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Mujaddadi A, Zaki S, M Noohu M, Naqvi IH, Veqar Z. Predictors of Cardiac Autonomic Dysfunction in Obesity-Related Hypertension. High Blood Press Cardiovasc Prev 2024; 31:77-91. [PMID: 38345729 DOI: 10.1007/s40292-024-00623-7] [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: 09/20/2023] [Accepted: 01/04/2024] [Indexed: 03/12/2024] Open
Abstract
INTRODUCTION Cardiac Autonomic Dysfunction (CAD) is an overlooked cardiovascular risk factor in individuals with obesity-related hypertension. Despite its clinical significance, there is a notable lack of clarity regarding the pathophysiological correlates involved in its onset and progression. AIM The present study aimed to identify potential predictors of CAD in obesity-related hypertension. METHODS A total of 72 participants (34 men and 38 women) were enrolled. Comprehensive evaluations were conducted, including cardiac autonomic function assessments, body composition estimation and biochemical analysis. Participants were categorized as CAD-positive or CAD-negative based on Ewing's criteria for autonomic dysfunction. Univariate logistic regression analysis was performed to identify potential predictors for CAD. Multivariate logistic regression models were further constructed by adjusting clinically relevant covariates to identify independent predictors of CAD. RESULTS Multivariate logistic regression analysis revealed that resting heart rate (HRrest), (odds ratio, confidence interval: 0.85, 0.78-0.93; p = 0.001) and percentage body fat (BF%), (odds ratio, confidence interval: 0.78, 0.64-0.96; p = 0.018) were significant independent predictors of CAD. Receiver Operating Characteristic curve analysis depicted optimal cut-off values for HRrest and BF% as > 74.1 bpm and > 33.6%, respectively. Multicolinearity analysis showed variance inflation factors (VIF) below the cautionary threshold of 3. CONCLUSIONS The HRrest and BF% emerged as significant independent predictors of CAD in obesity-related hypertension. Therapeutic strategies should target HRrest < 74.1 bpm and BF% < 33.6% to mitigate CAD risk in this population. Future trials are required to establish causal relationships and may consider additional confounding variables in obesity-related hypertension.
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Affiliation(s)
- Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Saima Zaki
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Majumi M Noohu
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Irshad Husain Naqvi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
- Dr. M.A. Ansari Health Centre, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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Chou YT, Sun ZJ, Shao SC, Yang YC, Lu FH, Chang CJ, Liao TC, Li CY, Chen THH, Wu JS, Lai ECC. Autonomic modulation and the risk of dementia in a middle-aged cohort: A 17-year follow-up study. Biomed J 2023; 46:100576. [PMID: 36581249 PMCID: PMC10749883 DOI: 10.1016/j.bj.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Altered autonomic modulation, measured by heart rate variability (HRV), has been found to be associated with dementia risk in the elderly. However, long-term follow-up study evaluating the association between autonomic modulation from middle-age and the incidence of dementia has been limited. METHODS This retrospective cohort analyzed data from Taiwan's National Health Insurance Database covering the period from 2001 to 2017, with a linkage to citywide health examinations conducted by Tainan Metropolitan City, Taiwan. We included subjects aged 45-64 years. The mean follow-up period was 15.75 ± 3.40 years. The measurements of HRV included resting heart rate, high frequency (HF), low frequency (LF), standard deviation of normal-to-normal R-R intervals (SDNN), ratio between the 30th and 15th R-R interval after standing up from the supine position (30/15 ratio), ratio between the R-R intervals during expiration and inspiration, and the ratio between the high- and low-frequency components (LF/HF). The main study outcome was the incidence of dementia. We performed multivariable Cox proportional hazard regression models to compare the risk of dementia among different HRV subgroups. RESULTS We included 565 participants with a mean age of 53 (SD: 6) years, of whom 44% were male. The risk of dementia was significantly increased in association with lower parasympathetic HRV modulation, including SDNN (HR: 3.23, 95% CI: 1.55-6.73) and 30/15 ratio (HR: 3.52, 95%CI: 1.67-7.42). Moreover, the risk of dementia was increased in subjects with higher LF/HF ratios (HR: 2.05, 95% CI: 1.12-3.72). CONCLUSIONS Lower parasympathetic activity and higher sympathetic-vagal imbalance in middle-age were associated with dementia risk.
