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Mohammed A, Mamoojee YH, Quinton R. Testosterone-induced erythrocytosis in transgender males: Challenges arising from an increasing prevalence of metabolic syndrome and wider therapeutic indications for prescribing SGLT2 inhibitor drugs. Best Pract Res Clin Endocrinol Metab 2024; 38:101930. [PMID: 39198051 DOI: 10.1016/j.beem.2024.101930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2024]
Affiliation(s)
- Azmi Mohammed
- Department of Endocrinology & Metabolism, John Hopkins Aramco Healthcare, Kingdom of Saudi Arabia.
| | - Yaasir H Mamoojee
- Department of Endocrinology, Newcastle Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Richard Quinton
- Northern Regional Gender Dysphoria Service, Cumbria Northumberland Tyne & Wear NHS Foundation Trust, Newcastle-upon-Tyne, UK; Department of Metabolism, Digestion & Reproduction, Imperial College London, UK
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Bao H, Huang Y, Sun Y, Chen Y, Luo Y, Yan L, Man S, Yu C, Lv J, Ge M, Wang L, Li L, Wang B, Liu H, Liu X. Prevalence of anemia of varying severity, geographic variations, and association with metabolic factors among women of reproductive age in China: a nationwide, population-based study. Front Med 2024:10.1007/s11684-024-1070-x. [PMID: 39060865 DOI: 10.1007/s11684-024-1070-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/08/2024] [Indexed: 07/28/2024]
Abstract
To investigate the epidemiological characteristics of anemia of varying severity among women of reproductive age, we conducted a nationwide, cross-sectional study between January 1, 2019 and December 31, 2019, including 4 184 547 nonpregnant women aged 18-49 years from all 31 provinces in the mainland of China. Anemia was defined as having hemoglobin concentration < 120.0 g/L and categorized as mild, moderate, and severe. Multivariate logistic models with cluster effect were used to explore the association of anemia and metabolic risk factors. The standardized prevalence of anemia and moderate and worse anemia among women of reproductive age in China was 15.8% (95% CI 15.1%-16.6%) and 6.6% (6.3%-7.0%), respectively. The prevalence of anemia and the proportion of moderate and worse anemia significantly increased with age. We also observed great geographic variations in the prevalence of anemia, with a high likelihood in south, central, and northwest China. Moderate and/or severe anemia was positively associated with overweight and obesity, diabetes, and impaired kidney function. In conclusion, anemia remains a significant challenge for women of reproductive age in China. Geographic variations and metabolic risk factors should be considered in the comprehensive and targeting strategy for anemia reduction.
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Affiliation(s)
- Heling Bao
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Yuanyuan Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Yi Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Yunli Chen
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Yan Luo
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Liping Yan
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Sailimai Man
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Meinian Institute of Health, Beijing, 100044, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Meili Ge
- Anaemia Diagnosis and Treatment Center, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300052, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.
- Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China.
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China.
| | - Bo Wang
- Meinian Institute of Health, Beijing, 100044, China.
- Peking University Health Science Center Meinian Public Health Institute, Beijing, 100191, China.
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China.
| | - Hui Liu
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China.
| | - Xiaoxi Liu
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China.
