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Hu C, Yu Z, Wei C, Sheng G, Chen J, Zou Y. Evaluating the relative importance of different blood pressure indices in screening for NAFLD: a survey report based on a health examination population. Front Cardiovasc Med 2024; 11:1338156. [PMID: 38742174 PMCID: PMC11089114 DOI: 10.3389/fcvm.2024.1338156] [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: 11/18/2023] [Accepted: 04/18/2024] [Indexed: 05/16/2024] Open
Abstract
Objective While hypertension is a well-recognized risk factor for non-alcoholic fatty liver disease (NAFLD), the specific roles of various common blood pressure measurements [diastolic blood pressure (DBP), systolic blood pressure (SBP), pulse pressure (PP), mean arterial pressure (MAP)] in detecting NAFLD and evaluating the associated risk in adults remain unclear. Methods A retrospective analysis was conducted on 14,251 adult participants undergoing health screenings in the NAfld in the Gifu Area, Longitudinal Analysis project (NAGALA). Following the Z-transformation of the independent variables, we evaluated the relationships between the four blood pressure indices and NAFLD through multivariable logistic regression models. This analysis documented the odds ratio (OR) and 95% confidence interval (CI) for each standard deviation (SD) increase. Additionally, the effectiveness of these indices in identifying NAFLD was comparatively analyzed using receiver operating characteristic (ROC) curves. Results After adequately adjusting for confounders, all blood pressure indices except PP showed a positive correlation with NAFLD. For each SD increment, MAP had the strongest association with NAFLD compared to SBP and DBP. This finding was confirmed in populations without exercise habits, under 60 years of age, with normal blood pressure, and in non-obese groups. Furthermore, based on ROC analysis, MAP was found to have the highest accuracy in identifying NAFLD compared to the other three blood pressure indices. Conclusion Among the four blood pressure indices evaluated, MAP demonstrates the greatest efficacy in identifying NAFLD and assessing its associated risk. These findings underscore the potential of MAP as the most promising blood pressure index for screening NAFLD.
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Affiliation(s)
- Chong Hu
- Department of Gastroenterology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Ziqi Yu
- Munich Medical Research School, LMU Munich, Munich, Germany
| | - Changli Wei
- Department of Gastroenterology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Jianyong Chen
- Department of Gastroenterology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Chou YT, Chen HY, Shen WC, Wu IH, Su FL, Lee WH, Hsu HL, Tai JT, Li CY, Chao TH. Blood pressure levels within normotensive range are independently associated with increased risk of arterial stiffness in adults without hypertension or prehypertension. Nutr Metab Cardiovasc Dis 2023; 33:2363-2371. [PMID: 37788952 DOI: 10.1016/j.numecd.2023.08.009] [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: 06/23/2023] [Revised: 07/30/2023] [Accepted: 08/13/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS High blood pressure (BP) indices, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) predict cardiovascular diseases and mortality. However, the association of these BP indices with arterial stiffness (AS) in the normotensive population (BP < 120/80 mmHg) remains unclear. METHODS AND RESULTS Study participants who underwent health checkups at a tertiary referred center were recruited between November 2018 to December 2019. 2129 participants were enrolled after excluding those aged <18 years old, with elevated BP, history of hypertension, cardiovascular disease, and stroke, or with incomplete data. The brachial-ankle pulse wave velocity (baPWV) values were examined for evaluation of AS. Participants with higher blood pressure indices had significantly higher baPWV. Multiple linear regression revealed that all BP indices were positively associated with baPWV. According to the binary logistic regression analysis, participants in the higher SBP and MAP quartiles were significantly related to AS. The odds ratio (OR) for SBP Q2, Q3 and Q4 vs. Q1 were 6.06, 10.06 and 17.78 whereas the OR for MAP Q2, Q3 and Q4 vs. Q1 were: 5.07, 5.28 and 10.34. For DBP and PP, only participants belonging to the highest quartile were associated with AS(OR for DBP Q4 vs. Q1: 2.51; PP Q4 vs Q1: 1.94). CONCLUSIONS BP indices were linearly related to the baPWV. Normotensive participants with higher quartiles of SBP, DBP, MAP, and PP, remained associated with increased AS. The SBP and MAP levels exhibited a more prominent relationship with AS.
