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Lone SS, Majid S, Bhat MH, Wani GA. Exploring the burden of mixed dyslipidemia in patients with type 2 diabetes mellitus: A cross-sectional study in Kashmir, India. Am J Hum Biol 2024; 36:e24012. [PMID: 37982356 DOI: 10.1002/ajhb.24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Diabetes-related dyslipidemia is a multifaceted, complicated disorder characterized by an abnormal lipid profile in individuals with diabetes. The incidence of different types of dyslipidemia, however, was not a focus of prior investigations. The patients were characterized into three categories of dyslipidemia. Different patterns of dyslipidemia were combined into single dyslipidemia (7 patterns), mixed dyslipidemia (16 patterns), and triple dyslipidemia (4 patterns). METHODS In this cross-sectional study, 586 people suffering from type 2 diabetes mellitus (T2DM) were included. We assessed the serum lipid profile and used log (TG/HDL-C) to determine the atherogenic index of plasma (AIP). Dyslipidemia was examined as a categorical variable, and the findings were presented as percentages and numbers. To compare categorical variables, we either utilized Fisher exact tests or Chi square tests. RESULTS The study comprised of 586 T2DM patients, with 310 (52.9%) women and 276 (47.1%) men. Women have significantly higher hypertension (33.6%) as compared to men (23.2%). 18.94% (111) of patients were having coronary artery disease (CAD) history consisting of 12.28% (72) females and 6.66% (39) males, a difference which is statistically significant. 98.12% of total individuals had as a minimum of one lipid abnormality. 4.61% (27) of study subjects were having isolated dyslipidemia and 93.51% (548) had dual or triple pattern of dyslipidemia (mixed dyslipidemia). High AIP >0.24 (94.8%) was the most predominant trend of dyslipidemia. The dual combination of AIP (>0.24) and HDL (<50 mg/dL in Females and <40 mg/dL in Males) was found to be the most common pattern of mixed dyslipidemia (68.08%). The most prevalent trend of isolated dyslipidemia was found to be high AIP (>0.24), In patients with CAD history. Among the mixed dyslipidemia, the common pattern of dyslipidemia (71.17%) was the dual combination of high AIP (>0.24) and low HDL (<50 mg/dL women and <40 mg/dL males). The triple combination of TG (≥200 mg/dL) and HDL (<40 and <50 mg/dL) and LDL (≥100 mg/dL) was only found in females. CONCLUSION In conclusion, dyslipidemia is highly prevalent in T2DM patients, with mixed dyslipidemia being the most common type observed in the community of Kashmir valley, India. High AIP was the most prevalent pattern in the current investigation.
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Affiliation(s)
- Suhail Shafi Lone
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
- Multidisciplinary Research Unit (MRU), Government Medical College Srinagar, Srinagar, India
| | - Sabhiya Majid
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
| | - Mohammad Hayat Bhat
- Department of Medicine, Government Medical College Srinagar, Srinagar, India
| | - Gulzar Ahmad Wani
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
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Prasad GVR, Bhamidi V. Managing cardiovascular disease risk in South Asian kidney transplant recipients. World J Transplant 2021; 11:147-160. [PMID: 34164291 PMCID: PMC8218347 DOI: 10.5500/wjt.v11.i6.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023] Open
Abstract
South Asians (SA) are at higher cardiovascular risk than other ethnic groups, and SA kidney transplant recipients (SA KTR) are no exception. SA KTR experience increased major adverse cardiovascular events both early and late post-transplantation. Cardiovascular risk management should therefore begin well before transplantation. SA candidates may require aggressive screening for pre-transplant cardiovascular disease (CVD) due to their ethnicity and comorbidities. Recording SA ethnicity during the pre-transplant evaluation may enable programs to better assess cardiovascular risk, thus allowing for earlier targeted peri- and post-transplant intervention to improve cardiovascular outcomes. Diabetes remains the most prominent post-transplant cardiovascular risk factor in SA KTR. Diabetes also clusters with other metabolic syndrome components including lower high-density lipoprotein cholesterol, higher triglycerides, hypertension, and central obesity in this population. Dyslipidemia, metabolic syndrome, and obesity are all significant CVD risk factors in SA KTR, and contribute to increased insulin resistance. Novel biomarkers such as adiponectin, apolipoprotein B, and lipoprotein (a) may be especially important to study in SA KTR. Focused interventions to improve health behaviors involving diet and exercise may especially benefit SA KTR. However, there are few interventional clinical trials specific to the SA population, and none are specific to SA KTR. In all cases, understanding the nuances of managing SA KTR as a distinct post-transplant group, while still screening for and managing each CVD risk factor individually in all patients may help improve the long-term success of all kidney transplant programs catering to multi-ethnic populations.
