1
|
Andishmand A, Seyedhosseini S, Namayandeh SM, Adelzadeh E, Entezari A, Mirjalili SR. Sildenafil's effectiveness in the primary coronary slow flow phenomenon: a pilot randomised controlled clinical trial. Open Heart 2024; 11:e002772. [PMID: 39214536 DOI: 10.1136/openhrt-2024-002772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND On the one hand, the primary coronary slow flow phenomenon (CSFP) can cause recurrence of chest pain, prompting medical examinations and further healthcare costs, while on the other hand, it can lead to myocardial infarction, ventricular arrhythmia and sudden cardiac death. Nevertheless, there is not any agreement on the optimal treatment for primary CSFP, so we decided to examine the effectiveness of sildenafil in this context. METHODS This pilot study is a 12-week, triple-blind, randomised, placebo-controlled trial for receiving either 50 mg daily oral sildenafil or placebo. Twenty eligible patients aged 30-70 years from a tertiary hospital in Yazd were randomly allocated in a 1:1 ratio to two groups. The primary outcomes were the alterations in functional capacity (metabolic equivalents, METs), Duke treadmill score (DTS) and angina severity (Canadian Cardiovascular Society (CCS) class). The study protocol registration code is IRCT20220223054103N1. RESULTS The angina severity in the Sildenafil group improved, with all receivers achieving a state of being asymptomatic during regular physical activity (CCS I). Whereas just 40% of the recipients in the placebo group achieved the same level of improvement (p=0.011). Mean METs at baseline were 9.9 (SD: 3.1) and at week 12 were 13.1 (SD: 3.3) for sildenafil and 9.56 (SD: 2.1) and 9.63 (SD: 2.4) for placebo (difference favouring sildenafil with a median increase of 3.1 (IQR: 1.1 to 4.1, p=0.008)). Median DTS scores at baseline were 3 (IQR: 0 to 9) and at week 12 were 9.5 (IQR: 7.75 to 15) for sildenafil and 7 (IQR: -1.5 to 9.25) and 8 (IQR: 1.5 to 11.25) for placebo (difference favouring sildenafil with a median increase of 5.5 (IQR: 1 to 9.2, p=0.01)). CONCLUSIONS We suggest that a daily low dose of sildenafil could be a valuable therapeutic option for primary CSFP. TRIAL REGISTRATION NUMBER IRCT20220223054103N1.
Collapse
Affiliation(s)
- Abbas Andishmand
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyedmostafa Seyedhosseini
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyedeh Mahdieh Namayandeh
- Epidemiologist, Associated Professor, Afshar Research Development Center, Yazd, Iran
- Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elnaz Adelzadeh
- Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Amin Entezari
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Reza Mirjalili
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
2
|
Lee H, Rhee TM, Park HE, Han K, Choi SY. Association between cumulative metabolic risk exposure and cardiovascular disease: a nationwide cohort of over 3.6 million young adults. Eur J Prev Cardiol 2024; 31:1288-1300. [PMID: 38421612 DOI: 10.1093/eurjpc/zwae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
AIMS As lifetime accumulation of cardiovascular risk factors is gaining importance, early identification and management of risk factors are being emphasized. The global prevalence of metabolic syndrome (MetS), a constellation of these risk factors, is increasing, particularly among young adults. In this study, we aim to investigate the association between cumulative exposure to metabolic risk and cardiovascular disease (CVD) in young adults. METHODS AND RESULTS In this nationwide population-based cohort, we analysed 3 688 787 young adults (<40 years) with 2 biennial National Health Screening examinations from 2009 to 2012. Participants were categorized into MetS-free, MetS-developed, MetS-recovered, or MetS-persistent group, based on MetS presence at each examination. The endpoint was new CVD development, including myocardial infarction (MI) and ischaemic stroke. During follow-up (median, 7.7 years), CVD occurred in 19 219 individuals (0.5%). The incidence rates of CVD were 0.58, 1.17, 1.20, and 1.83 (1000 person-years) in the MetS-free, MetS-developed, MetS-recovered, and MetS-persistent groups, respectively. The CVD risk was proportionally associated with cumulative metabolic risk exposure, with a maximum two-fold increase in the MetS-persistent group [adjusted hazard ratio (aHR) 1.94, 95% confidence interval (CI) 1.84-2.04], followed by the MetS-recovered and the MetS-developed groups with similar risks. Among the MetS components, persistent exposure to elevated blood pressure (BP) had the greatest association with CVD risk (aHR 1.69, 95% CI 1.63-1.76). This tendency was consistent in the separate analyses of the risk of MI and ischaemic stroke. CONCLUSION The risk of CVD increased in an exposure-dependent manner among young adults. Efforts to optimize the cardiometabolic profile, particularly BP, even after the establishment of MetS, might help promote long-term cardiovascular prognosis.
Collapse
Affiliation(s)
- Heesun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Centre, 39th Floor, Gangnam Finance Centre, 152, Teheran-ro, Gangnam-gu, Seoul 06236, Republic of Korea
| | - Tae-Min Rhee
- Department of Internal Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Centre, 39th Floor, Gangnam Finance Centre, 152, Teheran-ro, Gangnam-gu, Seoul 06236, Republic of Korea
| | - Hyo Eun Park
- Department of Internal Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Centre, 39th Floor, Gangnam Finance Centre, 152, Teheran-ro, Gangnam-gu, Seoul 06236, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-ro, Dongjak-gu, Seoul 06978, Republic of Korea
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Division of Cardiology, Seoul National University Hospital Healthcare System Gangnam Centre, 39th Floor, Gangnam Finance Centre, 152, Teheran-ro, Gangnam-gu, Seoul 06236, Republic of Korea
| |
Collapse
|
3
|
Buchanan Z, Hopkins SE, Ryman TK, Austin MA, Wiener HW, Tiwari HK, Klejka JA, Boyer BB, Fohner AE. Electronic health record reveals community-level cardiometabolic health benefits associated with 10 years of community-based participatory research. Public Health 2024; 232:38-44. [PMID: 38733959 PMCID: PMC11176004 DOI: 10.1016/j.puhe.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND While a major goal of community-based participatory research (CBPR) is to improve community health; it is unclear how to measure longstanding success of CBPR. OBJECTIVE We sought to determine the impact of ongoing CBPR on cardiometabolic health of participating communities, including in people not directly participating in research. METHODS We used linear mixed-effects modelling with electronic medical records from 2002 to 2012 from the Yukon-Kuskokwim Health Corporation, which provides health care to all Alaska Native people in southwestern Alaska, to compare rates of change in cardiometabolic risk factors between communities that did and did not participate in ongoing CBPR beginning in 2003. RESULTS We analysed 1,262,035 medical records from 12,402 individuals from 10 study and 38 control communities. Blood pressure declined faster in study than in control communities: systolic blood pressure (0.04 mmHg/year; 95% confidence interval [CI]: 0.01, 0.08); diastolic blood pressure (DBP) (0.07 mmHg/year; 95% CI: 0.04, 0.09). Body mass index increased 0.04 units/year faster in study communities than in control communities (95% CI: 0.03, 0.05). More study visits were associated with faster reduction of DBP and triglyceride levels in study communities. CONCLUSIONS Ongoing CBPR may improve overall cardiometabolic health in communities, perhaps by increasing engagement in health and advocacy.
Collapse
Affiliation(s)
- Z Buchanan
- University of Washington, Department of Epidemiology, Seattle, WA, USA
| | - S E Hopkins
- Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, USA; University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA
| | - T K Ryman
- University of Washington, Department of Epidemiology, Seattle, WA, USA; Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - M A Austin
- University of Washington, Department of Epidemiology, Seattle, WA, USA
| | - H W Wiener
- University of Alabama at Birmingham, Department of Epidemiology, Birmingham, AL, USA
| | - H K Tiwari
- University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL, USA
| | - J A Klejka
- Yukon-Kuskokwim Health Corporation, Bethel, AK, USA
| | - B B Boyer
- Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, USA; University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA
| | - A E Fohner
- University of Washington, Department of Epidemiology, Seattle, WA, USA.
| |
Collapse
|
4
|
Qi Y, Zhao Y, Yan Y, Wu D. Surgical failure guided by DISE in patients with obstructive sleep apnea: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:3333-3343. [PMID: 38324055 DOI: 10.1007/s00405-024-08484-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/15/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVES The failure rate and risk factors of upper airway surgery with drug induced sleep endoscopy (DISE) remain unknown in the treatment of obstructive sleep apnea (OSA). This review aims to analyze the failure rate of upper airway surgery with DISE and identify obstruction sites for surgical failure. METHODS A systematic review was conducted using PubMed, Embase, Web of Science, and Google Scholar until May 20th, 2023. We included studies that used DISE to assess obstructive sites before upper airway surgery and reported surgical failure rates and outcomes in patients with OSA. RESULTS 25 studies with a total of 1522 patients were included in the systematic review and meta-analysis. Upper airway surgery guided by DISE had a relatively low failure rate of 37% (95% CI 0.31-0.44) in the random effects model (I2 = 85.97%, P < 0.001). According to the velum, oropharynx, tongue base, and epiglottis (VOTE) scoring system, major risk factors for surgical failure included circumferential collapse at the velum, lateral wall collapse and small tonsils at the oropharynx, anterior-posterior lingual collapse and complete collapse at the tongue base. High body mass index and large preoperative apnea hypopnea index were also risk factors for OSA surgical failure. CONCLUSIONS Upper airway surgery guided by DISE in patients with OSA had a low failure rate of 37%. DISE can identify obstruction sites associated with surgical failure and guide single-level and multi-level surgeries.
Collapse
Affiliation(s)
- Yingting Qi
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China
- Department of Medicine, Peking University, Beijing, People's Republic of China
| | - Yi Zhao
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China
- Department of Medicine, Peking University, Beijing, People's Republic of China
| | - Yan Yan
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China.
| | - Dawei Wu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, People's Republic of China.
| |
Collapse
|
5
|
Robinson CH, Hussain J, Jeyakumar N, Smith G, Birken CS, Dart A, Dionne J, Garg A, Kandasamy S, Karam S, Marjerrison S, South AM, Thabane L, Wahi G, Zappitelli M, Chanchlani R. Long-Term Cardiovascular Outcomes in Children and Adolescents With Hypertension. JAMA Pediatr 2024; 178:688-698. [PMID: 38709137 PMCID: PMC11217870 DOI: 10.1001/jamapediatrics.2024.1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
Importance Hypertension affects 6% of all children, and its prevalence is increasing. Childhood hypertension tracks into adulthood and is associated with subclinical cardiovascular disease; however, there is a lack of evidence linking childhood hypertension to cardiovascular outcomes, which may contribute to underdiagnosis and undertreatment. Objective To determine the long-term associated risk of major adverse cardiac events (MACE) among children diagnosed with hypertension. Design, Setting, and Participants This was a population-based, retrospective, matched cohort study conducted from 1996 to 2022. The study included all children (aged 3-18 years) alive in Ontario, Canada, from 1996 to 2021, who were identified using provincial administrative health databases. Children with prior kidney replacement therapy were excluded. Exposure Incident hypertension diagnosis, identified by validated case definitions using diagnostic and physician billing claims. Each case was matched with 5 controls without hypertension by age, sex, birth weight, maternal gestational hypertension, prior comorbidities (chronic kidney disease, diabetes, cardiovascular surgery), and a propensity score for hypertension. Main Outcomes and Measures The primary outcome was MACE (a composite of cardiovascular death, stroke, hospitalization for myocardial infarction or unstable angina, or coronary intervention). Time to MACE was evaluated using the Kaplan-Meier method and Cox proportional hazards regression. Results A total of 25 605 children (median [IQR] age, 15 [11-17] years; 14 743 male [57.6%]) with hypertension were matched to 128 025 controls without hypertension. Baseline covariates were balanced after propensity score matching, and prior comorbidities were uncommon (hypertension vs control cohort: malignancy, 1451 [5.7%] vs 7908 [6.2%]; congenital heart disease, 1089 [4.3%] vs 5408 [4.2%]; diabetes, 482 [1.9%] vs 2410 [1.9%]). During a median (IQR) of 13.6 (7.8-19.5) years of follow-up, incidence of MACE was 4.6 per 1000 person-years in children with hypertension vs 2.2 per 1000 person-years in controls (hazard ratio, 2.1; 95% CI, 1.9-2.2). Children with hypertension were at higher associated risk of stroke, hospitalization for myocardial infarction or unstable angina, coronary intervention, and congestive heart failure, but not cardiovascular death, compared with nonhypertensive controls. Conclusions and Relevance Children diagnosed with hypertension had a higher associated long-term risk of MACE compared with controls without hypertension. Improved detection, follow-up, and control of pediatric hypertension may reduce the risk of adult cardiovascular disease.
Collapse
Affiliation(s)
- Cal H. Robinson
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Junayd Hussain
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nivethika Jeyakumar
- Lawson Health Research Institute and London Health Sciences Centre, London, Ontario, Canada
| | - Graham Smith
- Lawson Health Research Institute and London Health Sciences Centre, London, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Allison Dart
- Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Janis Dionne
- Department of Pediatrics, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anika Garg
- Infant, Child, and Youth Health Lab, Brock University, St Catharine’s, Ontario, Canada
| | - Sujane Kandasamy
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sabine Karam
- Department of Medicine, Division of Nephrology and Hypertension, University of Minnesota, Minneapolis
| | - Stacey Marjerrison
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Andrew M. South
- Department of Pediatrics, Brenner Children’s, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Gita Wahi
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Michael Zappitelli
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rahul Chanchlani
- ICES, Toronto, Ontario, Canada
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
6
|
Chen A, Mocumbi AO, Ojji DB, Waite L, Chan YK, Beilby J, Celermajer DS, Nkeh-Chungag BN, Damasceno A, Codde J, Stewart S. Projected burden and distribution of elevated blood pressure levels and its consequence among adolescents in sub-Saharan Africa. J Glob Health 2024; 14:04136. [PMID: 38940275 PMCID: PMC11212112 DOI: 10.7189/jogh.14.04136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Abstract
Background There is minimal data on the number of adolescents in sub-Saharan Africa (SSA) with elevated blood pressure (BP) at increased risk of future cardiovascular events. Combining country-specific population data with data derived from two previously conducted meta-analyses (one African-specific, one based on international cohorts), we sought to address this knowledge deficit. Methods We used meta-analysis data from 37 926 adolescents participating in 36 contemporary SSA studies to generate sex-specific proportions of adolescents aged 10-14 and 15-19 years with elevated BP. The estimates were applied to the 2021 World Bank population data for each country in SSA. We then applied the rate of cardiovascular events attributable to elevated BP levels, derived from a meta-analysis of 17 observational, longitudinal cohort studies comprising 4.5 million young adults (non-African), to determine the excess number of cardiovascular events linked to hypertension among those aged 15-19 years transitioning to adulthood. Results The estimated prevalence of elevated BP among male and female adolescents aged 10-14 years living in SSA was 7.2% (95% confidence interval (CI) = 4.9-9.9) and 6.9% (95% CI = 4.7-9.5), respectively, which increased to 13.0% (95% CI = 10.6-15.6) and 12.5% (95% CI = 10.4-15.3) among male and female adolescents aged 15-19 years, respectively. Consequently, we estimate that 13.6/138.0 million (95% CI = 10.4-17.3) male and 12.9/135.7 million (95% CI = 9.83-16.3) female adolescents living in SSA have elevated BP. Among the estimated 16.1 million adolescents aged 15-19 years with elevated BP approaching adulthood, the projected excess in cardiovascular events attributable to hypertension (vs normotension) is 201 000 (95% CI = 115 000-322 000) to 503 000 (95% CI = 286 000-805 000) over the next 10-25 years. Conclusions Based on the best available data, we estimate that 26.5 million adolescents living in SSA have elevated BP. If left undetected and untreated among those approaching adulthood (those aged 15-19 years), they will experience >0.5 million excess cardiovascular events associated with persistently elevated BP within the next 25 years. Registration PROSPERO: CRD42022297948.