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Affiliation(s)
- Yu-Tsung Chou
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chen Shen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Hsuan Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fei-Lin Su
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Huang Lee
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Lung Hsu
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Gastroenterology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Ting Tai
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ting-Hsing Chao
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Wang J, Shen H, Liu J, Xiao C, Chen C, Teng H, Hu J, Yin J. School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents. BMC Cardiovasc Disord 2021; 21:141. [PMID: 33731001 PMCID: PMC7967982 DOI: 10.1186/s12872-021-01947-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/28/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The predictive importance of visit-to-visit blood pressure variability (VVV) for high blood pressure (HBP) in a pediatric population has been largely unsettled. We aimed to evaluate it based on Health Promotion Program for Children and Adolescents (HPPCA), a school-based surveillance conducted from 2012 to 2018 in Suzhou, China. METHODS A total of 330,618 participants had BP measurement in 2018 and ≥ 3 BP records during 2012-2017, were recruited from HPPCA. Absolute BP values (in mmHg) were converted into age-, sex- and height- normalized z-scores. VVV was expressed as standard deviation (SD), coefficient of variation (CV) or average real variability (ARV) of BP z-scores during 2012-2017. Logistic regression models were used to assess the associations between VVV and HBP in 2018. RESULTS In 2018, 42,554 (12.87%) subjects were defined as HBP. VVV, except for SBP-CV and DBP-CV, was significantly higher in the HBP group than normotensives group. After adjusting for covariates including mean BP values from 2012 to 2017, SBP-SD, SBP-ARV, DBP-SD and DBP-ARV, increased the risk of HBP by 5.70 [95% confidence interval (95% CI) 5.54-5.87], 4.10 (95% CI 4.01-4.20), 4.70 (95% CI 4.50-4.90) and 3.39 (95% CI 3.28-3.50) times, respectively. Notably, SBP-SD significantly improved risk discrimination of HBP based on other risk variables (c-statistics, net reclassification index and integrated discrimination improvement significantly increased). CONCLUSIONS Higher SD or ARV of BP, was independently related with higher probability of HBP in Chinese pediatric population. SBP-SD could be potentially helpful for detecting HBP. Future researches investigating the predictive value of VVV are warrant.
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Affiliation(s)
- Jiaxiang Wang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Hui Shen
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China
| | - Jieyu Liu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Chengqi Xiao
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Cailong Chen
- Children Health Management Center, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Haoyue Teng
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Jia Hu
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, 215004, Jiangsu, China.
| | - Jieyun Yin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China.
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Oliveira-Dantas FF, Browne RAV, Oliveira RS, Cabral LLP, de Farias Junior LF, Costa EC. Effect of High-velocity Resistance Exercise on 24-h Blood Pressure in Hypertensive Older Women. Int J Sports Med 2020; 42:41-47. [PMID: 32785911 DOI: 10.1055/a-1202-1536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated the acute post-exercise effect of high-velocity resistance exercise on ambulatory blood pressure in hypertensive older women. Fourteen volunteers (67.9±5.1 years) performed a high-velocity resistance exercise session (8 exercises using Thera-Band, 3 sets of 6 repetitions as fast as possible in the concentric phase with moderate intensity) and a control session, separated by a 7-10-day period. Ambulatory blood pressure was monitored following 12-h post-sessions and compared between conditions at 1 to 4-h, 5 to 8-h, and 9 to 12-h. Average 24-h ambulatory blood pressure, awake, asleep periods, and blood pressure load were also analyzed. There was a condition by time interaction for systolic ambulatory blood pressure over 12-h post-sessions (P=0.043). It was observed a lower systolic ambulatory blood pressure in the first 4-h period following the high-velocity resistance exercise session compared to the control session (-6.7 mmHg, 95% CI - 11.6 to -1.8 mmHg; P=0.011). No changes were observed for diastolic ambulatory blood pressure over 12-h post-sessions as well as for the other variables analyzed (P>0.05). In summary, a single high-velocity resistance exercise session elicits a post-exercise antihypertensive effect and may be considered as a strategy to acutely improve blood pressure control in hypertensive older women.
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Zhang X, Li Y, Wang Y, Hu K, Tu R, Zhang H, Tian Z, Qiao D, Zhang G, Wang C. Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study. BMJ Open 2019; 9:e029179. [PMID: 31699722 PMCID: PMC6858237 DOI: 10.1136/bmjopen-2019-029179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the relationship between mean arterial pressure (MAP) and coronary heart disease (CHD) in Chinese rural population. In addition, we hypothesised that this relationship might be mediated by some degree of serum lipids. DESIGN This is a cross-sectional study. SETTING The participants were from the Henan Rural Cohort Study, initiated in five rural areas (Tongxu county of Kaifeng city, Yima county of Sanmenxia city, Suiping county of Zhumadian city, Xinxiang county of Xinxiang city and Yuzhou county of Xuchang city) in Henan Province, China, during July 2015 and September 2017. PARTICIPANTS The study included 39 020 subjects aged 18-79 years as current research population. OUTCOME MEASURES Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using an electronic sphygmomanometer. MAP was calculated by one-third SBP plus two-thirds DBP. The study used restricted cubic splines and logistic regression models to evaluate the ORs and 95% CIs. Mediation analysis using bootstrap was performed to examine the contribution of serum lipids to MAP-related CHD. RESULTS The adjusted OR (95% CI) for the highest MAP quartile with the risk of CHD was 1.45 (1.24 to 1.69) compared with the lowest quartile. Simultaneously, each 1-SD increment in MAP was significantly associated with a 12% increased risk of CHD. A linear dose-response relationship between MAP and CHD was found (p value for non-linear=0.1169) in the fully adjusted model. We further reported that 36.07% of proportion explained risk of CHD was mediated through serum lipids. CONCLUSIONS Increased MAP was a significant marker of CHD in Chinese rural population. Meanwhile, the relationship was mediated by some degree of serum lipids, and triglyceride was the strongest mediator. TRIAL REGISTRATION NUMBER Henan Rural Cohort study has been registered at Chinese Clinical Trial Register (ChiCTR-OOC-15006699) and the stage it relates to is Post-results.
