, 10.5), obesity (aOR = 3.1; 95% CI: 1.01, 8.9), having pulmonary embolism (aOR = 0.2; 95% CI: 0.06, 0.04), and hyperkalemia (aOR = 9.3; 95% CI: 1.8, 47.3) showed statistically significant association with new onset of diabetes mellitus. CONCLUSION A significant proportion of COVID-19 patients had been diagnosed with new onset of diabetes mellitus, and new-onset type 2 diabetes mellitus is the most common diabetes mellitus type. Being male, obesity, having a pulmonary embolism, family history of hypertension, and hyperkalemia were independently associated with new onset of diabetes mellitus among COVID-19 patients. Therefore, focused interventions need to be strengthened towards the identified factors.
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Affiliation(s)
| | - Migbar Sibhat Mekonnen
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Melsew Getnet Tsegaw
- Millennium COVID-19 Care Center, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wuletaw Chane Zewde
- Millennium COVID-19 Care Center, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Edmialem Getahun Mesfin
- Millennium COVID-19 Care Center, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Hailu Asmare Beyene
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Taye Mezgebu Ashine
- Schools of Nursing, College of Health Science and Medicine, Wachemo University, Hosaena, Ethiopia
| | - Kasie Gebeyehu Tiruneh
- Department of Nursing, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
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Kotiso KS, Degemu N, Gebremedhin S, Taye M, Petros A, Belayneh F, Wolde D, Hailu D. Determinants of hypertension among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa: A case-control study. PLoS One 2021; 16:e0256399. [PMID: 34424924 PMCID: PMC8382175 DOI: 10.1371/journal.pone.0256399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Hypertension (HTN) in patients with diabetes mellitus (DM) is a common problem that increases the risk of mortality and morbidity, and lowers the quality of life. Despite the disproportionately high burden of HTN in DM patients, determinants for the comorbidity have not been sufficiently explored. Therefore, this study aimed to identify the determinants of HTN among patients with type 2 diabetes mellitus on follow-up at Tikur Anbessa Specialized Hospital. METHODS AND MATERIALS We conducted a hospital-based unmatched case-control study at Tikur Anbessa Specialized Hospital on 386 randomly selected patients with type 2 diabetes on follow-up (200 cases and 186 controls). We collected data by using a structured interviewer-administered questionnaire and data extraction form. To identify determinants of hypertension, a multivariable binary logistic regression was fitted, and the findings are presented using adjusted odds ratio (AOR) with 95% confidence interval (CI). RESULTS The mean reported age (±SD) of the cases and the controls was 60.3 (±9.9) and 55.3 (±11.3) years, respectively. The eight identified independent determinants of hypertension with AOR [95% CI] were obesity: 2.82 [1.43, 5.57], sedentary activity of ≥4hrs/day: 1.75 [1.10, 2.79], higher stress score: 1.05 [1.01, 1.10], serum creatinine above 1.1 mg/dl: 2.35 [1.13, 4.91], age: 1.05 [1.02, 1.08], being government employee as compared to private workers: 2.18 [1.06, 4.50] and family history of hypertension: 2.11 [1.26, 3.54]. Further, interaction of diabetes duration with insulin use: 1.03 [1.01, 1.07] was also a significant predictor of HTN among DM patients. CONCLUSION The finding calls for interventions for mitigating these determinants. Further research is needed to examine the interaction between diabetes duration and insulin use.