Collapse
Affiliation(s)
- Alexander Chen
- Torrens University Australia, Adelaide, South Australia, Australia
| | - Ana O Mocumbi
- Universidade Eduardo Mondlane, Maputo, Mozambique
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Dike B Ojji
- University of Abuja, Abuja, Nigeria
- University of Cape Town, Cape Town, South Africa
| | - Laura Waite
- South Eastern Melbourne Primary Health Network Australia, Victorian Department of Health, Melbourne, Victoria, Australia
| | - Yih-Kai Chan
- Australian Catholic University, Melbourne, Victoria, Australia
| | - Justin Beilby
- Torrens University Australia, Adelaide, South Australia, Australia
| | | | | | - Albertino Damasceno
- Universidade Eduardo Mondlane, Maputo, Mozambique
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Jim Codde
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Simon Stewart
- Universidade Eduardo Mondlane, Maputo, Mozambique
- Instituto Nacional de Saúde, Marracuene, Mozambique
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| |
Collapse
|
7
|
Berkman AM, Andersen CR, Landstrom AP, Hildebrandt MAT, Gilchrist SC, Roth ME. Cardiovascular Disease in Childhood, Adolescent, and Young Adult Cancer Survivors: The Impact of Family History of Premature Heart Disease. J Adolesc Young Adult Oncol 2024; 13:548-556. [PMID: 38261412 DOI: 10.1089/jayao.2023.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Purpose: Childhood, adolescent, and young adult (CAYA) cancer survivors (age 0-39 years at diagnosis) are at increased risk of cardiovascular disease (CVD). Family history of early heart disease increases the risk of CVD in the general population; however, it is unknown whether this association is seen in CAYA cancer survivors. Methods: Self-report data from the National Health and Nutrition Examination Survey (2005-2018) were used to identify CAYA survivors (>5 years post-diagnosis). The risk of CVD based on family history status (parent or sibling with a diagnosis of heart attack or angina before age 50 years), personal sociodemographic factors, personal medical history factors, and personal behavioral risk factors was determined using logistic regression models. Results: Included were 95 CAYA survivors with CVD and 491 CAYA survivors without CVD. The odds of CVD were significantly higher in survivors with a first-degree family history of early heart disease (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.14-3.74). A history of diabetes (OR: 2.61, 95% CI: 1.41-4.84), hypertension (OR: 1.81, 95% CI: 1.04-3.16), and any smoking (OR: 2.19, 95% CI: 1.19-4.02) was also associated with higher odds of CVD in CAYA survivors. Reporting any physical activity in the past month was associated with lower odds (OR: 0.54, 95% CI: 0.30-0.97) of CVD. Conclusions: Family history of early heart disease was associated with increased odds of CVD in CAYA cancer survivors. Obtaining complete and accurate family history information is important both at time of diagnosis and throughout follow-up.
Collapse
Affiliation(s)
- Amy M Berkman
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Clark R Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Andrew P Landstrom
- Division of Pediatric Cardiology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Cell Biology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Michelle A T Hildebrandt
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention and Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael E Roth
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
8
|
Keiser T, Katz S, Robson SM, Greaney JL, Healy S, Malone SK, Farrahi V, Patterson F. Association between time-of-day for eating, exercise, and sleep with blood pressure in adults with elevated blood pressure or hypertension: a systematic review. J Hypertens 2024; 42:951-960. [PMID: 38647159 PMCID: PMC11062822 DOI: 10.1097/hjh.0000000000003732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The purpose of this review is to synthesize results from studies examining the association between time-of-day for eating, exercise, and sleep with blood pressure (BP) in adults with elevated BP or hypertension. Six databases were searched for relevant publications from which 789 were identified. Ten studies met inclusion criteria. Four studies examined time-of-day for eating, five examined time-of-day for exercise, and one examined time-of-day for sleep and their associations with BP. Results suggested that later time-of-day for eating ( n = 2/4) and later sleep mid-point ( n = 1/1) were significantly related to higher BP in multivariable models, whereas morning ( n = 3/5) and evening ( n = 4/5) exercise were associated with significantly lower BP. Although this small body of work is limited by a lack of prospective, randomized controlled study designs and underutilization of 24 h ambulatory BP assessment, these results provide preliminary, hypothesis-generating support for the independent role of time-of-day for eating, exercise, and sleep with lower BP.
Collapse
Affiliation(s)
- Thomas Keiser
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Sarah Katz
- Department of Library, Museums, and Press, University of Delaware, Newark, Delaware, USA
| | - Shannon M Robson
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Jody L Greaney
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Sean Healy
- Department of Physical Education and Sports Science, University of Limerick, Limerick, Ireland
| | - Susan K Malone
- Rory Meyers College of Nursing, New York University, New York, USA
| | - Vahid Farrahi
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Freda Patterson
- College of Health Sciences, University of Delaware, Newark, Delaware, USA
| |
Collapse
|
9
|
Ahmed IA, Liu M, Gomez D. Nuclear Control of Vascular Smooth Muscle Cell Plasticity during Vascular Remodeling. THE AMERICAN JOURNAL OF PATHOLOGY 2024; 194:525-538. [PMID: 37820925 PMCID: PMC10988766 DOI: 10.1016/j.ajpath.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
Control of vascular smooth muscle cell (SMC) gene expression is an essential process for establishing and maintaining lineage identity, contractility, and plasticity. Most mechanisms (epigenetic, transcriptional, and post-transcriptional) implicated in gene regulation occur in the nucleus. Still, intranuclear pathways are directly impacted by modifications in the extracellular environment in conditions of adaptive or maladaptive remodeling. Integration of extracellular, cellular, and genomic information into the nucleus through epigenetic and transcriptional control of genome organization plays a major role in regulating SMC functions and phenotypic transitions during vascular remodeling and diseases. This review aims to provide a comprehensive update on nuclear mechanisms, their interactions, and their integration in controlling SMC homeostasis and dysfunction. It summarizes and discusses the main nuclear mechanisms preponderant in SMCs in the context of vascular disease, such as atherosclerosis, with an emphasis on studies employing in vivo cell-specific loss-of-function and single-cell omics approaches.
Collapse
Affiliation(s)
- Ibrahim A Ahmed
- Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mingjun Liu
- Department of Pathology, New York University, New York, New York
| | - Delphine Gomez
- Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| |
Collapse
|
10
|
Ma S, Xie X, Yuan R, Xin Q, Miao Y, Leng SX, Chen K, Cong W. Vascular Aging and Atherosclerosis: A Perspective on Aging. Aging Dis 2024:AD.2024.0201-1. [PMID: 38502584 DOI: 10.14336/ad.2024.0201-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/01/2024] [Indexed: 03/21/2024] Open
Abstract
Vascular aging (VA) is recognized as a pivotal factor in the development and progression of atherosclerosis (AS). Although various epidemiological and clinical research has demonstrated an intimate connection between aging and AS, the candidate mechanisms still require thorough examination. This review adopts an aging-centric perspective to deepen the comprehension of the intricate relationship between biological aging, vascular cell senescence, and AS. Various aging-related physiological factors influence the physical system's reactions, including oxygen radicals, inflammation, lipids, angiotensin II, mechanical forces, glucose levels, and insulin resistance. These factors cause endothelial dysfunction, barrier damage, sclerosis, and inflammation for VA and promote AS via distinct or shared pathways. Furthermore, the increase of senescent cells inside the vascular tissues, caused by genetic damage, dysregulation, secretome changes, and epigenetic modifications, might be the primary cause of VA.
Collapse
Affiliation(s)
- Shudong Ma
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuena Xie
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- School of Pharmacy, Macau University of Science and Technology, Macau, China
| | - Rong Yuan
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiqi Xin
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Miao
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Sean Xiao Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Keji Chen
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, China
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weihong Cong
- Laboratory of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- School of Pharmacy, Macau University of Science and Technology, Macau, China
| |
Collapse
|
11
|
Hou Y, Wu F, Fan H, Li H, Hao B, Deng Z, Lu X, Zhou Y, Ran P. Association of non-obstructive dyspnoea with all-cause mortality and incident chronic obstructive pulmonary disease: a systematic literature review and meta-analysis. BMJ Open Respir Res 2024; 11:e001933. [PMID: 38395457 PMCID: PMC10895236 DOI: 10.1136/bmjresp-2023-001933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Controversy exists regarding the association between non-obstructive dyspnoea and the future development of chronic obstructive pulmonary disease (COPD) and mortality. Therefore, we aimed to evaluate the association of non-obstructive dyspnoea with mortality and incident COPD in adults. METHODS We searched PubMed, Embase, and Web of Science to identify studies published from inception to 13 May 2023. Eligibility screening, data extraction, and quality assessment of the retrieved articles were conducted independently by two reviewers. Studies were included if they were original articles comparing incident COPD and all-cause mortality between individuals with normal lung function with and without dyspnoea. The primary outcomes were incident COPD and all-cause mortality. The secondary outcome was respiratory disease-related mortality. We used the random-effects model to calculate pooled estimates and corresponding 95% confidence interval (CI). Heterogeneity was determined using the I² statistic. RESULTS Of 6486 studies, 8 studies involving 100 758 individuals fulfilled the inclusion and exclusion criteria and were included in the study. Compared with individuals without non-obstructive dyspnoea, individuals with non-obstructive dyspnoea had an increased risk of incident COPD (relative risk: 1.41, 95% CI: 1.08 to 1.83), and moderate heterogeneity was found (p=0.079, I2=52.2%). Individuals with non-obstructive dyspnoea had a higher risk of all-cause mortality (hazard ratio: 1.21, 95% CI: 1.14 to 1.28, I2=0.0%) and respiratory disease-related mortality (hazard ratio: 1.52, 95% CI: 1.14 to 2.02, I2=0.0%) than those without. CONCLUSIONS Individuals with non-obstructive dyspnoea are at a higher risk of incident COPD and all-cause mortality than individuals without dyspnoea. Further research should investigate whether these high-risk adults may benefit from risk management and early therapeutic intervention. PROSPERO REGISTRATION NUMBER CRD42023395192.
Collapse
Affiliation(s)
- Yuyan Hou
- Jiaying University, Meizhou, Guangdong, China
| | - Fan Wu
- State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou National Laboratory, Guangzhou, China
| | - Huanhuan Fan
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haiqing Li
- State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Binwei Hao
- Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhishan Deng
- State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoyan Lu
- State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou National Laboratory, Guangzhou, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease & Guangzhou Institute of Respiratory Health & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou National Laboratory, Guangzhou, China
| |
Collapse
|
12
|
Qu H, Shen AL, Yang K, Huang MY, Li HZ, Yang WW, Fan SY, Tan L, Wang J, Peng YX, Chu JF, Peng J, Fu CG, Long LZ, Chen KJ. Efficacy and safety of Qingda granule versus valsartan capsule in Chinese grade 1 hypertensive patients with low-moderate risk: A randomized, double-blind, double dummy, non-inferiority, multi-center trial. Pharmacol Res 2024; 200:107052. [PMID: 38181857 DOI: 10.1016/j.phrs.2023.107052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/08/2023] [Accepted: 12/31/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND The efficacy and safety of Qingda granule (QDG) in managing blood pressure (BP) among grade 1 hypertensive patients with low-moderate risk remain uncertain. METHODS In the randomized, double-blind, double dummy, non-inferiority and multicenter trial, 552 patients with grade 1 hypertension at low-moderate risk were assigned at a ratio of 1:1 to receive either QDG or valsartan for 4 weeks, followed up by a subsequent 4 weeks. RESULTS Post-treatment, clinic systolic/diastolic BPs (SBP/DBP) were reduced by a mean change of 9.18/4.04 mm Hg in the QDG group and 9.85/5.05 mm Hg in the valsartan group (SBP P = 0.47, DBP P = 0.16). Similarly, 24-hour, daytime and nighttime BPs were proportional in both groups (P > 0.05) after 4 weeks treatment. After discontinuing medications for 4 weeks, the mean reduction of clinic SBP/DBP were 0.29/0.57 mm Hg in the QDG group compared to -1.59/-0.48 mm Hg in the valsartan group (SBP P = 0.04, DBP P = 0.04). Simultaneously, the 24-hour SBP/DBP were reduced by 0.9/0.31 mm Hg in the QDG group and -1.66/-1.08 mm Hg in the valsartan group (SBP P = 0.006, DBP P = 0.02). And similar results were observed regarding the outcomes of daytime and nighttime BPs. There was no difference in occurrence of adverse events between two groups (P > 0.05). CONCLUSION QDG proves to be efficacious for grade 1 hypertension at a low-to-medium risk, even after discontinuation of the medication for 4 weeks. These findings provide a promising option for managing grade 1 hypertension and suggest the potential for maintaining stable BP through intermittent administration of QDG. TRIAL REGISTRATION ChiCTR2000033890.
Collapse
Affiliation(s)
- Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China; National Cardiovascular Clinical Medical Research Center of Traditional Chinese Medicine, China
| | - A-Ling Shen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, China
| | - Kuo Yang
- Beijing Jiaotong University, China
| | - Ming-Yan Huang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China; National Cardiovascular Clinical Medical Research Center of Traditional Chinese Medicine, China
| | - Hong-Zheng Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China
| | - Wen-Wen Yang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China
| | | | - Ling Tan
- The Eighth Affiliated Hospital of Sun Yat-sen University, China
| | - Jie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China
| | - Yu-Xuan Peng
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China
| | - Jian-Feng Chu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, China
| | - Jun Peng
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, China
| | - Chang-Geng Fu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China; National Cardiovascular Clinical Medical Research Center of Traditional Chinese Medicine, China.
| | - Lin-Zi Long
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China.
| | - Ke-Ji Chen
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, China; National Cardiovascular Clinical Medical Research Center of Traditional Chinese Medicine, China
| |
Collapse
|
13
|
Guo L, Tian F, Wang J, Xu W, Li W, Hou X, Zheng M, Yang X, Gao L, Chen S, Zhang N, Wu S. Effect of 10-year cumulative blood pressure exposure on atherosclerotic cardiovascular disease of different age groups: kailuan cohort study. Front Cardiovasc Med 2024; 11:1341097. [PMID: 38361586 PMCID: PMC10867219 DOI: 10.3389/fcvm.2024.1341097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
Background The level at which cumulative blood pressure (BP) can increase the risk of ASCVD in different age groups remains unclear. This study aimed to investigate the association of 10-year cumulative BP levels with the long-term risk of ASCVD of different age groups. Methods Cumulative BP exposure was assessed using the time-weighted average (TWA) BP divided into four BP groups. The participants were also divided into four groups according to their baseline age (<50, 50-59, 60-69, or ≥70 years). The association between TWA BP and the risk of ASCVD was assessed by age group using multivariate Cox models. The China-PAR prediction model was used to assess the ability of TWA BP to predict ASCVD. Results In the group aged <50 years, the hazard ratios and 95% confidence intervals for the risk of ASCVD were 2.66 (1.04-6.80), 3.38 (1.54-7.43), and 3.13 (1.36-7.24) for the elevated BP, stage 1 hypertension, and stage 2 hypertension groups, respectively, when compared with the normal BP group. There was a significant difference in the risk of ASCVD between the age groups, with participants aged <50 years having the highest risk, followed by those aged 50-59, 60-69, and ≥70 years. Conclusions The risk of ASCVD with high cumulative BP exposure was age-dependent, with a gradual decrease in risk with increasing age.