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Affiliation(s)
- Xia Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, China
| | - Yanhua Wang
- Department of Encephalopathy District, The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan, China
| | - Kai Hu
- Department of health policy research, Henan Academy of Medical Sciences, Zhengzhou, Henan, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhongyan Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Dou Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Gongyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Ghanbari J, Mohammadpoorasl A, Jahangiry L, Farhangi MA, Amirzadeh J, Ponnet K. Subgroups of lifestyle patterns among hypertension patients: a latent-class analysis. BMC Med Res Methodol 2018; 18:127. [PMID: 30419828 PMCID: PMC6233281 DOI: 10.1186/s12874-018-0607-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 11/02/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hypertension remains one of the most important preventable risk factors for diseases and death. Identifying clustered patterns of modifiable lifestyle risk factors for hypertension and demographics factors related to these clustered patterns allows for targeting health prevention interventions. Therefore, this study aims to identify latent classes of hypertensive patients' lifestyle risk factors based on the clustering of four modifiable lifestyle risk factors: eating, physical activity patterns, smoking habits, and blood pressure control. METHODS A total of 750 patients (Mage = 65.38 years, SDage = 9.2 years) with diagnosed hypertension in urban and rural primary health care centers in Takab (Iran) were recruited randomly from August 2016 to February 2017. Latent class analysis was performed by using proc. LCA in SAS 9.2. RESULTS Three classes of lifestyle patterns were identified. About 14.4% of hypertensive patients were categorized in a low-risk class (I), 54.6% in an intermediate-risk class (II), and 31% in a high-risk class (III) of lifestyle. A one-year increase in age significantly increases the risk of membership in classes II and III. Similarly, being widowed or divorced increases the risk of membership in classes II and III. Also, having a higher education level decreases the risk of membership in classes II and III. CONCLUSIONS This study contributes to the literature on lifestyle behaviors among older adults and provides evidence that there are considerable differences in lifestyle behaviors between subgroups of older adult patients. The three profiles of hypertensive patients' conditions suggest that because behaviors often occur simultaneously within an individual level, a latent-class approach helps cluster co-occurrence risk behaviors and focuses on interventions targeted to several healthy behaviors among high-risk patients.
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Affiliation(s)
- Jalileh Ghanbari
- Health Education and Health Promotion Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Epidemiology and Biostatistics Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Jahangiry
- Health Education and Health Promotion Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Nutrition Research Center, Department of Community Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jamileh Amirzadeh
- Department of Public Health, Health and Paramedical Faculty, Urmia University of Medical Sciences, Nazlou Campus, Urmia, Iran
| | - Koen Ponnet
- Department of Communication Sciences, Faculty of Political and Social Sciences, imec-mict-Ghent University, Ghent, Belgium
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Lefferts WK, Heffernan KS. Cerebral hemodynamics and intracranial aneurysms: Reflecting on pipeline embolization devices. Interv Neuroradiol 2018; 24:631-634. [PMID: 30033786 DOI: 10.1177/1591019918788693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Wesley K Lefferts
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA
| | - Kevin S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA
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Lee MK, Hsu PC, Chu CY, Lee WH, Chen SC, Chen HC, Su HM, Lin TH, Voon WC, Lai WT, Sheu SH. Significant Correlation between Brachial Pulse Pressure Index and Renal Resistive Index. ACTA CARDIOLOGICA SINICA 2016; 31:98-105. [PMID: 27122855 DOI: 10.6515/acs20140821d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The renal resistive index (RI) is calculated as (peak systolic velocity - minimum diastolic velocity)/peak systolic velocity, and has been significantly associated with renal function. Pulse pressure index (PPI) is derived from a formula similar to renal RI, i.e. (systolic blood pressure - diastolic blood pressure)/systolic blood pressure. The purpose of this study was to investigate whether brachial PPI had a significant correlation with renal RI and could be used in identifying patients with impaired renal function. METHODS We consecutively enrolled 255 patients referred for echocardiographic examination. The renal RI was measured from Doppler ultrasonography and blood pressure was measured from an ABI-form device. RESULTS Patients with brachial PPI ≥ 0.428 (mean value of brachial PPI) had a lower estimated glomerular filtration rate (eGFR) than those with brachial PPI < 0.428 (p < 0.001). After the multivariate analysis was completed, brachial PPI had a significant correlation with renal RI (unstandardized coefficient β = 0.53, p < 0.001). The areas under the curve for brachial PPI and renal RI in prediction of eGFR < 45 mL/min/1.73 m(2) were 0.682 and 0.893 (both p < 0.001), respectively. CONCLUSIONS Brachial PPI was significantly correlated with renal RI. Patients with higher brachial PPI had a more reduced renal function. Hence, brachial PPI may be able to quickly reflect the intrarenal vascular hemodynamics, and may serve as an important tool for screening and follow-up for patients with abnormal renovascular resistance. KEY WORDS Chronic kidney disease; Pulse pressure index; Resistive index.