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Taha Z, Elhag H, Hassan AA, Adam I. Association Between Hemoglobin Level, Anemia, and Hypertension Among Adults in Northern Sudan: A Community-Based Cross-Sectional Study. Vasc Health Risk Manag 2024; 20:323-331. [PMID: 39070218 PMCID: PMC11277984 DOI: 10.2147/vhrm.s472480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
Background Hypertension and anemia are major health problems globally. However, data regarding the association between hypertension and hemoglobin/anemia among adults are few and controversial. Therefore, the current study aimed to investigate the associations between hemoglobin/anemia and hypertension among Sudanese adults. Methods A community-based cross-sectional study was conducted in Northern Sudan from September to December 2022. The participants' sociodemographic characteristics were assessed using a questionnaire. Standardized procedures measured participants' weight, height, body mass index (BMI), hemoglobin, and hypertension. Multivariate regression analysis was performed to determine the association between anemia and hypertension. Results Three hundred eighty-four adults were enrolled; 195 (50.8%) and 189 (49.2%) were males and females, respectively. The median interquartile age of the enrolled adults of age, BMI, and hemoglobin level was 45.0 (33.0‒55.8) years, 26.6 (22.6‒30.6) kg/m2, and 13.4 (12.4‒14.4) g/dl, respectively. Of 384 adults, 216 (56.3%) had hypertension, and 148 (38.5%) were newly diagnosed hypertensive. Eighty-six adults (22.4%) had anemia. In univariate analysis, while increasing age, being female, being unmarried, having a positive family history of hypertension, and increasing BMI were positively associated with hypertension, anemia was inversely associated with hypertension. Education, occupation, cigarette smoking, and alcohol consumption were not associated with hypertension. In multivariate analysis, age (adjusted odd ratio [AOR] = 1.05, 95% confidence interval [CI] = 1.03‒1.07), BMI (AOR= 1.07, 95% CI = 1.03‒1.12) were inversely associated with hypertension, being female (AOR = 2.92, 95% CI = 1.43‒5.94), positive family history of hypertension (AOR= 1.73, 95% CI = 1.09‒2.75), and hemoglobin level (AOR= 1.34, 95% CI = 1.12‒1.61) were associated with hypertension. Anemia (AOR = 0.58, 95% CI = 0.34‒0.99) was inversely associated with hypertension. Conclusion Both anemia and hypertension are major public health problems in Northern Sudan. Anemia is associated with hypertension. Further research is needed to explore the complex association between hemoglobin/anemia and hypertension.
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Affiliation(s)
- Zainab Taha
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Hiba Elhag
- Department of Public Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ahmed Ali Hassan
- Department of Public Health, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ishag Adam
- Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
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Alemayehu E, Mohammed O, Debash H, Belete MA, Weldehanna DG, Tilahun M, Gedefie A, Ebrahim H. Hematological parameters of hypertensive patients in northeast Ethiopia: A comparative cross-sectional study. Heliyon 2024; 10:e34069. [PMID: 39071591 PMCID: PMC11283052 DOI: 10.1016/j.heliyon.2024.e34069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/24/2024] [Accepted: 07/03/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction Hypertension has emerged as a significant public health concern, ranking among the leading causes of mortality in low- and middle-income countries. Moreover, it is closely associated with structural and functional alterations in hematopoietic cells. Therefore, this study aimed to evaluate the hematological parameters of hypertensive patients in Northeast Ethiopia. Methods A comparative cross-sectional study was conducted from January to March 2023, involving 248 participants. This included 124 hypertensive patients and 124 apparently healthy controls selected using a systematic random sampling technique. Socio-demographic and clinical data were collected through a structured questionnaire, and anthropometric measurements were obtained following established guidelines. Ethical approval was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences at Wollo University. After obtaining informed consent, approximately 5 ml of venous blood was drawn from each participant for complete blood count and fasting blood glucose analysis, performed using the Mindray BC-3000 Plus hematology analyzer and the DIRUI CS-T240 automated clinical chemistry analyzer, respectively. Data analysis involved independent t-tests, Mann-Whitney U-tests, correlation tests, and logistic regression. A p-value of <0.05 was considered statistically significant. Results The study found that white blood cell count, platelet count, platelet distribution width, red cell distribution width, and mean platelet volume were significantly higher in hypertensive patients compared to the control group (p < 0.05). Conversely, red blood cell count, hematocrit, and hemoglobin levels were significantly higher in the control group than in hypertensive patients (p < 0.05). Additionally, white blood cells and platelets exhibited a positive correlation with systolic and diastolic blood pressure (p < 0.05), while red blood cell count, hematocrit, and hemoglobin demonstrated a negative correlation with blood pressure indices and body mass index. Anemia was observed in 20.2 % of hypertensive patients. Notably, an abnormal body mass index (AOR: 3.5, 95 % CI: 1.3-9.6, p = 0.011) and high systolic blood pressure (AOR: 4.6, 95 % CI: 1.3-15.5, p = 0.013) were significantly associated with anemia among hypertensive patients. Conclusion This study identified significant differences in various hematological parameters between hypertensive patients and the control group. Routine assessments of hematological parameters should be considered to effectively manage hypertension-related complications in hypertensive patients.