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Affiliation(s)
- Kehabtimer Shiferaw Kotiso
- Department of Public Health, College of Medicine and Health Sciences, Werabe University, Werabe, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Nabiha Degemu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Samson Gebremedhin
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Melaku Taye
- School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adane Petros
- School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fanuel Belayneh
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Deneke Wolde
- Department of Medical Laboratory, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Dejene Hailu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Lehrer P, Ottaviani C, Jamner LD. In Memoriam: David Shapiro (1924–2020). Psychophysiology 2020. [DOI: 10.1111/psyp.13677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Paul Lehrer
- Department of Psychiatry Rutgers Robert Wood Johnson Medical School Piscataway NJ USA
| | | | - Larry D. Jamner
- Department of Psychological Science School of Social Ecology University of California Irvine CA USA
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Facca TA, Mastroianni-Kirsztajn G, Sabino ARP, Passos MT, dos Santos LF, Famá EAB, Nishida SK, Sass N. Pregnancy as an early stress test for cardiovascular and kidney disease diagnosis. Pregnancy Hypertens 2018; 12:169-173. [DOI: 10.1016/j.preghy.2017.11.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023]
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Motta JM, Lemos TM, Consolim-Colombo FM, Moyses RMA, Gusmão MAN, Egan BM, Lopes HF. Abnormalities of Anthropometric, Hemodynamic, and Autonomic Variables in Offspring of Hypertensive Parents. J Clin Hypertens (Greenwich) 2016; 18:942-8. [PMID: 26935870 PMCID: PMC8032096 DOI: 10.1111/jch.12800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/12/2016] [Accepted: 01/17/2016] [Indexed: 11/29/2022]
Abstract
Young adult offspring of hypertensive parents (pHTN⊕) are a good model for assessing abnormalities of anthropometric, cardiometabolic, and autonomic variables prior to clinical hypertension. The objectives of this study were to determine whether these variables and autonomic responses to oral carbohydrates were altered in offspring of pHTN⊕. Two hundred consecutive patients, including 100 pHTN⊕, were evaluated, with 29 patients, including 14 pHTN⊕, given a 70-gram carbohydrate load. The pHTN⊕ group had higher blood pressure, pulse pressure, abdominal circumference (AC), weight, body mass index, and basal metabolic rate than offspring of normotensive parents (pHTN∅). At baseline, the low-frequency (LF, sympathetic) to high-frequency (HF, parasympathetic) ratio, assessed by spectral analysis of heart rate variability, was similar in both groups. After the carbohydrate load, the LF/HF ratio was greater in offspring of pHTN⊕. pHTN⊕ individuals have abnormalities of anthropometric and hemodynamic variables at baseline and autonomic responses to oral carbohydrates before developing hypertension.
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Affiliation(s)
- Josiane M Motta
- Universidade Nove de Julho-UNINOVE, Sao Paulo, Brasil.
- Hospital Campo Limpo, São Paulo, Brasil.
| | | | - Fernanda M Consolim-Colombo
- Universidade Nove de Julho-UNINOVE, Sao Paulo, Brasil
- Heart Institute (InCor) Medical School Universidade de Sao Paulo, São Paulo, Brasil
| | | | | | - Brent M Egan
- Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC, USA
| | - Heno F Lopes
- Universidade Nove de Julho-UNINOVE, Sao Paulo, Brasil
- Heart Institute (InCor) Medical School Universidade de Sao Paulo, São Paulo, Brasil
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Liu M, He Y, Jiang B, Wang J, Wu L, Wang Y, Zhang D, Zeng J, Yao Y. Association Between Family History and Hypertension Among Chinese Elderly. Medicine (Baltimore) 2015; 94:e2226. [PMID: 26632912 PMCID: PMC4674215 DOI: 10.1097/md.0000000000002226] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This study aimed to evaluate the association between family history and prevalence of hypertension among Chinese community elderly, and also explore the gender difference. A population-based cross-sectional study was conducted in Miyun district of Beijing, in 2014. The family history information was obtained from each subject and was divided into 3 categories, no family history (FH0), 1 generation of first-degree relatives with hypertension (FH1), and 2 generations of first-degree relatives with hypertension (FH2). The prevalence of hypertension was 53.0%. Participants with positive family history had a significantly higher prevalence of hypertension (67.5%, 95% CI: 63.3-71.7) than those without (47.9%, 95% CI: 45.2-50.6), and even among participants without hypertension, the blood pressure levels were higher with positive FH. Multiple logistic regression analysis showed that a significantly linear-trend increase in hypertension according to family history of first degree relative numbers was observed in both genders (P for trend < 0.001). This study suggests that family history had not only a significant but also graded association with hypertension and with blood pressure levels, and this association exists even among those without hypertension.