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Affiliation(s)
- Meng-Kuang Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital
| | - Po-Chao Hsu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yuan Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Wen-Hsien Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huang-Chi Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital
| | - Ho-Ming Su
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chol Voon
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Ter Lai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Hsiung Sheu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital; ; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Ayo-Yusuf OA, Omole OB. Snuff use and the risk for hypertension among black South African women. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2008.10873702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Ikewuchi JC, Ikewuchi CC, Ifeanacho MO, Igboh NM. Blood pressure lowering activity of a flavonoid and phytosterol rich extract of the sclerotia of Pleurotus tuberregium (Fr) Sing in salt-loaded rats. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.bionut.2014.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee WH, Hsu PC, Chu CY, Chen SC, Su HM, Lin TH, Lee CS, Yen HW, Voon WC, Lai WT, Sheu SH. Associations of pulse pressure index with left ventricular filling pressure and diastolic dysfunction in patients with chronic kidney disease. Am J Hypertens 2014; 27:454-9. [PMID: 24326205 DOI: 10.1093/ajh/hpt228] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) often have poor vascular compliance and poor left ventricular diastolic dysfunction (LVDD). The pulse pressure index (PPI) defined as ((systolic blood pressure - diastolic blood pressure)/systolic blood pressure) reflects vascular compliance. Vascular compliance is reportedly associated with left ventricular diastolic function. This study of CKD patients investigated whether PPI correlates with the ratio of transmitral E wave velocity (E) to early diastole mitral annulus velocity (Ea) or with LVDD. METHODS This study enrolled 511 CKD patients who had been referred for echocardiographic examination. Blood pressure was automatically measured with an ABI-form device. The LVDD was defined as E-to-transmitral A wave velocity ratio of ≥0.9, Ea <8 cm/s, or E/Ea ≥15. RESULTS Compared with those with E/Ea <15, patients with E/Ea ≥15 had significantly higher systolic blood pressure, pulse pressure, and PPI (all P < 0.001). Multivariable analysis showed that PPI was independently associated with E/Ea (unstandardized coefficient β = 1.348; P < 0.001) and with LVDD (odds ratio = 1.441 per 0.064 increase; P < 0.001). CONCLUSIONS This study showed that increased PPI significantly correlates with elevated E/Ea and LVDD in CKD patients. Because PPI can be rapidly acquired during blood pressure measurement, it may be helpful for identifying CKD patients with a high left ventricular filling pressure and LVDD.
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Affiliation(s)
- Wen-Hsien Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Park JE, Jung H, Lee JE. Dietary pattern and hypertension in Korean adults. Public Health Nutr 2014; 17:597-606. [PMID: 23442232 PMCID: PMC10282319 DOI: 10.1017/s1368980013000219] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 10/29/2012] [Accepted: 01/04/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the dietary pattern associated with hypertension and pre-hypertension among Korean male and female adults. DESIGN Cross-sectional study from a representative sample of the Korean population. SETTING The Korea National Health and Nutrition Examination Survey IV, which was conducted in 2007 and 2008. SUBJECTS Males and females (n 5308) over the age of 20 years. RESULTS Scores for three major dietary patterns ('whole food', 'Western' and 'drinking') were generated using a factor analysis of thirty predefined food groups based on the food items consumed. We used polytomous logistic regression analyses to obtain odds ratios and 95% confidence intervals for pre-hypertension and hypertension. Participants with a high drinking pattern score (moderate to high alcohol intake, salted fermented seafood intake) had a significantly higher prevalence of pre-hypertension or hypertension than those with a lower drinking pattern score; odds for the top quintile v. the bottom quintile were OR = 1·56 (95% CI 1·23, 1·99; P trend = 0·001) for pre-hypertension and OR = 3·05 (95% CI 2·12, 4·40; P trend < 0·001) for hypertension. The whole food pattern was not associated with either pre-hypertension or hypertension, while the Western pattern was associated with the prevalence of hypertension only among men. CONCLUSIONS Our finding warrants further prospective studies to examine whether alcohol drinking and salty food consumption increase the risk of developing hypertension in Koreans.
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Affiliation(s)
- Jong Eun Park
- Department of Food and Nutrition, Sookmyung Women's University, 52 Hyochangwon gil, Yongsan gu, Seoul 140-742, Republic of Korea
| | - Hyeyoung Jung
- Department of Food and Nutrition, Sookmyung Women's University, 52 Hyochangwon gil, Yongsan gu, Seoul 140-742, Republic of Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Sookmyung Women's University, 52 Hyochangwon gil, Yongsan gu, Seoul 140-742, Republic of Korea
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Clinic and ambulatory blood pressure lowering effect of aliskiren/amlodipine/hydrochlorothiazide combination in patients with moderate-to-severe hypertension: a randomized active-controlled trial. J Hypertens 2013; 30:2047-55. [PMID: 22828090 DOI: 10.1097/hjh.0b013e328356b8ea] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the clinic and ambulatory blood pressure (BP)-lowering efficacy and safety of an aliskiren/amlodipine/hydrochlorothiazide (HCT) triple combination compared with the component dual combinations, in patients with moderate-to-severe hypertension. METHODS This 8-week, double-blind, randomized, active-controlled study, after 1-4 weeks single-blind placebo run-in period, randomized 1191 patients to receive once-daily aliskiren/amlodipine 150/5 mg (n = 287), aliskiren/HCT 150/12.5 mg (n = 298), amlodipine/HCT 5/12.5 mg (n = 296), or aliskiren/amlodipine/HCT 150/5/12.5 mg (up-titrated from aliskiren/HCT 150/12.5 mg after initial 3 days) (n = 310) for 4 weeks, followed by forced titration to double the initial dose for the next 4 weeks. RESULTS Baseline mean sitting SBP and DBP (msSBP/msDBP) was comparable among treatment groups. The aliskiren/amlodipine/HCT combination resulted in significant least squares mean reduction in msSBP/msDBP from baseline to endpoints (week 4, -30.7/-15.9 mmHg; week 8, -37.9/-20.6 mmHg), superior (P < 0.001) to each of the dual combinations. The triple combination was associated with -27.8 mmHg reduction in msSBP at week 2, significantly better than the dual combinations (P < 0.05). Significantly greater mean SBP/DBP-lowering effect for triple vs. dual combinations was also demonstrated through 24-h, daytime, and night-time ambulatory BP measurements. Significantly greater (P < 0.001) BP control (msSBP/msDBP < 140/90 mmHg) was achieved with triple combination in patients with moderate-to-severe (62.3%) and severe (57.5%) hypertension. CONCLUSION Aliskiren/amlodipine/HCT at 150/5/12.5 mg (week 4) and 300/10/25 mg (week 8) provided statistically superior reductions in msSBP/msDBP and greater BP control rates vs. the dual combinations, and was well tolerated. The improved efficacy of BP reduction was evident within 2 weeks of initiating triple therapy even at low dose.
