1
|
Jeong S, Linder BA, Barnett AM, Tharpe MA, Hutchison ZJ, Culver MN, Sanchez SO, Nichols OI, Grosicki GJ, Bunsawat K, Nasci VL, Gohar EY, Fuller-Rowell TE, Robinson AT. Interplay of race and neighborhood deprivation on resting and ambulatory blood pressure in young adults. Am J Physiol Heart Circ Physiol 2024; 327:H601-H613. [PMID: 38995211 DOI: 10.1152/ajpheart.00726.2023] [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: 11/17/2023] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024]
Abstract
Nighttime blood pressure (BP) and BP dipping (daytime-nighttime BP) are prognostic for cardiovascular disease. When compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping. Neighborhood deprivation may contribute to disparities in cardiovascular health, but its effects on resting and ambulatory BP patterns in young adults are unclear. Therefore, we examined associations between neighborhood deprivation with resting and nighttime BP and BP dipping in young Black and White adults. We recruited 19 Black and 28 White participants (23 males/24 females, 21 ± 1 yr, body mass index: 26 ± 4 kg/m2) for 24-h ambulatory BP monitoring. We assessed resting BP, nighttime BP, and BP dipping (absolute dip and nighttime:daytime BP ratio). We used the area deprivation index (ADI) to assess average neighborhood deprivation during early and mid-childhood and adolescence. When compared with White participants, Black participants exhibited higher resting systolic and diastolic BP (Ps ≤ 0.029), nighttime systolic BP (114 ± 9 vs. 108 ± 9 mmHg, P = 0.049), diastolic BP (63 ± 8 vs. 57 ± 7 mmHg, P = 0.010), and attenuated absolute systolic BP dipping (12 ± 5 vs. 9 ± 7 mmHg, P = 0.050). Black participants experienced greater average ADI scores compared with White participants [110 (10) vs. 97 (22), P = 0.002], and select ADI scores correlated with resting BP and some ambulatory BP measures. Within each race, select ADI scores correlated with some BP measures for Black participants, but there were no ADI and BP correlations for White participants. In conclusion, our findings suggest that neighborhood deprivation may contribute to higher resting BP and impaired ambulatory BP patterns in young adults warranting further investigation in larger cohorts.NEW & NOTEWORTHY We demonstrate that young Black adults exhibit higher resting blood pressure, nighttime blood pressure, and attenuated systolic blood pressure dipping compared with young White adults. Black adults were exposed to greater neighborhood deprivation, which demonstrated some associations with resting and ambulatory blood pressure. Our findings add to a growing body of literature indicating that neighborhood deprivation may contribute to increased blood pressure.
Collapse
Affiliation(s)
- Soolim Jeong
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Braxton A Linder
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Alex M Barnett
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - McKenna A Tharpe
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Zach J Hutchison
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Meral N Culver
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Sofia O Sanchez
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Olivia I Nichols
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama, United States
| | - Gregory J Grosicki
- Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, United States
| | - Kanokwan Bunsawat
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- George E. Wahlen Department of Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah, United States
| | - Victoria L Nasci
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Eman Y Gohar
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Thomas E Fuller-Rowell
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama, United States
| | - Austin T Robinson
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana, United States
| |
Collapse
|
2
|
Massengale K, Xu Y, Snieder H, Su S, Wang X. A longitudinal study of blood pressure circadian rhythm from childhood to early adulthood. J Hum Hypertens 2024; 38:437-443. [PMID: 38627604 DOI: 10.1038/s41371-024-00911-8] [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: 11/13/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 05/09/2024]
Abstract
Altered blood pressure (BP) circadian rhythmicity has been increasingly linked with cardiovascular risk. However, little is known about BP circadian rhythm change with age and its possible sociodemographic, anthropometric, and genetic moderators. Twenty-four-hour ambulatory BP was measured up to 16 times over a 23-year period in 339 European Americans (EAs) and 293 African Americans (AAs), with an average age of 15 years at the initial visit. BP circadian rhythms were indexed by amplitude and percent rhythm (a measure of rhythm integrity) and calculated using Fourier analysis. BP amplitude and percent rhythm increased with age and average BP (BP mesor). AAs were more likely to have lower BP amplitude and percent rhythm than their EA counterparts. BP amplitude and percent rhythm also decreased with adiposity (BMI and waist circumference). The summer season was associated with lower BP amplitude in AAs and lower percent rhythm in both AAs and EAs. Sex, height, socioeconomic status, physical activity, and family history of essential hypertension did not have an independent impact on BP amplitude or percent rhythm. The results of the present study suggest that BP circadian rhythm increases with age and BP mesor from childhood to young adulthood, decreases with adiposity, and that AAs are more likely to have lower circadian rhythm than EAs. Furthermore, we demonstrated that the summer season is associated with lower BP rhythmicity.
Collapse
Affiliation(s)
| | - Yanyan Xu
- Department of Biostatistics and Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| |
Collapse
|
3
|
An J, Fischer H, Ni L, Xia M, Choi SK, Morrissette KL, Wei R, Reynolds K, Muntner P, Safford MM, Moran AE, Bellows BK, Isasi CR, Allen NB, Xanthakis V, Colantonio LD, Zhang Y. Association Between Young Adult Characteristics and Blood Pressure Trajectories. J Am Heart Assoc 2024; 13:e033053. [PMID: 38563367 PMCID: PMC11262534 DOI: 10.1161/jaha.123.033053] [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: 10/10/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Blood pressure (BP) trajectories from young adulthood through middle age are associated with cardiovascular risk. We examined the associations of hypertension risk factors with BP trajectories among a large diverse sample. METHODS AND RESULTS We analyzed data from young adults, aged 18 to 39 years, with untreated BP <140/90 mm Hg at baseline from Kaiser Permanente Southern California (N=355 324). We used latent growth curve models to identify 10-year BP trajectories and to assess the associations between characteristics in young adulthood and BP trajectories. We identified the following 5 distinct systolic BP trajectories, which appeared to be determined mainly by the baseline BP with progressively higher BP at each year: group 1 (lowest BP trajectory, 7.9%), group 2 (26.5%), group 3 (33.0%), group 4 (25.4%), and group 5 (highest BP trajectory, 7.3%). Older age (adjusted odds ratio for 30-39 versus 18-29 years, 1.23 [95% CI, 1.18-1.28]), male sex (13.38 [95% CI, 12.80-13.99]), obesity (body mass index ≥30 versus 18.5-24.9 kg/m2, 14.81 [95% CI, 14.03-15.64]), overweight (body mass index 25-29.9 versus 18.5-24.9 kg/m2, 3.16 [95% CI, 3.00-3.33]), current smoking (1.58 [95% CI, 1.48-1.67]), prediabetes (1.21 [95% CI, 1.13-1.29]), diabetes (1.60 [95% CI, 1.41-1.81]) and high low-density lipoprotein cholesterol (≥160 versus <100 mg/dL, 1.52 [95% CI, 1.37-1.68]) were associated with the highest BP trajectory (group 5) compared with the reference group (group 2). CONCLUSIONS Traditional hypertension risk factors including smoking, diabetes, and elevated lipids were associated with BP trajectories in young adults, with obesity having the strongest association with the highest BP trajectory group.
Collapse
Affiliation(s)
- Jaejin An
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCAUSA
- Department of Health Systems ScienceKaiser Permanente Bernard J. Tyson School of MedicinePasadenaCAUSA
| | - Heidi Fischer
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCAUSA
| | - Liang Ni
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCAUSA
| | - Mengying Xia
- Division of General MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Soon Kyu Choi
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCAUSA
| | | | - Rong Wei
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCAUSA
| | - Kristi Reynolds
- Department of Research & EvaluationKaiser Permanente Southern CaliforniaPasadenaCAUSA
- Department of Health Systems ScienceKaiser Permanente Bernard J. Tyson School of MedicinePasadenaCAUSA
| | - Paul Muntner
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Monika M. Safford
- Division of General Internal MedicineWeill Cornell MedicineNew YorkNYUSA
| | - Andrew E. Moran
- Division of General MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Brandon K. Bellows
- Division of General MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| | - Carmen R. Isasi
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNYUSA
| | | | - Vanessa Xanthakis
- Department of MedicineBoston University Chobanian and Avedisian School of MedicineBostonMAUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMAUSA
| | | | - Yiyi Zhang
- Division of General MedicineColumbia University Irving Medical CenterNew YorkNYUSA
| |
Collapse
|
4
|
Massengale K, Barnes VA, Williams C, Mansuri A, Norland K, Altvater M, Bailey H, Harris RA, Su S, Wang X. Nocturnal blood pressure dipping, blood pressure variability, and cognitive function in early and middle-aged adults. J Clin Hypertens (Greenwich) 2024; 26:235-240. [PMID: 38332546 PMCID: PMC10918738 DOI: 10.1111/jch.14764] [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: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 02/10/2024]
Abstract
Higher nighttime blood pressure (BP), less BP dipping, and higher BP variability have been linked with worse cognitive function in the elderly. The goal of this study is to explore whether this relationship already exists in early and middle adulthood. We further examined whether ethnic differences between African Americans and European Americans in BP parameters can explain ethnic differences in cognitive function. 24-h ambulatory BP monitoring and cognitive function were obtained from 390 participants (average age: 37.2 years with a range of 25-50; 54.9% African Americans; 63.6% females). We observed that higher nighttime BP, decreased dipping, and higher variability were significantly associated with lower scores on the Picture Sequence Memory Test. Significant negative associations between variability and overall composite scores were also observed. No significant associations between average 24-h or daytime BP and cognitive function were observed. Ethnic differences in nighttime diastolic pressures and dipping can explain 6.81% to 10.8% of the ethnicity difference in the score of the Picture Sequence Memory Test (ps < .05). This study suggests that the associations of nighttime BP, dipping, and variability with cognitive function already exist in young and middle-aged adults. Ethnic differences in nighttime BP and dipping can at least partially explain ethnic differences in cognitive function. The stronger association of these parameters with cognitive function than daytime or average BP in this age range raises the importance of using ambulatory BP monitoring for more precise detection of abnormal BP patterns in young adulthood.
Collapse
Affiliation(s)
| | - Vernon A. Barnes
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Celestin Williams
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Asifhusen Mansuri
- Division of Pediatric Nephrology and HypertensionChildren's Hospital of GeorgiaMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Kimberly Norland
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Michelle Altvater
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Hallie Bailey
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Ryan A. Harris
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Shaoyong Su
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| | - Xiaoling Wang
- Georgia Prevention InstituteMedical College of GeorgiaAugusta UniversityAugustaGeorgiaUSA
| |
Collapse
|
5
|
Baugh A, McIntosh J. Truth and Consequences: Choosing the Best Interpretative Framework for Spirometry. Am J Respir Crit Care Med 2024; 209:6-7. [PMID: 37699143 PMCID: PMC10870875 DOI: 10.1164/rccm.202308-1493ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 09/12/2023] [Indexed: 09/14/2023] Open
Affiliation(s)
- Aaron Baugh
- University of California, San Francisco San Francisco, California
| | | |
Collapse
|
6
|
Xu Y, Barnes VA, Harris RA, Altvater M, Williams C, Norland K, Looney J, Crandall R, Su S, Wang X. Sleep Variability, Sleep Irregularity, and Nighttime Blood Pressure Dipping. Hypertension 2023; 80:2621-2626. [PMID: 37800322 PMCID: PMC10873041 DOI: 10.1161/hypertensionaha.123.21497] [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: 05/11/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Circadian rhythm regulates many important biological functions in humans. The goal of this study is to explore the impact of day-to-day deviations in the sleep-wake cycle on nighttime blood pressure (BP) dipping and further examine whether the ethnic difference in day-to-day deviations in sleep patterns can explain the ethnic difference in nighttime BP dipping. METHODS Twenty-four-hour ambulatory BP monitoring and 7-day accelerometer data were obtained from 365 adult participants (age range, 18.7-50.1 years; 52.6% Black participants and 47.3% European Americans; 64.1% females). Systolic BP dipping level was used to represent nighttime BP dipping. The SD of sleep duration was calculated as the index of sleep variability, and the SD of sleep midpoint was calculated as the index of sleep irregularity. RESULTS A 1-hour increase in the SD of sleep midpoint was associated with a 1.16% decrease in nighttime BP dipping (P<0.001). A 1-hour increase in the SD of sleep duration was associated with a 1.39% decrease in nighttime BP dipping (P=0.017). The ethnic difference in the SD of sleep midpoint can explain 29.2% of the ethnicity difference in BP dipping (P=0.008). CONCLUSIONS Sleep variability and sleep irregularity are associated with blunted BP dipping in the general population. In addition, data from the present investigation also demonstrate that the ethnic difference in sleep irregularity could partly explain the ethnic difference in BP dipping, an important finding that may help reduce the health disparity between Black participants and European Americans.