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Affiliation(s)
- Yu-Tsung Chou
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan
| | - Shih-Chieh Shao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Tzu-Chi Liao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Tony Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan; Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Guo G, Hu Y, Kong F, Zheng H, Liu G. Evaluation of Heart Rate Recovery in Obese Children and Adolescents With Prehypertension. Clin Pediatr (Phila) 2023; 62:1040-1047. [PMID: 36852784 DOI: 10.1177/00099228231151399] [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] [Indexed: 03/01/2023]
Abstract
Heart rate recovery (HRR), a noninvasive assessment of autonomic nervous function, is widely studied in adults with hypertension or prehypertension. This study aimed to evaluate whether HRR was independently associated with prehypertension in obese children. A total of 326 obese children aged 7 to 16 years were divided into 2 groups: prehypertension group and normal blood pressure (BP) group (control group). Anthropometric indexes, physical activity (PA) information, biochemical parameters, and HRR were collected. Multiple logistic regression analysis showed that body mass index (BMI) (odds ratio [OR] = 1.116; P < .05), waist-to-hip ratio (WHR) (OR = 1.258; P < .05), homeostasis model assessment (HOMA-IR) (OR = 1.087; P < .01), diastolic blood pressure (DBP) (OR = 1.304; P < .01), and HRR values (OR = 0.892; P < .05) were independent risk factors of prehypertension in obese children. Our findings demonstrated decreased HRR was closely associated with prehypertension in obese children, which indicated studying the role of sympathetic/parasympathetic imbalance might be helpful to explore the underlying mechanism.
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Affiliation(s)
- Gang Guo
- Department of Emergency, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yao Hu
- Department of Gastroenterology, Hepatology and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fanjun Kong
- Department of Surgery, Jiangsu Cancer Hospital, Nanjing, China
| | - Huan Zheng
- Department of Cardiology, Worldpath Clinic International, Shanghai, China
| | - Guanghui Liu
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Zawadka-Kunikowska M, Rzepiński Ł, Tafil-Klawe M, Veronese N, Barbagallo M, Habek M, Gilhus NE. Altered Cardiac Autonomic Regulation in Individuals with Myasthenia Gravis-A Systematic Review and Meta-Analysis. Neurol Int 2023; 15:1140-1154. [PMID: 37755362 PMCID: PMC10537350 DOI: 10.3390/neurolint15030071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and healthy controls (HCs). Two reviewers searched four electronic databases, namely PubMed, Web of Science, EMBASE, and SCOPUS, from database inception to 7 July 2023 for studies investigating cardiovascular autonomic parameters in MG vs. HCs. A random-effects meta-analysis was performed to compute Hedges' g ± 95% confidence intervals (CI). Out of a total of 2200 records, 8 observational studies with a sample size of 301 patients with MG and 454 HCs were included in the systematic review. Meta-analysis revealed lower values of expiration/inspiration ratio (g = -0.45, I2 = 74.7), baroreflex sensitivity (g = -0.56, 95%CI -0.80, -0.33; I2 = 0.3), percentage of adjacent NN intervals differing by more than 50 ms (g = -1.2, I2 = 82.8), square root of the mean of squared differences between successive beat intervals (g = -1.94, I2 = 95.1), mean of the standard deviations of all NN intervals (g = -0.83, 95%CI -1.37, -0.28; I2 = 55.5), and high frequency of HRV during tilt (g = -0.75, 95%CI -0.11, -0.39; I2 = 0). MG patients vs. HCs had higher systolic blood pressure (g = 0.39; I2 = 56.1), sympathovagal balance at rest/during tilt (LF/HF-RRIsupine, g = 0.44; I2 = 0; LF/HF-RRItilt, g = 0.86; I2 = 0; LF/HFtilt, g = 0.40; I2 = 0). As a group, MG patients have altered cardiac autonomic function, including decreased parasympathetic function, lower baroreflex sensitivity, and higher sympathovagal balance at rest and during orthostatic challenges.