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14
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Heck JE, Marcotte EL, Argos M, Parvez F, Ahmed A, Islam T, Sarwar G, Hasan R, Ahsan H, Chen Y. Betel quid chewing in rural Bangladesh: prevalence, predictors and relationship to blood pressure. Int J Epidemiol 2012; 41:462-71. [PMID: 22253307 PMCID: PMC3324453 DOI: 10.1093/ije/dyr191] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2011] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Betel quid is chewed by 600 million people worldwide and it has been linked to obesity and cardiovascular disease. The purpose of our study was to examine the prevalence and predictors of betel quid chewing in a rural area of Bangladesh, and determine its effects on body mass index (BMI) and blood pressure. METHODS In this population-based prospective study, we analysed data on 19 934 Bangladeshi adults. Linear and multivariate logistic regression was used to determine the socio-demographic predictors of betel quid chewing and the effect of betel quid on change in BMI and on systolic and diastolic blood pressure, pulse pressure, arterial pressure, overweight or obesity, and hypertension. RESULTS At baseline, betel quid was chewed by 33.2% of the cohort (35.5% of men, 31.6% of women). In a subsample in which we collected methods of use, 17.5% chewed it without tobacco and 82.5% chewed it with tobacco. In multivariate analysis, betel quid chewing was associated with female sex, older age, tobacco smoking and lower socio-economic status, as measured by fewer years of formal education and not owning land. Betel quid was chewed more times per day among women and older persons. At follow-up, persons who chewed betel quid without tobacco had higher systolic blood pressure, diastolic blood pressure and arterial pressure in comparison with never users. After controlling for other explanatory variables, chewing betel quid without tobacco was associated with general hypertension [odds ratio (OR) 1.48, 95% confidence interval (CI) 1.04-2.10] and systolic hypertension (OR 1.55, 95% CI 1.01-2.37). We did not observe associations of betel quid chewing with BMI or overweight. CONCLUSIONS Betel quid chewing is likely contributing to high blood pressure in Bangladesh, particularly among women.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, University of California, Los Angeles, CA, USA.
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15
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Andersen UO, Marott JL, Jensen GB. Decreasing systolic blood pressure and declining mortality rates in an untreated population: results from the Copenhagen City Heart Study. ACTA ACUST UNITED AC 2011; 18:248-53. [DOI: 10.1177/1741826710389355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ulla O Andersen
- Copenhagen City Heart Study, Copenhagen University Hospital, Denmark
- Division of Cardiology, Holbaek Hospital, Denmark
| | - Jacob L Marott
- Copenhagen City Heart Study, Copenhagen University Hospital, Denmark
| | - Gorm B Jensen
- Copenhagen City Heart Study, Copenhagen University Hospital, Denmark
- Copenhagen University Hospital, Hvidovre, Department of Cardiology, Denmark
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16
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Abstract
OBJECTIVES to compare the mortality rates of elderly demented and nondemented subjects and the differential association of midlife risk factors with mortality according to dementia status. DESIGN : Prospective historical study. SETTINGS community based. PARTICIPANTS from the 10,059 male Jewish civil servants who participated in the Israel Ischemic Heart Disease study in the 1960s, the 1,713 who were evaluated for dementia in 1999/2000 and who were unequivocally classified as demented or nondemented. MEASUREMENTS : Midlife sociodemographic and cardiovascular risk factors, late-life dementia, and mortality. RESULTS over a period of 6 years, 718 (42%) subjects died. Of the 307 demented subjects, 71.8% died and of the 1,407 nondemented subjects, 35.4% died. Multivariate survival analyses showed that compared with subjects without dementia, demented subjects had a hazard ratio [HR] for mortality of 2.27 (95% confidence interval [CI] 1.92-2.68). Other risk factors associated with mortality were socioeconomic status (HR 0.94 [0.88-1.00]), higher systolic (HR 1.16 per 20 mm Hg [1.06-1.28 mm Hg]) and diastolic blood pressure (HR 1.15 per 10 mm Hg [1.06-1.25 mm Hg]), and ever smoking (HR 1.38 [1.18-1.61]). Midlife total cholesterol was not associated with mortality (1.01 per 40 mg/dL [0.93-1.10 mg/dL]). None of the interactions of the risk factors with dementia was significant. CONCLUSIONS dementia was associated with more than double the risk of mortality, but this increased risk did not reflect exacerbation by midlife sociodemographic and cardiovascular risk factors. Our findings suggest that the dementing process itself or its consequences may go beyond well-established midlife risk factors for mortality.