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Affiliation(s)
- G V Ramesh Prasad
- Kidney Transplant Program, St. Michael's Hospital, Toronto M5C 2T2, ON, Canada
| | - Vaishnavi Bhamidi
- Kidney Transplant Program, St. Michael's Hospital, Toronto M5C 2T2, ON, Canada
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Krupp K, Adsul P, Wilcox ML, Srinivas V, Frank E, Srinivas A, Madhivanan P. Prevalence and correlates of metabolic syndrome among rural women in Mysore, India. Indian Heart J 2020; 72:582-588. [PMID: 33357649 PMCID: PMC7772584 DOI: 10.1016/j.ihj.2020.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 07/24/2020] [Accepted: 09/16/2020] [Indexed: 02/08/2023] Open
Abstract
Aims Metabolic Syndrome (MetS) is a strong predictor of Coronary Heart Disease (CHD). Studies in urban India have found about one-third of Indians suffer from MetS. Less is known about the prevalence of MetS in rural areas, where 70% of the population reside. This study examined the prevalence of Metabolic Syndrome in a population of rural women in India. Methods Data were gathered in a community-based study of 500 rural and tribal women residing in the Mysore district, between the age of 30–59 years. The study used the WHO STEPS approach, in which information on demographics and behavioral risk factors were collected. Along with anthropometric measurements, blood pressure, blood glucose, lipids were measured. A harmonized definition of MetS recommended by International Diabetes Federation Task Force on Epidemiology and Prevention was used in this study. Results Three out of five study participants were found to have MetS (47.1%, n = 223). Of those, 56.5% met 3 of the 5 criteria, 32.2% met 4 criteria, and 11.2% met all 5 criteria. Among the entire sample, low HDL was the most prevalent criterion (88.4%), followed by elevated glucose (57.9%), elevated triglycerides (49.3%), elevated BP (41.5%), and increased waist circumference (15.3%). In this sample, women with METS were generally older (p < 0.001), housewives (p = 0.001), that consumed salty highly processed foods (p = 0.020) and had low physical activity (p = 0.015). Conclusions This study showed a high prevalence of MetS in rural women. There is a compelling need for interventions aimed at reducing CHD risk factors in this population.
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Affiliation(s)
- Karl Krupp
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA; Public Health Research Institute of India, Mysore, India.
| | - Prajakta Adsul
- National Cancer Institute, National Institutes for Health, USA
| | - Meredith L Wilcox
- Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Addison, IL, USA; MB Clinical Research, Boca Raton, FL, USA
| | | | | | - Arun Srinivas
- Department of Cardiology, Apollo Hospital, Mysore, India
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA; Public Health Research Institute of India, Mysore, India; Division of Infectious Diseases, College of Medicine, University of Arizona, Tucson, USA; Department of Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
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Arif M, Nabavizadeh P, Song T, Desai D, Singh R, Bazrafshan S, Kumar M, Wang Y, Gilbert RJ, Dhandapany PS, Becker RC, Kranias EG, Sadayappan S. Genetic, clinical, molecular, and pathogenic aspects of the South Asian-specific polymorphic MYBPC3 Δ25bp variant. Biophys Rev 2020; 12:1065-1084. [PMID: 32656747 PMCID: PMC7429610 DOI: 10.1007/s12551-020-00725-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 02/06/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a cardiac genetic disease characterized by ventricular enlargement, diastolic dysfunction, and increased risk for sudden cardiac death. Sarcomeric genetic defects are the predominant known cause of HCM. In particular, mutations in the myosin-binding protein C gene (MYBPC3) are associated with ~ 40% of all HCM cases in which a genetic basis has been established. A decade ago, our group reported a 25-base pair deletion in intron 32 of MYBPC3 (MYBPC3Δ25bp) that is uniquely prevalent in South Asians and is associated with autosomal dominant cardiomyopathy. Although our studies suggest that this deletion results in left ventricular dysfunction, cardiomyopathies, and heart failure, the precise mechanism by which this variant predisposes to heart disease remains unclear. Increasingly appreciated, however, is the contribution of secondary risk factors, additional mutations, and lifestyle choices in augmenting or modifying the HCM phenotype in MYBPC3Δ25bp carriers. Therefore, the goal of this review article is to summarize the current research dedicated to understanding the molecular pathophysiology of HCM in South Asians with the MYBPC3Δ25bp variant. An emphasis is to review the latest techniques currently applied to explore the MYBPC3Δ25bp pathogenesis and to provide a foundation for developing new diagnostic strategies and advances in therapeutics.