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Affiliation(s)
- Monika Zawadka-Kunikowska
- Department of Human Physiology, Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza 24, 85-092 Bydgoszcz, Poland;
| | - Łukasz Rzepiński
- Sanitas—Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland;
- Department of Neurology, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
| | - Małgorzata Tafil-Klawe
- Department of Human Physiology, Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum in Bydgoszcz, Karłowicza 24, 85-092 Bydgoszcz, Poland;
| | - Nicola Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, 90133 Palermo, Italy; (N.V.); (M.B.)
| | - Mario Barbagallo
- Geriatrics Section, Department of Internal Medicine, University of Palermo, 90133 Palermo, Italy; (N.V.); (M.B.)
| | - Mario Habek
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, 10000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Nils E. Gilhus
- Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway;
- Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
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Jung MH, Ihm SH. Obesity-related hypertension and chronic kidney disease: from evaluation to management. Kidney Res Clin Pract 2023; 42:431-444. [PMID: 37551125 PMCID: PMC10407638 DOI: 10.23876/j.krcp.23.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/14/2023] [Accepted: 06/15/2023] [Indexed: 08/09/2023] Open
Abstract
With the recent obesity pandemic, obesity-related hypertension and its complications (e.g., heart failure, coronary disease, and chronic kidney disease [CKD]) are gaining attention in clinical and research fields. Obesity-related hypertension frequently precedes the onset of CKD and aggravates its progression. In this review, we discuss the role of visceral fat in the pathophysiology of obesity-related hypertension and the potential therapeutic strategies for its prevention and management. Various factors, including the sympathetic nervous system, renin-angiotensin-aldosterone system, and inflammatory pathways, are intricately involved in the pathogenesis of obesity-related hypertension. These factors individually and jointly contribute to the development of hypertension (usually sodium-sensitive or resistant hypertension) and, ultimately, to the progression of CKD. From a clinical standpoint, a decline in renal function in advanced CKD further makes blood pressure control challenging since only a few options are available for blood pressure-lowering medications. Proactive lifestyle modification, pharmacological treatment for obesity, and bariatric surgery can be considered for obesity control and management. Furthermore, intensive blood pressure control is required to prevent and halt the development and progression of CKD.
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Grants
- 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E330 0201, 2016E3300202,2019E320100, 2019E320101, 2019 E320102, 2022-11-007 Korea Disease Control and Prevention Agency
- NRF-2019R1A2C2086276 National Research Foundation of Korea
- BCRI22042, BCRI22079 Chonnam National University Hospital Biomedical Research Institute
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Affiliation(s)
- Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyun Ihm
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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The Modulation of Arachidonic Acid Metabolism and Blood Pressure-Lowering Effect of Honokiol in Spontaneously Hypertensive Rats. Molecules 2022; 27:molecules27113396. [PMID: 35684335 PMCID: PMC9182499 DOI: 10.3390/molecules27113396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Cardiovascular diseases have consistently been the leading cause of death in the United States over the last two decades, with 30% of the adult American population having hypertension. The metabolites of arachidonic acid (AA) in the kidney play an important role in blood pressure regulation. The present study investigates the antihypertensive effect of honokiol (HON), a naturally occurring polyphenol, and examines its correlation to the modulation of AA metabolism. Methods: Spontaneously hypertensive rats (SHR) were randomly divided into four groups. Treatment groups were administered HON intraperitoneally at concentrations of 5, 20, and 50 mg/kg. Blood pressure was monitored at seven-day intervals. After a total of 3 weeks of treatment, the rats were euthanized and the kidney tissues were collected to examine the activity of the two major enzymes involved in AA metabolism in the kidney, namely cytochrome P450 (CYP)4A and soluble epoxide hydrolase (sEH). Results: Rats treated with HON did not experience the rise in blood pressure observed in the untreated SHR. High-dose HON significantly reduced blood pressure and inhibited the activity and protein expression of the CYP4A enzyme in the rat kidney. The activity of the sEH enzyme in renal cytosol was significantly inhibited by medium and high doses of HON. Conclusion: Our data demonstrate the antihypertensive effect of HON and provide a novel mechanism for its underlying cardioprotective properties.