Collapse
Affiliation(s)
- Yanyan Xu
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
- Center for Biotechnology and Genomic Medicine (Y.X., X.W.), Medical College of Georgia, Augusta University, GA
| | - Vernon A Barnes
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Ryan A Harris
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Michelle Altvater
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Celestine Williams
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Kimberly Norland
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Jacob Looney
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Reva Crandall
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Shaoyong Su
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
| | - Xiaoling Wang
- Georgia Prevention Institute (Y.X., V.A.B., R.A.H., M.A., C.W., K.N., J.L., R.C., S.S., X.W.), Medical College of Georgia, Augusta University, GA
- Center for Biotechnology and Genomic Medicine (Y.X., X.W.), Medical College of Georgia, Augusta University, GA
| |
Collapse
|
7
|
Mohammed H, Chen HB, Li Y, Sabor N, Wang JG, Wang G. Meta-Analysis of Pulse Transition Features in Non-Invasive Blood Pressure Estimation Systems: Bridging Physiology and Engineering Perspectives. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2023; 17:1257-1281. [PMID: 38015673 DOI: 10.1109/tbcas.2023.3334960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
The pulse transition features (PTFs), including pulse arrival time (PAT) and pulse transition time (PTT), hold significant importance in estimating non-invasive blood pressure (NIBP). However, the literature showcases considerable variations in terms of PTFs' correlation with blood pressure (BP), accuracy in NIBP estimation, and the comprehension of the relationship between PTFs and BP. This inconsistency is exemplified by the wide-ranging correlations reported across studies investigating the same feature. Furthermore, investigations comparing PAT and PTT have yielded conflicting outcomes. Additionally, PTFs have been derived from various bio-signals, capturing distinct characteristic points like the pulse's foot and peak. To address these inconsistencies, this study meticulously reviews a selection of such research endeavors while aligning them with the biological intricacies of blood pressure and the human cardiovascular system (CVS). Each study underwent evaluation, considering the specific signal acquisition locale and the corresponding recording procedure. Moreover, a comprehensive meta-analysis was conducted, yielding multiple conclusions that could significantly enhance the design and accuracy of NIBP systems. Grounded in these dual aspects, the study systematically examines PTFs in correlation with the specific study conditions and the underlying factors influencing the CVS. This approach serves as a valuable resource for researchers aiming to optimize the design of BP recording experiments, bio-signal acquisition systems, and the fine-tuning of feature engineering methodologies, ultimately advancing PTF-based NIBP estimation.
Collapse
|
8
|
Jeong S, Linder BA, Barnett AM, Tharpe MA, Hutchison ZJ, Culver MN, Sanchez SO, Nichols OI, Grosicki GJ, Bunsawat K, Nasci VL, Gohar EY, Fuller-Rowell TE, Robinson AT. Interplay of Race and Neighborhood Deprivation on Ambulatory Blood Pressure in Young Adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.11.23295160. [PMID: 37745604 PMCID: PMC10516077 DOI: 10.1101/2023.09.11.23295160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Background Ambulatory blood pressure (BP) monitoring measures nighttime BP and BP dipping, which are superior to in-clinic BP for predicting cardiovascular disease (CVD), the leading cause of death in America. Compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping, including in young adulthood. Social determinants of health contribute to disparities in CVD risk, but the contribution of neighborhood deprivation on nighttime BP is unclear. Therefore, we examined associations between neighborhood deprivation with nighttime BP and BP dipping in young Black and White adults. Methods We recruited 21 Black and 26 White participants (20 M/27 F, mean age: 21 years, body mass index: 25±4 kg/m2) for 24-hour ambulatory BP monitoring. We assessed nighttime BP and BP dipping (nighttime:daytime BP ratio). The area deprivation index (ADI) was used to measure neighborhood deprivation. Associations between ADI and ambulatory BP were examined. Results Black participants exhibited higher nighttime diastolic BP compared with White participants (63±8 mmHg vs 58±7 mmHg, p=0.003), and attenuated BP dipping ratios for both systolic (0.92±0.06 vs 0.86±0.05, p=0.001) and diastolic BP (0.86±0.09 vs 0.78±0.08, p=0.007). Black participants experienced greater neighborhood deprivation compared with White participants (ADI scores: 110±8 vs 97±21, p<0.001), and ADI was associated with attenuated systolic BP dipping (ρ=0.342, p=0.019). Conclusions Our findings suggest neighborhood deprivation may contribute to higher nighttime BP and attenuated BP dipping, which are prognostic of CVD, and more prevalent in Black adults. Targeted interventions to mitigate the effects of neighborhood deprivation may help to improve nighttime BP. Clinical Trial Registry URL: https://www.clinicaltrials.gov; Unique identifier: NCT04576338.
Collapse
Affiliation(s)
- Soolim Jeong
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - Braxton A. Linder
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - Alex M. Barnett
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - McKenna A. Tharpe
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - Zach J. Hutchison
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - Meral N. Culver
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - Sofia O. Sanchez
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| | - Olivia I. Nichols
- Department of Human Development and Family Studies, Auburn University, Auburn, AL, USA 36849
| | - Gregory J. Grosicki
- Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, GA, USA 31419
| | - Kanokwan Bunsawat
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT, USA 84132
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA 84148
| | - Victoria L. Nasci
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA 37232
| | - Eman Y. Gohar
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA 37232
| | - Thomas E. Fuller-Rowell
- Department of Human Development and Family Studies, Auburn University, Auburn, AL, USA 36849
| | - Austin T. Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, AL, USA 36849
| |
Collapse
|
9
|
Omboni S, Khan NA, Kunadian V, Olszanecka A, Schutte AE, Mihailidou AS. Sex Differences in Ambulatory Blood Pressure Levels and Subtypes in a Large Italian Community Cohort. Hypertension 2023; 80:1417-1426. [PMID: 37315119 DOI: 10.1161/hypertensionaha.122.20589] [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: 11/02/2022] [Accepted: 04/11/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sex differences in blood pressure control are recognized. We systematically investigated sex differences in specific components of ambulatory blood pressure (ABP), including variability, day-night changes, morning surge, and hypertension types. METHODS We analyzed ABPs of 52 911 participants (45.6% male, 54.4% female, 37.0% treated for hypertension) visiting 860 Italian community pharmacies. Sex differences in ABP levels and patterns were evaluated in the whole group and 4 risk groups (antihypertensive-treated patients, patients with diabetes, dyslipidemia, or cardiovascular disease). RESULTS Average 24-hour, day-time, and night-time blood pressure values were consistently higher in males than females (P<0.001). Variability in ABP was higher in females, except during the night. Nondippers and an abnormal morning surge were more common among males (odds ratio and 95% CI, 1.282 [1.230-1.335] and 1.244 [1.159-1.335]; P<0.001). The prevalence of 24-hour and masked hypertension was higher in males (odds ratio and 95% CI, 2.093 [2.019-2.170] and 1.347 [1.283-1.415]; P<0.001) and that of white-coat hypertension in females (0.719 [0.684-0.755]; P<0.001). Ambulatory heart rate mean values were higher (P<0.001) in females. Day-time HR variability was higher and night-time heart rate variability lower in females (P<0.001). Sex differences in ABP levels and patterns detected in the whole population were replicated in all risk groups, except for the prevalence of abnormal morning surge (between sexes difference in antihypertensive-treated participants only). CONCLUSIONS Females show better ABP control than males, but with an increased blood pressure variability and a greater prevalence of white-coat hypertension. These findings support tailored management of hypertension. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03781401.
Collapse
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy (S.O.)
- Department of Cardiology, Sechenov First Moscow State Medical University, Russian Federation (S.O.)
| | - Nadia A Khan
- Department of Medicine, University of British Columbia, Vancouver, Canada (N.A.K.)
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University (V.K.), Newcastle upon Tyne, United Kingdom
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust (V.K.), Newcastle upon Tyne, United Kingdom
| | - Agnieszka Olszanecka
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Krakow, Poland (A.O.)
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, Australia (A.E.S.)
- Hypertension in Africa Research Team, South African Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (A.E.S.)
| | - Anastasia S Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital (A.S.M.), Sydney, New South Wales, Australia
- Macquarie University (A.S.M.), Sydney, New South Wales, Australia
| |
Collapse
|
10
|
van der Heijden LB, Groothoff JW, Feskens EJ, Janse AJ. Office blood pressure versus ambulatory blood pressure measurement in childhood obesity. BMC Pediatr 2023; 23:205. [PMID: 37120521 PMCID: PMC10148489 DOI: 10.1186/s12887-023-04010-4] [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: 08/05/2022] [Accepted: 04/13/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND The prevalence of obesity-related co-morbidities is rising parallel to the childhood obesity epidemic. High blood pressure (BP), as one of these co-morbidities, is detected nowadays at increasingly younger ages. The diagnosis of elevated BP and hypertension, especially in the childhood population, presents a challenge to clinicians. The added value of ambulatory blood pressure measurement (ABPM) in relation to office blood pressure (OBP) measurements in obese children is unclear. Furthermore, it is unknown how many overweight and obese children have an abnormal ABPM pattern. In this study we evaluated ABPM patterns in a population of overweight and obese children and adolescents, and compared these patterns with regular OBP measurements. METHODS In this cross-sectional study in overweight or obese children and adolescents aged 4-17 years who were referred to secondary pediatric obesity care in a large general hospital in The Netherlands, OBP was measured during a regular outpatient clinic visit. Additionally, all participants underwent a 24-hour ABPM on a regular week-day. Outcome measures were OBP, mean ambulatory SBP and DBP, BP load (percentage of readings above the ambulatory 95th blood pressure percentiles), ambulatory BP pattern (normal BP, white-coat hypertension, elevated BP, masked hypertension, ambulatory hypertension), and BP dipping. RESULTS We included 82 children aged 4-17 years. They had a mean BMI Z-score of 3.3 (standard deviation 0.6). Using ABPM, 54.9% of the children were normotensive (95% confidence interval 44.1-65.2), 26.8% had elevated BP, 9.8% ambulatory hypertension, 3.7% masked hypertension, and 4.9% white-coat hypertension. An isolated night-time BP load > 25% was detected in almost a quarter of the children. 40% of the participants lacked physiologic nocturnal systolic BP dipping. In the group of children with normal OBP, 22.2% turned out to have either elevated BP or masked hypertension on ABPM. CONCLUSIONS In this study a high prevalence of abnormal ABPM patterns in overweight or obese children and adolescents was detected. Additionally, OBP poorly correlated with the child's actual ABPM pattern. Herewith, we emphasized the usefulness of ABPM as an important diagnostic tool in this population.
Collapse
Affiliation(s)
- Laila B van der Heijden
- Department of Pediatrics, Hospital Gelderse Vallei, P.O. Box 9025, Ede, 6710 HN, The Netherlands.
| | - Jaap W Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Edith Jm Feskens
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, Wageningen, 6700 AA, The Netherlands
| | - Arieke J Janse
- Department of Pediatrics, Hospital Gelderse Vallei, P.O. Box 9025, Ede, 6710 HN, The Netherlands
| |
Collapse
|
11
|
Pagi R, Yadin O, Wesseling-Perry K, Norris K, Laster ML. Racial-ethnic diversity in ambulatory blood pressure monitoring in children with chronic kidney disease. Pediatr Nephrol 2023; 38:819-827. [PMID: 35802270 PMCID: PMC9842582 DOI: 10.1007/s00467-022-05659-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Black adults with chronic kidney disease (CKD) have higher rates of hypertension as compared to White adults with CKD. Little is known of how race and ethnicity associate with the prevalence of hypertension in pediatric CKD patients. The aim was to compare ambulatory blood pressure monitoring (ABPM) results for patients with CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study across racial-ethnic groups. METHODS Patients from the CKiD study who identified as non-Hispanic White, non-Hispanic Black, or Hispanic were included to analyze differences in ABPM results across these racial-ethnic groups. The outcomes were fitted using 3 progressively adjusted models. RESULTS This study included 501 CKiD participants with at least one successful ABPM study. Compared to White participants, Black participants had 4.2 mmHg higher mean sleep systolic blood pressure and 2.7 mmHg higher mean sleep diastolic blood pressure (p = 0.001 and p = 0.004, respectively). Additionally, Black participants had higher odds of abnormal wake systolic load (OR 1.88, 1.21-2.91, p = 0.005), wake diastolic load (OR 1.68, 1.03-2.73, p = 0.04), sleep systolic load (OR 2.19, 1.36-3.5, p = 0.001), sleep diastolic load (OR 2.01, 1.28-3.15, p = 0.002), systolic non-dipping (OR 2.02, 1.31-3.10, p = 0.001), and diastolic non-dipping (OR 2.69, 1.60-4.51, p < 0.001). Compared to White participants, Hispanic participants demonstrated only a lower sleep diastolic load (OR 0.54, 0.31-0.95, p = 0.03). CONCLUSIONS Black children with CKD have higher absolute nocturnal blood pressures and higher rates of abnormal dipping. Further studies are needed to determine the etiology of these differences and the clinical implications of racial-ethnic differences in ABPM outcomes within the pediatric CKD population. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Reut Pagi
- Department of Pediatrics, Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA
| | - Ora Yadin
- Department of Pediatrics, Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA
| | - Katherine Wesseling-Perry
- Department of Pediatrics, Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA
| | - Keith Norris
- Department of Pediatrics, Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA
- Department of Medicine, Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Marciana Lee Laster
- Department of Pediatrics, Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, MDCC A2-383, Los Angeles, CA, 90095-1752, USA.
| |
Collapse
|
12
|
Hanevold CD. Racial-ethnic disparities in childhood hypertension. Pediatr Nephrol 2023; 38:619-623. [PMID: 35962260 DOI: 10.1007/s00467-022-05707-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Coral D Hanevold
- Professor Emeritus of Pediatrics, Division of Nephrology, University of Washington, Seattle, WA, USA.
| |
Collapse
|
13
|
Holzer DW, Counts CJ, Ashmore EP, Hammock C, John-Henderson N. Childhood environments and their relationship with sleep and ambulatory blood pressure in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:190-199. [PMID: 33759718 PMCID: PMC8460682 DOI: 10.1080/07448481.2021.1885414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/23/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
Objective: Investigate whether psychosocial risk in the childhood family environment moderates the relationship between childhood socioeconomic status (SES) and sleep, and the relationship between childhood SES and ambulatory blood pressure (ABP) in college students, two factors that are linked to future risk for cardiovascular disease. Participants: 124 American college students. Methods: Childhood SES and psychosocial risk in childhood family environments were measured by self-report instruments. Sleep was measured with self-report and actigraphy (over 5 days) and ABP over a 2-day period. Results: Linear regressions adjusting for age, sex, current SES, and current depressive symptoms indicated that SES and psychosocial risk in family environments during childhood interact to inform sleep quality, actigraphy derived wake after sleep onset (WASO), actigraphy derived Sleep Efficiency (SE) and ABP. Conclusions: Psychosocial risk in the childhood family environment may offset previously documented relationships between childhood SES and health-relevant outcomes in college students.