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Affiliation(s)
- Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtu Debash
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik Weldehanna
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Mahmood A, Samad S, Haider H, Hassan W, Mushtaq R, Perwaiz A, Ali A, Azharuddin M. Association of Red Blood Cell and Platelet Parameters with Metabolic Syndrome: A Systematic Review and Meta-Analysis of 170,000 Patients. Horm Metab Res 2024; 56:517-525. [PMID: 38195797 DOI: 10.1055/a-2241-5361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
This systematic review and meta-analysis aim to establish associations between metabolic syndrome (MetS) and erythrocyte and platelet markers, contributing to improved diagnostic tests for identifying individuals at risk. Observational studies and Randomized Controlled Trials (RCTs) were included. The standardized mean difference (SMD) and 95% confidence intervals (CI) of erythrocyte and platelet markers between individuals with and without MetS were used as effect size (inverse variance model). Methodological quality assessment was conducted using the Newcastle-Ottawa scale (NOS) for observational studies and the Cochrane Risk of Bias tool 2.0 for RCTs. The analysis included 51 articles. Compared to controls, individuals with MetS exhibited significantly higher concentrations of mean red blood cell count [Standardized Mean Difference (95% CI): 0.15 (0.13-0.18); p<0.00001], hemoglobin [0.24 (0.18-0.31); p<0.00001], blood platelet count [5.49 (2.78-8.20); p<0.0001], and red blood cell distribution width [(0.55 (0.05-1.04); p=0.03]. Regarding mean platelet volume [0.16 (- 0.03 to 0.35); p=0.10] and platelet-to-lymphocyte ratio (PLR) [7.48 (-2.85-17.81); p=0.16], a non-significant difference was observed in patients with MetS. There was no statistically significant difference in hematocrit counts between the two groups [0.47 (-0.40 to -1.34); p=0.29]. Biomarkers such as mean red blood cell count, hemoglobin, blood platelet count, and RDW are associated with higher levels in patients in MetS, whereas mean platelet volume and PLR tend to be lower. These markers can potentially provide new avenues for early diagnosis of MetS.
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Affiliation(s)
- Aysal Mahmood
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Saba Samad
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hoorain Haider
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Wardah Hassan
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rabeea Mushtaq
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Aimen Perwaiz
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abraish Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Alves S, Silva F, Esteves F, Costa S, Slezakova K, Alves M, Pereira M, Teixeira J, Morais S, Fernandes A, Queiroga F, Vaz J. The Impact of Sleep on Haematological Parameters in Firefighters. Clocks Sleep 2024; 6:291-311. [PMID: 39051311 PMCID: PMC11270419 DOI: 10.3390/clockssleep6030021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Sleep is a vital process that impacts biological functions such as cell renewal, bone regeneration, and immune system support. Disrupted sleep can interrupt erythropoiesis, leading to fewer red blood cells, reduced haemoglobin concentration, and decreased haematocrit levels, potentially contributing to haematological disorders. This is particularly concerning for shift workers for example firefighters. While previous studies have explored sleep's adverse effects on various professions, research specific to firefighters is limited. This study investigates the relationship between sleep quality and haematological parameters among firefighters in Northeast Portugal. From a sample of 201 firefighters, variations in red blood cells, haemoglobin, and haematocrit values were linked to sleep quality. The study utilised non-parametric tests (Wilcoxon-Mann-Whitney, Spearman's correlation) to explore the connection between sleep quality and haematological profile. The impact of covariates on haematological parameters was assessed using non-parametric ANCOVA (Quade's). A multiple regression analysis was employed to further understand how sleep quality and various confounding variables impact haematological levels. Findings suggest a negative link between sleep quality and haematological levels, meaning that as sleep quality deteriorates, there is a tendency for haematological levels to decrease, as indicated by Spearman's correlation (rRBC = -0.157, pRBC = 0.026; rHb = -0.158, pHb = 0.025; rHCT = -0.175, pHCT = 0.013). As observed in scientific literature, the correlation found suggests a possible inhibition of erythropoiesis, the process responsible for red blood cell production. Despite firefighters presenting a haematological profile within the reference range (RBC: 5.1 × 106/mm3 (SD ± 0.4), Hb: 15.6 g/dL (SD ± 1.3), 47% (SD ± 1.0), there is already an observable trend towards lower levels. The analysis of co-variables did not reveal a significant impact of sleep quality on haematological levels. In conclusion, this study underscores the importance of sleep quality in determining haematological parameters among firefighters. Future research should investigate the underlying mechanisms and long-term implications of poor sleep quality on firefighter health. Exploring interventions to enhance sleep quality is vital for evidence-based strategies promoting firefighter well-being.