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Zwack CC, McDonald R, Tursunalieva A, Cooray A, Lambert GW, Lambert EA. Does autonomic nervous system dysfunction influence cardiovascular disease risk in young adults with intellectual disability? Am J Physiol Heart Circ Physiol 2020; 320:H891-H900. [PMID: 33566748 DOI: 10.1152/ajpheart.00807.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
People with intellectual disability (ID) experience cardiometabolic-related morbidity and mortality. However, it has been suggested that this population presents and lives with underestimated cardiovascular risk factors at a younger age, hence affecting their overall health and quality of life and contributing to early mortality. We assessed autonomic nervous system function in subjects with ID (n = 39), aged 18-45 yr, through measures of sudomotor function, heart rate and systolic blood pressure variability, and cardiac baroreflex function. Traditional clinical cardiovascular measurements and a biochemical analysis were also undertaken. We found that young adults with ID presented with sudomotor dysfunction, impaired cardiac baroreflex sensitivity, and systolic blood pressure variability, when compared with age-matched control subjects (n = 38). Reduced hand and feet electrochemical skin conductance and asymmetry were significantly associated with having a moderate-profound ID. Autonomic dysfunction in individuals with ID persisted after controlling for age, sex, and other metabolic parameters. Subjects in the ID group also showed significantly increased blood pressure, body mass index, and waist/hip circumference ratio, as well as increased plasma hemoglobin A1c and high-sensitivity C-reactive protein levels. We conclude that autonomic dysfunction is present in young adults with ID and is more marked in those with more severe disability. These finding have important implications in developing preventative strategies to reduce the risk of cardiovascular disease in people with ID.NEW & NOTEWORTHY Adults with intellectual disability experience higher risk of premature death than the general population. Our investigation highlights increased cardiovascular risk markers and autonomic dysfunction in young adults with intellectual disability compared with control adults. Autonomic dysfunction was more marked in those with a more severe disability but independent of cardiovascular parameters. Assessment of autonomic nervous system (ANS) function may provide insight into the mechanisms of cardiometabolic disease development and progression in young adults with intellectual disability.
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Affiliation(s)
- Clara C Zwack
- Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Rachael McDonald
- Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Ainura Tursunalieva
- Department of Econometrics and Business Statistics, Monash University, Clayton, Victoria, Australia
| | - Amali Cooray
- Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Jung MH, Ihm SH, Park SM, Jung HO, Hong KS, Baek SH, Youn HJ. Effects of sarcopenia, body mass indices, and sarcopenic obesity on diastolic function and exercise capacity in Koreans. Metabolism 2019; 97:18-24. [PMID: 31125536 DOI: 10.1016/j.metabol.2019.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/02/2019] [Accepted: 05/17/2019] [Indexed: 12/22/2022]
Abstract
AIMS Obesity induces left ventricular diastolic dysfunction and ultimately causes heart failure. Sarcopenic obesity is common in heart failure with preserved ejection fraction (HFpEF). However, the precise mechanism by which sarcopenic obesity is related to HFpEF is poorly understood. We aimed to evaluate the combined effect of sarcopenia (SP) and obesity on left ventricular diastolic function and exercise capacity. METHODS This study included 733 healthy subjects who underwent health check-ups in a tertiary hospital in Korea. All participants were categorized into four groups: non-SP/non-obese, SP/non-obese, non-SP/obese, and SP/obese. Comprehensive echocardiography with cardiopulmonary exercise testing was performed. Diastolic dysfunction was defined as an E/e' ratio ≥ 10. RESULTS Across SP and obesity groups, a gradual decrease in e' velocity and an increase in the E/e' ratio was noted after adjustment for age and sex. Furthermore, a gradual decrease in percent-predicted peak VO2 was observed across the groups. In the multivariate logistic regression analysis, the SP/obese group had the highest risk for diastolic dysfunction (OR 4.27, 95% CI 2.41-7.57), followed by the non-SP/obese group (OR 2.88, 95% CI 1.57-5.29) and the SP/non-obese group (OR 1.90, 95% CI 1.01-3.56) compared with the reference (non-SP/non-obese) group even after controlling for various confounders. CONCLUSION Sarcopenic obesity was associated with impaired diastolic function and decreased exercise capacity, suggesting a possible mechanism by which sarcopenic obesity contributes to the development of HFpEF.
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Affiliation(s)
- Mi-Hyang Jung
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-si, Republic of Korea.