Collapse
|
14
|
Ghazi L, Annabathula RV, Bello NA, Zhou L, Stacey RB, Upadhya B. Hypertension Across a Woman's Life Cycle. Curr Hypertens Rep 2022; 24:723-733. [PMID: 36350493 PMCID: PMC9893311 DOI: 10.1007/s11906-022-01230-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE OF REVIEW We reviewed the effects of hypertension and the means to prevent and treat it across the spectrum of a woman's lifespan and identified gaps in sex-specific mechanisms contributing to hypertension in women that need to be addressed. RECENT FINDINGS Hypertension continues to be an important public health problem for women across all life stages from adolescence through pregnancy, menopause, and older age. There remain racial, ethnic, and socioeconomic differences in hypertension rates not only overall but also between the sexes. Blood pressure cutoffs during pregnancy have not been updated to reflect the 2017 ACC/AHA changes due to a lack of data. Additionally, the mechanisms behind hypertension development in menopause, including sex hormones and genetic factors, are not well understood. In the setting of increasing inactivity and obesity, along with an aging population, hypertension rates are increasing in women. Screening and management of hypertension throughout a women's lifespan are necessary to reduce the burden of cardiovascular disease, and further research to understand sex-specific hypertension mechanisms is needed.
Collapse
Affiliation(s)
- Lama Ghazi
- Department of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, USA
| | - Rahul V Annabathula
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA
| | - Natalie A Bello
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA
| | - Li Zhou
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA
| | - Richard Brandon Stacey
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA
| | - Bharathi Upadhya
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA.
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
| |
Collapse
|
15
|
Hines AL, Brody R, Zhou Z, Collins SV, Omenyi C, Miller ER, Cooper LA, Crews DC. Contributions of Structural Racism to the Food Environment: A Photovoice Study of Black Residents With Hypertension in Baltimore, MD. Circ Cardiovasc Qual Outcomes 2022; 15:e009301. [PMID: 36378767 PMCID: PMC9710204 DOI: 10.1161/circoutcomes.122.009301] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Disproportionate exposure to poor food environments and food insecurity among Black Americans may partially explain critical chronic disease disparities by race and ethnicity. A complex set of structural factors and interactions between Black residents and their food environments, including store types, quantity, proximity, and quality of goods and consumer interactions within stores, may affect nutritional behaviors and contribute to higher cardiovascular and kidney disease risk. METHODS We used the Photovoice methodology to explore the food environment in Baltimore, MD, through the perspectives of Black residents with hypertension between August and November 2019. Twenty-four participants were enrolled in the study (mean age: 65.1 years; 67% female). After a brief photography training, participants captured photos of their food environment, which they discussed in small focus groups over the course of 5 weeks. Discussions were audiotaped and analyzed for emergent themes using a line-by-line inductive approach. Themes were, then, organized into a collective narrative. RESULTS Findings describe physical and social features of the food environment as well as participants' perceptions of its origins and holistic and generational health effects. The study illustrates the interrelationships among the broader socio-political environment, the quality and quantity of stores in the food landscape, and the ways in which they engage with the food environment as residents and consumers who have been marginalized due to their race and/or social class. The following meta-themes emerged from the data: (1) social injustice; (2) structural racism and classism; (3) interpersonal racism; (4) generational effects; (5) mistrust; (6) social programs; and (7) community asset-based approaches, including advocacy and civic engagement. CONCLUSIONS Understanding residents' perceptions of the foundations and effects of the food environment on their health may help stakeholders to cocreate multilevel interventions alongside residents to improve access to healthy food and health outcomes among disparities affected populations.
Collapse
Affiliation(s)
- Anika L. Hines
- Virginia Commonwealth University School of Medicine, Richmond, VA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rebecca Brody
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zehui Zhou
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sarah V. Collins
- Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Chiazam Omenyi
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Edgar R. Miller
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Deidra C. Crews
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
16
|
Sinha SK, Sun L, Didero M, Martins D, Norris KC, Lee JE, Meng YX, Sung JH, Sayre M, Carpio MB, Nicholas SB. Vitamin D3 Repletion Improves Vascular Function, as Measured by Cardiorenal Biomarkers in a High-Risk African American Cohort. Nutrients 2022; 14:3331. [PMID: 36014837 PMCID: PMC9414215 DOI: 10.3390/nu14163331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/02/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background: 25-hydroxy vitamin D (Vit D)-deficiency is common among patients with chronic kidney disease (CKD) and contributes to cardiovascular disease (CVD). African Americans (AAs) suffer disproportionately from CKD and CVD, and 80% of AAs are Vit D-deficient. The impact of Vit D repletion on cardio-renal biomarkers in AAs is unknown. We examined Vit D repletion on full-length osteopontin (flOPN), c-terminal fibroblast growth factor-23 (FGF-23), and plasminogen activator inhibitor-1 (PAI-1), which are implicated in vascular and kidney pathology. Methods: We performed a randomized, placebo-controlled study of high-risk AAs with Vit D deficiency, treated with 100,000 IU Vit D3 (cholecalciferol; n = 65) or placebo (n = 65) every 4 weeks for 12 weeks. We measured kidney function (CKD-EPI eGFR), protein-to-creatinine ratio, vascular function (pulse wave velocity; PWV), augmentation index, waist circumference, sitting, and 24-h-ambulatory blood pressure (BP), intact parathyroid hormone (iPTH) and serum calcium at baseline and study end, and compared Vit D levels with laboratory variables. We quantified plasma FGF-23, PAI-1, and flOPN by enzyme-linked immunosorbent assay. Multiple regression analyzed the relationship between log flOPN, FGF-23, and PAI-1 with vascular and renal risk factors. Results: Compared to placebo, Vit D3 repletion increased Vit D3 2-fold (p < 0.0001), decreased iPTH by 12% (p < 0.01) and was significantly correlated with PWV (p < 0.009). Log flOPN decreased (p = 0.03), log FGF-23 increased (p = 0.04), but log PAI-1 did not change. Multiple regression indicated association between log flOPN and PWV (p = 0.04) and diastolic BP (p = 0.02), while log FGF-23 was associated with diastolic BP (p = 0.05), and a trend with eGFR (p = 0.06). Conclusion: Vit D3 repletion may reduce flOPN and improve vascular function in high risk AAs with Vit D deficiency.
Collapse
Affiliation(s)
- Satyesh K. Sinha
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Ling Sun
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | - Michelle Didero
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | - David Martins
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Keith C. Norris
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | - Jae Eun Lee
- Department of Epidemiology and Biostatistics, School of Health, Jackson State University, Jackson, MS 39217, USA
| | - Yuan-Xiang Meng
- Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Jung Hye Sung
- Department of Epidemiology and Biostatistics, School of Health, Jackson State University, Jackson, MS 39217, USA
| | - Michael Sayre
- National Institute of Health, National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
| | - Maria Beatriz Carpio
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | - Susanne B. Nicholas
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| |
Collapse
|
17
|
Allen TS, Bhatia HS, Wood AC, Momin SR, Allison MA. State-of-the-Art Review: Evidence on Red Meat Consumption and Hypertension Outcomes. Am J Hypertens 2022; 35:679-687. [PMID: 35561332 DOI: 10.1093/ajh/hpac064] [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: 03/09/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Hypertension (HTN) is a well-established risk factor for cardiovascular diseases (CVDs), including ischemic heart disease, stroke, heart failure, and atrial fibrillation. The prevalence of HTN, as well as mortality rates attributable to HTN, continue to increase, particularly in the United States and among Black populations. The risk of HTN involves a complex interaction of genetics and modifiable risk factors, including dietary patterns. In this regard, there is accumulating evidence that links dietary intake of red meat with a higher risk of poorly controlled blood pressure and HTN. However, research on this topic contains significant methodological limitations, which are described in the review. The report provided below also summarizes the available research reports, with an emphasis on processed red meat consumption and how different dietary patterns among certain populations may contribute to HTN-related health disparities. Finally, this review outlines potential mechanisms and provides recommendations for providers to counsel patients with evidence-based nutritional approaches regarding red meat and the risk of HTN, as well as CVD morbidity and mortality.
Collapse
Affiliation(s)
- Tara Shrout Allen
- Division of Preventive Medicine, Department of Family Medicine, University of California, San Diego, San Diego, California, USA
| | - Harpreet S Bhatia
- Division of Cardiovascular Medicine, University of California, San Diego, San Diego, California, USA
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Shabnam R Momin
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew A Allison
- Division of Preventive Medicine, Department of Family Medicine, University of California, San Diego, San Diego, California, USA
| |
Collapse
|
18
|
Adegoke O, Ojo OO, Ozoh OB, Akinkugbe AO, Odeniyi IA, Bello BT, Agabi OP, Okubadejo NU. The impact of sex on blood pressure and anthropometry trajectories from early adulthood in a Nigerian population: insights into women's cardiovascular disease risk across the lifespan. BMC Womens Health 2022; 22:303. [PMID: 35869545 PMCID: PMC9306031 DOI: 10.1186/s12905-022-01888-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sex disparities in blood pressure and anthropometry may account for differences in cardiovascular (CV) risk burden with advancing age; modulated by ethnic variability. We explored trajectories of blood pressures (BPs) and anthropometric indices with age on the basis of sex in an urban Nigerian population. METHODS We conducted a secondary analysis on data from 5135 participants (aged 16-92 years; 2671(52%) females) from our population-based cross-sectional study of BP profiles. We utilized the WHO STEPS and standardized methods for documenting BPs, body mass index (BMI) and waist circumference (WC). Data was analyzed using Analysis of variance (ANOVA), Spearman correlation analysis and mean difference in variables (with 95% confidence interval). We explored the influence of age and sex on BP profiles and specific anthropometric indices using generalized regression analysis. RESULTS In those aged 15-44 years, males had significantly higher systolic BP (SBP) and pulse pressure (PP). However, mean SBP and PP rose more steeply in females from 25 to 34 years, intersected with that of males from 45 to 54 years and remained consistently higher. Difference in mean BPs (95% Confidence Interval) (comparing < and > 45 years) was higher in females compared to males for SBP (17.4 (15.8 to 19.0) v. 9.2 (7.7 to 10.7), DBP (9.0 (7.9 to 10.1) v. 7.8 (6.7 to 8.9)), and PP (8.4 (7.3 to 9.5) v. 1.4 (0.3 to 2.5)). Females had significantly higher BMI and WC across all age groups (p < 0.001). Age more significantly correlated with BPs, BMI and WC in females. Interaction models revealed that SBP was significantly predicted by age category in females from (15-54 years), while DBP was only significantly predicted by age in the 15-34-year category (p < 0.01). BMI and WC were significantly predicted by age only in the 25-34-year category in females, (p < 0.01). CONCLUSIONS Our population demonstrates sex disparity in trajectories of SBP, PP, BMI and WC with age; with steeper rise in females. There is a need to focus on CV risk reduction in females, starting before, or during early adulthood.
Collapse
Affiliation(s)
- Oluseyi Adegoke
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria.
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria.
| | - Oluwadamilola O Ojo
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Obianuju B Ozoh
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Ayesha O Akinkugbe
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Ifedayo A Odeniyi
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Babawale T Bello
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Osigwe P Agabi
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Njideka U Okubadejo
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, PMB 12003, Lagos State, Nigeria
- Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| |
Collapse
|
19
|
Chu C, Liao YY, He MJ, Ma Q, Zheng WL, Yan Y, Hu JW, Xu XJ, Fan YN, Yang RH, Mu JJ. Blood Pressure Trajectories From Childhood to Youth and Arterial Stiffness in Adulthood: A 30-Year Longitudinal Follow-Up Study. Front Cardiovasc Med 2022; 9:894426. [PMID: 35845038 PMCID: PMC9278647 DOI: 10.3389/fcvm.2022.894426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to identify the subgroups of individuals sharing similar blood pressure (BP) trajectories from childhood to youth and explore the associations of these trajectories with arterial stiffness in adulthood. Methods A group-based trajectory model was used to identify BP trajectories among 2,082 individuals in the Hanzhong adolescent hypertension cohort by using BP values repeatedly measured at four visits from childhood (6–15 years) to youth (14–23 years). The brachial–ankle pulse wave velocity (baPWV) was examined 30 years after the baseline survey. Mixed linear regression models were used to examine the associations of these trajectories with adult baPWV. Results Among the 2,082 individuals, three trajectory groups of systolic BP were identified as follows: the low-level group (n = 889), medium-level group (n = 1,021), and high-level group (n = 172). The baPWV in adulthood was higher in medium-level and high-level groups compared with the low-level group (1271.4 ± 224.7 cm/s, 1366.1 ± 249.8 cm/s vs. 1190.1 ± 220.3 cm/s, all p < 0.001). After adjustment for potential confounding factors, the association between baPWV and systolic BP trajectories was statistically significant (adjusted β = 49.4 cm/s; p < 0.001 for the medium-level group and β = 107.6 cm/s; p < 0.001 for the high-level group compared with the low-level group). Similar results were obtained for the association of baPWV with the trajectories of diastolic BP and mean arterial pressure (MAP), except for pulse pressure. Conclusion Our investigation demonstrates different BP trajectories from childhood to youth and shows the trajectories of systolic BP, diastolic BP, and MAP are significant predictors of arterial stiffness in adulthood.