Collapse
Affiliation(s)
- Lu Guo
- The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Faming Tian
- The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Jingyao Wang
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Wenqi Xu
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Wenjuan Li
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiaoli Hou
- The School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Mengyi Zheng
- Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xuemei Yang
- The School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Lishu Gao
- Department of Endocrinology, Tangshan People’s Hospital, Tangshan, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Nan Zhang
- Department of Orthopedics, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| |
Collapse
|
14
|
Tao L, Miao L, Guo YJ, Liu YL, Xiao LH, Yang ZJ. Associations of body roundness index with cardiovascular and all-cause mortality: NHANES 2001-2018. J Hum Hypertens 2024; 38:120-127. [PMID: 37752175 DOI: 10.1038/s41371-023-00864-4] [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: 04/02/2023] [Revised: 08/31/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
Body roundness index (BRI) was associated with cardiovascular diseases. But the relationship between BRI with cardiovascular disease (CVD) mortality and all-cause mortality remains largely unknown in hypertensive patients. This prospective cohort study included patients with hypertension who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2018, and aimed to evaluate the association between BRI with CVD mortality and all-cause mortality. A total of 15570 patients were included. Over a median follow-up of 8.0 years (interquartile range, 4.3-12.6 years), 3445 individuals died, including 1166 CVD deaths. Weighted restricted cubic spline regression results showed a nonlinear association between BRI and CVD mortality and all-cause mortality (both P for nonlinear trend <0.001). The weighted multivariate Cox proportional hazards regression showed the hazard ratio (HRs) for CVD mortality were 0.93 (95% CI: 0.84-1.03, P = 0.160) in the low levels of BRI (≤5.9) and 1.11 (95% CI: 1.05-1.19, P < 0.001) in the high levels of BRI (>5.9). Similar associations were observed for all-cause mortality, the HRs were 0.91 (95% CI: 0.87-0.96, P < 0.001) in the low levels of BRI (≤6.3) and 1.09 (95% CI: 1.05-1.13, P < 0.001) in the high levels of BRI (>6.3). This cohort study supported that BRI was nonlinearly associated with CVD mortality and all-cause mortality among patients with hypertension. The thresholds of 5.9 and 6.3 for CVD mortality and all-cause mortality, respectively, may represent intervention targets for lowering the risk of premature death, but this needs to be confirmed in large clinical trials.
Collapse
Affiliation(s)
- Lin Tao
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People's Republic of China
| | - Liu Miao
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People's Republic of China
| | - Yu-Jie Guo
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People's Republic of China
| | - Yan-Li Liu
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People's Republic of China
| | - Li-Hong Xiao
- Departments of General Medicine, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People's Republic of China
| | - Zhi-Jie Yang
- Departments of Cardiology, Liuzhou People's Hospital, 8 Wenchang Road, Liuzhou, 545006, Guangxi, People's Republic of China.
| |
Collapse
|
15
|
Farhadi A, Emamat H, Nemati R, Marzban M, Shafiee G, Nabipour I, Ostovar A, Jalaliyan Z, Malekizadeh H, Larijani B. The association between continuous metabolic syndrome score and its components with electrocardiographic abnormalities in community-dwelling older adults: the Bushehr elderly health (BEH) program. BMC Cardiovasc Disord 2024; 24:81. [PMID: 38297215 PMCID: PMC10829232 DOI: 10.1186/s12872-024-03733-1] [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: 09/15/2022] [Accepted: 01/17/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) known as a risk factor for cardiovascular diseases (CVDs) has developed into a major source of health issue, especially for the elderly. In the present study, we investigated the association between continuous MetS (cMetS) score and its components with electrocardiographic (ECG) abnormalities in the community-dwelling older adults. METHODS This cross-sectional study is derived from the second phase of BEH cohort study which is conducted on individuals aged over 60 years old. Standard 12-lead ECGs were recorded and coded by qualified physicians and continuous values of metabolic syndrome risk scores (cMetS) were measured. Data regarding socio-demographic, medical history, and lifestyle variables were collected by trained interviewers. The multinomial regression analysis was used to investigate the relationship between cMetS and its components with ECG abnormalities in the included participants. RESULTS 2426 individuals (mean age ± standard deviation: 69.30 ± 6.33 years) were included in the final analysis. Overall, 22.5% of the participants showed ECG abnormalities. Among these, 8.0% (n = 139) of participants had minor and 14.6% (n = 354) had major ECG abnormalities. In the final models, cMetS (OR = 1.04), mean arterial pressure (MAP((OR = 1.01), and higher fasting blood glucose (FBG) (OR = 1.01) increased the risk of ECG abnormalities (p < 0.05). Also, cMetS (OR = 1.05) and MAP (OR = 1.02) were associated with an increased risk of major ECG abnormalities (p < 0.05). CONCLUSION MetS and MAP were significantly associated with ECG abnormalities. The results of the present study suggest that ECG screening in the older population with MetS could potentially help to detect those at the higher risk of CVDs.
Collapse
Affiliation(s)
- Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hadi Emamat
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Nemati
- Department of Medical Emergencies, School of Allied Medical Sciences, Bushehr University of Medical Sciences, Bushehr, Iran
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hasan Malekizadeh
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Graffy P, Zimmerman L, Luo Y, Yu J, Choi Y, Zmora R, Lloyd-Jones D, Allen NB. Longitudinal clustering of Life's Essential 8 health metrics: application of a novel unsupervised learning method in the CARDIA study. J Am Med Inform Assoc 2024; 31:406-415. [PMID: 38070172 PMCID: PMC10797259 DOI: 10.1093/jamia/ocad240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE Changes in cardiovascular health (CVH) during the life course are associated with future cardiovascular disease (CVD). Longitudinal clustering analysis using subgraph augmented non-negative matrix factorization (SANMF) could create phenotypic risk profiles of clustered CVH metrics. MATERIALS AND METHODS Life's Essential 8 (LE8) variables, demographics, and CVD events were queried over 15 ears in 5060 CARDIA participants with 18 years of subsequent follow-up. LE8 subgraphs were mined and a SANMF algorithm was applied to cluster frequently occurring subgraphs. K-fold cross-validation and diagnostics were performed to determine cluster assignment. Cox proportional hazard models were fit for future CV event risk and logistic regression was performed for cluster phenotyping. RESULTS The cohort (54.6% female, 48.7% White) produced 3 clusters of CVH metrics: Healthy & Late Obesity (HLO) (29.0%), Healthy & Intermediate Sleep (HIS) (43.2%), and Unhealthy (27.8%). HLO had 5 ideal LE8 metrics between ages 18 and 39 years, until BMI increased at 40. HIS had 7 ideal LE8 metrics, except sleep. Unhealthy had poor levels of sleep, smoking, and diet but ideal glucose. Race and employment were significantly different by cluster (P < .001) but not sex (P = .734). For 301 incident CV events, multivariable hazard ratios (HRs) for HIS and Unhealthy were 0.73 (0.53-1.00, P = .052) and 2.00 (1.50-2.68, P < .001), respectively versus HLO. A 15-year event survival was 97.0% (HIS), 96.3% (HLO), and 90.4% (Unhealthy, P < .001). DISCUSSION AND CONCLUSION SANMF of LE8 metrics identified 3 unique clusters of CVH behavior patterns. Clustering of longitudinal LE8 variables via SANMF is a robust tool for phenotypic risk assessment for future adverse cardiovascular events.
Collapse
Affiliation(s)
- Peter Graffy
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Lindsay Zimmerman
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Yuan Luo
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Jingzhi Yu
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Yuni Choi
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55455, United States
| | - Rachel Zmora
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| | - Norrina Bai Allen
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, United States
| |
Collapse
|
17
|
Shaver N, Beck A, Bennett A, Wilson BJ, Garritty C, Subnath M, Grad R, Persaud N, Thériault G, Flemming J, Thombs BD, LeBlanc J, Kaczorowski J, Liu P, Clark CE, Traversy G, Graham E, Feber J, Leenen FHH, Premji K, Pap R, Skidmore B, Brouwers M, Moher D, Little J. Screening for hypertension in adults: protocol for evidence reviews to inform a Canadian Task Force on Preventive Health Care guideline update. Syst Rev 2024; 13:17. [PMID: 38183086 PMCID: PMC10768239 DOI: 10.1186/s13643-023-02392-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/16/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening in a primary care setting for hypertension in adults aged 18 years and older. This protocol outlines the scope and methods for a series of systematic reviews and one overview of reviews. METHODS To evaluate the benefits and harms of screening for hypertension, the Task Force will rely on the relevant key questions from the 2021 United States Preventive Services Task Force systematic review. In addition, a series of reviews will be conducted to identify, appraise, and synthesize the evidence on (1) the association of blood pressure measurement methods and future cardiovascular (CVD)-related outcomes, (2) thresholds for discussions of treatment initiation, and (3) patient acceptability of hypertension screening methods. For the review of blood pressure measurement methods and future CVD-related outcomes, we will perform a de novo review and search MEDLINE, Embase, CENTRAL, and APA PsycInfo for randomized controlled trials, prospective or retrospective cohort studies, nested case-control studies, and within-arm analyses of intervention studies. For the thresholds for discussions of treatment initiation review, we will perform an overview of reviews and update results from a relevant 2019 UK NICE review. We will search MEDLINE, Embase, APA PsycInfo, and Epistemonikos for systematic reviews. For the acceptability review, we will perform a de novo systematic review and search MEDLINE, Embase, and APA PsycInfo for randomized controlled trials, controlled clinical trials, and observational studies with comparison groups. Websites of relevant organizations, gray literature sources, and the reference lists of included studies and reviews will be hand-searched. Title and abstract screening will be completed by two independent reviewers. Full-text screening, data extraction, risk-of-bias assessment, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers. Results from included studies will be synthesized narratively and pooled via meta-analysis when appropriate. The GRADE approach will be used to assess the certainty of evidence for outcomes. DISCUSSION The results of the evidence reviews will be used to inform Canadian recommendations on screening for hypertension in adults aged 18 years and older. SYSTEMATIC REVIEW REGISTRATION This protocol is registered on PROSPERO and is available on the Open Science Framework (osf.io/8w4tz).
Collapse
Affiliation(s)
- Nicole Shaver
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Andrew Beck
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alexandria Bennett
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Brenda J Wilson
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Chantelle Garritty
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Melissa Subnath
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Navindra Persaud
- Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Guylène Thériault
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Jennifer Flemming
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Kingston Health Sciences Centre, Kingston, Canada
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
- Faculty of Medicine, McGill University, Montreal, Canada
| | - John LeBlanc
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Janusz Kaczorowski
- Department of Family and Emergency Medicine, University of Montreal, Montreal, QC, Canada
| | - Peter Liu
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada
| | - Christopher E Clark
- Primary Care Research Group, University of Exeter Medical School, Exeter, Devon, England
| | - Gregory Traversy
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Eva Graham
- Substance-Related Harms Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Janusz Feber
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Frans H H Leenen
- Department of Medicine and Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Kamila Premji
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Robert Pap
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Melissa Brouwers
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
18
|
Sarfika R, Sulistiawati, Afriyanti E, Saifudin IMMY. Self-care behavior among adult patients with hypertension in Padang, West Sumatra, Indonesia: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:595-602. [PMID: 38130680 PMCID: PMC10731429 DOI: 10.33546/bnj.2915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/25/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023] Open
Abstract
Background Self-care behavior is crucial in preventing chronic diseases, such as hypertension, which has become highly prevalent in Indonesia. Hypertension, often referred to as the "silent killer" due to its asymptomatic nature, can easily go unnoticed. Neglecting its treatment can lead to severe complications, including heart disease, heart failure, and stroke. Despite adults with hypertension feeling well, embracing self-care behavior, including making healthy lifestyle choices, disease management, and enhancing life quality, remains essential. Objective This study aimed to describe the self-care behavior of adult patients with hypertension in Indonesia. Methods A cross-sectional study design was employed, involving 270 participants selected through consecutive sampling. Data were collected between 15 March and 4 April 2023, using the Hypertension Blood Pressure Self Care Profile (HBP-SCP) questionnaire in six public healthcare centers in Padang City, West Sumatra, Indonesia. The data were analyzed using descriptive analysis, Mann-Whitney, and Kruskal-Wallis tests. Results The self-care behavior among adult patients with hypertension was at a moderate level (Mean = 49.78, SD = 6.64), and it had significant differences according to ethnicity (p = 0.041), marital status (p = 0.017), and body mass index (p = 0.008). Conclusion The findings highlight the influence of diverse ethnic backgrounds, various marital statuses, and differing body mass index levels, which may lead to distinct approaches to managing hypertension. These results offer valuable insights for nurses and other healthcare professionals to develop comprehensive strategies to enhance self-care among adult patients with hypertension.
Collapse
Affiliation(s)
- Rika Sarfika
- Mental Health and Community Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Sulistiawati
- Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Esi Afriyanti
- Medical and Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | | |
Collapse
|
19
|
Liu Z, Li H, Li W, Zhuang D, Zhang F, Ouyang W, Wang S, Bertolaccini L, Alskaf E, Pan X. Noncontact remote sensing of abnormal blood pressure using a deep neural network: a novel approach for hypertension screening. Quant Imaging Med Surg 2023; 13:8657-8668. [PMID: 38106309 PMCID: PMC10722034 DOI: 10.21037/qims-23-970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/27/2023] [Indexed: 12/19/2023]
Abstract
Background As the global burden of hypertension continues to increase, early diagnosis and treatment play an increasingly important role in improving the prognosis of patients. In this study, we developed and evaluated a method for predicting abnormally high blood pressure (HBP) from infrared (upper body) remote thermograms using a deep learning (DL) model. Methods The data used in this cross-sectional study were drawn from a coronavirus disease 2019 (COVID-19) pilot cohort study comprising data from 252 volunteers recruited from 22 July to 4 September 2020. Original video files were cropped at 5 frame intervals to 3,800 frames per slice. Blood pressure (BP) information was measured using a Welch Allyn 71WT monitor prior to infrared imaging, and an abnormal increase in BP was defined as a systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg. The PanycNet DL model was developed using a deep neural network to predict abnormal BP based on infrared thermograms. Results A total of 252 participants were included, of which 62.70% were male and 37.30% were female. The rate of abnormally high HBP was 29.20% of the total number. In the validation group (upper body), precision, recall, and area under the receiver operating characteristic curve (AUC) values were 0.930, 0.930, and 0.983 [95% confidence interval (CI): 0.904-1.000], respectively, and the head showed the strongest predictive ability with an AUC of 0.868 (95% CI: 0.603-0.994). Conclusions This is the first technique that can perform screening for hypertension without contact using existing equipment and data. It is anticipated that this technique will be suitable for mass screening of the population for abnormal BP in public places and home BP monitoring.