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Affiliation(s)
- Mohammed Arif
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA.
| | - Pooneh Nabavizadeh
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Taejeong Song
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Darshini Desai
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Rohit Singh
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Sholeh Bazrafshan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Mohit Kumar
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Yigang Wang
- Department of Pathology and Laboratory Medicine, University of Cincinnati, College of Medicine, Cincinnati, OH, 45267, USA
| | - Richard J Gilbert
- Research Service, Providence VA Medical Center, Providence, RI, 02908, USA
| | - Perundurai S Dhandapany
- Centre for Cardiovascular Biology and Disease, Institute for Stem Cell Biology and Regenerative Medicine (inStem), Bangalore, India
- The Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
| | - Richard C Becker
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
| | - Evangelia G Kranias
- Department of Pharmacology and Systems Physiology, University of Cincinnati, College of Medicine, Cincinnati, OH, 45267, USA
| | - Sakthivel Sadayappan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, Heart, Lung and Vascular Institute, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA
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Effects of processed red meat consumption on the risk of type 2 diabetes and cardiovascular diseases among Korean adults: the Korean Genome and Epidemiology Study. Eur J Nutr 2018; 58:2477-2484. [PMID: 30069618 DOI: 10.1007/s00394-018-1799-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 07/26/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Few studies have evaluated the effects of processed red meat (PRM) consumption on chronic disease risk, especially among low average PRM consumption populations. This study examined association between PRM intake and type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) incidences in Korea. METHODS Participants (n = 10,030; aged 40-69 years) were recruited from the Ansan-Ansung cohort study, a subset of Korean Genome Epidemiology Study. Validated 103-item semi-quantitative food frequency questionnaire was used to assess dietary information, at baseline (2001-2002) and at second follow-up (2005-2006). T2DM and CVD incidences were identified using biennial questionnaire-based interview during a 10-year follow-up period. Cox proportional hazards regression analysis was used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Over the 10-year follow-up period, 668 and 493 incident cases of T2DM (62,130 person-years) and CVD (63,150 person-years), respectively, were documented. In crude models, comparing the highest and lowest levels of PRM intake, no significant association occurred with incident T2DM [HR, 95% CI (0.94, 0.76-1.17)], while significant association occurred with incident CVD (0.67, 0.51-0.88). However, in adjusted models, this association was no longer significant, showing HRs (95% CI) of PRM intake for T2DM and CVD of 1.07 (0.85-1.35) and 1.14 (0.85-1.55), respectively. CONCLUSIONS PRM intake did not affect T2DM and CVD incidences among Korean middle-aged adults, although extremely low average consumption of PRM may explain the finding. Therefore, limiting PRM intake may not be a top priority for the prevention of chronic diseases in Korean population.
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Park K, Seo E. Association between Toenail Mercury and Metabolic Syndrome Is Modified by Selenium. Nutrients 2016; 8:nu8070424. [PMID: 27420091 PMCID: PMC4963900 DOI: 10.3390/nu8070424] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 06/30/2016] [Accepted: 07/06/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although Asian populations consume relatively large amounts of fish and seafood and have a high prevalence of metabolic diseases, few studies have investigated the association between chronic mercury exposure and metabolic syndrome and its effect modification by selenium. METHODS We analyzed baseline data from the Trace Element Study of Korean Adults in the Yeungnam area. Participants included 232 men and 269 women, aged 35 years or older, who had complete data regarding demographic, lifestyle, diet, toenail mercury and selenium levels, and health. Toenail mercury and selenium concentrations were measured using instrumental neutron-activation analysis. The metabolic biomarker levels were obtained through biannual medical checkups. RESULTS Higher toenail mercury levels were associated with habitual consumption of whale and shark meats, older age, obesity, smoking, alcohol drinking, and higher household income. Multivariable analysis showed a positive association between toenail mercury exposure and metabolic syndrome. In addition, this association was significantly stronger at lower selenium levels and was weaker at higher selenium levels. CONCLUSION The possible harmful effects of mercury on metabolic syndrome may be attenuated by high levels of selenium. Future studies are needed to suggest optimal dietary guidelines regarding fish and selenium intakes, particularly for Asians with high levels of fish intake.