Collapse
Affiliation(s)
- Chao Chu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Yue-yuan Liao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Ming-jun He
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Wen-ling Zheng
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Jia-wen Hu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Xian-jing Xu
- Department of Cardiovascular Medicine, Henan Province People’s Hospital, Zhengzhou, China
| | - Ya-ning Fan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Rui-hai Yang
- Institute of Cardiovascular Sciences, Hanzhong People’s Hospital, Hanzhong, China
| | - Jian-jun Mu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
- *Correspondence: Jian-jun Mu,
| |
Collapse
|
20
|
Hsieh HF, Heinze JE, Caruso E, Scott BA, West BT, Mistry R, Eisman AB, Assari S, Buu A, Zimmerman MA. The Protective Effects of Social Support on Hypertension Among African American Adolescents Exposed to Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP7202-NP7224. [PMID: 33107367 PMCID: PMC10834025 DOI: 10.1177/0886260520969390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
African Americans develop hypertension earlier in life than Whites and the racial/ethnic disparities in blood pressure level can appear as early as adolescence. Violence victimization, a prevalent environmental stressor among inner-city youth, may play a role in such disparities. In a sample of inner-city youth in the United States, the current study examines the relationship between violence victimization and hypertension while investigating the role of social support in moderating that relationship. We analyzed eight waves of data from a longitudinal study of African American youth (n = 353, 56.7% female) from mid-adolescence (9th grade, mean age = 14.9 years old) to emerging adulthood (mean age = 23.1 years old) using probit regression. Higher levels of self-reported violence victimization during ages 14-18 was associated with more reports of hypertension during ages 20-23, after adjusting for sex, socioeconomic status, substance use, and mental distress. The relationship of violence victimization with hypertension was moderated by friends' support, but not parental support. The association between victimization and hypertension was weaker and non-significant among individuals with more peer support compared to those with less support. Researchers have reported many instances of associations of early violence exposure to later risk for hypertension; however, most have focused on childhood maltreatment or intimate partner violence. We extend these findings to violence victimization in an African American sample of youth from adolescence to early adulthood, while examining social support modifiers. The disparity in African American hypertension rates relative to Whites may partly be explained by differential exposure to violence. Our findings also suggest that having supportive friends when faced with violence can be beneficial for young adulthood health outcomes.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Shervin Assari
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Anne Buu
- University of Texas Health Science Center, Houston, USA
| | | |
Collapse
|
21
|
Abdel Magid HS, Milliren CE, Rice K, Molanphy N, Ruiz K, Gooding HC, Richmond TK, Odden MC, Nagata JM. Adolescent individual, school, and neighborhood influences on young adult hypertension risk. PLoS One 2022; 17:e0266729. [PMID: 35482649 PMCID: PMC9049504 DOI: 10.1371/journal.pone.0266729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Geographic and contextual socioeconomic risk factors in adolescence may be more strongly associated with young adult hypertension than individual-level risk factors. This study examines the association between individual, neighborhood, and school-level influences during adolescence on young adult blood pressure. METHODS Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health (1994-1995 aged 11-18 and 2007-2008 aged 24-32). We categorized hypertension as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. Secondary outcomes included continuous systolic and diastolic blood pressure. We fit a series of cross-classified multilevel models to estimate the associations between young adulthood hypertension with individual-level, school-level, and neighborhood-level factors during adolescence (i.e., fixed effects) and variance attributable to each level (i.e., random effects). Models were fit using Bayesian estimation procedures. For linear models, intra-class correlations (ICC) are reported for random effects. RESULTS The final sample included 13,911 participants in 128 schools and 1,917 neighborhoods. Approximately 51% (7,111) young adults were hypertensive. Individual-level characteristics-particularly older ages, Non-Hispanic Black race, Asian race, male sex, BMI, and current smoking-were associated with increased hypertension. Non-Hispanic Black (OR = 1.21; 95% CI: 1.03-1.42) and Asian (OR = 1.28; 95% CI: 1.02-1.62) students had higher odds of hypertension compared to non-Hispanic White students. At the school level, hypertension was associated with the percentage of non-Hispanic White students (OR for 10% higher = 1.06; 95% CI: 1.01-1.09). Adjusting for individual, school, and neighborhood predictors attenuated the ICC for both the school (from 1.4 null to 0.9 fully-adjusted) and neighborhood (from 0.4 to 0.3). CONCLUSION We find that adolescents' schools and individual-level factors influence young adult hypertension, more than neighborhoods. Unequal conditions in school environments for adolescents may increase the risk of hypertension later in life. Our findings merit further research to better understand the mechanisms through which adolescents' school environments contribute to adult hypertension and disparities in hypertension outcomes later in life.
Collapse
Affiliation(s)
- Hoda S. Abdel Magid
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, United States of America
- Public Health Sciences Program, Santa Clara University, Santa Clara, California, United States of America
| | - Carly E. Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Kathryn Rice
- Public Health Sciences Program, Santa Clara University, Santa Clara, California, United States of America
| | - Nina Molanphy
- Public Health Sciences Program, Santa Clara University, Santa Clara, California, United States of America
| | - Kennedy Ruiz
- Public Health Sciences Program, Santa Clara University, Santa Clara, California, United States of America
| | - Holly C. Gooding
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Children’s Healthcare of Atlanta, Atlanta, Georgia, United States of America
| | - Tracy K. Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michelle C. Odden
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, United States of America
| | - Jason M. Nagata
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, San Francisco, California, United States of America
| |
Collapse
|
22
|
Rosa MJ, Politis MD, Tamayo-Ortiz M, Colicino E, Pantic I, Estrada-Gutierrez G, Tolentino MC, Espejel-Nuñez A, Solano-Gonzalez M, Kloog I, Rivera NR, Baccarelli AA, Tellez-Rojo MM, Wright RO, Just AC, Sanders AP. Critical windows of perinatal particulate matter (PM 2.5) exposure and preadolescent kidney function. ENVIRONMENTAL RESEARCH 2022; 204:112062. [PMID: 34537199 PMCID: PMC8678189 DOI: 10.1016/j.envres.2021.112062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
Air pollution exposure, especially particulate matter ≤2.5 μm in diameter (PM2.5), is associated with poorer kidney function in adults and children. Perinatal exposure may occur during susceptible periods of nephron development. We used distributed lag nonlinear models (DLNMs) to examine time-varying associations between early life daily PM2.5 exposure (periconceptional through age 8 years) and kidney parameters in preadolescent children aged 8-10 years. Participants included 427 mother-child dyads enrolled in the PROGRESS birth cohort study based in Mexico City. Daily PM2.5 exposure was estimated at each participant's residence using a validated satellite-based spatio-temporal model. Kidney function parameters included estimated glomerular filtration rate (eGFR), serum cystatin C, and blood urea nitrogen (BUN). Models were adjusted for child's age, sex and body mass index (BMI) z-score, as well as maternal education, indoor smoking report and seasonality (prenatal models were additionally adjusted for average first year of life PM2.5 exposure). We also tested for sex-specific effects. Average perinatal PM2.5 was 22.7 μg/m3 and ranged 16.4-29.3 μg/m3. Early pregnancy PM2.5 exposures were associated with higher eGFR in preadolescence. Specifically, we found that PM2.5 exposure between weeks 1-18 of gestation was associated with increased preadolescent eGFR, whereas exposure in the first 14 months of life after birth were associated with decreased eGFR. Specifically, a 5 μg/m3 increase in PM2.5 during the detected prenatal window was associated with a cumulative increase in eGFR of 4.44 mL/min/1.732 (95%CI: 1.37, 7.52), and during the postnatal window we report a cumulative eGFR decrease of -10.36 mL/min/1.732 (95%CI: -17.68, -3.04). We identified perinatal windows of susceptibility to PM2.5 exposure with preadolescent kidney function parameters. Follow-up investigating PM2.5 exposure with peripubertal kidney function trajectories and risk of kidney disease in adulthood will be critical.
Collapse
Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria D Politis
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Mexico City, Mexico
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ivan Pantic
- National Institute of Perinatology, Mexico City, Mexico
| | | | | | | | - Maritsa Solano-Gonzalez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. Beer Sheva, Israel
| | - Nadya Rivera Rivera
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Martha M Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison P Sanders
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
23
|
Binns HJ, Joseph M, Ariza AJ, Cuda SE, Skinner AC, Xu H, Tucker JM, Hampl SE, Santos M, Mayo S, King EC, Kirk S. Elevated blood pressure in youth in pediatric weight management programs in the Pediatric Obesity Weight Evaluation Registry (POWER). J Clin Hypertens (Greenwich) 2022; 24:122-130. [PMID: 35099099 PMCID: PMC8845448 DOI: 10.1111/jch.14423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 02/01/2023]
Abstract
Blood pressure (BP) assessment and management are important aspects of care for youth with obesity. This study evaluates data of youth with obesity seeking care at 35 pediatric weight management (PWM) programs enrolled in the Pediatric Obesity Weight Evaluation Registry (POWER). Data obtained at a first clinical visit for youth aged 3–17 years were evaluated to: (1) assess prevalence of BP above the normal range (high BP); and (2) identify characteristics associated with having high BP status. Weight status was evaluated using percentage of the 95th percentile for body mass index (%BMIp95); %BMIp95 was used to group youth by obesity class (class 1, 100% to < 120% %BMIp95; class 2, 120% to < 140% %BMIp95; class 3, ≥140% %BMIp95; class 2 and class 3 are considered severe obesity). Logistic regression evaluated associations with high BP. Data of 7943 patients were analyzed. Patients were: mean 11.7 (SD 3.3) years; 54% female; 19% Black non‐Hispanic, 32% Hispanic, 39% White non‐Hispanic; mean %BMIp95 137% (SD 25). Overall, 48.9% had high BP at the baseline visit, including 60.0% of youth with class 3 obesity, 45.9% with class 2 obesity, and 37.7% with class 1 obesity. Having high BP was positively associated with severe obesity, older age (15–17 years), and being male. Nearly half of treatment‐seeking youth with obesity presented for PWM care with high BP making assessment and management of BP a key area of focus for PWM programs.
Collapse
Affiliation(s)
- Helen J Binns
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Madeline Joseph
- College of Medicine, University of Florida, Jacksonville, Florida, USA
| | - Adolfo J Ariza
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Suzanne E Cuda
- Children's Hospital of San Antonio, Baylor College of Medicine, San Antonio, Texas, USA
| | - Asheley C Skinner
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Haolin Xu
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Jared M Tucker
- Helen DeVos Children's Hospital, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Sarah E Hampl
- Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | | | - Shawyntee Mayo
- College of Medicine, University of Florida, Jacksonville, Florida, USA
| | - Eileen C King
- Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Shelley Kirk
- Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.,The Heart Institute, Center for Better Health and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | -
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
24
|
Xu Y, Su S, Brown M, Snieder H, Harshfield G, Wang X. Ethnic differences and heritability of blood pressure circadian rhythm in African and European American youth and young adults. J Hypertens 2022; 40:163-170. [PMID: 34857708 PMCID: PMC8646444 DOI: 10.1097/hjh.0000000000002988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The aim of this study was to investigate whether blood pressure (BP) circadian rhythm in African Americans differed from that in European Americans. We further examined the genetic and/or environmental sources of variances of the BP circadian rhythm parameters and the extent to which they depend on ethnicity or sex. METHOD Quantification of BP circadian rhythm was obtained using Fourier transformation from the ambulatory BP monitoring data of 760 individuals (mean age, 17.2 ± 3.3; 322 twin pairs and 116 singletons; 351 African Americans). RESULTS BP circadian rhythm showed a clear difference by ethnic group with African Americans having a lower amplitude (P = 1.5e-08), a lower percentage rhythm (P = 2.8e-11), a higher MESOR (P = 2.5e-05) and being more likely not to display circadian rhythm (P = 0.002) or not in phase (P = 0.003). Familial aggregation was identified for amplitude, percentage rhythm and acrophase with genetic factors and common environmental factors together accounting for 23 to 33% of the total variance of these BP circadian rhythm parameters. Unique environmental factors were the largest contributor explaining up to 67--77% of the total variance of these parameters. No sex or ethnicity difference in the variance components of BP circadian rhythm was observed. CONCLUSION This study suggests that ethnic differences in BP circadian rhythm already exist in youth with African Americans having a dampened circadian rhythm and better BP circadian rhythm may be achieved by changes in environmental factors.
Collapse
Affiliation(s)
- Yanyan Xu
- Georgia Prevention Institute, Department of Medicine
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Shaoyong Su
- Georgia Prevention Institute, Department of Medicine
| | | | - Harold Snieder
- Georgia Prevention Institute, Department of Medicine
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Xiaoling Wang
- Georgia Prevention Institute, Department of Medicine
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta, Georgia, USA
| |
Collapse
|
25
|
Anadani M, Qureshi AI, Menacho S, Grandhi R, Yaghi S, Jumaa MA, de Havenon A. Race/ethnicity and response to blood pressure lowering treatment after intracerebral hemorrhage. Eur Stroke J 2021; 6:343-348. [PMID: 35342813 PMCID: PMC8948521 DOI: 10.1177/23969873211046116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It is unknown if race/ethnicity modifies the response to blood pressure (BP) lowering treatment after intracerebral hemorrhage (ICH). We aimed to examine the race/ethnicity differences in the response to BP lowering treatment after ICH. METHODS This is a post hoc analysis of the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-2) trial. The primary outcome is good outcome, defined as 90-day modified Rankin Scale 0-3. The primary predictor is race/ethnicity for which we included non-Hispanic categories of White, Black, Asian, and the category of Hispanic. We fit adjusted logistic regression models with the predictor of race/ethnicity and models with the interaction term of treatment*race/ethnicity. RESULTS We included a total of 953 patients in our analysis (White = 213, Black = 112, Asian = 554, and Hispanic = 74). In the models with the interaction between race/ethnicity and treatment, we found that White patients assigned to the intensive treatment arm had lower predicted probability of good outcome than those assigned to the standard treatment arm (Model 1: 56.2% vs. 68.1%, p = .027; Model 2: 53.4% vs. 68.3%, p = .009). When divided into White and non-White groups, intensive treatment was associated with higher odds of serious adverse events in White group but not in the non-White group. In addition, there was an association between intensive treatment and higher risk of hematoma expansion in White patients and lower risk of hematoma expansion in non-White patients. CONCLUSIONS In the ATACH-2, there was an interaction between race/ethnicity and response to BP lowering treatment after ICH, with White patients having an association between intensive blood pressure reduction and worse outcome.