Collapse
Affiliation(s)
- Zeye Liu
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hang Li
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wenchao Li
- Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Huazhong Fuwai Hospital, Pediatric Cardiac Surgery, Zhengzhou, China
| | - Donglin Zhuang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Fengwen Zhang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wenbin Ouyang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shouzheng Wang
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ebraham Alskaf
- School of Biomedical Engineering & Imaging Sciences, King’s College London, St. Thomas’ Hospital, London, UK
| | - Xiangbin Pan
- Department of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, Beijing, China
- Key Laboratory of Innovative Cardiovascular Devices, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
20
|
Rodriguez C, Stratton MT, Harty PS, Siedler MR, Boykin JR, Green JJ, Keith DS, White SJ, DeHaven B, Brojanac A, Tinoco E, Taylor LW, Tinsley GM. Effects of a ready-to-drink thermogenic beverage on resting energy expenditure, hemodynamic function, and subjective outcomes. J Int Soc Sports Nutr 2023; 20:2211958. [PMID: 37162193 PMCID: PMC10173796 DOI: 10.1080/15502783.2023.2211958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Thermogenic supplements are often consumed by individuals seeking to improve energy levels and reduce body fat. These supplements are sold in powdered or ready-to-drink (RTD) forms and consist of a blend of ingredients such as caffeine, green tea extract, and other botanical compounds. While there is evidence that thermogenic supplements can positively affect resting energy expenditure (REE), the effect varies based on the combination of active ingredients. Additionally, there is some concern that thermogenic supplements may cause unwanted side effects on hemodynamic variables, like heart rate (HR) and blood pressure (BP). Therefore, further investigation into the efficacy and safety of commercially available products is warranted. METHODS Twenty-eight individuals (14 F, 14 M; age: 23.3 ± 3.9 yrs; height: 169.4 ± 8.6 cm; body mass: 73.3 ± 13.1 kg) completed two visits in a randomized, double-blind, crossover fashion. Each visit began with baseline REE, HR, and BP assessments, which were followed by ingestion of an active RTD thermogenic beverage (RTD; OxyShred Ultra Energy) or placebo (PL). Assessments were repeated at the intervals of 35-50- and 85-100-minutes post-ingestion. In addition, subjective outcomes of energy, focus, concentration, alertness, and mood were collected five times throughout each visit. Repeated-measures analysis of variance was performed with condition and time specified as within-subjects factors and sex and resistance training (RT) status as between-subjects factors. Statistical significance was accepted at p < 0.05. RESULTS A significant condition × time interaction was observed for REE (p < 0.001). Higher REE values were demonstrated at 35-50 min (0.08 ± 0.02 kcal/min; p = 0.001; 5.2% difference) and 85-100 min (0.08 ± 0.02 kcal/min; p = 0.001; 5.5% difference) after RTD ingestion as compared to PL. No significant condition × time interactions were observed for respiratory quotient, HR, or BP. Condition main effects indicated lower HR (3.0 ± 0.9 bpm; p = 0.003), higher SBP (3.5 ± 1.1 mm Hg; p = 0.003) and higher DBP (3.5 ± 0.9 mm Hg; p < 0.001) in RTD as compared to PL, irrespective of time. Condition × time interactions were observed for all subjective outcomes (p ≤ 0.02). Post hoc tests indicated statistically significant benefits of the RTD over PL for energy, focus, concentration, and alertness, without significant differences for mood after correction for multiple comparisons. Sex and RT status were not involved in interactions for any outcomes, except for a Sex × RT status interaction for energy, indicating higher energy ratings in non-resistance-trained vs. resistance-trained males. CONCLUSIONS These data suggest that acute ingestion of a thermogenic RTD beverage significantly increases REE, and this elevated caloric expenditure is sustained for at least 100 minutes following ingestion. Furthermore, the RTD beverage increased measures of energy, focus, concentration, and alertness as compared to placebo. While minor differences in hemodynamic variables were observed between conditions, all values stayed within normal ranges. Individuals aiming to increase energy expenditure may benefit from acute ingestion of an RTD thermogenic supplement.
Collapse
Affiliation(s)
- Christian Rodriguez
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Matthew T Stratton
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Patrick S Harty
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Madelin R Siedler
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Jake R Boykin
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Jacob J Green
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Dale S Keith
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Sarah J White
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Brielle DeHaven
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Alexandra Brojanac
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Ethan Tinoco
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Lem W Taylor
- University of Mary Hardin-Baylor, Human Performance Laboratory, School of Exercise and Sport Science, Belton, TX, USA
| | - Grant M Tinsley
- Texas Tech University, Energy Balance & Body Composition Laboratory; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| |
Collapse
|
21
|
Wang Y, Jiang Y, Luo Y, Lin X, Song M, Li J, Zhao J, Li M, Jiang Y, Yin P, Tang P, Lyu H, Zhang L. Prognostic nutritional index with postoperative complications and 2-year mortality in hip fracture patients: an observational cohort study. Int J Surg 2023; 109:3395-3406. [PMID: 37526114 PMCID: PMC10651254 DOI: 10.1097/js9.0000000000000614] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND The prognostic nutritional index (PNI) has been proposed as a useful prognostic tool in multiple populations. However, its prognostic value has not been fully evaluated in the hip fracture population. We aimed to assess the relationship between PNI and postoperative complications as well as 2-year all-cause mortality in the hip fracture population. MATERIALS AND METHODS We included patients aged 45 or older who underwent surgery for hip fracture between 2000 and 2022. The baseline serum albumin and total lymphocyte count were used to calculate PNI with the following formula: 10×serum albumin level (g/dl)+0.005×total lymphocyte count (per mm 3 ). Patients were classified into low, medium, and high categories based on tertiles of PNI (≤43.23, 43.23-47.35, and >47.35, respectively). Logistic regression and Cox proportional hazards models were used to calculate the odds ratio (OR) for postoperative compilations and the hazard ratio (HR) for mortality, adjusting for potential confounders. RESULTS Of 3351 hip patients, 236 (7.04%) developed postoperative complications, and 305 (9.10%) died during the 2-year follow-up. Compared to the low-category patients, the medium-category and high-category patients showed lower odds of postoperative complications (ORs 0.69, 95% CI 0.48-0.98; and 0.61, 95% CI 0.40-0.93, respectively), and lower hazards of 2-year mortality (HRs 0.66, 95% CI 0.49-0.88; and 0.61, 95% CI 0.42-0.88, respectively). These associations were robust across a series of analyses, including subgroup analyses and dose-response sensitivity analyses. CONCLUSION PNI is an independent predictor of postoperative complications and 2-year all-cause mortality in hip fracture patients. PNI can be used to identify patients who may be at high risk of a poor prognosis.
Collapse
Affiliation(s)
- Yilin Wang
- Medical School of Chinese PLA
- Department of Orthopedics, Chinese PLA General Hospital
| | - Yu Jiang
- Medical School of Chinese PLA
- Department of Orthopedics, Chinese PLA General Hospital
| | - Yan Luo
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Xisheng Lin
- Department of Orthopedics, Chinese PLA General Hospital
- Department of Rehabilitation, the Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Mi Song
- Medical School of Chinese PLA
- Department of Orthopedics, Chinese PLA General Hospital
| | - Jia Li
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Jingxin Zhao
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Ming Li
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Yuheng Jiang
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Pengbin Yin
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Peifu Tang
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Houchen Lyu
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| | - Licheng Zhang
- Department of Orthopedics, Chinese PLA General Hospital
- National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation
| |
Collapse
|
22
|
Zhang D, Sun B, Yi X, Dong N, Gong G, Yu W, Guo L. Prevalence of high blood pressure and its associated factors among students in Shenyang, China: A cross-sectional study. Medicine (Baltimore) 2023; 102:e35536. [PMID: 37861490 PMCID: PMC10589542 DOI: 10.1097/md.0000000000035536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023] Open
Abstract
There is growing evidence that the prevalence of high blood pressure is increasing, and it may have serious consequences. However, research on the prevalence and influencing factors of high blood pressure among primary and secondary school students is still relatively scarce. This study aims to investigate the prevalence and influencing factors of high blood pressure among primary and secondary school students in Shenyang, in order to provide scientific evidence for the prevention and management of this disease. From April to May 2020, 4892 students aged 7 to 17 years were selected as the survey subjects, and on-site physical measurements and questionnaire surveys were conducted. The prevalence of high blood pressure was described. Restricted cubic spline was used to analyze the dose-response relationship between sleep duration, BMI and the risk of high blood pressure. Logistic regression was used to analyze the risk factors. Multiplicative and additive models were used to analyze the interaction between sleep duration and BMI. The results showed that the overall prevalence of high blood pressure among students aged 7 to 17 years in Shenyang was 9.9%, with a higher prevalence in females than males (12.1% vs 7.9%) and in urban areas than suburban areas (11.8% vs 7.7%). The prevalence was lowest in students with normal weight (8.3%) and highest in those who were obese (12.5%). The prevalence fluctuated to some extent among different age groups, but overall, it increased with age, with the lowest prevalence in primary school students (7.0%), 11.4% in mild school students, and the highest prevalence of 14.3% in high school students. Multivariable analysis showed that the risk of high blood pressure in female students was 1.90 times higher than that in male students (95% CI: 1.54-2.35), and the risk in suburban areas was 0.65 times lower than that in urban areas (95% CI: 0.52-0.81). Students with a BMI ≥ 21 kg/m2 had a 1.58 times higher risk than those with a BMI < 21 kg/m2(95% CI: 1.28-1.96), while those with a sleep time ≥ 8 hours had a 0.80 times lower risk than those with a sleep time < 8 hours (95% CI: 0.65-0.99). Exercise can significantly reduce the risk of high blood pressure, while using electronic devices for more than 0.5 hours significantly increases the risk of high blood pressure. BMI and sleep duration have no interaction effect on the risk of high blood pressure. To reduce the prevalence of high blood pressure, students should reduce the use of electronic devices, ensure adequate exercise, maintain a reasonable weight, and ensure sufficient sleep.
Collapse
Affiliation(s)
- Dan Zhang
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Baijun Sun
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Xiaodan Yi
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Nan Dong
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Guifang Gong
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Wenbo Yu
- Department of School Health, Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Lianying Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Shenyang Medical College, Shenyang, China
| |
Collapse
|
23
|
Murgia C, Dehlia A, Guthridge MA. New insights into the nutritional genomics of adult-onset riboflavin-responsive diseases. Nutr Metab (Lond) 2023; 20:42. [PMID: 37845732 PMCID: PMC10580530 DOI: 10.1186/s12986-023-00764-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023] Open
Abstract
Riboflavin, or vitamin B2, is an essential nutrient that serves as a precursor to flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN). The binding of the FAD and/or FMN cofactors to flavoproteins is critical for regulating their assembly and activity. There are over 90 proteins in the human flavoproteome that regulate a diverse array of biochemical pathways including mitochondrial metabolism, riboflavin transport, ubiquinone and FAD synthesis, antioxidant signalling, one-carbon metabolism, nitric oxide signalling and peroxisome oxidative metabolism. The identification of patients with genetic variants in flavoprotein genes that lead to adult-onset pathologies remains a major diagnostic challenge. However, once identified, many patients with adult-onset inborn errors of metabolism demonstrate remarkable responses to riboflavin therapy. We review the structure:function relationships of mutant flavoproteins and propose new mechanistic insights into adult-onset riboflavin-responsive pathologies and metabolic dysregulations that apply to multiple biochemical pathways. We further address the vexing issue of how the inheritance of genetic variants in flavoprotein genes leads to an adult-onset disease with complex symptomologies and varying severities. We also propose a broad clinical framework that may not only improve the current diagnostic rates, but also facilitate a personalized approach to riboflavin therapy that is low cost, safe and lead to transformative outcomes in many patients.
Collapse
Affiliation(s)
- Chiara Murgia
- The School of Agriculture, Food and Ecosystem Sciences (SAFES), Faculty of Science, The University of Melbourne, Parkville, Australia.
| | - Ankush Dehlia
- School of Life and Environmental Sciences, Deakin University, Burwood, Australia
| | - Mark A Guthridge
- School of Life and Environmental Sciences, Deakin University, Burwood, Australia
| |
Collapse
|
24
|
Chen Y, Xu L, Cheng Z, Zhang D, Yang J, Yin C, Li S, Li J, Hu Y, Wang Y, Liu Y, Wang Z, Zhang L, Chen R, Dou Q, Bai Y. Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model. Eur J Prev Cardiol 2023; 30:1482-1491. [PMID: 37315161 DOI: 10.1093/eurjpc/zwad196] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/17/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
AIMS To quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and cardiovascular death, and the effects of risk factors on the rates of transition. METHODS AND RESULTS We used data from the Jinchang Cohort of 42 585 adults aged 20-88 free of coronary heart disease (CHD) and stroke at baseline. A multistate model was applied for analysing the progression of CVD and its relation to various risk factors. During a median follow-up of 7 years, 7498 participants developed pre-diabetes, 2307 developed T2DM, 2499 developed CVD, and 324 died from CVD. Among 15 postulated transitions, transition from comorbid CHD and stroke to cardiovascular death had the highest rate (157.21/1000 person-years), followed by transition from stroke alone to cardiovascular death (69.31/1000 person-years) and transition from pre-diabetes to normoglycaemia (46.51/1000 person-years). Pre-diabetes had a sojourn time of 6.77 years, and controlling weight, blood lipids, blood pressure, and uric acid within normal limits may promote reversion to normoglycaemia. Among transitions to CHD alone and stroke alone, transition from T2DM had the highest rate (12.21/1000 and 12.16/1000 person-years), followed by transition from pre-diabetes (6.81/1000 and 4.93/1000 person-years) and normoglycaemia (3.28/1000 and 2.39/1000 person-years). Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions. CONCLUSION Pre-diabetes was the optimal intervention stage in the disease trajectory. The derived transition rates, sojourn time, and influence factors could provide scientific support for the primary prevention of both T2DM and CVD.