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Affiliation(s)
- Sara Alves
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Francisca Silva
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal (F.Q.)
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health, Rua das Taipas 135, 4050-600 Porto, Portugal; (F.E.); (S.C.); (J.T.)
- EPIUnit, National Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Solange Costa
- Environmental Health Department, National Institute of Health, Rua das Taipas 135, 4050-600 Porto, Portugal; (F.E.); (S.C.); (J.T.)
- EPIUnit, National Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Klara Slezakova
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal; (K.S.); (S.M.)
| | - Maria Alves
- AquaValor-Centro de Valorização e Transferência de Tecnologia da Água-Associação, Rua Dr. Júlio Martins n.º 1, 5400-342 Chaves, Portugal;
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal;
| | - Maria Pereira
- LEPABE-ALiCE, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - João Teixeira
- Environmental Health Department, National Institute of Health, Rua das Taipas 135, 4050-600 Porto, Portugal; (F.E.); (S.C.); (J.T.)
- EPIUnit, National Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal; (K.S.); (S.M.)
| | - Adília Fernandes
- Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Felisbina Queiroga
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal (F.Q.)
| | - Josiana Vaz
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal;
- Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
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Wasco C, Khan Z, Willett A, Volio A, Carter C, Kesari A, Kothari S, Scheidemantel A, Bennett K, Schafer J, Lockhart M, Chopra N. Incidence and prevalence of hypertension in 18-40-year-old patients referred for palpitations with normal cardiac monitor findings. J Clin Hypertens (Greenwich) 2024; 26:696-702. [PMID: 38641880 PMCID: PMC11180676 DOI: 10.1111/jch.14813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/21/2024]
Abstract
Sixteen percent of patients referred for cardiology evaluation are found to have no cause for palpitations. Studies show that hypertension intricately influences "heart rate" and "contractility,?" the key components of "palpitation." While the prevalence of hypertension is 22.4% in 18-39-year-olds, the relationship between palpitations and hypertension remains unknown in this age group. In our study, we assessed the incidence and prevalence of hypertension over 5 years in 18-40-year-olds referred for palpitations who had no known arrhythmic cause for palpitations between January 1, 206 and December 31, 2017. We found that over a period of 2.2 (0.7-4.1) years, an additional 56% patients were diagnosed with stage 1 (65/130) and stage 2 (28/130) hypertension, increasing the prevalence from 16% at the start of the study period to 72% at the end of the study period (p < .0001). Hypertensive patients were obese (BMI: 29 [24-36] kg/m2 vs. 25 [22-31] kg/m2; p = .03), used nonsteroidal anti-inflammatory drugs (NSAIDs) (62 vs. 35%; p = .04), had a stronger family history of hypertension (55 vs. 4%; p < .0001) and exhibited higher systolic (124[120-130] mmHg vs. 112[108-115] mmHg; p < .0001) and diastolic (80[76-83] mmHg vs. 72[69-75] mmHg; p < .0001) blood pressures. Hypertension is commonly diagnosed in 18-40-year-old predominantly white female patients referred for palpitations without a known arrhythmic cause. The possibility of untreated hypertension causing palpitations in this cohort needs further evaluation.