Collapse
Affiliation(s)
- Mohammad Anadani
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Adnan I Qureshi
- Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, USA
| | - Sarah Menacho
- Department of Neurosurgery, University of Utah, Salt Lake, UT, USA
| | - Ramesh Grandhi
- Department of Neurosurgery, University of Utah, Salt Lake, UT, USA
| | - Shadi Yaghi
- Department of Neurology, New York University, New York, NY, USA
| | | | - Adam de Havenon
- Department of Neurology, University of Utah, Salt Lake, UT, USA
| |
Collapse
|
26
|
Hao G, Halbert J, Su S, Bagi Z, Robinson V, Thayer J, Harshfield G, Kapuku G. Rapid decline of resting heart rate trajectories from childhood to young adulthood is paradoxically associated with increased cardiac mass. Acta Cardiol 2021; 76:1117-1123. [PMID: 33557704 DOI: 10.1080/00015385.2020.1871262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Little is known about the varied resting heart rate (RHR) trajectory patterns from childhood to young adulthood and their clinical significance. We aim to identify RHR trajectories from childhood to young adulthood, and to determine their relationship with left ventricular mass (LVM) index. METHODS RHR was measured up to 15 times over a 21-year period in 759 participants from childhood to young adulthood. LVM was measured using echocardiography and was normalised to body surface area to obtain LVM index in 546 participants. RESULTS Using latent class models, three trajectory groups in RHR from childhood to young adulthood were identified, including high-decreasing group (HDG), moderate-decreasing group (MDG), and low-decreasing group (LDG). We found that trajectory of RHR was a significant predictor of LVM index with faster decrease of RHR associated with higher levels of total peripheral resistance (P for trend <0.001) and LVM index (P for trend <0.001). Compared to the LDG, individuals in the HDG showed higher LVM index (β = 6.08, p < 0.001). In addition, the interactions between race and RHR trajectories for LVM index was significant (p < 0.05). CONCLUSION Our findings show an association between RHR trajectories from childhood to young adulthood with cardiac mass, suggesting that monitoring RHR may help identify subpopulation at high cardiovascular risk.
Collapse
Affiliation(s)
- Guang Hao
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - James Halbert
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shayong Su
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Zsolt Bagi
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Vincent Robinson
- Division of Cardiology, Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Julian Thayer
- Department of Psychology and Neurosciences, The Ohio State University, Columbus, OH, USA
| | - Gregory Harshfield
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Gaston Kapuku
- Georgia Prevention Institute, Departments of Medicine, Pediatrics, and Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.,Division of Cardiology, Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| |
Collapse
|
27
|
Ernst B, Su S, Treiber F, Snieder H, Wang X. Diurnal Cortisol Slope and Nighttime Blood Pressure: A Study in European Americans and African Americans. Ethn Dis 2021; 31:481-488. [PMID: 34720551 DOI: 10.18865/ed.31.4.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives African Americans (AAs) have higher nighttime blood pressure (BP) than European Americans (EAs). Stress has been suggested to play a role in this difference, but the mechanism is not well-understood. Flatter diurnal cortisol slope (DCS) is a well-known biological marker of stress. The objectives of this study were to: 1) examine ethnic differences in DCS; 2) evaluate the association between DCS and nighttime BP; and 3) determine the extent to which ethnic differences in nighttime BP can be explained by ethnic differences in DCS. Methods A total of 510 participants (age range: 14-35 years; 49.6% AAs, 54.5% females) provided four salivary cortisol samples at bedtime, wakeup, 30-minutes post-wakeup, and 60-minutes post-wakeup. Additionally, participants wore an ambulatory BP monitor for 24 hours. DCS was calculated as the average of the three morning samples minus the bedtime measurement. Results After adjustment for age, sex, BMI, and smoking, AAs had blunted DCS (P=.018) and higher nighttime systolic BP (SBP) and diastolic BP (DBP) (Ps<.001) compared with EAs. The DCS was inversely related to nighttime SBP and this relationship did not depend on ethnicity. The ethnic difference of nighttime SBP was significantly attenuated upon addition of DCS to the model. Mediation test showed that 9.5% of ethnic difference in nighttime SBP could be explained by DCS (P=.039). Conclusion This study confirms ethnic differences in DCS and nighttime BP and further demonstrates that the ethnic differences in DCS can, at least partially, explain the ethnic differences found in nighttime BP.
Collapse
Affiliation(s)
- Brooke Ernst
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Shaoyong Su
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Frank Treiber
- College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Harold Snieder
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA.,Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Xiaoling Wang
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| |
Collapse
|
28
|
Koochakkhani S, Nabizadeh F, Nejatizadeh A, Eftekhar E. Association of methylenetetrahydrofolate reductase (MTHFR) and cystathionine β-synthase (CBS) genes promoter methylation pattern with the risk of essential hypertension. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
29
|
Yuan WL, Kramer MS, Michael N, Sadananthan SA, Tint MT, Chen LW, Pang WW, Velan SS, Godfrey KM, Chong YS, Chong MFF, Choo JTL, Ling LH, Eriksson JG, Lee YS. Trajectories of Systolic Blood Pressure in Children: Risk Factors and Cardiometabolic Correlates. J Pediatr 2021; 236:86-94.e6. [PMID: 34019883 PMCID: PMC7611585 DOI: 10.1016/j.jpeds.2021.05.027] [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: 02/02/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify systolic blood pressure (SBP) percentile trajectories in children and to describe the early-life risk factors and cardiometabolic correlates of those trajectories. STUDY DESIGN Using age-, sex-, and height-specific SBP percentiles based on the American Academy of Pediatrics reference, we examined SBP trajectories using latent class mixed models from ages 3 to 8 years (n = 844) from the Growing Up in Singapore Towards healthy Outcomes-study, a Singaporean mother-offspring cohort study. We analyzed associations between SBP trajectories and early-life risk factors using multinomial logistic regression and differences across trajectories in cardiometabolic outcomes using multiple linear regression. RESULTS Children were classified into 1 of 4 SBP percentile trajectories: "low increasing" (15%), "high stable" (47%), "high decreasing" (20%), and "low stable" (18%). Maternal hypertension during early pregnancy was a predictor of the "high stable" and "low increasing" SBP trajectories. Rapid child weight gain in the first 2 years of life was only associated with the "high stable" trajectory. Compared with children in the "low stable" trajectory, children in the "high stable" SBP trajectory had greater body mass index z scores, sum of skinfold thicknesses, waist circumference from ages 3 to 8 years, and abdominal adipose tissue (milliliters) at 4.5 years (adjusted mean difference [95% CI]: superficial and deep subcutaneous abdominal adipose tissue: 115.2 [48.1-182.3] and 85.5 [35.2-135.8]). Their fat mass (kilograms) (1.3 [0.6-2.0]), triglyceride levels (mmol/L) (0.10 [0.02-0.18]), and homeostasis model assessment of insulin resistance (0.28 [0.11 0.46]) at age 6 years were also greater but not their arterial thickness and stiffness. CONCLUSIONS Reducing maternal blood pressure during pregnancy and infant weight gain in the first 2 years of life might help to prevent the development of high SBP.
Collapse
Affiliation(s)
- Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michael S Kramer
- Department of Paediatrics, Faculty of Medicine, McGill University, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Suresh A Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Mya T Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Ling-Wei Chen
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Wei Wei Pang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sendhil S Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Singapore Bioimaging Consortium, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Mary FF Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Lieng Hsi Ling
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Johan G Eriksson
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| |
Collapse
|
30
|
Bundy JD, Jaeger BC, Huffman MD, Knox SS, Thomas SJ, Shimbo D, Booth JN, Lewis CE, Edwards LJ, Schwartz JE, Muntner P. Twenty-Five-Year Changes in Office and Ambulatory Blood Pressure: Results From the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Hypertens 2021; 34:494-503. [PMID: 33201230 PMCID: PMC8140654 DOI: 10.1093/ajh/hpaa189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/09/2020] [Accepted: 11/10/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Blood pressure (BP) measured in the office setting increases from early through later adulthood. However, it is unknown to what extent out-of-office BP derived via ambulatory BP monitoring (ABPM) increases over time, and which participant characteristics and risk factors might contribute to these increases. METHODS We assessed 25-year change in office- and ABPM-derived BP across sex, race, diabetes mellitus (DM), and body mass index (BMI) subgroups in the Coronary Artery Risk Development in Young Adults study using multivariable-adjusted linear mixed effects models. RESULTS We included 288 participants who underwent ABPM at the Year 5 Exam (mean [SD] age, 25.1 [3.7]; 45.8% men) and 455 participants who underwent ABPM at the Year 30 Exam (mean [SD] age, 49.5 [3.7]; 42.0% men). Office, daytime, and nighttime systolic BP (SBP) increased 12.8 (95% confidence interval [CI], 7.6-17.9), 14.7 (95% CI, 9.7-19.8), and 16.6 (95% CI, 11.4-21.8) mm Hg, respectively, over 25 years. Office SBP increased 6.5 (95% CI, 2.3-10.6) mm Hg more among black compared with white participants. Daytime SBP increased 6.3 (95% CI, 0.2-12.4) mm Hg more among participants with a BMI ≥25 vs. <25 kg/m2. Nighttime SBP increased 4.7 (95% CI, 0.5-8.9) mm Hg more among black compared with white participants, and 17.3 (95% CI, 7.2-27.4) mm Hg more among participants with vs. without DM. CONCLUSIONS Office- and ABPM-derived BP increased more from early through middle adulthood among black adults and participants with DM and BMI ≥25 kg/m2.
Collapse
Affiliation(s)
- Joshua D Bundy
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Tulane University Translational Science Institute, New Orleans, Louisiana, USA
| | - Byron C Jaeger
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mark D Huffman
- Department of Preventive Medicine and Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Sarah S Knox
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - S Justin Thomas
- Department of Psychiatry, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Daichi Shimbo
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - John N Booth
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- CTI Clinical Trials and Consulting Services, Inc., Covington, Kentucky, USA
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lloyd J Edwards
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Joseph E Schwartz
- Department of Psychiatry, Stony Brook University, New York, New York, USA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
31
|
Allen NB, Khan SS. Blood Pressure Trajectories Across the Life Course. Am J Hypertens 2021; 34:234-241. [PMID: 33821941 DOI: 10.1093/ajh/hpab009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
High blood pressure (BP) is a strong modifiable risk factor for cardiovascular disease (CVD). Longitudinal BP patterns themselves may reflect the burden of risk and vascular damage due to prolonged cumulative exposure to high BP levels. Current studies have begun to characterize BP patterns as a trajectory over an individual's lifetime. These BP trajectories take into account the absolute BP levels as well as the slope of BP changes throughout the lifetime thus incorporating longitudinal BP patterns into a single metric. Methodologic issues that need to be considered when examining BP trajectories include individual-level vs. population-level group-based modeling, use of distinct but complementary BP metrics (systolic, diastolic, mean arterial, mid, and pulse pressure), and potential for measurement errors related to varied settings, devices, and number of readings utilized. There appear to be very specific developmental periods during which divergent BP trajectories may emerge, specifically adolescence, the pregnancy period, and older adulthood. Lifetime BP trajectories are impacted by both individual-level and community-level factors and have been associated with incident hypertension, multimorbidity (CVD, renal disease, cognitive impairment), and overall life expectancy. Key unanswered questions remain around the additive predictive value of BP trajectories, intergenerational contributions to BP patterns (in utero BP exposure), and potential genetic drivers of BP patterns. The next phase in understanding BP trajectories needs to focus on how best to incorporate this knowledge into clinical care to reduce the burden of hypertensive-related outcomes and improve health equity.
Collapse
Affiliation(s)
- Norrina B Allen
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Sadiya S Khan
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
32
|
De Luca M, Bryan DR, Hunter GR. Circulating Levels of the Heparan Sulfate Proteoglycan Syndecan-4 Positively Associate with Blood Pressure in Healthy Premenopausal Women. Biomolecules 2021; 11:biom11030342. [PMID: 33668381 PMCID: PMC7996250 DOI: 10.3390/biom11030342] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/15/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022] Open
Abstract
Syndecans (SDCs) are transmembrane proteins that are present on most cell types where they play a role in multiple physiological processes, including cell-matrix adhesion and inflammation. Growing evidence suggests that elevated levels of both shed SDC1 and SDC4 are associated with hypertension and cardiovascular diseases, but their relationships with cardiovascular risk factors in healthy individuals are unknown. The primary objective of this study was to investigate whether serum levels of SDC4 and SDC1 were associated with body composition, hemodynamic parameters, pro-inflammatory cytokine concentrations, and urinary noradrenaline and dopamine levels in healthy women (17 African American and 20 European American) between the ages of 20 and 40 years old. Univariate analyses revealed only a significant (p < 0.05) inverse correlation between serum SDC1 and body fat percentage. On the other hand, serum SDC4 was positively correlated with systolic blood pressure, diastolic blood pressure, and urinary levels of noradrenaline and dopamine. Serum SDC4 was also a significant predictor of systolic blood pressure in a multivariate regression model that included fat-free mass and urinary dopamine levels as significant independent variables. The result did not change even adjusting for race. Our findings indicate that SDC4 has an important role in the physiological regulation of blood pressure.