Collapse
Affiliation(s)
- Yarong Chen
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Lulu Xu
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 xueyuan Street, Shenzhen, Guangdong 518055, China
| | - Desheng Zhang
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, 53 Beijing Road, Jinchang, Gansu 737100, China
| | - Jingli Yang
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Chun Yin
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, 53 Beijing Road, Jinchang, Gansu 737100, China
| | - Siyu Li
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Jing Li
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Yujia Hu
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Yufeng Wang
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, 53 Beijing Road, Jinchang, Gansu 737100, China
| | - Yanyan Liu
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Zhongge Wang
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Lizhen Zhang
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Ruirui Chen
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Qian Dou
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| | - Yana Bai
- Institution of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, Gansu 730000, China
| |
Collapse
|
25
|
Rietz H, Pennlert J, Nordström P, Brunström M. Blood Pressure Level in Late Adolescence and Risk for Cardiovascular Events : A Cohort Study. Ann Intern Med 2023; 176:1289-1298. [PMID: 37748180 DOI: 10.7326/m23-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Not enough is known about the association between blood pressure (BP) in adolescence and future cardiovascular events. OBJECTIVE To measure this association using the 2017 American College of Cardiology/American Heart Association guidelines for classifying BP elevation. DESIGN Cohort study. SETTING Sweden. PARTICIPANTS Males in late adolescence who were conscripted into the military from 1969 to 1997. MEASUREMENTS Baseline BP was measured at conscription. The primary outcome was a composite of cardiovascular death or first hospitalization for myocardial infarction, heart failure, ischemic stroke, or intracerebral hemorrhage. RESULTS The study included 1 366 519 males with a mean age of 18.3 years. The baseline BP was classified as elevated (120 to 129/<80 mm Hg) for 28.8% of participants and hypertensive (≥130/80 mm Hg) for 53.7%. During a median follow-up of 35.9 years, 79 644 had a primary outcome. The adjusted hazard ratio was 1.10 for elevated BP (95% CI, 1.07 to 1.13), 1.15 for stage 1 isolated systolic hypertension (ISH) (CI, 1.11 to 1.18), 1.23 for stage 1 isolated diastolic hypertension (IDH) (CI, 1.18 to 1.28), 1.32 for stage 1 systolic-diastolic hypertension (SDH) (CI, 1.27 to 1.37), 1.31 for stage 2 ISH (CI, 1.28 to 1.35), 1.55 for stage 2 IDH (CI, 1.42 to 1.69), and 1.71 for stage 2 SDH (CI, 1.58 to 1.84). The cumulative risk for cardiovascular events also increased gradually across BP stages, ranging from 14.7% for normal BP to 24.3% for stage 2 SDH at age 68 years. LIMITATION This was an observational study of Swedish men. CONCLUSION Increasing BP levels in late adolescence are associated with gradually increasing risks for major cardiovascular events, beginning at a BP level of 120/80 mm Hg. PRIMARY FUNDING SOURCE Västerbotten County Council, Swedish Society for Medical Research, and Heart Foundation of Northern Sweden.
Collapse
Affiliation(s)
- Helene Rietz
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (H.R., J.P., M.B.)
| | - Johanna Pennlert
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (H.R., J.P., M.B.)
| | - Peter Nordström
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden (P.N.)
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (H.R., J.P., M.B.)
| |
Collapse
|
26
|
Sin MK, Cheng Y, Roseman JM, Zamrini E, Ahmed A. Relationships between Late-Life Blood Pressure and Cerebral Microinfarcts in Octogenarians: An Observational Autopsy Study. J Clin Med 2023; 12:6080. [PMID: 37763020 PMCID: PMC10531732 DOI: 10.3390/jcm12186080] [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: 08/11/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Mid-life high blood pressure (BP) is a risk factor for cerebral microinfarcts. Less is known about the relationship between late-life BP and cerebral microinfarcts, the examination of which is the objective of the current study. This case-control study analyzed data from 551 participants (94.6% aged ≥80 years; 58.6% women) in the Adult Changes in Thought (ACT) study who had autopsy data on microinfarcts and four values of systolic and diastolic blood pressure (SBP and DBP) before death. Using the average of four values, SBP was categorized using 10 mmHg intervals; a trend was defined as a ≥10 mmHg rise or fall from the first to fourth values (average gap of 6.5 years). Multivariable-adjusted regression models were used to examine the associations of BP and microinfarcts, adjusting for age, sex, last BP-to-death time, APOE genotype, and antihypertensive medication use. Microinfarcts were present in 274 (49.7%) participants; there were multiple in 51.8% of the participants, and they were located in cortical areas in 40.5%, subcortical areas in 29.6%, and both areas in 29.9% of the participants. All SBP categories (reference of 100-119 mmHg) and both SBP trends were associated with higher odds of both the presence and number of microinfarcts. The magnitude of these associations was numerically greater for subcortical than cortical microinfarcts. Similar associations were observed with DBP. These hypothesis-generating findings provide new information about the overall relationship between BP and cerebral microinfarcts in octogenarians.
Collapse
Affiliation(s)
- Mo-Kyung Sin
- College of Nursing, Seattle University, Seattle, WA 98122, USA
| | - Yan Cheng
- Biomedical Informatics Center and School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA; (Y.C.); (A.A.)
| | - Jeffrey M. Roseman
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Edward Zamrini
- Biomedical Informatics Center and School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA; (Y.C.); (A.A.)
- Irvine Clinical Research, Irvine, CA 92614, USA
- VA Medical Center, Washington, DC 20242, USA
| | - Ali Ahmed
- Biomedical Informatics Center and School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA; (Y.C.); (A.A.)
- VA Medical Center, Washington, DC 20242, USA
- School of Medicine, Georgetown University, Washington, DC 20057, USA
| |
Collapse
|
27
|
Polo-López A, Calatayud J, Núñez-Cortés R, Andersen LL, Moya-Ramón M, López-Bueno R. Dose-Response Association Between Handgrip Strength and Hypertension: A Longitudinal Study of 76,503 European Older Adults. Curr Probl Cardiol 2023; 48:101813. [PMID: 37209803 DOI: 10.1016/j.cpcardiol.2023.101813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Abstract
To examine the prospective dose-response association between handgrip strength and the incidence of hypertension in a representative sample of older European adults. We retrieved data from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, 7, and 8. Handgrip strength was measured and participants reported whether they had a medical diagnosis of hypertension. We assessed the longitudinal dose-response associations of handgrip strength with hypertension using restricted cubic splines. During the follow-up, 27,149 (35.5%) were diagnosed with incident hypertension. At the fully adjusted model, the minimum and optimal dose of handgrip strength for a significant reduction in the risk of hypertension was 28 Kg (HR: 0.92; 95% CI: 0.89-0.96) and 54 Kg (HR: 0.83; 95% CI: 0.78-0.89), respectively. There exists an association between increased handgrip strength and reduced risk of developing hypertension in older European adults.
Collapse
Affiliation(s)
- Ana Polo-López
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Department of Physiotherapy, University of Valencia, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Valencia, Spain
| | | | - Manuel Moya-Ramón
- Sports Research Centre (Department of Sport Sciences), Miguel Hernández University of Elche, Alicante, Spain; Department of Sport Sciences, Miguel Hernandez University, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Rubén López-Bueno
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
28
|
Somnuk S, Komindr S, Monkhai S, Poolsawat T, Nakphaichit M, Wanikorn B. Metabolic and inflammatory profiles, gut microbiota and lifestyle factors in overweight and normal weight young thai adults. PLoS One 2023; 18:e0288286. [PMID: 37450433 PMCID: PMC10348517 DOI: 10.1371/journal.pone.0288286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
Obesity among young adults, especially those living in developing countries is increasing. A high body mass index (BMI) is one of the major causes of several diseases worldwide, constituting an important risk factor for non-communicable diseases (NCDs). Investigations describing the relationship between BMI, clinical and gut microbiota characteristics and lifestyle factors of overweight young adults, especially from Southeast Asian countries are limited. Metabolic and inflammatory biomarkers, fecal microbiota profiles and lifestyle factors were compared between overweight Thai young adults (n = 30, mean age 33 ± 9.48) and those with normal weight (n = 30, mean age 27 ±7.50). This study was registered with the Thai Clinical Trials Registry (TCTR20220204007). Health status including body composition, fasting glucose and insulin, lipid profiles, liver and kidney function, inflammatory biomarkers, blood pressure and fecal microbiota using 16S rRNA gene sequencing data was determined. Dietary intake was assessed using a 3-day dietary record and a food frequency questionnaire (FFQ), with physical activity levels compared using the international physical activity questionnaire (IPAQ). The overweight group had significantly higher BMI, waist-hip ratio, body fat mass, % body fat, skeletal mass, triglyceride level, C-reactive protein, insulin and blood pressure, with lower levels of high-density lipoprotein cholesterol (HDL-C) and blood urea nitrogen compared to the normal weight group. Significant differences in fecal microbiota composition at the family and genus levels were observed between the two groups. In our clinical setting, we also observed that unhealthy diets with high consumption of food rich in fat and sugar, processed meat and alcohol, and physical inactivity were associated with an increased prevalence of overweight in Thai young adults. Results provided the big picture of health and lifestyle characteristics of overweight young Thai people. Young adults should be encouraged to engage in health-promoting activities that maintain healthy bodyweight.
Collapse
Affiliation(s)
- Surasawadee Somnuk
- Department of Sports and Health Sciences, Faculty of Sports Science, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom, Thailand
| | - Surat Komindr
- Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sudjai Monkhai
- Wangnumkeaw Sub-district Health Promotion Hospital, Nakhon Pathom, Thailand
| | - Thitirat Poolsawat
- Department of Biotechnology, Faculty of Agro-Industry, Kasetsart University, Bangkok, Thailand
| | - Massalin Nakphaichit
- Department of Biotechnology, Faculty of Agro-Industry, Kasetsart University, Bangkok, Thailand
| | - Bandhita Wanikorn
- Department of Biotechnology, Faculty of Agro-Industry, Kasetsart University, Bangkok, Thailand
| |
Collapse
|
29
|
de Souza Cazarim M, Cruz-Cazarim ELC, Boyd K, Wu O, Nunes AA. Effect of Medication Therapy Management by Pharmaceutical Care on Blood Pressure and Cardiovascular Risk in Hypertension: A Systematic Review, Meta-Analysis, and Meta-Regression. Pharmaceuticals (Basel) 2023; 16:845. [PMID: 37375792 DOI: 10.3390/ph16060845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
Medication therapy management by pharmaceutical care (MTM-PC) has been shown to improve the effectiveness of antihypertensive treatments. The aim was to answer the question: what are the MTM-PC models and their impact on hypertensive patients' outcomes? This is a systematic review with meta-analysis. The search strategies were run on 27 September 2022 in the following databases: PubMed, EMBASE, Scopus, LILACs, Central Cochrane Library, Web of Science; and International Pharmaceutical Abstracts. The quality and bias risk was assessed by the Downs and Black instrument. Forty-one studies met the eligibility criteria and were included, Kappa = 0.86; 95% CI, 0.66-1.0; (p < 0.001). Twenty-seven studies (65.9%) had MTM-PC models outlined by the clinical team, showing as characteristics the mean of 10.0 ± 10.7 months of follow-up of hypertensive patients, with 7.7 ± 4.9 consultations. Instruments to assess the quality of life measured the enhancement by 13.4 ± 10.7% (p = 0.047). The findings of the meta-analysis show a mean reduction of -7.71 (95% CI, -10.93 to -4.48) and -3.66 (95% CI, -5.51 to -1.80), (p < 0.001) in mmHg systolic and diastolic pressures, respectively. Cardiovascular relative risk (RR) over ten years was 0.561 (95% CI, 0.422 to 0.742) and RR = 0.570 (95% CI, 0.431 to 0.750), considering homogeneous studies, I² = 0%. This study shows the prevalence of MTM-PC models outlined by the clinical team, in which there are differences according to the models in reducing blood pressure and cardiovascular risk over ten years with the improvement in quality of life.
Collapse
Affiliation(s)
- Maurilio de Souza Cazarim
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Federal University of Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil
| | - Estael Luzia Coelho Cruz-Cazarim
- Department of Pharmaceutical Service, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
| | - Kathleen Boyd
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Olivia Wu
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Altacílio Aparecido Nunes
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil
| |
Collapse
|
30
|
Delgadillo-Centeno JS, Grover-Páez F, Hernández-González SO, Ramos-Zavala MG, Cardona-Müller D, López-Castro A, Pascoe-González S. Cinnamomum cassia on Arterial Stiffness and Endothelial Dysfunction in Type 2 Diabetes Mellitus: Outcomes of a Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Med Food 2023. [PMID: 37262194 DOI: 10.1089/jmf.2022.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Cinnamomum cassia is a medicinal plant whose use has demonstrated benefits on body weight, blood pressure, glucose, and lipids. This study aimed to evaluate the effect of C. cassia on arterial stiffness and endothelial dysfunction (ED) in patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled clinical trial was carried out in 18 subjects aged 40-65 years, with a diagnosis of T2DM of one year or less since diagnosis and treated with Metformin 850 mg daily. Patients were randomly assigned to receive either C. cassia or a placebo in 1000 mg capsules, thrice a day, before each meal for 12 weeks. At baseline and after 12 weeks of intervention, brachial-ankle pulse wave velocity and Flow Mediated Dilation were measured, as well as body weight, body mass index (BMI), blood pressure (BP), fasting glucose (FG), glycated hemoglobin A1c (HbA1c), total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and very low density lipoprotein cholesterol, respectively, triglycerides, creatinine, and transaminases. The Mann-Whitney U test for differences between groups and the Wilcoxon signed-rank test for intragroup differences were used, and a P ≤ .05 was considered statistically significant. After C. cassia administration, statistically significant reductions in body weight (81.4 ± 10.4 kg vs. 79.9 ± 9.0 kg, P = .037), BMI (30.6 ± 4.2 kg/m2 vs. 30.1 ± 4.2 kg/m2, P = .018), and HbA1c (53 ± 5.4 mmol/mol vs. 45 ± 2.1 mmol/mol, P = .036) were observed. No changes statistically significant on arterial stiffness, ED, FG, BP, and lipids were observed. C. cassia administration decreases body weight, BMI, and HbA1c without statistically significant changes on arterial stiffness, ED, FG, BP, and lipids. CTR Number: NCT04259606.