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Affiliation(s)
- Miao Liu
- From the Institute of Geriatrics, Chinese PLA General Hospital, Beijing Key Laboratory of Aging and Geriatrics (ML, YH, JW, LW, YW, DZ, JZ, YY), State Key Laboratory of Kidney Disease (YH), and Department of Chinese Traditional Medicine and Acupuncture (BJ), Chinese PLA General Hospital, Beijing, China
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Ranasinghe P, Cooray DN, Jayawardena R, Katulanda P. The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults. BMC Public Health 2015; 15:576. [PMID: 26092387 PMCID: PMC4475303 DOI: 10.1186/s12889-015-1927-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/10/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Hypertension is a major contributor to the global non-communicable disease burden. Family history is an important non-modifiable risk factor for hypertension. The present study aims to describe the influence of family history (FH) on hypertension prevalence and associated metabolic risk factors in a large cohort of South Asian adults, from a nationally representative sample from Sri Lanka. METHODS A cross-sectional survey among 5,000 Sri Lankan adults, evaluating FH at the levels of parents, grandparents, siblings and children. A binary logistic regression analysis was performed in all patients with 'presence of hypertension' as dichotomous dependent variable and using family history in parents, grandparents, siblings and children as binary independent variables. The adjusted odds ratio controlling for confounders (age, gender, body mass index, diabetes, hyperlipidemia and physical activity) are presented below. RESULTS In all adults the prevalence of hypertension was significantly higher in patients with a FH (29.3%, n = 572/1951) than those without (24.4%, n = 616/2530) (p < 0.001). Presence of a FH significantly increased the risk of hypertension (OR:1.29; 95% CI:1.13-1.47), obesity (OR:1.36; 95% CI: 1.27-1.45), central obesity (OR:1.30; 95% CI 1.22-1.40) and metabolic syndrome (OR:1.19; 95% CI: 1.08-1.30). In all adults presence of family history in parents (OR:1.28; 95% CI: 1.12-1.48), grandparents (OR:1.34; 95% CI: 1.20-1.50) and siblings (OR:1.27; 95% CI: 1.21-1.33) all were associated with significantly increased risk of developing hypertension. CONCLUSIONS Our results show that the prevalence of hypertension was significantly higher in those with a FH of hypertension. FH of hypertension was also associated with the prevalence of obesity, central obesity and metabolic syndrome. Individuals with a FH of hypertension form an easily identifiable group who may benefit from targeted interventions.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Dilini N Cooray
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Ranil Jayawardena
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. .,Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo, Sri Lanka.
| | - Prasad Katulanda
- Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo, Sri Lanka.
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James GD, Alfarano AS, van Berge-Landry HM. Differential circadian catecholamine and cortisol responses between healthy women with and without a parental history of hypertension. Am J Hum Biol 2014; 26:753-9. [PMID: 25043989 DOI: 10.1002/ajhb.22586] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/12/2014] [Accepted: 06/27/2014] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Previous studies suggest that otherwise healthy individuals who have a parental history of hypertension (PH+) have an accentuated reactive rise in catecholamines and cortisol to laboratory stressors as well as elevated plasma levels when compared with those with no parental history (PH-); however, few, if any, studies have evaluated whether parental history affects the responses of these hormones to changing environmental circumstances in everyday life. The purpose of this study was to compare urinary catecholamine (epinephrine and norepinephrine) and cortisol excretion and ambulatory blood pressures (BPs) across three daily microenvironments between women with and without a parental history of hypertension. METHODS The women in the study (PH+, N = 62, age = 35.2 ± 9.1; PH-, N = 72, age = 33.8 ± 10.0) worked in clerical, technical, or professional positions at a major medical center in New York City. Urinary hormone excretion rates and ambulatory BP were measured across three daily microenvironments: work (11 am to 3 p.m.), home (approximately 6 p.m. to 10 p.m.), and during sleep (approximately 10 p.m. to 6 a.m.). History group comparisons by microenvironment were made using repeated-measures ANCOVA and ANOVA analyses. RESULTS The results show that epinephrine excretion among PH+ women was 36% higher than PH- women (P < 0.008) over the entire day and that nocturnal cortisol excretion was also greater among PH+ women (P < 0.045). PH+ women also had statistically significantly higher systolic (4 mm Hg higher; P < 0.01) and diastolic (2 mm Hg higher, P < 0.03) BP when compared with PH- women across all daily microenvironments. CONCLUSION These findings suggest that there may be genetically linked mechanisms which elevate tonic epinephrine levels and nocturnal cortisol levels that contribute to elevating circadian BP.
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Affiliation(s)
- Gary D James
- Department of Anthropology, Binghamton University, Binghamton, New York, 13902; Decker School of Nursing, Binghamton University, Binghamton, New York 13902; Department of Bioengineering, Binghamton University, Binghamton, New York 13902
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Abstract
Over the last two decades, essential hypertension has become common in adolescents, yet remains under-diagnosed in absence of symptoms. Diagnosis is based on normative percentiles that factor in age, sex and height. Evaluation is more similar to adult essential hypertension than childhood secondary hypertension. Modifiable risk factors such as obesity, sodium consumption and low exercise should be addressed first. Many anti-hypertensive medications now have specific regulatory approval for children. Sports participation need not be limited in mild or well-controlled cases. Primary care physicians play an important role in reduction of cardiovascular mortality by early detection and referral when needed.