Collapse
Affiliation(s)
- Maria De Luca
- Correspondence: ; Tel.: +1-205-934-7033; Fax: +1-205-934-7050
| | | | | |
Collapse
|
33
|
Doamekpor LA, Gleason JL, Opara I, Amutah-Onukagha NN. Nativity and Cardiovascular Dysregulation: Evidence from the 2001-2016 National Health and Nutrition Examination Survey. J Racial Ethn Health Disparities 2021; 8:136-146. [PMID: 32410072 PMCID: PMC8324316 DOI: 10.1007/s40615-020-00765-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/14/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine nativity-based differences in 3 cardiovascular biomarkers commonly used to assess cardiovascular dysregulation. METHODS Data was pooled from the 2001-2016 National Health and Nutrition Examination Survey to compare biomarker risk scores for the US-born (n = 4693) and foreign-born (n = 2968) Black adults. We used multivariable-adjusted logistic regression to assess the association between nativity and cardiovascular biomarkers, controlling for gender, age, health behaviors, and socioeconomic status. RESULTS In the full model, a foreign-born health advantage was not observed in all 3 cardiovascular biomarkers. In fact, foreign-born Blacks were almost twice as likely to have high mean diastolic blood pressure compared with the US-born individuals (OR = 1.82; 95% CI = 1.15, 2.88) and had an increased risk of high 60-s pulse. Foreign-born individuals living in the USA for less than 5 years were 62% less likely to have high mean systolic blood pressure than individuals living in the USA for 20 years or more. CONCLUSIONS The foreign-born health advantage among Blacks was not observed in the cardiovascular biomarkers under study, suggesting that the commonly cited Healthy Immigrant Effect may need to be reassessed.
Collapse
Affiliation(s)
| | - Jessica L Gleason
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Ijeoma Opara
- Stony Brook University School of Social Welfare, Stony Brook, NY, 11794, USA
| | - Ndidiamaka N Amutah-Onukagha
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, 136 Harrison Avenue, Boston, MA, 02111, USA
| |
Collapse
|
34
|
Hill LK, Thayer JF, Williams DP, Halbert JD, Hao G, Robinson V, Harshfield G, Kapuku G. Ethnic and sex differences in the longitudinal association between heart rate variability and blood pressure. Blood Press 2021; 30:165-171. [PMID: 33504215 DOI: 10.1080/08037051.2021.1876517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Elevated blood pressure is a risk factor for increased cardiovascular morbidity and mortality. Decreased vagally-mediated heart rate variability has previously been prospectively linked with increased blood pressure; however, to date, no such prospective data exist regarding this relationship among Blacks. MATERIALS AND METHODS We examined this association in 387 normotensive young adults (mean age, 23 years, 52% female, 54% Black) who participated in two laboratory evaluations spanning approximately six years. Blood pressure was measured at both timepoints with a non-invasive oscillometric device and heart rate variability was assessed via bio-impedance. RESULTS In the total sample, heart rate variability significantly predicted systolic (p = .022) and diastolic (p < .001) blood pressure increases six years into the future. However, this pattern varied as a function of ethnicity and sex with the effect of heart rate variability on Time 2 systolic blood pressure only significant among White males (p = .007). Heart rate variability was also predictive of Time 2 diastolic blood pressure in White males (p = .038) as well as among both White (p = .032) and Black (p = .015) females, but was not related to blood pressure among Black males. CONCLUSION We report for the first time significant ethnic and sex differences in the prospective relationship between heart rate variability and blood pressure change. These findings may give clues as to the underlying mechanisms that are involved in the well-known health disparities in blood pressure and hypertension-related cardiovascular diseases.
Collapse
Affiliation(s)
- LaBarron K Hill
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,Center for Biobehavioral Health Disparities Research, Duke University, Durham, NC, USA
| | - Julian F Thayer
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - DeWayne P Williams
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - James D Halbert
- Departments of Population Health Sciences and Medicine (Cardiology), Augusta University, Augusta, GA, USA
| | - Guang Hao
- Departments of Population Health Sciences and Medicine (Cardiology), Augusta University, Augusta, GA, USA
| | - Vincent Robinson
- Departments of Population Health Sciences and Medicine (Cardiology), Augusta University, Augusta, GA, USA
| | - Gregory Harshfield
- Departments of Population Health Sciences and Medicine (Cardiology), Augusta University, Augusta, GA, USA
| | - Gaston Kapuku
- Departments of Population Health Sciences and Medicine (Cardiology), Augusta University, Augusta, GA, USA
| |
Collapse
|
35
|
Kapuku G, Howie M, Ghosh S, Doshi V, Bykhovsky M, Ange B, Halbert JD, Robinson V, Bagi Z, Harshfield G, George V. Effects of Race, Cardiac Mass, and Cardiac Load on Myocardial Function Trajectories from Childhood to Young Adulthood: The Augusta Heart Study. J Am Heart Assoc 2021; 10:e015612. [PMID: 33459030 PMCID: PMC7955424 DOI: 10.1161/jaha.119.015612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background The overall goal of this longitudinal study was to determine if the Black population has decreased myocardial function, which has the potential to lead to the early development of congestive heart failure, compared with the White population. Methods and Results A total of 673 subjects were evaluated over a period of 30 years including similar percentages of Black and White participants. Left ventricular systolic function was probed using the midwall fractional shortening (MFS). A longitudinal analysis of the MFS using a mixed effect growth curve model was performed. Black participants had greater body mass index, higher blood pressure readings, and greater left ventricular mass compared with White participants (all P<0.01). Black participants had a 0.54% decrease of MFS compared with White participants. As age increased by 1 year, MFS increased by 0.05%. As left ventricular mass increased by 1 g, MFS decreased by 0.01%. As circumferential end systolic stress increased by 1 unit, MFS decreased by 0.04%. The MFS trajectories for race differed from early age to young adulthood. Conclusions Changes in myocardial function mirror the race‐dependent variations in blood pressure, afterload, and cardiac mass, suggesting that myocardial function depression occurs early in childhood in populations at high cardiovascular risk such as Black participants.
Collapse
Affiliation(s)
- Gaston Kapuku
- Departments of Medicine Georgia Prevention InstituteMedical College of GeorgiaAugusta University Augusta GA.,Department of Pediatrics Medical College of GeorgiaAugusta University Augusta GA.,Department of Population Health Sciences Medical College of GeorgiaAugusta University Augusta GA
| | - Melissa Howie
- Department of Population Health Sciences Medical College of GeorgiaAugusta University Augusta GA
| | - Santu Ghosh
- Department of Population Health Sciences Medical College of GeorgiaAugusta University Augusta GA
| | - Vishal Doshi
- Departments of Medicine Georgia Prevention InstituteMedical College of GeorgiaAugusta University Augusta GA
| | - Michael Bykhovsky
- Department of Pediatrics Medical College of GeorgiaAugusta University Augusta GA
| | - Brittany Ange
- Department of Population Health Sciences Medical College of GeorgiaAugusta University Augusta GA
| | - James D Halbert
- Departments of Medicine Georgia Prevention InstituteMedical College of GeorgiaAugusta University Augusta GA.,Department of Leadership and Applied Psychology Adler University Chicago IL
| | - Vincent Robinson
- Departments of Medicine Georgia Prevention InstituteMedical College of GeorgiaAugusta University Augusta GA
| | - Zsolt Bagi
- Department of Physiology Medical College of GeorgiaAugusta University Augusta GA
| | - Gregory Harshfield
- Departments of Medicine Georgia Prevention InstituteMedical College of GeorgiaAugusta University Augusta GA.,Department of Pediatrics Medical College of GeorgiaAugusta University Augusta GA.,Department of Population Health Sciences Medical College of GeorgiaAugusta University Augusta GA
| | - Varghese George
- Department of Population Health Sciences Medical College of GeorgiaAugusta University Augusta GA
| |
Collapse
|
36
|
Serum 25-Hydroxyvitamin D Concentrations Are Associated with Mental Health and Psychosocial Stress in Young Adults. Nutrients 2020; 12:nu12071938. [PMID: 32629761 PMCID: PMC7400417 DOI: 10.3390/nu12071938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
We aimed to test the hypothesis that serum 25-hydroxyvitamin D3 (25(OH)D) concentration is associated with mental health and life stress measures in young adults and investigate gender and racial disparities in these associations. This study comprised 327 black and white participants. Depression, trait anxiety, perceived stress, and hostility were measured by the following validated instruments: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and Cook–Medley Hostility Scale (CMHS). Linear regression was used to estimate correlations between serum 25(OH)D concentration and mental health measurements in the total population and in subgroups stratified by gender and race. In this sample (28.2 ± 3.1 years, 52% female, 53% black), serum 25(OH)D concentration was negatively related to BDI, STAI, PSS, total CMHS score, and the majority of CMHS subscale scores (p-values < 0.05). Stratified by gender, most of these associations remained significant only in women (p-values < 0.05). Stratified by race, higher 25(OH)D concentrations in white participants were significantly related to lower BDI, STAI, PSS, and CMHS-cynicism subscales (p-values < 0.05); 25(OH)D concentrations in the black participants were only inversely associated with CMHS and most CMHS subscales (p-values < 0.05) but not with BDI, STAI, and PSS. We present novel findings of consistent inverse relationships between serum 25(OH)D concentration and various measures of mental health and life stress. Long-term interventional studies are warranted in order to investigate the roles of vitamin D supplementation in the prevention and mitigation of depression, anxiety, and psychological stress in young adults.
Collapse
|
37
|
Rosa MJ, Hair GM, Just AC, Kloog I, Svensson K, Pizano-Zárate ML, Pantic I, Schnaas L, Tamayo-Ortiz M, Baccarelli AA, Tellez-Rojo MM, Wright RO, Sanders AP. Identifying critical windows of prenatal particulate matter (PM 2.5) exposure and early childhood blood pressure. ENVIRONMENTAL RESEARCH 2020; 182:109073. [PMID: 31881529 PMCID: PMC7024649 DOI: 10.1016/j.envres.2019.109073] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Exposure to air pollution is associated with increased blood pressure (BP) in adults and children. Some evidence suggests that air pollution exposure during the prenatal period may contribute to adverse cardiorenal health later in life. Here we apply a distributed lag model (DLM) approach to identify critical windows that may underlie the association between prenatal particulate matter ≤ 2.5 μm in diameter (PM2.5) exposure and children's BP at ages 4-6 years. METHODS Participants included 537 mother-child dyads enrolled in the Programming Research in Obesity, GRowth Environment, and Social Stress (PROGRESS) longitudinal birth cohort study based in Mexico City. Prenatal daily PM2.5 exposure was estimated using a validated satellite-based spatio-temporal model and BP was measured using the automated Spacelabs system with a sized cuff. We used distributed lag models (DLMs) to examine associations between daily PM2.5 exposure and systolic and diastolic BP (SBP and DBP), adjusting for child's age, sex and BMI, as well as maternal education, preeclampsia and indoor smoking report during the second and third trimester, seasonality and average postnatal year 1 PM2.5 exposure. RESULTS We found that PM2.5 exposure between weeks 11-32 of gestation (days 80-226) was significantly associated with children's increased SBP. Similarly, PM2.5 exposure between weeks 9-25 of gestation (days 63-176) was significantly associated with increased DBP. To place this into context, a constant 10 μg/m3 increase in PM2.5 sustained throughout this critical window would predict a cumulative increase of 2.6 mmHg (CI: 0.5, 4.6) in SBP and 0.88 mmHg (CI: 0.1, 1.6) in DBP at ages 4-6 years. In a stratified analysis by sex, this association persisted in boys but not in girls. CONCLUSIONS Second and third trimester PM2.5 exposure may increase children's BP in early life. Further work investigating PM2.5 exposure with BP trajectories later in childhood will be important to understanding cardiorenal trajectories that may predict adult disease. Our results underscore the importance of reducing air pollution exposure among susceptible populations, including pregnant women.
Collapse
Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Gleicy Macedo Hair
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B., Beer Sheva, Israel
| | | | - María Luisa Pizano-Zárate
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Ivan Pantic
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Lourdes Schnaas
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- National Council of Science and Technology (CONACYT), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico; Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Martha M Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alison P Sanders
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
38
|
Fishman B, Leiba A, Twig G, Shlomai G, Orr O, Landau R, Derazne E, Grossman E. Ethnic Variability Among Jews is Associated With Hypertension: Results of a Nationwide Study of 1.44 Million Adolescents. Am J Hypertens 2020; 33:175-181. [PMID: 31777921 DOI: 10.1093/ajh/hpz167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/17/2019] [Accepted: 10/29/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Adolescent hypertension is a major cardiovascular risk factor that may be related to ethnic variability. Contemporary Jews can be divided into three distinct ethnic groups: Ashkenazi, Oriental, and Sephardi origins. The aim of our study was to investigate the association of ethnicity and hypertension among Israeli adolescents. METHODS We conducted a population retrospective cohort study of males and females, aged 16-19, eligible for mandatory military service in the Israeli Defense Forces (IDF) between 1994 and 2013. Medical and sociodemographic data, including body mass index (BMI), age, years of education, residential socioeconomic status, and parents' country of birth, were retrieved. Ethnicity of the parents was based upon their country of birth. The examinees were assigned to a certain ethnicity only if both parents had the same ethnicity. Logistic regression models were applied to compute the odds ratio (OR) and 95% confidence intervals (95% CI) for hypertension among the different Jewish ethnicities. RESULTS The final cohort included 1,445,176 adolescents, of whom 716,289 were born to parents of the same Jewish ethnicity. Ashkenazi ethnicity was associated with an increased risk of hypertension compared to Sephardi and Oriental ethnicities (adjusted OR of 2.93 (95% CI, 2.52-3.41) and 1.56 (1.38-1.77), respectively). Oriental ethnicity was associated with an increased risk of hypertension compared with the Sephardi ethnicity (OR of 1.91 (1.60-2.27)). Similar results were observed in a sub-analysis, which included only Israeli-born examinees. CONCLUSIONS Our results indicate that ethnicity is significantly associated with hypertension among Jewish adolescents. Ashkenazi Jews had the highest risk of hypertension.