Collapse
Affiliation(s)
- Jesús S Delgadillo-Centeno
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Fernando Grover-Páez
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Sandra O Hernández-González
- Unidad de Investigación Biomédica 02. Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Guadalajara, Jalisco, México
| | - María G Ramos-Zavala
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - David Cardona-Müller
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Alicia López-Castro
- Unidad de Investigación Biomédica 02. Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Guadalajara, Jalisco, México
| | - Sara Pascoe-González
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| |
Collapse
|
31
|
Wu J, Han X, Sun D, Zhang J, Li J, Qin G, Deng W, Yu Y, Xu H. Age-specific association of stage of hypertension at diagnosis with cardiovascular and all-cause mortality among elderly patients with hypertension: a cohort study. BMC Cardiovasc Disord 2023; 23:270. [PMID: 37221473 DOI: 10.1186/s12872-023-03250-7] [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: 01/24/2023] [Accepted: 04/19/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Hypertension affects 31.1% of adults worldwide, with higher prevalence of great than 60% in elderly. Advanced hypertension stage was associated with the higher risk of mortality. However, little is known about the age-specific association of stage of hypertension at diagnosis on cardiovascular mortality or all-cause mortality. Therefore, we aim to explore this age-specific association among the hypertensive elderly through stratified and interaction analyses. METHODS This cohort study included 125,978 elderly hypertensive patients aged 60+ years from Shanghai of China. Cox regression was used to estimate the independent and joint effect of hypertension stage and age at diagnosis on cardiovascular and all-cause mortality. Interactions were evaluated both additively and multiplicatively. Multiplicative interaction was examined by the Wald test of the interaction term. Additive interaction was assessed by relative excess risk due to interaction (RERI). All analyses were performed stratified by sex. RESULTS 28,250 patients died during the follow-up up to 8.85 years, and 13,164 died of cardiovascular events. Older age and advanced hypertension stage were risk factors of cardiovascular mortality and all-cause mortality. Besides, smoking, rarely exercise, BMI < 18.5 and diabetes were also the risk factors. When we compared stage 3 hypertension with stage 1 hypertension, hazard ratios (95% confidence interval) of cardiovascular mortality and all-cause mortality were 1.56(1.41-1.72) and 1.29(1.21-1.37) for males aged 60-69 years, 1.25(1.14-1.36) and 1.13(1.06-1.20) for males aged 70-85 years, 1.48(1.32-1.67) and 1.29(1.19-1.40) for females aged 60-69 years, and 1.19(1.10-1.29) and 1.08(1.01-1.15) for females aged 70-85 years, respectively. Negative multiplicative interaction and positive additive interaction between age at diagnosis and stage of hypertension at diagnosis on cardiovascular mortality were observed in males (HR: 0.81, 95% CI: 0.71-0.93 RERI: 0.59, 95% CI: 0.09-1.07) and females (HR: 0.81, 95% CI: 0.70-0.93 RERI: 0.66, 95% CI: 0.10-1.23). CONCLUSIONS Diagnosed with stage 3 hypertension was associated with higher risks of cardiovascular mortality and all-cause mortality, which were stronger among patients with age at diagnosis of 60-69 years compared with those with age at diagnosis of 70-85 years. Therefore, for the younger part of the elderly, the Department of Health should pay more attention to treating patients with stage 3 hypertension.
Collapse
Affiliation(s)
- Jingyi Wu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaojie Han
- The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Di Sun
- Department of Cardiology, Shengli Oilfield Central Hospital, Dongying, Shandong, China
| | - Jie Zhang
- Department of Public Health, Aarhus University, Aarhus, Denmark
- NCRR-National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jiong Li
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Wei Deng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
- , 130 Dong'an Road, Shanghai, 200032, China.
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
- , 130 Dong'an Road, Shanghai, 200032, China.
| | - Huilin Xu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China.
- , 965 Zhong Yi Road, Shanghai, 201101, China.
| |
Collapse
|
32
|
Filatova VA, Rozhivanov RV, Bondarenko IZ, Ioutsi VA, Andreeva EN, Mel'nichenko GA, Mokrysheva NG. [Features of steroidogenesis and arterial hypertension in men in different types of "physiological" male hyperandrogenism]. PROBLEMY ENDOKRINOLOGII 2023; 69:80-91. [PMID: 37448275 DOI: 10.14341/probl13226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 07/15/2023]
Abstract
AIM To reveal the peculiarities of steroidogenesis and arterial hypertension in «physiological» hyperandrogenism in men. MATERIALS AND METHODS One-stage simultaneous study. The groups of men with hyperandrogenism caused by increased total testosterone (n=34) and those with hyperandrogenism caused by increased dihydrotestosterone (DHT) (n=66) were compared. In determining the type of hyperandrogenism and allocating patients to groups, DHT and total testosterone levels were determined by enhanced chemiluminescence. Subgroups of men with and without arterial hypertension were compared in the group of patients with hyperandrogenism due to an increase in total testosterone. Body mass index, waist circumference, systolic and diastolic blood pressure, pulse, and LH, SBHG, estradiol, blood multisteroid levels by isotope dilution liquid chromatography/tandem mass spectrometry, glucose, blood lipid spectrum, uric acid, creatinine, renin, potassium, sodium, and blood chloride were assessed in all patients. Patients with arterial hypertension additionally underwent daily BP monitoring, albuminuria assessment, electrocardiography, ocular fundus examination. The baseline threshold level of significance was p<0.05. For multiple comparisons, the p significance level was calculated using the Bonferroni correction. RESULTS Statistically significant differences were found in the levels of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione, which were higher in men with elevated levels of total testosterone. No statistically significant differences in other laboratory parameters were found. No cases of increased blood pressure were detected in the group of men with elevated DHT. In the group of men with elevated total testosterone, 23,5% of men with arterial hypertension without targetorgan lesions were identified, while hyperandrogenism was associated with 17,6% of cases. Arterial hypertension associated with hyperandrogenism was characterized by a rise in blood pressure in the early morning hours. Estradiol levels, while remaining within normal limits, were statistically significantly lower in patients with arterial hypertension compared with men with elevated testosterone but without hypertension. CONCLUSION No cases of arterial hypertension were observed in «physiological» hyperandrogenism due to elevated DHT levels, whereas its incidence in «physiological» hyperandrogenism due to elevated total testosterone was 23,5%. The features of steroidogenesis were increased production of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione in men with testosterone hyperandrogenism and decreased estradiol production in patients with arterial hypertension compared with patients without testosterone hyperandrogenism.
Collapse
|
33
|
Behl TA, Stamford BA, Moffatt RJ. The Effects of Smoking on the Diagnostic Characteristics of Metabolic Syndrome: A Review. Am J Lifestyle Med 2023; 17:397-412. [PMID: 37304742 PMCID: PMC10248373 DOI: 10.1177/15598276221111046] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Metabolic syndrome is a growing epidemic that increases the risk for cardiovascular disease, diabetes, stroke, and mortality. It is diagnosed by the presence of three or more of the following risk factors: 1) obesity, with an emphasis on central adiposity, 2) high blood pressure, 3) hyperglycemia, 4) dyslipidemia, with regard to reduced high-density lipoprotein concentrations, and 5) dyslipidemia, with regard to elevated triglycerides. Smoking is one lifestyle factor that can increase the risk for metabolic syndrome as it has been shown to exert negative effects on abdominal obesity, blood pressure, blood glucose concentrations, and blood lipid profiles. Smoking may also negatively affect other factors that influence glucose and lipid metabolism including lipoprotein lipase, adiponectin, peroxisome proliferator-activated receptors, and tumor necrosis factor-alpha. Some of these smoking-related outcomes may be reversed with smoking cessation, thus reducing the risk for metabolic disease; however, metabolic syndrome risk may initially increase post cessation, possibly due to weight gain. Therefore, these findings warrant the need for more research on the development and efficacy of smoking prevention and cessation programs.
Collapse
Affiliation(s)
- Taylor A. Behl
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| | - Bryant A. Stamford
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| | - Robert J. Moffatt
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| |
Collapse
|
34
|
Elhakeem A, Taylor AE, Inskip HM, Huang JY, Mansell T, Rodrigues C, Asta F, Blaauwendraad SM, Håberg SE, Halliday J, Harskamp-van Ginkel MW, He JR, Jaddoe VWV, Lewis S, Maher GM, Manios Y, McCarthy FP, Reiss IKM, Rusconi F, Salika T, Tafflet M, Qiu X, Åsvold BO, Burgner D, Chan JKY, Gagliardi L, Gaillard R, Heude B, Magnus MC, Moschonis G, Murray D, Nelson SM, Porta D, Saffery R, Barros H, Eriksson JG, Vrijkotte TGM, Lawlor DA. Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis. Eur Heart J 2023; 44:1464-1473. [PMID: 36740401 PMCID: PMC10119029 DOI: 10.1093/eurheartj/ehac726] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/23/2022] [Accepted: 11/23/2022] [Indexed: 02/07/2023] Open
Abstract
AIMS To examine associations of assisted reproductive technology (ART) conception (vs. natural conception: NC) with offspring cardiometabolic health outcomes and whether these differ with age. METHODS AND RESULTS Differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance markers were examined using multiple linear regression models in 14 population-based birth cohorts in Europe, Australia, and Singapore, and results were combined using meta-analysis. Change in cardiometabolic outcomes from 2 to 26 years was examined using trajectory modelling of four cohorts with repeated measures. 35 938 (654 ART) offspring were included in the meta-analysis. Mean age ranged from 13 months to 27.4 years but was <10 years in 11/14 cohorts. Meta-analysis found no statistical difference (ART minus NC) in SBP (-0.53 mmHg; 95% CI:-1.59 to 0.53), DBP (-0.24 mmHg; -0.83 to 0.35), or HR (0.02 beat/min; -0.91 to 0.94). Total cholesterol (2.59%; 0.10-5.07), HDL cholesterol (4.16%; 2.52-5.81), LDL cholesterol (4.95%; 0.47-9.43) were statistically significantly higher in ART-conceived vs. NC offspring. No statistical difference was seen for triglycerides (TG), glucose, insulin, and glycated haemoglobin. Long-term follow-up of 17 244 (244 ART) births identified statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and TG in young adulthood; however, most differences were not statistically significant. CONCLUSION These findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease.
Collapse
Affiliation(s)
- Ahmed Elhakeem
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Amy E Taylor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Jonathan Y Huang
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore
- Duke-NUS Medical School, Centre for Quantitative Medicine,Singapore, Singapore
| | - Toby Mansell
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Carina Rodrigues
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Federica Asta
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Sophia M Blaauwendraad
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jane Halliday
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Margreet W Harskamp-van Ginkel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Vincent W V Jaddoe
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sharon Lewis
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Fergus P McCarthy
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Irwin K M Reiss
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Franca Rusconi
- Department of Mother and Child Health, Ospedale Versilia, Viareggio, AUSL Toscana Nord Ovest, Pisa, Italy
| | - Theodosia Salika
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Muriel Tafflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Bjørn O Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - David Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Jerry K Y Chan
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Academic Clinical Program in Obstetrics and Gynaecology, Duke-NUS Medical School, Singapore, Singapore
| | - Luigi Gagliardi
- Department of Mother and Child Health, Ospedale Versilia, Viareggio, AUSL Toscana Nord Ovest, Pisa, Italy
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Deirdre Murray
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
- Department of Pediatrics and Child Health, University College Cork, Cork, Ireland
| | - Scott M Nelson
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- School of Medicine, University of Glasgow, Glasgow, UK
| | - Daniela Porta
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Richard Saffery
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia
- University of Melbourne, Parkville, VIC, Australia
| | - Henrique Barros
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Johan G Eriksson
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| |
Collapse
|
35
|
Khanal MK, Bhandari P, Dhungana RR, Gurung Y, Rawal LB, Pandey G, Bhandari M, Bhuiyan R, Devkota S, de Courten M, de Courten B. Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities-based cross-sectional study in Dang district of Nepal. J Diabetes Investig 2023; 14:602-613. [PMID: 36747483 PMCID: PMC10034961 DOI: 10.1111/jdi.13985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/28/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
AIMS/INTRODUCTION The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal. METHODS We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment. RESULTS The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8-8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5-51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01-1.07), higher education (OR 3.50, 95% CI 1.31-9.33), unemployment (OR 3.02, 95% CI 1.08-8.48), body mass index (OR 1.09, 95% CI 1.02-1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19-4.93). The proportion of renal impairment was 3.5% (95% CI 1.5-4.5%) which was associated with older age (OR 1.08, 95% CI 1.00-1.17) and hypertension (OR 12.12, 95% CI 1.07-138.22). CONCLUSION A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.
Collapse
Affiliation(s)
| | | | - Raja Ram Dhungana
- Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Yadav Gurung
- Child and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand
| | - Lal B Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney, NSW, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Sydney, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, NSW, Australia
| | - Gyanendra Pandey
- Dirghayu Polyclinic and Research Center Pvt. Ltd, Tulsipur, Dang, Nepal
| | - Madan Bhandari
- Ministry of Health, Provincial Ayurveda Hospital, Dang, Nepal
| | - Rijwan Bhuiyan
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Surya Devkota
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Maximilian de Courten
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Vic., Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Vic., Australia
| |
Collapse
|
36
|
Yamamoto R, Li Q, Otsuki N, Shinzawa M, Yamaguchi M, Wakasugi M, Nagasawa Y, Isaka Y. A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate: A Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:nu15071592. [PMID: 37049433 PMCID: PMC10097279 DOI: 10.3390/nu15071592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Previous cohort studies have reported conflicting associations between alcohol consumption and chronic kidney disease, characterized by proteinuria and low glomerular filtration rate (GFR). This systematic review, which included 14,634,940 participants from 11 cohort studies, assessed a dose-dependent association of alcohol consumption and incidence of proteinuria and low estimated GFR (eGFR) of <60 mL/min/1.73 m2. Compared with non-drinkers, the incidence of proteinuria was lower in drinkers with alcohol consumption of ≤12.0 g/day (relative risk 0.87 [95% confidence interval 0.83, 0.92]), but higher in drinkers with alcohol consumption of 36.1–60.0 g/day (1.09 [1.03, 1.15]), suggesting a J-shaped association between alcohol consumption and the incidence of proteinuria. Incidence of low eGFR was lower in drinkers with alcohol consumption of ≤12.0 and 12.1–36.0 than in non-drinkers (≤12.0, 12.1–36.0, and 36.1–60.0 g/day: 0.93 [0.90, 0.95], 0.82 [0.78, 0.86], and 0.89 [0.77, 1.03], respectively), suggesting that drinkers were at lower risk of low eGFR. In conclusion, compared with non-drinkers, mild drinkers were at lower risk of proteinuria and low eGFR, whereas heavy drinkers had a higher risk of proteinuria but a lower risk of low eGFR. The clinical impact of high alcohol consumption should be assessed in well-designed studies.
Collapse
Affiliation(s)
- Ryohei Yamamoto
- Health and Counseling Center, Osaka University, Toyonaka 560-0043, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
- Correspondence:
| | - Qinyan Li
- Health and Counseling Center, Osaka University, Toyonaka 560-0043, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| | - Naoko Otsuki
- Health and Counseling Center, Osaka University, Toyonaka 560-0043, Japan
| | - Maki Shinzawa
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| | - Makoto Yamaguchi
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Minako Wakasugi
- Department of Inter-Organ Communication Research, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, Hyogo Medical College, Nishinomiya 663-8501, Japan
| | - Yoshitaka Isaka
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| |
Collapse
|
37
|
Xu Y, Guo Y. Platelet indices and blood pressure: a multivariable mendelian randomization study. Thromb J 2023; 21:31. [PMID: 36941692 PMCID: PMC10026509 DOI: 10.1186/s12959-023-00475-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/10/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Platelet indices are blood-based parameters reflecting the activation of platelets. Previous studies have identified an association between platelet indices and blood pressure (BP). However, causal inferences are prone to bias by confounding effects and reverse causation. We performed a Mendelian randomization (MR) study to compare the causal roles between genetically determined platelet indices and BP levels. METHODS Single-nucleotide polymorphisms (SNPs) associated with platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and BP at the level of genome-wide significance (p < 5 × 10- 8) in the UK Biobank were used as instrumental variables. In bidirectional univariable MR analyses, inverse variance-weighted (IVW), MR‒Egger, and weighted median methods were used to obtain estimates for individual causal power. In addition, heterogeneity and sensitivity analyses were performed to examine the pleiotropy of effect estimates. Finally, multivariable MR analyses were undertaken to disentangle the comparative effects of four platelet indices on BP. RESULTS In the univariable MR analyses, increased levels of PLT and PCT were associated with higher BP, and PDW was associated with higher DBP alone. In the reverse direction, SBP had a minor influence on PLT and PCT. In multivariable MR analysis, PDW and PLT revealed an independent effect, whereas the association for PCT and MPV was insignificant after colinear correction. CONCLUSION These findings suggest that platelets and BP may affect each other. PDW and PLT are independent platelet indices influencing BP. Increased platelet activation and aggregation may be involved in the pathogenesis of hypertension, which may provide insights into evaluating thromboembolic events in people with high BP. The necessity of initiating antiplatelet therapy among hypertension groups needs further investigation.