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Ota H, Furuhashi M, Ishimura S, Koyama M, Okazaki Y, Mita T, Fuseya T, Yamashita T, Tanaka M, Yoshida H, Shimamoto K, Miura T. Elevation of fatty acid-binding protein 4 is predisposed by family history of hypertension and contributes to blood pressure elevation. Am J Hypertens 2012; 25:1124-30. [PMID: 22717543 PMCID: PMC3449332 DOI: 10.1038/ajh.2012.88] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Fatty acid-binding protein 4 (FABP4/A-FABP/aP2), a lipid chaperone, is expressed in
both adipocytes and macrophages. Recent studies have shown secretion of FABP4 from
adipocytes and association of elevated serum FABP4 level with obesity, insulin
resistance, and atherosclerosis. However, little is known about the role of FABP4 in
essential hypertension. Methods We first examined serum FABP4 concentrations in 18 normotensives (NT) and 30 nontreated
essential hypertensives (EHT). The EHT were divided into 18 insulin-sensitive EHT
(EHT-S) and 12 insulin-resistant EHT (EHT-R) based on their insulin-sensitivity index,
the M value, determined by the hyperinsulinemic–euglycemic clamp
technique. In the second study, we determined FABP4 levels in 30 young NT men with or
without a family history of hypertension (FH+ and FH–,
respectively; n = 15 each). Results Serum FABP4 level was significantly higher in the EHT-R than in the NT, whereas
elevation of FABP4 level in the EHT-S was not statistically significant. FABP4 level was
positively correlated with age, body mass index (BMI), blood pressure, and triglycerides
and negatively correlated with the M value. FABP4 level was an independent
predictor of mean arterial pressure after adjustment of age, gender, and adiposity. The
FH+ group had a significantly lower level of M value and
higher level of FABP4 than did the FH– group, and FABP4 concentration
was an independent determinant of the M value. Conclusions FABP4 contributes to blood pressure elevation and atherogenic metabolic phenotype in
hypertensives, and the elevation of FABP4 is predisposed by a family history of
hypertension.
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Mitsumata K, Saitoh S, Ohnishi H, Akasaka H, Miura T. Effects of parental hypertension on longitudinal trends in blood pressure and plasma metabolic profile: mixed-effects model analysis. Hypertension 2012; 60:1124-30. [PMID: 23006727 DOI: 10.1161/hypertensionaha.112.201129] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The mechanism underlying the association of parental hypertension with cardiovascular events in offspring remains unclear. In this study, the effects of parental hypertension on longitudinal trends of blood pressure and metabolic parameters were examined by mixed-effects model analysis. From 1977 to 2006, 5198 subjects participated in the Tanno-Sobetsu Study, and we selected 2607 subjects (1095 men and 1512 women) for whom data on parental history of hypertension were available. In both men and women with and without parental hypertension, systolic blood pressure and fasting blood glucose levels consistently increased from the third to eighth decades of life, whereas diastolic blood pressure and serum triglyceride levels followed biphasic (inverted U shape) time courses during that period. However, the relationships between the parameters and age were significantly shifted upward (by ≈5.3 mm Hg in systolic blood pressure, 2.8 mm Hg in diastolic blood pressure, 0.30 mmol/L in blood glucose, and 0.09 mmol/L in triglyceride) in the group with parental hypertension compared with those in the group without parental hypertension. Both paternal and maternal histories of hypertension were determinants of systolic blood pressure and diastolic blood pressure, and there was no significant interaction between the sides of parental history. There were no significant effects of parental hypertension on age-dependent or body mass index-dependent changes in serum low-density lipoprotein cholesterol or high-density lipoprotein cholesterol level. The present results indicate that parental hypertension has an age-independent impact on elevation of blood pressure, plasma glucose, and triglyceride levels, which may underlie the reported increase in cardiovascular events by family history of hypertension.