Collapse
Affiliation(s)
- Boris Fishman
- Israel Defense Forces Medical Corps, Israel
- Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Leiba
- Israel Defense Forces Medical Corps, Israel
- Division of Nephrology and Hypertension, Assuta Ashdod Academic Medical Center, Ben Gurion University, Beer Sheva, Israel
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gilad Twig
- Israel Defense Forces Medical Corps, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Military Medicine, The Faculty of Medicine, The Hebrew University, of Jerusalem, Jerusalem, Israel
| | - Gadi Shlomai
- Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Institute of Endocrinology, The Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Omri Orr
- Israel Defense Forces Medical Corps, Israel
| | - Regev Landau
- Israel Defense Forces Medical Corps, Israel
- Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Grossman
- Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
39
|
Jeong J, Zhu H, Harris RA, Dong Y, Su S, Tingen MS, Kapuku G, Pollock JS, Pollock DM, Harshfield GA, Wang X. Ethnic Differences in Nighttime Melatonin and Nighttime Blood Pressure: A Study in European Americans and African Americans. Am J Hypertens 2019; 32:968-974. [PMID: 31112592 DOI: 10.1093/ajh/hpz083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/26/2019] [Accepted: 05/20/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Ethnic differences in nighttime blood pressure (BP) have long been documented with African Americans (AAs) having higher BP than European Americans (EAs). At present, lower nighttime melatonin, a key regulator of circadian rhythms, has been associated with higher nighttime BP levels in EAs. This study sought to test the hypothesis that AAs have lower nighttime melatonin secretion compared with EAs. We also determined if this ethnic difference in melatonin could partially explain the ethnic difference in nighttime BP. METHODS A total of 150 young adults (71 AA; 46% females; mean age: 27.7 years) enrolled in the Georgia Stress and Heart study provided an overnight urine sample for the measurement of 6-sulfatoxymelatonin, a major metabolite of melatonin. Urine melatonin excretion (UME) was calculated as the ratio between 6-sulfatoxymelatonin concentration and creatinine concentration. Twenty-four-hour ambulatory BP was assessed and nighttime systolic BP (SBP) was used as a major index of BP regulation. RESULTS After adjustment of age, sex, body mass index, and smoking, AAs had significantly lower UME (P = 0.002) and higher nighttime SBP than EAs (P = 0.036). Lower UME was significantly associated with higher nighttime SBP and this relationship did not depend on ethnicity. The ethnicity difference in nighttime SBP was significantly attenuated after adding UME into the model (P = 0.163). CONCLUSION This study is the first to document the ethnic difference in nighttime melatonin excretion, demonstrating that AAs have lower melatonin secretion compared with EAs. Furthermore, the ethnic difference in nighttime melatonin can partially account for the established ethnic difference in nighttime SBP.
Collapse
Affiliation(s)
- Jinhee Jeong
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Haidong Zhu
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Ryan A Harris
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Yanbin Dong
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Shaoyong Su
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Martha S Tingen
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Gaston Kapuku
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Jennifer S Pollock
- Cardio Renal Physiology and Medicine Section, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David M Pollock
- Cardio Renal Physiology and Medicine Section, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gregory A Harshfield
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Xiaoling Wang
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| |
Collapse
|
40
|
Sharma N, Dev R, Ruiz-Rosado JDD, Partida-Sanchez S, Guerau-de-Arellano M, Dhakal P, Kuivaniemi H, Hans CP. Pharmacological inhibition of Notch signaling regresses pre-established abdominal aortic aneurysm. Sci Rep 2019; 9:13458. [PMID: 31530833 PMCID: PMC6748927 DOI: 10.1038/s41598-019-49682-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/27/2019] [Indexed: 12/22/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is characterized by transmural infiltration of myeloid cells at the vascular injury site. Previously, we reported preventive effects of Notch deficiency on the development of AAA by reduction of infiltrating myeloid cells. In this study, we examined if Notch inhibition attenuates the progression of pre-established AAA and potential implications. Pharmacological Notch inhibitor (N-[N-(3,5-difluorophenacetyl)-L-alanyl]-(S)-phenylglycine t-butyl ester; DAPT) was administered subcutaneously three times a week starting at day 28 of angiotensin II (AngII) infusion. Progressive increase in pulse wave velocity (PWV), maximal intra-luminal diameter (MILD) and maximal external aortic diameter (MEAD) were observed at day 56 of the AngII. DAPT prevented such increase in MILD, PWV and MEAD (P < 0.01). Histologically, the aortae of DAPT-treated Apoe-/- mice had significant reduction in inflammatory response and elastin fragmentation. Naked collagen microfibrils and weaker banded structure observed in the aortae of Apoe-/- mice in response to AngII, were substantially diminished by DAPT. A significant decrease in the proteolytic activity in the aneurysmal tissues and vascular smooth muscle cells (vSMCs) was observed with DAPT (P < 0.01). In human and mouse AAA tissues, increased immunoreactivity of activated Notch signaling correlated strongly with CD38 expression (R2 = 0.61). Collectively, we propose inhibition of Notch signaling as a potential therapeutic target for AAA progression.
Collapse
MESH Headings
- ADP-ribosyl Cyclase 1/metabolism
- Angiotensin II/adverse effects
- Animals
- Aorta/drug effects
- Aorta/metabolism
- Aortic Aneurysm, Abdominal/chemically induced
- Aortic Aneurysm, Abdominal/diagnostic imaging
- Aortic Aneurysm, Abdominal/drug therapy
- Aortic Aneurysm, Abdominal/metabolism
- Cells, Cultured
- Collagen/metabolism
- Cytokines/metabolism
- Dipeptides/pharmacology
- Disease Models, Animal
- Extracellular Matrix/drug effects
- Extracellular Matrix/metabolism
- Gene Expression Regulation/drug effects
- Humans
- Male
- Membrane Glycoproteins/metabolism
- Mice
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Receptors, Notch/antagonists & inhibitors
- Receptors, Notch/metabolism
- Signal Transduction/drug effects
Collapse
Affiliation(s)
- Neekun Sharma
- Department of Cardiovascular Medicine, University of Missouri, Columbia, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, USA
| | - Rishabh Dev
- Department of Cardiovascular Medicine, University of Missouri, Columbia, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, USA
| | - Juan de Dios Ruiz-Rosado
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Santiago Partida-Sanchez
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Mireia Guerau-de-Arellano
- School of Health and Rehabilitation Sciences, Medical Laboratory Science Division, The Ohio State University, Columbus, OH, USA
| | - Pramod Dhakal
- Animal Science Research Center, University of Missouri, Columbia, USA
| | - Helena Kuivaniemi
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Stellenbosch University, Cape Town, South Africa
| | - Chetan P Hans
- Department of Cardiovascular Medicine, University of Missouri, Columbia, USA.
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, USA.
- Medical Pharmacology and Physiology, University of Missouri, Columbia, USA.
| |
Collapse
|
41
|
Rader F, Franklin SS, Mirocha J, Vongpatanasin W, Haley RW, Victor RG. Superiority of Out-of-Office Blood Pressure for Predicting Hypertensive Heart Disease in Non-Hispanic Black Adults. Hypertension 2019; 74:1192-1199. [PMID: 31522619 DOI: 10.1161/hypertensionaha.119.13542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34-1.64 for out-of-office systolic BP and 1.15 [1.04-1.28] for clinic systolic BP; 1.71 [1.43-2.05] for out-of-office diastolic BP, and 1.03 [0.86-1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT00344903.
Collapse
Affiliation(s)
- Florian Rader
- From the Smidt Heart Institute, Hypertension Center of Excellence (F.R., R.G.V.), Cedars-Sinai Medical Center, Los Angeles, CA
| | - Stanley S Franklin
- Heart Disease Prevention Program Department of Medicine, University of California, Irvine (S.S.F.)
| | - James Mirocha
- Research Institute and Clinical and Translational Science Institute (J.M.), Cedars-Sinai Medical Center, Los Angeles, CA
| | - Wanpen Vongpatanasin
- Hypertension Section, Cardiology Division (W.V.), University of Texas Southwestern Medical Center, Dallas
| | - Robert W Haley
- Department of Internal Medicine/Division of Epidemiology (R.W.H.), University of Texas Southwestern Medical Center, Dallas
| | - Ronald G Victor
- From the Smidt Heart Institute, Hypertension Center of Excellence (F.R., R.G.V.), Cedars-Sinai Medical Center, Los Angeles, CA
| |
Collapse
|
42
|
Xu C, Zhang Y, Xu K, Nie JJ, Yu B, Li S, Cheng G, Li Y, Du J, Xu FJ. Multifunctional cationic nanosystems for nucleic acid therapy of thoracic aortic dissection. Nat Commun 2019; 10:3184. [PMID: 31320641 PMCID: PMC6639375 DOI: 10.1038/s41467-019-11068-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 06/17/2019] [Indexed: 02/03/2023] Open
Abstract
Thoracic aortic dissection (TAD) is an aggressive vascular disease that requires early diagnosis and effective treatment. However, due to the particular vascular structure and narrowness of lesion location, there are no effective drug delivery systems for the therapy of TAD. Here, we report a multifunctional delivery nanosystem (TP-Gd/miRNA-ColIV) composed of gadolinium-chelated tannic acid (TA), low-toxic cationic PGEA (ethanolamine-aminated poly(glycidyl methacrylate)) and type IV collagen targeted peptide (ColIV) for targeted nucleic acid therapy, early diagnosis and noninvasive monitoring of TAD. Such targeted therapy with miR-145 exhibits impressive performances in stabilizing the vascular structures and preventing the deterioration of TAD. After the treatment with TP-Gd/miR-145-ColIV, nearly no dissection occurs in the thoracic aortic arches of the mice with TAD model. Moreover, TP-Gd/miRNA-ColIV also demonstrates good magnetic resonance imaging (MRI) ability and can be used to noninvasively monitor the development conditions of TAD.
Collapse
Affiliation(s)
- Chen Xu
- State Key Laboratory of Chemical Resource Engineering, Key Laboratory of Carbon Fiber and Functional Polymers (Beijing University of Chemical Technology), Ministry of Education, Beijing Laboratory of Biomedical Materials, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Yanzhenzi Zhang
- Key Laboratory of Remodeling-Related Cardiovascular Diseases (Ministry of Education), and Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, 100029, China
| | - Ke Xu
- Key Laboratory of Remodeling-Related Cardiovascular Diseases (Ministry of Education), and Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, 100029, China
| | - Jing-Jun Nie
- State Key Laboratory of Chemical Resource Engineering, Key Laboratory of Carbon Fiber and Functional Polymers (Beijing University of Chemical Technology), Ministry of Education, Beijing Laboratory of Biomedical Materials, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Bingran Yu
- State Key Laboratory of Chemical Resource Engineering, Key Laboratory of Carbon Fiber and Functional Polymers (Beijing University of Chemical Technology), Ministry of Education, Beijing Laboratory of Biomedical Materials, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Sijin Li
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Molecular Imaging Precision Medical Collaborative Innovation Center, Shanxi Medical University, Shanxi, 030001, China
| | - Gang Cheng
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Yulin Li
- Key Laboratory of Remodeling-Related Cardiovascular Diseases (Ministry of Education), and Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, 100029, China.
| | - Jie Du
- Key Laboratory of Remodeling-Related Cardiovascular Diseases (Ministry of Education), and Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, 100029, China.
| | - Fu-Jian Xu
- State Key Laboratory of Chemical Resource Engineering, Key Laboratory of Carbon Fiber and Functional Polymers (Beijing University of Chemical Technology), Ministry of Education, Beijing Laboratory of Biomedical Materials, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China.
| |
Collapse
|
43
|
Minocha M, Li H, Chiu YL, Carter D, Othman AA. Models of Variability and Circadian Rhythm in Heart Rate, Blood Pressure, and QT Interval for Healthy Subjects Who Received Placebo in Phase I Trials. Clin Transl Sci 2019; 12:470-480. [PMID: 31021448 PMCID: PMC6742942 DOI: 10.1111/cts.12640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/06/2019] [Indexed: 12/02/2022] Open
Abstract
This work characterized the time‐course, circadian rhythm, and inherent variability in key cardiovascular variables (heart rate, corrected QT interval, and systolic and diastolic blood pressure) that are routinely collected as part of safety monitoring in phase I trials. Longitudinal data from 1,035 healthy volunteers who received placebo in 65 single‐dose and multiple‐dose phase I trials conducted by AbbVie were compiled and analyzed using nonlinear mixed‐effects modeling. An independent nonlinear mixed‐effects model was developed for each variable, and combinations of cosine functions were used to capture circadian oscillations. Gender, race, age, and body weight were significant covariates for variability in baseline measures, and the contributions of these covariates were quantitatively characterized. Based on the extensive data set analyzed, the developed models represent valuable tools to help contextualize and differentiate inherent variability that can be expected in a typical phase I setting from true drug‐related cardiovascular safety signals. In addition, these placebo models can be used to support exposure–response analyses that estimate treatment‐related effects on the evaluated cardiovascular measures.