Collapse
Affiliation(s)
- Yuhan Xu
- School of Medicine, Southeast University, Nanjing, Jiangsu Province, 210009, China
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Yijing Guo
- School of Medicine, Southeast University, Nanjing, Jiangsu Province, 210009, China.
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China.
| |
Collapse
|
38
|
Dunteman AN, Lee SY. Characterizing the effect of sodium reduction and monosodium glutamate supplementation on white and multigrain breads. J Food Sci 2023; 88:1128-1143. [PMID: 36660891 DOI: 10.1111/1750-3841.16460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/10/2022] [Accepted: 12/23/2022] [Indexed: 01/21/2023]
Abstract
Sodium overconsumption has become a serious health concern resulting in the Food and Drug Administration (FDA) publishing voluntary sodium reduction guidelines for a wide spectrum of packaged and processed foods. Reducing sodium through the removal of salt may decrease the palatability of foods, thus increasing the need for new approaches to prevent such palatability loss. The objective of this research was to characterize white and multigrain breads with either 43% or 60% reduction in sodium and with and without monosodium glutamate (MSG) using descriptive analysis methodology as well as to identify the drivers of liking for white and multigrain breads of varying sodium contents with and without MSG. Significant differences were identified in the attributes of salty taste and aftertaste, savory aftertaste, and chewy and firm textures in white bread and of salty taste and aftertaste, sweet taste, and density in multigrain bread. By regressing consumer test data of these breads onto their principal component analysis biplots, textural attributes and salty taste and aftertaste were identified as primary drivers of liking in white and multigrain breads. Flavor enhancers such as MSG show promise in mitigating palatability loss that occurs when the sodium content of bread is greatly reduced and thus provide a promising solution to produce breads with an improved nutritional profile. Future research on flavor enhancement in other food matrices would be valuable as well as in other bread and carbohydrate-based food categories. PRACTICAL APPLICATION: The findings of our study suggest that texture and a salty taste and aftertaste drive consumer liking of reduced-sodium white and multigrain breads and liking of breads could be improved with the addition of monosodium glutamate. Increasing the acceptance of reduced-sodium food products could help to improve the health of the American population by resulting in a reduced risk of hypertension and subsequently heart attacks and stroke.
Collapse
Affiliation(s)
- Aubrey N Dunteman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Soo-Yeun Lee
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| |
Collapse
|
39
|
Cheng YJ, Luo DL, Bi WT, Mei WY, Wu SH, Li ZY, Xie JD. Systolic Blood Pressure and Cardiovascular Risk in Normotensive Adults. Mayo Clin Proc 2023; 98:386-397. [PMID: 36868746 DOI: 10.1016/j.mayocp.2022.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/06/2022] [Accepted: 10/06/2022] [Indexed: 03/05/2023]
Abstract
OBJECTIVE To examine the association of systolic blood pressure (SBP) and cardiovascular risk in normotensive adults. PATIENTS AND METHODS This study analyzed data from 7 prospective cohorts between September 29, 1948, and December 31, 2018. Complete information on history of hypertension and baseline blood pressure measurements were required for inclusion. We excluded individuals younger than 18 years old, those with a history of hypertension, and patients with baseline SBP measurements of less than 90 mm Hg or 140 mm Hg or higher. Cox proportional hazards regression and restricted cubic spline models were used to evaluate the hazards of cardiovascular outcomes. RESULTS A total of 31,033 participants were included. The mean ± SD age was 45.3±14.8 years, 16,693 of the participants (53.8%) were female, and the mean ± SD SBP was 115.8±11.7. Over a median follow-up of 23.5 years, 7005 cardiovascular events occurred. Compared with those who had SBP levels of 90 to 99 mm Hg, participants with SBP levels of 100 to 109, 110 to 119, 120 to 129, and 130 to 139 mm Hg experienced 23% (hazard ratio [HR], 1.23; 95% CI, 1.07 to 1.42), 53% (HR, 1.53; 95% CI, 1.33 to 1.76), 87% (HR, 1.87; 95% CI, 1.62 to 2.16), and 117% (HR, 2.17; 95% CI, 1.87 to 2.52) increased risks of cardiovascular events, respectively. Compared with follow-up SBP of 90 to 99 mm Hg, the HRs for cardiovascular events were 1.25 (95% CI, 1.02 to 1.54), 1.93 (95% CI, 1.58 to 2.34), 2.55 (95% CI, 2.09 to 3.10), and 3.39 (95% CI, 2.78 to 4.14), respectively, for follow-up SBP levels of 100 to 109, 110 to 119, 120 to 129, and 130 to 139 mm Hg. CONCLUSION In adults without hypertension, there is a stepwise increase in risk of cardiovascular events, with increasing SBP starting at levels as low as 90 mm Hg.
Collapse
Affiliation(s)
- Yun-Jiu Cheng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
| | - Dong-Ling Luo
- Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Wen-Tao Bi
- Department of Cardiology the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China; Department of Cardiovascular Medicine, People's Hospital of Macheng City, Macheng, China
| | - Wei-Yi Mei
- Department of Cardiology the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Su-Hua Wu
- Department of Cardiology the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Zhu-Yu Li
- Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
| | - Jing-Dun Xie
- Department of Anesthesiology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
| |
Collapse
|
40
|
Circ_0000284: A risk factor and potential biomarker for prehypertension and hypertension. Hypertens Res 2023; 46:720-729. [PMID: 36543889 DOI: 10.1038/s41440-022-01140-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/26/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022]
Abstract
CircRNAs have been shown to be involved in the development of certain diseases, but their application in prehypertension and hypertension remains unclear. We aimed to explore the potential role of circ_0000284 in revealing the molecular regulatory mechanisms of prehypertension and hypertension. We enrolled a total of 100 patients with normal blood pressure, 100 patients with prehypertension and 100 patients with hypertension. The expression of circ_0000284 among the groups was detected by real-time fluorescence quantitative polymerase chain reaction (qRT‒PCR). Multivariate logistic models were constructed combining conventional risk factors with circ_0000284. A receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of circRNAs in the clinical model. Spearman correlation was used to analyze the correlation of circ_0000284 and the biochemical characteristics of all subjects. The results showed that circ_0000284 was differentially expressed among the normal blood pressure group, prehypertensive group and hypertensive group and showed a significantly upregulated trend in the progression to hypertension (P < 0.05). The ROC curve revealed a high diagnostic ability of circ_0000284 in hypertension in the clinical model (AUC = 0.812). Circ_0000284 also presented a certain ability for early diagnosis of prehypertension (AUC = 0.628). Spearman correlation showed that circ_0000284 was positively correlated with Na and CKMB. Our study suggested that upregulated expression of circ_0000284 was an independent risk factor for prehypertension and hypertension. Circ_0000284 was a potential fingerprint for the early diagnosis of hypertension and distinguished the intermediate stage of hypertension development. Moreover, our study provided new insight into the correlation between circ_0000284 and cardiac injury in the progression to hypertension.
Collapse
|
41
|
Taler SJ. Lowering the Norms for Blood Pressure. Mayo Clin Proc 2023; 98:363-365. [PMID: 36868742 DOI: 10.1016/j.mayocp.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/19/2023] [Indexed: 03/05/2023]
Affiliation(s)
- Sandra J Taler
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
| |
Collapse
|
42
|
Wu S, Li M, Lu J, Tang X, Wang G, Zheng R, Niu J, Chen L, Huo Y, Xu M, Wang T, Zhao Z, Wang S, Lin H, Qin G, Yan L, Wan Q, Chen L, Shi L, Hu R, Su Q, Yu X, Qin Y, Chen G, Gao Z, Shen F, Luo Z, Chen Y, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Li Q, Mu Y, Zhao J, Ning G, Bi Y, Wang W, Xu Y. Blood Pressure Levels, Cardiovascular Events, and Renal Outcomes in Chronic Kidney Disease Without Antihypertensive Therapy: A Nationwide Population-Based Cohort Study. Hypertension 2023; 80:640-649. [PMID: 36601917 DOI: 10.1161/hypertensionaha.122.19902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND High blood pressure (BP) is highly prevalent in patients with chronic kidney disease. However, the thresholds to initiate BP-lowering treatment in this population are unclear. We aimed to examine the associations between BP levels and clinical outcomes and provide evidence on potential thresholds to initiate BP-lowering therapy in people with chronic kidney disease. METHODS This nationwide, multicenter, prospective cohort study included 12 523 chronic kidney disease participants without antihypertensive therapy in mainland China. Participants were followed up during 2011 to 2016 for cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, hospitalized or treated heart failure, and cardiovascular death) and renal events (≥20% decline in the estimated glomerular filtration rate, end-stage kidney disease, and renal death). RESULTS Overall, 652 cardiovascular events and 1268 renal events occurred during 43 970 person-years of follow-up. We observed a positive and linear relationship between systolic BP and risks of cardiovascular and renal events down to 90 mm Hg, as well as between diastolic BP and risks of renal events down to 50 mm Hg. A J-shaped trend was noted between diastolic BP and risks of cardiovascular events, but a linear relationship was revealed in participants <60 years (P for interaction <0.001). A significant increase in the risk of cardiovascular and renal outcomes was observed at systolic BP ≥130 mm Hg (versus 90-119 mm Hg) and at diastolic BP ≥90 mm Hg (versus 50-69 mm Hg). CONCLUSIONS In people with chronic kidney disease, a higher systolic BP/diastolic BP level (≥130/90 mm Hg) is significantly associated with a greater risk of cardiovascular and renal events, indicating potential thresholds to initiate BP-lowering treatment.
Collapse
Affiliation(s)
- Shujing Wu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Xulei Tang
- The First Hospital of Lanzhou University, China (X.T.)
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun, China (G.W.)
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Jingya Niu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, China (J.N.)
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China (L.C.)
| | - Yanan Huo
- Jiangxi People's Hospital, Nanchang, China (Y.H.)
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Hong Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, China (G.Q.)
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China (L.Y.)
| | - Qin Wan
- The Affiliated Hospital of Southwest Medical University, Luzhou, China (Q.W.)
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (L.C.)
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College, China (L.S.)
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, China (R.H.)
| | - Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiao-Tong University School of Medicine, China (Q.S.)
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (X.Y.)
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China (Y.Q., Z.L.)
| | - Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China (G.C.)
| | | | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, China (F.S.)
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China (Y.Q., Z.L.)
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District, China (Y.Z.)
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China (C.L.)
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China (Y.W.)
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China (S.W.)
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, China (T.Y.)
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Q.L.)
| | - Yiming Mu
- Chinese People's Liberation Army General Hospital, Beijing, China (Y.M.)
| | - Jiajun Zhao
- Shandong Provincial Hospital affiliated to Shandong University, Jinan, China (J.Z.)
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.).,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China (S.W., M.L., J.L., R.Z., J.N., M.X., T.W., Z.Z., S.W., H.L., Y.C., G.N., Y.B., W.W., Y.X.)
| | | |
Collapse
|
43
|
Tsai KZ, Huang RY, Cheng WC, Han CL, Huang WC, Sui X, Lavie CJ, Lin GM. Association Between Dental Calculus and Hypertension Phenotypes in Highly Fit Adults: CHIEF Oral Health Study. Am J Hypertens 2023; 36:102-108. [PMID: 36270011 DOI: 10.1093/ajh/hpac119] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/31/2022] [Accepted: 10/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Poor oral health evaluated by presence of dental calculus has been associated with hypertension (HTN) among middle- and old-aged adults. However, it is unclear for the association of HTN phenotypes with dental calculus in young adults. METHODS This study examined the association between dental calculus and HTN in 5,345 military personnel, aged 19-45 years, without antihypertensive medications therapy in Taiwan from 2018 to 2021. Dental calculus was defined as presence of supragingival calculus in any teeth, except impacted teeth, and third molar. Combined HTN (CHTN) was diagnosed as systolic blood pressure (SBP) ≥130 mm Hg and diastolic blood pressure (DBP) ≥80 mm Hg. Isolated systolic and diastolic HTN were, respectively, defined as SBP ≥130 mm Hg only (ISHTN) and DBP ≥80 mm Hg only (IDHTN). Multiple logistic regression with adjustments for sex, age, toxic substance use, anthropometrics, lipid profiles, fasting glucose, and blood leukocyte counts were used to determine the association between dental calculus and HTN phenotypes in young adults. RESULTS The prevalence of those with dental calculus, CHTN, ISHTN, and IDHTN was 20.8%, 10.8%, 10.2%, and 7.0%, respectively. The dental calculus was associated a greater possibility with CHTN [odds ratio (OR) and 95% confidence interval: 1.60 (1.31-1.95)]. However, the associations of dental calculus with ISHTN and IDHTN were null [OR: 1.05 (0.81-1.27) and 1.12 (0.86-1.46), respectively]. CONCLUSIONS Our findings suggest that among young adults, poor oral health manifested by presence of dental calculus was associated with a greater possibility of CHTN, while not for ISHTN and IDHTN.