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Affiliation(s)
- Kaneto Mitsumata
- Second Department of Internal Medicine, Sapporo Medical University School of Medicine, South-1 West-16, Sapporo 060-8556, Japan
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Association of intronic single-nucleotide polymorphisms in the EMILIN1 gene with essential hypertension in a Chinese population. J Hum Hypertens 2011; 26:553-61. [PMID: 21753788 DOI: 10.1038/jhh.2011.68] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Studies in mice suggest that the elastin microfibril interfacer-1 gene (EMILIN1), the gene encoding elastin microfibril interfacer-1 protein, contributes to the pathogenesis of essential hypertension (EH) in humans. EMILIN1 in part maintains elastic fibres in vessel walls, and hence peripheral arterial compliance. In a case-control study, we assessed 942 non-obese non-diabetic Chinese, comprising 467 patients with EH and 475 normotensive control subjects (166 without, and 309 with, family history of hypertension in first-degree relatives (FHH)). Hypertension in first-degree relatives occurred in 88%, 65% and 0% of cases, all controls and controls without FHH, respectively. We scanned for single-nucleotide polymorphisms (SNPs) and genotyped them in the EMILIN1 gene using high-resolution melt-curve analysis. No exonic variants were detected. We assessed the association of SNPs and their haplotypes with EH. Three SNPs in introns 1 and 5 (rs2289360, rs2011616 and rs7424556) were in strong pair-wise linkage disequilibrium (r(2)>0.89). All three SNPs were significantly associated with hypertension. Genotypic frequencies at the three SNPs differed significantly between cases and only those controls without FHH. Healthy controls with FHH should be excluded to increase the odds of detecting association. All the G alleles of rs2289360 (odds ratio = 1.69, P = 0.010), rs2011616 (odds ratio = 1.52, P = 0.038) and rs7424556 (odds ratio = 1.59, P = 0.023) were high-risk alleles in the recessive genetic model. We observed significant overall haplotypic association with EH (empirical P = 0.0072); GGG is a risk haplotype (P = 0.043). The overall results support EMILIN1 as a candidate gene for human EH.
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Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JMD, Guimarães GV. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res 2010; 33:836-43. [DOI: 10.1038/hr.2010.72] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Haemodynamic, metabolic and neuro-humoral abnormalities in young normotensive women at high familial risk for hypertension. J Hum Hypertens 2010; 24:814-22. [DOI: 10.1038/jhh.2010.21] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Davydov DM, Shapiro D, Goldstein IB. Relationship of Resting Baroreflex Activity to 24-Hour Blood Pressure and Mood in Healthy People. J PSYCHOPHYSIOL 2010. [DOI: 10.1027/0269-8803/a000012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives: Previous research suggests that mechanisms related to afferent and efferent components of the baroreflex are associated with blood pressure level and mood, and that mood as a component of subjective well-being may be mediated by changes in blood pressure. This study examines these mechanisms in 213 healthy women and men. Methods: Evaluation of spontaneous baroreflex activity using the sequence technique under resting conditions in the laboratory was followed by 2 days of 24-h ambulatory blood pressure recording and diary ratings of mood. Results: Patterns of components of the baroreflex loop were significant predictors of 24-h ambulatory blood pressure mean level, its circadian variability, and daily ratings of mood. Three mechanisms were found to be involved in the regulation: (1) interaction between gains of afferent and efferent cardiac components of the baroreflex, (2) gain of afferent signals related to fast cardiac responses to baroreceptor activation, and (3) gain of afferent signals related to late cardiac responses to baroreceptor inhibition. The interaction of afferent/efferent components of baroreflex loop appears to independently determine mean levels of systolic blood pressure and positive (happy) mood. The effect of the baroreceptor activation mechanism on subjective well-being (indexed by happy and alert moods) was mediated by the wake/sleep systolic blood pressure difference. Additionally, the baroreceptor inhibitory mechanism effect on subjective well-being (indexed by stressed and sleepy moods) was mediated by the wake/sleep diastolic blood pressure difference. Conclusions: Evaluation of the baroreflex components and their interaction provides important information about blood pressure and mood beyond that provided by baroreflex sensitivity and potential for the evaluation of risk for hypertension and mood disturbance in healthy people.
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Affiliation(s)
- Dmitry M. Davydov
- Moscow Research Centre of Narcology, Moscow, Russia
- Institut National de la Santé et de la Recherche Médicale, U.888 Pathologies du système nerveux: recherche épidémiologique et clinique, Hôpital La Colombière, Montpellier, France
| | - David Shapiro
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | - Iris B. Goldstein
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
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