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Affiliation(s)
- Michal Schnaider Beeri
- Department of Psychiatry (MSB), Mount Sinai School of Medicine, New York, NY 10029, USA.
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17
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Baba Y, Ishikawa S, Kayaba K, Gotoh T, Kajii E. High pulse pressure is associated with increased risk of stroke in Japanese: the JMS Cohort Study. Blood Press 2010; 20:10-4. [PMID: 20831451 DOI: 10.3109/08037051.2010.516075] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The relationship between pulse pressure (PP) and stroke has been described in populations outside Japan. Here, we investigated the relationship between PP and stroke incidence in Japan. METHODS Study subjects were 11,097 people (4315 men and 6782 women) in 12 rural areas of Japan enrolled in the Jichi Medical School Cohort Study, a population-based prospective study. The subjects were divided into quintiles of PP. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995, and the incidence of all strokes and stroke subtypes was monitored. RESULTS A total of 412 strokes were observed during a mean follow-up period of 10.7 years. After adjusting for age, smoking status, drinking status, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, body mass index and diabetes mellitus, hazard ratios [HRs] in the second to fifth quintiles of PP for all strokes were 1.06 (95% confidence interval [CI] 0.69-1.64), 1.53 (CI 1.02-2.28), 2.02 (CI 1.38-2.96) and 2.22 (CI 1.53-3.20) compared with the first quintile using Cox's proportional hazard model, respectively. CONCLUSION Our findings suggest high PP is at an increased risk of stroke.
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Affiliation(s)
- Yosuke Baba
- Haga Red Cross Hospital, 2461 Dai-machi, Moka, Tochigi, Japan.
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18
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Abstract
OBJECTIVE The augmentation index, a marker of arterial wave reflection, is considered to indicate cardiovascular risk burden, particularly in younger persons. We assessed whether the easily obtainable radial augmentation index (rAIx) is superior to systolic blood pressure (SBP) or pulse pressure (PP) in detecting atherosclerotic vascular disease at an early age. METHODS We determined rAIx by applanation tonometry, SBP and PP in 152 male patients with or without invasively documented coronary artery disease (CAD). Ejection fraction (EF) was visually estimated by echocardiography or left ventricular angiography. RESULTS In younger patients (age < or =60 years, EF > or =30%), rAIx was significantly higher in patients with CAD (79.8+/-13.5%, n=31) compared with patients without CAD (68.5+/-22.0%, n=21; P = 0.04), whereas SBP (121+/-16 vs. 131+/-18 mmHg, P=0.04) and PP (48.7+/-9.4 vs. 56.3+/-12.1 mmHg, P=0.01) were even lower in patients with CAD compared with patients without CAD. In patients aged < or =60 years, rAIx was highest when EF was less than 30% (90.0+/-9.2%) compared with patients with EF 30-54% (80.7+/-11.5%) or EF > or =55% (72.1+/-20.4%, P=0.01). In contrast, in patients above 60 years of age, rAIx, SBP or PP did not differ between patients with or without CAD and the rAIx tended to be lowest in patients with severely reduced EF (P=0.07). CONCLUSION We conclude that premature vascular disease in younger patients with CAD is reflected only by an elevated rAIx, and not by SBP or PP. The rAIx is not suited to distinguish between older patients with high or low cardiovascular risk. Age seems to influence the interplay between rAIx and systolic heart function.
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Chen YX, Fang CF, Wang X, Nie RQ, Li G, Tang L, Zhou SX, Wang JF. Glucometabolic state of in-hospital primary hypertension patients with normal fasting blood glucose in a sub-population of China. Diabetes Metab Res Rev 2009; 25:357-62. [PMID: 19267335 DOI: 10.1002/dmrr.950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is a high prevalence of abnormal glucometabolism (AGM) in patients with coronary heart disease (CHD) and primary hypertension (PH). However, little is known about the glucometabolic state of PH patients with normal fasting blood glucose (FBG). METHODS Oral glucose tolerance test (OGTT) was performed for 445 in-hospital PH patients with normal FBG and re-performed for those patients with impaired glucose tolerance (IGT) during the follow-up period. RESULTS Diabetes mellitus (DM), IGT, and AGM (including IGT and DM) accounted for 4.4, 24.5, and 28.9% of patients, respectively. Prevalence of AGM in patients with higher haemoglobin A(1c) (HbA(1c)) (> or =6.0%), risk factors (CHD, overweight, hyperlipidaemia, proteinuria) was significantly higher than that in patients without these factors. Regression analysis showed that age, overweight, proteinuria, HbA(1c), and CRP were the independent risk factors of AGM. Follow-up data in 98 IGT patients showed that no improvement of glucometabolism was found, but contrarily, a significant increase of new onset of impaired fasting glucose (IFG) and DM was found after 9 months (P < 0.05), even if diet control and moderate exercise were adopted. CONCLUSIONS AGM is prevalent and underestimated in PH patients with normal FBG, and it will develop even if therapeutic life-style changes are adopted. Except for FBG, more attention should be paid to postprandial blood glucose. OGTT should be a routine procedure for PH patients, especially in-hospital PH patients, regardless of normal FBG, and active drug intervention for IGT patients with PH may be recommended.