| | - Sang Min Park
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hae Ok Jung
- Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Soon Hong
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Sang Hong Baek
- Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Joong Youn
- Cardiovascular Center, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Jung M, Ihm S. Higher visceral fat rate estimated by bioelectrical impedance analysis increases risk for prehypertension in normal weight healthy adults. J Clin Hypertens (Greenwich) 2019; 21:540. [DOI: 10.1111/jch.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mi‐Hyang Jung
- Cardiovascular Center, Chuncheon Sacred Heart Hospital Hallym University College of Medicine Chuncheon Korea
| | - Sang‐Hyun Ihm
- Division of Cardiology, Department of Internal Medicine The Catholic University of Korea Seoul Korea
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Baretić M, Reschner A, Planinc I. Higher visceral fat rate estimated by bioelectrical impedance analysis increases risk for prehypertension in normal weight healthy adults. J Clin Hypertens (Greenwich) 2019; 21:538-539. [DOI: 10.1111/jch.13508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Maja Baretić
- Department of Endocrinology and Diabetes University Hospital Centre Zagreb, University of Zagreb School of Medicine Zagreb Croatia
| | | | - Ivo Planinc
- Department of Cardiovascular Diseases University Hospital Centre Zagreb, University of Zagreb School of Medicine Zagreb Croatia
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High Normal Blood Pressure and Left Ventricular Hypertrophy Echocardiographic Findings From the PAMELA Population. Hypertension 2019; 73:612-619. [DOI: 10.1161/hypertensionaha.118.12114] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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An SJ, Jung MH, Ihm SH, Yang YJ, Youn HJ. Effect of physical activity on the cardiometabolic profiles of non-obese and obese subjects: Results from the Korea National Health and Nutritional Examination Survey. PLoS One 2019; 14:e0208189. [PMID: 30822340 PMCID: PMC6396903 DOI: 10.1371/journal.pone.0208189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 11/13/2018] [Indexed: 11/21/2022] Open
Abstract
Background Physical inactivity is an important but often neglected risk factor for various cardiovascular diseases. We hypothesized that physical inactivity might have deleterious effects on metabolic health in obese and non-obese subjects. Methods We evaluated the effect of physical activity on the cardiometabolic profiles of a nationwide cohort of non-obese and obese individuals who did not have overt cardiovascular diseases. A total of 3,830 study subjects were divided into two groups based on their body mass index (BMI). Within each BMI group, participants were divided according to their physical activity level. To ascertain their cardiometabolic profiles, we collected data regarding the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, high-density lipoprotein (HDL)-cholesterol level, systolic blood pressure, heart rate, and high-sensitivity C-reactive protein (hsCRP) level. Results Physically inactive subjects demonstrated markedly elevated HOMA-IR index and heart rates in each BMI category, even after adjustments for baseline covariates. They also tended to have worse profiles for HDL-cholesterol, systolic blood pressure, and hsCRP levels. A significant elevation in cardiometabolic risk was noted across the four physical activity/obesity groups (p<0.05). HOMA-IR index was largely affected by obesity, but within each BMI category, physical inactivity independently elevated the risk for worsening insulin resistance. In addition, physical inactivity significantly increased the risk of elevated heart rate in both non-obese and obese individuals. Notably, the detrimental effect of physical activity on heart rate was not modified by obesity. Conclusions Physical activity was associated with favorable cardiometabolic risk profiles with regard to insulin resistance status and heart rate level in both BMI groups. Our results suggest that increasing physical activity could be a helpful strategy for improving the cardiometabolic health in the Korean population, regardless of obesity status.
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Affiliation(s)
- Sang Joon An
- Department of Neurology, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Mi-Hyang Jung
- Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
- * E-mail:
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yun-jung Yang
- Institute of Biomedical Science, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Ho-Joong Youn
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Prevalence of high blood pressure and high normal blood pressure among 7- to 17-year-old children and adolescents in developed regions, China from 2014 to 2017: using new national blood pressure reference for Chinese children and adolescents. J Hum Hypertens 2019; 33:400-410. [PMID: 30804460 DOI: 10.1038/s41371-019-0183-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 12/14/2022]
Abstract
As the first blood pressure (BP) reference considering influence of height in China, national blood pressure reference for Chinese han children and adolescents aged 7 to 17 years (CCBP) was issued in 2017. The current study aimed to observe the short-term trends in BP and prevalence of high blood pressure (HBP) and high normal blood pressure (HNBP) using this CCBP reference in Suzhou, China. Data of children and adolescents aged 7 to 17 years were collected from 2014 to 2017. Total population of 2014 to 2017 were 617,383, 684,453, 695,302, and 774,605, respectively, and proportions of males were 54.1%, 54.0%, 53.9%, and 53.8%, respectively. P-trend tests were conducted to examine the trends of BP among different age, region, body mass index, and socioeconomic status groups for each gender. Multivariate logistic regression analyses found secular decreases in prevalence of HBP and HNBP, after adjustment for potential confounders. Compared with that in 2014, the odds ratios (95% confidence intervals) for total study population were 0.936 (0.928, 0.944) in 2015, 0.879 (0.872, 0.887) in 2016, and 0.934 (0.926, 0.941) in 2017. In conclusion, prevalence of HBP and HNBP decreased among children and adolescents in developed regions of China from 2014 to 2017, and a slight rise were found in 2017.
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