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Affiliation(s)
- Christopher Wasco
- Department of Internal MedicineRiverside Methodist HospitalColumbusOhioUSA
| | - Zeryab Khan
- Department of Internal MedicineOhioHealth Doctors HospitalColumbusOhioUSA
| | - Aimee Willett
- Department of Internal MedicineRiverside Methodist HospitalColumbusOhioUSA
| | - Andrew Volio
- Department of Internal MedicineOhioHealth Doctors HospitalColumbusOhioUSA
| | - Cody Carter
- Department of Internal MedicineOhioHealth Doctors HospitalColumbusOhioUSA
| | - Aditya Kesari
- Department of Internal MedicineRiverside Methodist HospitalColumbusOhioUSA
| | - Shaili Kothari
- Department of Internal MedicineRiverside Methodist HospitalColumbusOhioUSA
| | | | - Katelyn Bennett
- Department of Internal MedicineOhioHealth Doctors HospitalColumbusOhioUSA
| | - Jessalyn Schafer
- Department of Internal MedicineOhioHealth Doctors HospitalColumbusOhioUSA
| | - Marie Lockhart
- Department of PharmacyRiverside Methodist HospitalColumbusOhioUSA
| | - Nagesh Chopra
- Section of Cardiac ElectrophysiologyDepartment of Cardiology, OhioHealth Heart and Vascular PhysiciansRiverside Methodist HospitalColumbusOhioUSA
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Olesen TB, Glintborg D, Jøhnk F, Olsen MH, Andersen MS. Blood pressure responses to testosterone therapy are amplified by hematocrit levels in opioid-induced androgen deficiency: a double-blind, randomized, placebo-controlled trial. J Hypertens 2024; 42:893-901. [PMID: 38088425 DOI: 10.1097/hjh.0000000000003638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Our study aimed to examine the effect of testosterone replacement therapy (TRT) on blood pressure in opioid-treated men with relative hypogonadism, and whether the effect of TRT on blood pressure was modified by body composition, red blood cell levels, or carotid intima media thickness. Men (over 18 years old) receiving opioid treatment and total testosterone less than 12 nmol were randomly assigned to receive either TRT or placebo. Baseline and 6-month measurements included anthropometric measurements, office blood pressure (OBPM), 24-h ambulatory blood pressure, blood samples, and carotid ultrasound. The mean systolic OBPM increased by 6.2 mmHg (0.2-12.1) in the TRT group and decreased by 7.0 mmHg (1.0-15.1) in the placebo group, with a mean difference of 13.2 mmHg (3.4-23.1), P = 0.01. In the TRT group, a 10 mmHg increase in systolic OBPM was associated with an increase in hematocrit of 0.3% points (0.1-0.5) ( P = 0.01), whereas no association was observed in the placebo group ( P = 0.266). Daytime SBP showed a nonsignificant increase of 5.2 mmHg (-1.7, 12.1) ( P = 0.134) in the TRT group compared to that in the placebo group. However, the impact of TRT on the increase in daytime ambulatory blood pressure was significantly accentuated by baseline values of BMI, hematocrit, and hemoglobin. In conclusion, TRT was associated with higher OBPM compared to placebo, and the increase in blood pressure was linked to higher hematocrit during TRT. Our data suggest that men with opioid-induced androgen deficiency, particularly those with obesity or red blood cell levels in the upper normal range, are more susceptible to increased daytime SBP during TRT.
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Affiliation(s)
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense
| | - Frederik Jøhnk
- Department of Internal Medicine, Sygehus Lillebaelt, Kolding
| | - Michael Hecht Olsen
- Department of Internal Medicine, Cardiology Section, Holbaek Hospital, Holbaek, Denmark
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9
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Hsu K. Erythroid anion transport, nitric oxide, and blood pressure. Front Physiol 2024; 15:1363987. [PMID: 38660536 PMCID: PMC11039876 DOI: 10.3389/fphys.2024.1363987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Glycophorin A and glycophorin B are structural membrane glycoproteins bound in the band 3 multiprotein complexes on human red blood cells (RBCs). Band 3 is an erythroid-specific anion exchanger (AE1). AE1-mediated HCO3 - transport provides the substrate for the enzyme-catalyzed conversion HCO3 - (aq) ⇌ CO2(g), which takes place inside the RBCs. Bicarbonate transport via AE1 supports intravascular acid-base homeostasis and respiratory excretion of CO2. In the past decade, we conducted several comparative physiology studies on Taiwanese people having the glycophorin variant GPMur RBC type (which accompanies greater AE1 expression). We found that increased anion transport across the erythrocyte membrane not only enhances gas exchange and lung functions but also elevates blood pressure (BP) and reduces nitric oxide (NO)-dependent vasodilation and exhaled NO fraction (FeNO) in healthy individuals with GP.Mur. Notably, in people carrying the GPMur blood type, the BP and NO-dependent, flow-mediated vasodilation (FMD) are both more strongly correlated with individual hemoglobin (Hb) levels. As blood NO and nitrite (NO2 -) are predominantly scavenged by intraerythrocytic Hb, and NO2 - primarily enters RBCs via AE1, could a more monoanion-permeable RBC membrane (i.e., GPMur/increased AE1) enhance NO2 -/NO3 - permeability and Hb scavenging of NO2 - and NO to affect blood pressure? In this perspective, a working model is proposed for the potential role of AE1 in intravascular NO availability, blood pressure, and clinical relevance.