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Affiliation(s)
- Kyong Park
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Gyeongbuk, Korea.
| | - Eunmin Seo
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Gyeongbuk, Korea.
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Khan SA, Jackson RT, Momen B. The Relationship between Diet Quality and Acculturation of Immigrated South Asian American Adults and Their Association with Metabolic Syndrome. PLoS One 2016; 11:e0156851. [PMID: 27299862 PMCID: PMC4907444 DOI: 10.1371/journal.pone.0156851] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/22/2016] [Indexed: 01/30/2023] Open
Abstract
Even though the total SA American population is increasing rapidly, there is a paucity of information on the relationship between diet quality, acculturation and health outcomes such as Metabolic Syndrome (MetS) in the low-income South Asian (SA) sub-population. Our goal was to examine diet quality, degree of acculturation and their potential influence on MetS in a diverse sample of SA Americans. A convenience sample of 401 adult SA men and women were studied using a cross-sectional study design. Volunteers from two low-income community health clinics in Maryland were interviewed by questionnaires. MetS, defined by the consensus harmonized definition by the presence of ≥ 3 of the 5 abnormal indicators, was studied. An interviewer obtained an automated self-administered 24-hour Recall (ASA24) and an acculturation index (using a previously validated (SL-ASIA). SA had a composite HEI2010 score of 68 suggesting an overall need for diet improvements. Males had a higher diet quality (mean HEI2010 score) than females. Males with MetS had lower diet quality (68) than males without MetS (73). The converse was true for females (68 vs. 65). Americanized (more acculturated) subjects had a higher diet quality compared to less acculturated SA. Small differences were found in diet quality scores among SA adults from different countries. Less acculturated females, had a higher percentage of MetS and lower diet quality compared to males. These results suggest that interventions are needed in males and females who were less acculturated because they may have greater MetS and lower diet quality compared to more Americanized SA.
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Affiliation(s)
- Saira A. Khan
- Department of Nutrition and Food Science, The University of Maryland, College Park, Maryland, United States of America
| | - Robert T. Jackson
- Department of Nutrition and Food Science, The University of Maryland, College Park, Maryland, United States of America
| | - Bahram Momen
- Department of Environmental Science, The University of Maryland, College Park, Maryland, United States of America
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Araújo MFMD, Freitas RWJFD, Lima ACS, Pereira DCR, Zanetti ML, Damasceno MMC. Relation between sleep quality and metabolic syndrome among university students. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-07072015002652014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This transversal study aimed to analyze the relationship between poor sleep quality and metabolic syndrome among university students. The sleep quality and the components of metabolic syndrome of 701 university students from Fortaleza, Brazil, were evaluated during 2011 and 2012. In the evaluation of the scale of the associations, robust Poisson regression was used, adjusted for sex and age. The prevalence of metabolic syndrome and poor quality sleep was 1.7% and 95.3% respectively. There was an increase in risk of 5% of developing metabolic syndrome among those university students who slept poorly (p=0.013). It is concluded that the university students in the sample who were poor sleepers present a greater probability of presenting metabolic syndrome.
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Yan Z, Liang Y, Jiang H, Cai C, Sun B, Qiu C. Metabolic Syndrome and Subclinical Carotid Atherosclerosis Among Chinese Elderly People Living in a Rural Community. Metab Syndr Relat Disord 2014; 12:269-76. [PMID: 24588080 DOI: 10.1089/met.2013.0135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Zhongrui Yan
- Department of Neurology, Jining First People's Hospital, Shandong, China
| | - Yajun Liang
- School of Public Health, Jining Medical University, Shandong, China
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Hui Jiang
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, Shandong, China
| | - Chuanzhu Cai
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, Shandong, China
| | - Binglun Sun
- Xing Long Zhuang Coal Mine Hospital, Yankuang Group, Shandong, China
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Ram CVS, Kumari A. Impact of anti-hypertensive therapy on cardiovascular disease burden in Asia: renewed hope with immense scope. ACTA ACUST UNITED AC 2014; 8:142-3. [PMID: 24534271 DOI: 10.1016/j.jash.2013.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 10/24/2013] [Indexed: 11/25/2022]
Affiliation(s)
- C Venkata S Ram
- Apollo Institute for Blood Pressure Management, Apollo Hospitals, Hyderabad, India; Texas Blood Pressure Institute, University of Texas Southwestern Medical School, Dallas, TX, USA.
| | - Anshu Kumari
- Division of General Medicine, Department of Medical Education, Apollo Hospitals, Hyderabad, India
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