Collapse
Affiliation(s)
- Mukul Minocha
- Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, Illinois, USA
| | - Hong Li
- Data and Statistical Sciences, AbbVie, North Chicago, Illinois, USA
| | - Yi-Lin Chiu
- Data and Statistical Sciences, AbbVie, North Chicago, Illinois, USA
| | - David Carter
- Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, Illinois, USA
| | - Ahmed A Othman
- Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, Illinois, USA
| |
Collapse
|
44
|
Demola P, Crocamo A, Ceriello L, Botti A, Cremonini I, Pattoneri P, Corradi D, Visioli F, Goldoni M, Pelà G. Hemodynamic and ECG responses to stress test in early adolescent athletes explain ethnicity-related cardiac differences. Int J Cardiol 2019; 289:125-130. [PMID: 31072636 DOI: 10.1016/j.ijcard.2019.04.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/10/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Ethnicity is an important determinant of athletes' cardiovascular adaptation. Black adolescent and adult athletes exhibit a left ventricular (LV) hypertrophy with a concentric remodelling higher than their Caucasian counterparts. Scant data, however, are available on race-related differences in hemodynamic response of adolescent athletes to exercise and its relation with heart remodelling. We evaluated if race-specific, sport-related structural and electrical remodelling in adolescent athletes of Caucasian and African ethnicity exclusively depends on race itself rather than on different cardiovascular responses to physical exercise. METHODS We examined 90 adolescent athletes, 60 Caucasian (WA) and 30 Black (BA). All participants underwent thorough clinical, echocardiographic and stress test evaluations. RESULTS BA had greater indexed LV mass (LVM/BSA) with increased relative wall thickness (RWT) implying a concentric remodelling. BA showed higher systolic blood pressure (SBP) compared to WA during the whole exercise test. ECG data showed that BA vs WA had a significant shorter QRS duration in each step considered with a significant greater QT dispersion. BA reached a higher relative pressure peak as compared to WA. RWT was strongly influenced by ethnicity and less by SBP at peak of exercise (PE), although LVM/BSA was significantly related to SBP at PE and just marginally to age and not significantly to race. CONCLUSIONS Black adolescent athletes showed higher SBP during all steps of exercise associated to a different trend. Ethnicity was the main determinant of RWT, suggesting that LV geometry is principally race-related rather than influenced by a different hemodynamic profile to physical activity.
Collapse
Affiliation(s)
- Pierluigi Demola
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | - Antonio Crocamo
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | - Laura Ceriello
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | - Andrea Botti
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | - Isabella Cremonini
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | | | - Domenico Corradi
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | - Francesco Visioli
- Department of Molecular Medicine, University of Padova, Italy; IMDEA-Food, CEI UAM+CSIC, Madrid, Spain
| | - Matteo Goldoni
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy
| | - Giovanna Pelà
- Department of Medicine and Surgery, University Medical School and University Hospital of Parma, Italy.
| |
Collapse
|
45
|
Abstract
OBJECTIVE We aimed to establish reference values for 24 h ambulatory blood pressure (ABP) monitoring in an African community. PATIENTS AND METHODS We randomly recruited 1219 participants of African ancestry from Soweto, a township in Johannesburg. Twenty-four hour ABP was measured using ABP monitors (model 90207; Spacelab). Complete 24 h ABP measurements from 530 healthy participants with a mean age of 38 were used to determine thresholds. RESULTS Twenty-four hour, daytime and night-time systolic and diastolic BP increased significantly with age. The 95th prediction bands of this relation at age 38 years were ∼135/85 mmHg for 24 h, 140/90 mmHg for daytime and 130/80 mmHg for night-time ABP values, respectively. These thresholds and absolute ABP values are similar to those observed in individuals of other demographics. These thresholds increase with age by an average of 1.5 mmHg with each decade's increase in age. CONCLUSION Pending authentication in prospective outcome-based studies, these values might be considered preliminary thresholds to diagnose hypertension in individuals of African descent.
Collapse
|
46
|
Revealing burden of elevated blood pressure among Polish adolescent participants in a population-based ADOPOLNOR study: prevalence and potent risk factors. ANTHROPOLOGICAL REVIEW 2019. [DOI: 10.2478/anre-2019-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
New category for elevated blood pressure introduced and described by JNC-7 for adults and adopted by the 2004 Working Group for children and adolescents stands for a pre-sign to hypertension. The ongoing rise in prevalence of high blood pressure in children and adolescents demands their regular screening. The objective of this study was to determine prevalence of elevated BP in Polish adolescents and explain the role of sex, age and body weight status as potent risk factors for this condition. A population-based cross-sectional survey was carried out on a sample of 4,941 students (2,451 boys and 2,490 girls) aged 10–18, participants in the ADOPOLNOR study. Body height and weight were measured and BMI was calculated. Blood pressure was measured twice on each visit on the right arm using a fully calibrated TECH MED TM-Z mercury gauge sphygmomanometer with sets of exchangeable cuffs and a clinical stethoscope. The blood pressure classification was determined using the surveillance method. The depended outcome variable was the elevated BP compared to normal BP for systolic (SBP), diastolic (DBP) and combined SBP and/or DBP. Explanatory variables included demographic characteristics, sex and age, and weight status. Two-way ANCOVA, Chi-square Pearson correlation, and multivariate logistic regression analysis (MLRA) were performed using the STATISTICA 13.1 data analysis software system; p-value <0.05 was considered statistically significant (StatSoft Inc. Tulsa, OK, USA). A clear gender pattern was found in prevalence of elevated BP with girls being more likely than boys to have elevated BP (4.9%, 5.3% and 7.4% for SBP, DBP and combined SBP and/or DBP in girls vs 3.5%, 3.5% and 5.9% in boys). The proportion of both genders with elevated BP gradually increased with age with 4.8% (SBP), 2.8% (DBP) and 5.8% (SBP and/or DBP), and 5.1%, 6.4% and 8.4% in early and late adolescence, respectively. Fifteen percent of obese adolescents had elevated SBP, 14.3% elevated DBP and 17.8% had elevated either SBP and/or DBP combined. At multivariate approach, the adjusted odds ratio for predictors of elevated BP revealed sex, age and weight status for SBP and SBP and/or DPB combined. Age and weight status were predictive for elevated DBP. Weight status (BMI) showed the highest predictive potential of elevated BP for both genders. The likelihood of developing elevated BP increased at least twice with each BMI category increase. Thus, overweight and obese adolescents were twice (overweight) and 4 to 5 times (obese) more likely than their normal weight counterparts in developing elevated BP. The study results confirmed predictive potential of sex, age, and weight status in developing elevated BP in adolescents. The highest odds of the weight status indicate that it is the strongest confounder of elevated BP condition.
Collapse
|
47
|
Guo X, Fang ZM, Wei X, Huo B, Yi X, Cheng C, Chen J, Zhu XH, Bokha AOKA, Jiang DS. HDAC6 is associated with the formation of aortic dissection in human. Mol Med 2019; 25:10. [PMID: 30925865 PMCID: PMC6441237 DOI: 10.1186/s10020-019-0080-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/19/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The pathological features of aortic dissection (AD) include vascular smooth muscle cell (VSMC) loss, elastic fiber fraction, and inflammatory responses in the aorta. However, little is known about the post-translational modification mechanisms responsible for these biological processes. METHODS A total of 72 aorta samples, used for protein detection, were collected from 36 coronary artery disease (CAD, served as the control) patients and 36 type A AD (TAAD) patients. Chromatin immunoprecipitation (ChIP)-PCR was used to identify the genes regulated by H3K23ac, and tubastatin A, an inhibitor of HDAC6, was utilized to clarify the downstream mechanisms regulated by HDAC6. RESULTS We found that the protein level of histone deacetylase HDAC6 was reduced in the aortas of patients suffering from TAAD and that the protein levels of H4K12ac, and H3K23ac significantly increased, while H3K18ac, H4K8ac, and H4K5ac dramatically decreased when compared with CAD patients. Although H3K23ac, H3K18ac, and H4K8ac increased in the human VSMCs after treatment with the HDAC6 inhibitor tubastatin A, only H3K23ac showed the same results in human tissues. Notably, the results of ChIP-PCR demonstrated that H3K23ac was enriched in extracellular matrix (ECM)-related genes, including Col1A2, Col3A1, CTGF, POSTN, MMP2, TIMP2, and ACTA2, in the aortic samples of TAAD patients. In addition, our results showed that HDAC6 regulates H4K20me2 and p-MEK1/2 in the pathological process of TAAD. CONCLUSIONS These results indicate that HDAC6 is involved in human TAAD formation by regulating H3K23ac, H4K20me2 and p-MEK1/2, thus, providing a strategy for the treatment of TAAD by targeting protein post-translational modifications (PTMs), chiefly histone PTMs.
Collapse
Affiliation(s)
- Xian Guo
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ze-Min Fang
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiang Wei
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China.,NHC Key Laboratory of Organ Transplantation, Wuhan, China.,Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China
| | - Bo Huo
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xin Yi
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Cai Cheng
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Chen
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xue-Hai Zhu
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China.,NHC Key Laboratory of Organ Transplantation, Wuhan, China.,Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China
| | | | - Ding-Sheng Jiang
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. .,Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China. .,NHC Key Laboratory of Organ Transplantation, Wuhan, China. .,Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, China.
| |
Collapse
|
48
|
Oh JH, Hong YM. Blood Pressure Trajectories from Childhood to Adolescence in Pediatric Hypertension. Korean Circ J 2019; 49:223-237. [PMID: 30808073 PMCID: PMC6393321 DOI: 10.4070/kcj.2018.0448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/24/2018] [Indexed: 11/29/2022] Open
Abstract
It has been known for a long time that elevated blood pressure (BP) in the young may persist and progress into adult hypertension (HTN). Multiple studies have revealed the predicted BP trajectory lines starting from childhood and related them to later cardiovascular (CV) risks in adulthood. As a small baby grows into a tall adult, BP will also naturally increase. Among early-life predictors of adult HTN, birth history, such as prematurity, and low birth weight have been popular subjects in research on pediatric HTN, because body size at birth has been reported to be inversely related to the risk of adulthood HTN. The hypothesis of HTN in prematurely born adolescents has been postulated as a physiological predisposition to postnatal excessive weight gain. Current body weight is a well-known independent predictor of HTN in children, and some studies showed that children demonstrating upward crossing of their weight percentiles while growing into adolescents have significantly increased risk for elevated BP later in life. Recently, reports focused on the adverse effect of excessive catch-up growth in this population are gradually drawing attention. Accordingly, children born prematurely or with intrauterine growth restriction who show rapid changes in their weight percentile should be under surveillance with BP monitoring. Prevention of childhood obesity, along with special care for premature infants or infants small for their gestational age, by providing healthy nutritional guidelines should be cardinal strategies for the prevention of adult HTN and CV risks later in life.
Collapse
Affiliation(s)
- Jin Hee Oh
- Department of Pediatrics, St.Vincent's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Young Mi Hong
- Department of Pediatrics, Ewha Womans University Hospital College of Medicine, Seoul, Korea.
| |
Collapse
|
49
|
Liang X, Su S, Hao G, Snieder H, Treiber F, Kapuku G, Wang X. Determinants of pulse wave velocity trajectories from youth to young adulthood: the Georgia Stress and Heart Study. J Hypertens 2019; 37:563-571. [PMID: 30234784 PMCID: PMC6355367 DOI: 10.1097/hjh.0000000000001933] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Increased arterial stiffness measured by pulse wave velocity (PWV) has been shown to be an important parameter of cardiovascular risk. Longitudinal development of PWV from youth to early adulthood and its possible sociodemographic, anthropometric, hemodynamic and behavioral moderators will be illustrated. METHODS Individual growth curves of carotid-distal PWV across age were created for 559 African American and European American men and women with a maximum of five assessments over an average of 7-year follow-up (mean age at participants' first assessment, 22.3 ± 3.4). RESULTS African Americans and men had significantly higher PWV than did European Americans and women (Ps < 0.01), respectively. A three-way interaction (P < 0.001) between age, sex and ethnicity was observed with African American men displaying a larger rate of increase in PWV with age than the other three ethnic and sex groups. The ethnicity and sex effects on PWV persisted when controlling for other moderators. Waist circumference was the strongest anthropometric predictor but its effect on PWV was only significant in women. Mean arterial pressure was the strongest hemodynamic predictor, marital status of parents was the strongest socioeconomic predictor and marijuana use was the strongest behavioral predictor of PWV. The best-fitting full model explained in total 59.4% of the between-subject variance in PWV with ethnicity, sex and age explaining 25.6%. CONCLUSION We observed significant ethnic and sex differences in longitudinal trajectories of PWV in youth and young adults. In addition, individual differences in PWV growth can largely be explained by mean arterial pressure, waist, marital status of parents and marijuana use.
Collapse
Affiliation(s)
- Xiaohua Liang
- Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China,
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Guang Hao
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Frank Treiber
- College of Nursing, Medical University of South Carolina, Charleston, USA
| | - Gaston Kapuku
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| |
Collapse
|
50
|
Carotid Artery Tortuosity Index Is Associated With the Need for Early Aortic Root Replacement in Patients With Loeys-Dietz Syndrome. J Comput Assist Tomogr 2018; 42:747-753. [PMID: 29901510 DOI: 10.1097/rct.0000000000000764] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to determine if carotid arterial tortuosity represents a marker of disease severity in Loeys-Dietz syndrome (LDS). METHODS Fifty-four 54 LDS patients (mean age, 17.0 years) who underwent computed tomogram angiography from January 2004 to December 2013 were retrospectively identified. Carotid artery tortuosity index (CATI) was calculated from computed tomogram angiography. Clinical variables were obtained from the medical records. Relationship between CATI and need for aortic root replacement was evaluated with Cox proportional hazard model and Kaplan-Meier analysis. RESULTS Higher CATI was associated with the need for aortic root replacement (P < 0.001) in the univariate Cox proportional hazard model. Patients were stratified based on both CATI and aortic root size in Kaplan-Meier analysis, and patients with higher CATI were more likely to require aortic root replacement (P < 0.001) in both aortic root size strata. CONCLUSION Increased carotid artery tortuosity is associated with the need for early aortic root replacement in patients with LDS.
Collapse
|