Collapse
Affiliation(s)
- Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan.,Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan
| | - Ren-Yeong Huang
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan
| | - Wan-Chien Cheng
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Chun Huang
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana, USA
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan.,Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
44
|
Nyulas KI, Germán-Salló M, Fazakas Z, Preg Z, Pál T, Pál S, Tripon RG, Cseh MJ, Simon-Szabó Z, Arbănași EM, Nemes-Nagy E. Relationship between Nutrition, Lifestyle Habits and Laboratory Parameters in Hypertensive Patients with/without Cognitive Dysfunction. Life (Basel) 2023; 13:life13020311. [PMID: 36836668 PMCID: PMC9960921 DOI: 10.3390/life13020311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
(1) Background: Cognitive dysfunction is a major concern in hypertensive patients. Lifestyle habits and nutrition influence laboratory parameters, with an impact on clinical course. The objective of the study was to evaluate nutrition and lifestyle habits in hypertensive patients with/without cognitive dysfunction and establish correlations to laboratory parameters. MATERIAL AND METHODS 50 patients admitted to the Cardiovascular Rehabilitation Clinic in Târgu Mureș were enrolled in this study between March-June 2021. We evaluated their cognitive function, and they filled in a questionnaire about lifestyle and nutrition. Biochemical blood tests were performed using a Konelab Prime 60i analyzer. IBM-SPSS22 and GraphPad InStat3 were used for statistics. RESULTS Mean age of hypertensive patients (n = 50) was 70.42 ± 4.82 (SD) years, half of them had cognitive dysfunction. Zinc deficiency was present in 74% of the subjects. The subgroup with cognitive dysfunction had significantly higher BMI (p = 0.009) and microalbuminuria (p = 0.0479), as well as significantly lower magnesium intake (p = 0.032) and cholesterol intake (p = 0.022), compared to those with normal cognitive status. CONCLUSIONS Nutrition is in a close relationship with laboratory parameters; significant differences (microalbuminuria, cholesterol intake, BMI, etc.) are present between hypertensive patients with/without cognitive dysfunction. A healthy diet is important for the maintenance of metabolic balance, the achievement of optimal body weight, and the prevention of complications.
Collapse
Affiliation(s)
- Kinga-Ilona Nyulas
- Doctoral School of GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Márta Germán-Salló
- Department of Internal Medicine II, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zita Fazakas
- Department of Biochemistry and Chemistry of Environmental Factors, Faculty of Pharmacy, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zoltán Preg
- Department of General Medicine, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Tünde Pál
- Emergency Institute for Cardiovascular Diseases and Transplantation, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Sándor Pál
- Department of Laboratory Medicine, Department of Transfusion Medicine, Medical School, University of Pécs, H-7622 Pécs, Hungary
| | - Robert Gabriel Tripon
- Department of Ophthalmology, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Margit Judit Cseh
- Nutrition and Dietetics Deparment, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zsuzsánna Simon-Szabó
- Department of Pathophysiology, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
- Correspondence: ; Tel.: +40-745-373-525
| | - Emil Marian Arbănași
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Târgu Mureș, Romania
| | - Enikő Nemes-Nagy
- Department of Chemistry and Medical Biochemistry, Faculty of Medicine in English, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| |
Collapse
|
45
|
Dritsas E, Trigka M. Efficient Data-Driven Machine Learning Models for Cardiovascular Diseases Risk Prediction. SENSORS (BASEL, SWITZERLAND) 2023; 23:1161. [PMID: 36772201 PMCID: PMC9921621 DOI: 10.3390/s23031161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Cardiovascular diseases (CVDs) are now the leading cause of death, as the quality of life and human habits have changed significantly. CVDs are accompanied by various complications, including all pathological changes involving the heart and/or blood vessels. The list of pathological changes includes hypertension, coronary heart disease, heart failure, angina, myocardial infarction and stroke. Hence, prevention and early diagnosis could limit the onset or progression of the disease. Nowadays, machine learning (ML) techniques have gained a significant role in disease prediction and are an essential tool in medicine. In this study, a supervised ML-based methodology is presented through which we aim to design efficient prediction models for CVD manifestation, highlighting the SMOTE technique's superiority. Detailed analysis and understanding of risk factors are shown to explore their importance and contribution to CVD prediction. These factors are fed as input features to a plethora of ML models, which are trained and tested to identify the most appropriate for our objective under a binary classification problem with a uniform class probability distribution. Various ML models were evaluated after the use or non-use of Synthetic Minority Oversampling Technique (SMOTE), and comparing them in terms of Accuracy, Recall, Precision and an Area Under the Curve (AUC). The experiment results showed that the Stacking ensemble model after SMOTE with 10-fold cross-validation prevailed over the other ones achieving an Accuracy of 87.8%, Recall of 88.3%, Precision of 88% and an AUC equal to 98.2%.
Collapse
|
46
|
Parati G, Goncalves A, Soergel D, Bruno RM, Caiani EG, Gerdts E, Mahfoud F, Mantovani L, McManus RJ, Santalucia P, Kahan T. New perspectives for hypertension management: progress in methodological and technological developments. Eur J Prev Cardiol 2023; 30:48-60. [PMID: 36073370 DOI: 10.1093/eurjpc/zwac203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/21/2022] [Accepted: 09/05/2022] [Indexed: 01/14/2023]
Abstract
Hypertension is the most common and preventable risk factor for cardiovascular disease (CVD), accounting for 20% of deaths worldwide. However, 2/3 of people with hypertension are undiagnosed, untreated, or under treated. A multi-pronged approach is needed to improve hypertension management. Elevated blood pressure (BP) in childhood is a predictor of hypertension and CVD in adulthood; therefore, screening and education programmes should start early and continue throughout the lifespan. Home BP monitoring can be used to engage patients and improve BP control rates. Progress in imaging technology allows for the detection of preclinical disease, which may help identify patients who are at greatest risk of CV events. There is a need to optimize the use of current BP control strategies including lifestyle modifications, antihypertensive agents, and devices. Reducing the complexity of pharmacological therapy using single-pill combinations can improve patient adherence and BP control and may reduce physician inertia. Other strategies that can improve patient adherence include education and reassurance to address misconceptions, engaging patients in management decisions, and using digital tools. Strategies to improve physician therapeutic inertia, such as reminders, education, physician-peer visits, and task-sharing may improve BP control rates. Digital health technologies, such as telemonitoring, wearables, and other mobile health platforms, are becoming frequently adopted tools in hypertension management, particularly those that have undergone regulatory approval. Finally, to fight the consequences of hypertension on a global scale, healthcare system approaches to cardiovascular risk factor management are needed. Government policies should promote routine BP screening, salt-, sugar-, and alcohol reduction programmes, encourage physical activity, and target obesity control.
Collapse
Affiliation(s)
- Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza (MB), Italy
| | | | - David Soergel
- Cardiovascular, Renal, and Metabolic Drug Development, Novartis, Basel, CH 4056, Switzerland
| | - Rosa Maria Bruno
- Paris Cardiovascular Research Centre (PARCC-INSERM U970) & Université de Paris, Paris 75015, France
| | - Enrico Gianluca Caiani
- Politecnico di Milano, Electronics, Information and Bioengineering Department, Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), National Research Council of Italy (CNR), Milan 20133 & 24-10129, Italy
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, Bergen NO-5020, Norway
| | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology, Intensive Care Medicine, Saarland University Hospital, Homburg 66123, Germany
| | - Lorenzo Mantovani
- Value-based Healthcare Unit, IRCCS MultiMedica Research Hospital, University of Milan, Milan, Italy
| | - Richard J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6HD, UK
| | - Paola Santalucia
- Italian Association Against Thrombosis and Cardiovascular Diseases (ALT Onlus), Milan 20123, Italy
| | - Thomas Kahan
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm SE 182 88, Sweden.,Department of Cardiology, Danderyd University Hospital Corp, Stockholm SE 182 88, Sweden
| |
Collapse
|
47
|
Sobierajski T, Surma S, Romańczyk M, Banach M, Oparil S. Knowledge of Primary Care Patients Living in the Urban Areas about Risk Factors of Arterial Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1250. [PMID: 36674001 PMCID: PMC9858931 DOI: 10.3390/ijerph20021250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
Arterial hypertension (AH), one of the most common diseases of civilization, is an independent risk factor for cardiovascular morbidity and mortality. This disease is the second, after lipid disorders, the most common cardiovascular risk factor and a significant cause of premature death. In Poland, one in three adults (approximately 11 million people) suffers from it. The aim of our survey was to determine patients’ knowledge of the factors (e.g., age, smoking cigarettes, drinking coffee, shift work) that may influence the development of hypertension. The survey was conducted among 205 adult primary care patients living in urban areas. There was a high correlation between patients’ education and risk factors of AH, such: as excess salt in the diet (p = 0.038), smoking electronic cigarettes (p = 0.005), moderate alcohol consumption (p = 0.028), moderate daily physical activity (p = 0.011), female and male sex (p = 0.032 and p = 0.012), air pollution (p < 0.001) and others. In addition, a statistically significant factor shaping patients’ attitudes toward hypertension prevention was the correlation between the respondents’ education and their parents’ prevalence of hypertension (p = 0.40). This study increases the knowledge of patients’ awareness of hypertension. It may serve as guidance for primary care providers to pay special attention to environmental interviews with patients and the patient’s family history for the prevention of hypertension incidence.
Collapse
Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 00-927 Warsaw, Poland
| | - Stanisław Surma
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Monika Romańczyk
- Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, 65-417 Zielona Gora, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93-338 Lodz, Poland
| | - Suzanne Oparil
- Department of Medicine, School of Medicine, University of Alabama at Brimingham, Brimingham, AL 35294, USA
| |
Collapse
|
48
|
Wyszyńska J, Łuszczki E, Sobek G, Mazur A, Dereń K. Association and Risk Factors for Hypertension and Dyslipidemia in Young Adults from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:982. [PMID: 36673736 PMCID: PMC9858900 DOI: 10.3390/ijerph20020982] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
Hypertension and dyslipidemia are major risk factors for cardiovascular disease. Studies on the association between abnormal levels of lipids and hypertension have yielded inconsistent results. The aim of this study was to examine the prevalence of hypertension and dyslipidemia and its risk factors in young Polish adults. Furthermore, the association between plasma lipid levels and the risk of hypertension was determined. A cross-sectional study was conducted among 115 volunteer participants. Blood pressure was measured using an automated oscillometric sphygmomanometer. Blood lipids were analyzed from a fasting blood sample received by finger prick. Body fat percentage was assessed using a bioelectrical impedance analysis device. Socioeconomic and lifestyle factors (age, date of birth, place of residence, screen time, and tobacco use) were self-reported by the participant. The prevalence of hypertension was higher in men than in women (61.5 vs. 21.3%). The prevalence of elevated TC, TG, high LDL, and low HDL was 22.6%, 7.8%, 38.3%, and 13.9%, respectively. Spending more than 2 h daily in front of a computer was identified as a significant predictor of hypertension and elevated TG levels (p < 0.05). A high number of cigarettes smoked daily was a significant risk factor for hypertension (p = 0.047). Hypertension contributed to a higher risk of abnormal values of TC (OR = 5.89), LDL (OR = 5.38), and TG (OR = 9.75). Participants with hypertension were more likely than normotensive subjects to have elevated levels of TC, LDL, and TG. The prevalence of hypertension was significantly higher in young men than in women. BMI was associated with the prevalence of hypertension and elevated TC levels. Spending more than 2 h per day in front of a computer contributed to the prevalence of hypertension and elevated TG levels. Participants with hypertension smoked a higher number of cigarettes daily compared to those with normotension.
Collapse
Affiliation(s)
- Justyna Wyszyńska
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Grzegorz Sobek
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Artur Mazur
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Katarzyna Dereń
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| |
Collapse
|
49
|
Maeda D, Dotare T, Matsue Y, Teramoto K, Sunayama T, Tromp J, Minamino T. Blood pressure in heart failure management and prevention. Hypertens Res 2023; 46:817-833. [PMID: 36604473 DOI: 10.1038/s41440-022-01158-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
Hypertension is a leading cause of heart failure and other cardiovascular diseases. Its role in the pathogenesis of heart failure with reduced ejection fraction (HFrEF) differs from that in heart failure with preserved ejection fraction (HFpEF). Moreover, rigorous blood pressure control may reduce the incidence of heart failure. However, once heart failure develops, prognosis is affected by blood pressure, which may differ between patients with and without heart failure. Therefore, the association between guideline-directed medical therapy (GDMT) for heart failure and its uptitration must be considered for blood pressure management and should not be overlooked. Heart failure medications affect the blood pressure and efficacy per baseline blood pressure value. This review discusses the potential mechanisms by which hypertension leads to HFrEF or HFpEF, the impact of hypertension on incident heart failure, and the recommended approaches for blood pressure management in patients with heart failure. Comparison between patients with and without heart failure regarding blood pressure The association between CV events and SBP is linear in patients without heart failure; however, it becomes J-shaped or inverse linear in those with heart failure. The management of BP, including optimal BP or pharmacotherapy, differs between the two populations. ACEi angiotensin-converting enzyme inhibitors, ARB angiotensin II receptor blockers; ARNi angiotensin receptor-neprilysin inhibitors, BB beta-blockers, BP blood pressure, CV cardiovascular, DASH Dietary Approaches to Stop Hypertension, GDMT guideline-directed medical therapy, HF heart failure, HFrEF heart failure with reduced ejection fraction, MRA mineralocorticoid receptor antagonists, SBP systolic blood pressure, SGLT2i sodium-glucose cotransporter 2 inhibitors.
Collapse
Affiliation(s)
- Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Kanako Teramoto
- National Heart Centre, Singapore, Singapore.,Department of Biostatistics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Jasper Tromp
- Saw Swee Hock School of Public Health, National University of Singapore & the National University Health System, Singapore, Singapore.,Duke-National University of Singapore, Singapore, Singapore.,Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
| |
Collapse
|
50
|
Lu Y, Wiltshire HD, Baker JS, Wang Q, Ying S. Associations between dairy consumption, physical activity, and blood pressure in Chinese young women. Front Nutr 2023; 10:1013503. [PMID: 37113293 PMCID: PMC10126246 DOI: 10.3389/fnut.2023.1013503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/13/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction The prevalence of hypertension (HTN) has been increasing in young adults. A healthy dietary pattern and increasing physical activity (PA) are commonly recommended as lifestyle modifications needed to manage blood pressure (BP). However, little is known about the relationship between dairy intake, PA, and BP in Chinese young women. The aim of this study was to examine whether BP was associated with dairy intake, moderate-to-vigorous intensity physical activity (MVPA) and total physical activity (TPA) in a sample of Chinese young women. Methods A total of 122 women (20.4 ± 1.4) who had complete data sets from the Physical Fitness in Campus (PFIC) study were included in this cross-sectional analysis. Data related to dairy intake and PA was collected using a food frequency questionnaire and an accelerometer. BP was measured following standardized procedures. The association between BP with dairy intake and PA was examined using multivariable linear regression models. Results After controlling for potential covariables, we observed a significant and independent relationship only between systolic BP with dairy intake [standardized beta (b) = -0.275, p < 0.001], MVPA (b = -0.167, p = 0.027), and TPA (b = -0.233, p = 0.002). Furthermore, we found a decrease of 5.82 ± 2.94, 1.13 ± 1.01, and 1.10 ± 0.60 mm Hg in systolic BP for daily additional servings of dairy, 10 min of MVPA, and 100 counts per minute of TPA, respectively. Conclusion Our results suggested that the higher amount of dairy consumption or PA was associated with lower level of SBP in Chinese young women.
Collapse
Affiliation(s)
- Yining Lu
- Faculty of Sport Science, Ningbo University, Ningbo, China
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Huw D. Wiltshire
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Julien S. Baker
- Centre for Population Health and Medical Informatics, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Qiaojun Wang
- Faculty of Sport Science, Ningbo University, Ningbo, China
- *Correspondence: Qiaojun Wang,
| | - Shanshan Ying
- Faculty of Sport Science, Ningbo University, Ningbo, China
| |
Collapse
|