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Affiliation(s)
- Yang-Xin Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, Guangdong, China
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20
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Miura K, Nakagawa H, Ohashi Y, Harada A, Taguri M, Kushiro T, Takahashi A, Nishinaga M, Soejima H, Ueshima H. Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies. Circulation 2009; 119:1892-8. [PMID: 19332464 DOI: 10.1161/circulationaha.108.823112] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Information has been sparse on the comparison of 4 blood pressure (BP) indexes (systolic BP [SBP], diastolic BP, pulse pressure, and mean BP [MBP]) in relation to long-term incidence of stroke and myocardial infarction, particularly in middle-aged and older Asians. METHODS AND RESULTS The Japan Arteriosclerosis Longitudinal Study Group conducted a meta-analysis of 16 cohort studies in Japan. A total of 48,224 men and women 40 to 89 years of age participated at baseline, and 1231 stroke events and 220 myocardial infarction events occurred during an average 8.4-year follow-up. Multivariate-adjusted hazard ratios with a 1-SD higher value for each BP index were determined by Poisson regression. Analyses were also done in 4 age-sex groups. All 4 BP indexes were significantly related to all stroke risk. Stroke risk was most strongly related to MBP and SBP in both sexes and most weakly related to pulse pressure. Both stroke subtypes, ischemic and hemorrhagic, were most strongly related to MBP and SBP in both sexes. In addition, in men and women 70 to 89 years of age, MBP or SBP showed the strongest relation to all stroke risk. Myocardial infarction risk was most strongly related to SBP or MBP in both sexes. For any end points in any age-sex groups, pulse pressure was not the strongest predictor. CONCLUSIONS The long-term incident risk of stroke and myocardial infarction associated with high BP in East Asian populations should be assessed mainly on the basis of SBP. MBP also may be an important predictor, but pulse pressure is a less important predictor for cardiovascular disease risk.
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Affiliation(s)
- Katsuyuki Miura
- Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan.
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Peng-Lin Y, Yue-Chun L. Pulse pressure index (pulse pressure/systolic pressure) may be better than pulse pressure for assessment of cardiovascular outcomes. Med Hypotheses 2009; 72:729-31. [PMID: 19231092 DOI: 10.1016/j.mehy.2008.12.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Revised: 12/18/2008] [Accepted: 12/20/2008] [Indexed: 10/21/2022]
Abstract
Pulse pressure (PP) is emerging as a major pressure predictor of cardiac disease. However, there are two major limitations for PP as an evaluation index. First, PP has alterability in the same individual. Second, PP is "floating", it has no relation to an absolute BP level. In order to overcome the defects of PP, we propose a novel parameter, "pulse pressure/systolic pressure" called "pulse pressure index (PPI)" for assessment of cardiovascular outcomes. On the basis of elastic chamber theory, the following equation can be derived: PPI=pulse pressure/systolic pressure=(Cs-Cd)/(Cs-C(0)), (Cs, Cd and C(0), arterial compliance at systolic pressure, diastolic pressure and zero-pressure, respectively). PPI can overcome the defects of PP and become a useful index in clinical evaluation for assessment of cardiovascular outcomes.
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Affiliation(s)
- Yang Peng-Lin
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan Road, Wenzhou, Zhejiang 325000, China.
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22
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Clinical predictors of the response to short-term thiazide treatment in nondiabetic essential hypertensives. J Hum Hypertens 2008; 22:329-37. [DOI: 10.1038/sj.jhh.1002330] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Glucometabolic state of in-hospital patients with primary hypertension in sub-population of partial regions in China. J Hum Hypertens 2008; 22:346-51. [DOI: 10.1038/sj.jhh.1002327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ishikawa S, Kazuomi K, Kayaba K, Gotoh T, Nago N, Nakamura Y, Tsutsumi A, Kajii E. Linear Relationship Between Blood Pressure and Stroke: The Jichi Medical School Cohort Study. J Clin Hypertens (Greenwich) 2007; 9:677-83. [PMID: 17786068 PMCID: PMC8109929 DOI: 10.1111/j.1524-6175.2007.07102.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Hypertension is a major risk for stroke; a linear or J-shaped relationship between blood pressure (BP) and stroke have been reported. The authors examined the relationship between systolic and diastolic BP and risk of stroke in the general population in Japan. The study included 11,097 men and women who were divided into quintiles by systolic BP and diastolic BP in each sex. Follow-up duration was 10.7 years. In men, risks of second to fifth quintiles of systolic BP for all stroke were 1.5 (95% confidence interval [CI], 0.7-3.0), 2.2 (CI, 1.2-4.2), 3.0 (CI, 1.7-5.5), and 4.2 (CI, 2.4-7.6) compared with a reference of the first quintile using Cox's proportional hazard model, respectively. In women, risk of second to fifth quintiles of systolic BP for all stroke were 1.2 (95% CI, 0.6-2.4), 1.5 (CI, 0.8-2.9), 2.2(CI, 1.2-4.1), and 3.1 (CI, 1.7-5.6), respectively. Systolic BP and diastolic BP were related to stroke incidence linearly in the general Japanese population. Systolic BP was slightly more predictive of the risk of stroke than diastolic BP.
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Affiliation(s)
- Shizukiyo Ishikawa
- Divisions of Community and Family Medicine, Jichi Medical University, Tochigi, Japan.
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25
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Walsh T, Donnelly T, Lyons D. Why a Sex Difference in Age-Adjusted Relationship Between Height and Stroke Mortality? Stroke 2007; 38:e92; author reply e93. [PMID: 17673722 DOI: 10.1161/strokeaha.107.489559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mosley WJ, Greenland P, Garside DB, Lloyd-Jones DM. Predictive Utility of Pulse Pressure and Other Blood Pressure Measures for Cardiovascular Outcomes. Hypertension 2007; 49:1256-64. [PMID: 17420336 DOI: 10.1161/hypertensionaha.106.083592] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Data are sparse regarding the actual predictive utility of pulse pressure and other blood pressure measures for cardiovascular events. We included all of the participants from the Chicago Heart Association Detection Project in Industry who were free of cardiovascular disease and not receiving antihypertensive treatment at baseline (1967–1973). Baseline blood pressure measures were assessed for predictive utility for fatal and nonfatal events over 33 years. Among 36 314 participants (mean age: 39±13 years; 43.4% women), there were 11 452 deaths: 745 were attributed to stroke, 2812 to coronary disease, and 599 to heart failure. Of the 16 393 participants who attained Medicare eligibility, 3050, 1367, and 2207 had ≥1 hospitalization for stroke, myocardial infarction, or heart failure, respectively. In univariate analyses, hazards ratios for stroke death per SD of pulse, systolic, and diastolic pressure, respectively, were 1.49, 1.75, and 1.71. Likelihood ratio χ
2
(134.3, 302.0, and 232.6, respectively), Bayes information criteria values (15 142, 14 974, and 15 044, respectively), and areas under receiver-operating characteristic curves (0.59, 0.64, and 0.63, respectively) all indicated better predictive utility for systolic and diastolic compared with pulse pressure. Results for coronary or heart failure death and stroke, myocardial infarction, or heart failure hospitalization were similar. Pulse pressure had weaker predictive utility at all ages but particularly for those <50 years. In this large cohort study, pulse pressure had predictive utility for cardiovascular events that was inferior to systolic or diastolic pressure. These findings support the approach of current guidelines in the use of systolic and diastolic blood pressure to assess risk and the need for treatment.
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Affiliation(s)
- William J Mosley
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago
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27
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Current World Literature. Curr Opin Anaesthesiol 2007; 20:284-6. [PMID: 17479036 DOI: 10.1097/aco.0b013e3281e3380b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zhou X, Ji WJ, Tu Y, Yao M, Li YM. Abdominal aortic aneurysm and cerebral aneurysm present different pathological evolutions and responses to pharmacological therapy. Med Hypotheses 2006; 68:601-6. [PMID: 17030100 DOI: 10.1016/j.mehy.2006.06.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Accepted: 06/28/2006] [Indexed: 10/24/2022]
Abstract
Over-degradation of extracellular components by matrix metalloproteinases (MMPs) has been implicated as an important characteristic during the pathological evolution of the abdominal aortic aneurysm (AAA) and cerebral aneurysm (CA), which contribute to progressive dilation of vascular wall. However, mRNA and protein expression of local rennin-angiotensin system (RAS) components are found down-regulated in CA walls, which is contrary to long-holding concept that local RAS will be activated in response to increased hemodynamic stress and contributes to thickening of arterial wall. Similarly, MMPs inhibition by doxycycline effectively ameliorate AAA expansion in basic and clinical researches, but can not reduce the incidence of CA formation in rat. These evidences may suggest that suppression of RAS favors the regression of AAA, but at an increased risk of CA rupture. As the strategies of RAS blockade have became the optimal antihypertensive drugs of choice in clinical arena, the discrepant responses to pharmacologic intervention of AAA and CA should be received considerable attentions, due to their high prevalence in hypertensive population. Here we proposed that AAA and CA, outward remodeling of elastic and muscular arteries respectively, presented with different pathological evolutions and distinct responses to drug intervention, i.e., RAS and MMPs inhibition. It can not be excluded that the potentially deleterious effects of RAS inhibition on CA may be masked by the beneficial action of controlled blood pressure, and the propagation of CA will be exacerbated once suboptimal dose have been prescribed, or under the condition of stress, even drug withdrawal. If the paradoxical outcomes of these two kinds of arterial remodeling were proven true in basic research, clinical use of RAS blockade should be prudent in hypertensive patients, and routine procedures to detect the existence of CA should be considered. Therefore, in depth investigation in their responses to pharmacological approaches will provide us with more insights into the pathogenesis of arterial aneurysm.
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Affiliation(s)
- Xin Zhou
- Graduate School of Medicine, Tianjin Medical University, Qi-Xiang-Tai Street, Tianjin, China
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