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Affiliation(s)
- Kate Hsu
- The Laboratory of Immunogenetics, Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
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10
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Schill F, Engström G, Melander O, Timpka S, Enhörning S. The possible role of the vasopressin system in hematopoiesis. Sci Rep 2024; 14:5085. [PMID: 38429469 PMCID: PMC10907562 DOI: 10.1038/s41598-024-55772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
Vasopressin is a pleiotropic hormone that controls body fluid homeostasis. Vasopressin has also been proposed to be involved in erythropoiesis, thrombocyte activity and inflammation. However, whether increasing vasopressin is associated with changes in hematopoietic markers is not known. To evaluate this gap of knowledge we measured the vasopressin marker copeptin and markers of erythropoiesis (erythrocyte count, hemoglobin (Hb), red blood cell distribution width (RDW), mean corpuscular volume (MCV), erythrocyte volume fraction (EVF)), leukocyte count (total count, lymphocytes, neutrophils) and thrombocyte count in 5312 participants from the Swedish CArdioPulmonary bioImage Study (SCAPIS). The associations between increasing copeptin tertile and the hematopoietic markers were analyzed in multivariate linear regression analyses. We found that increasing copeptin tertile was significantly (p < 0.001) associated with increasing erythrocytes, RDW, EVF, Hb, leukocytes and neutrophils after adjustment for age, sex, current smoking, prevalent diabetes, hypertension, creatinine, body mass index and physical activity. Increasing copeptin tertile was, however, not associated with change in MCV, lymphocyte or thrombocyte count. In conclusion, we found that increasing copeptin levels are positively associated with markers of erythropoiesis and leukocyte count in the general population. These results warrant further research on possible mechanistic effects of vasopressin on hematopoiesis.
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Affiliation(s)
- Fredrika Schill
- Department of Cardiology, Skåne University Hospital, Carl-Bertil Laurells Gata 9, 214 28, Malmö, Sweden.
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden.
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Jan Waldenströms Gata 11 A, 214 28, Malmö, Sweden
| | - Simon Timpka
- Perinatal and Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, 214 28, Malmö, Sweden
- Department of Obstetrics and Gynecology, Skåne University Hospital, Jan Waldenströms gata 47, 214 28, Malmö, Sweden
| | - Sofia Enhörning
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Jan Waldenströms Gata 11 A, 214 28, Malmö, Sweden
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11
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Mansoori A, Farizani Gohari NS, Etemad L, Poudineh M, Ahari RK, Mohammadyari F, Azami M, Rad ES, Ferns G, Esmaily H, Ghayour Mobarhan M. White blood cell and platelet distribution widths are associated with hypertension: data mining approaches. Hypertens Res 2024; 47:515-528. [PMID: 37880498 DOI: 10.1038/s41440-023-01472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
In this paper, we are going to investigate the association between Hypertension (HTN) and routine hematologic indices in a cohort of Iranian adults. The data were obtained from a total population of 9704 who were aged 35-65 years, a prospective study was designed. The association between hematologic factors and HTN was assessed using logistic regression (LR) analysis and a decision tree (DT) algorithm. A total of 9704 complete datasets were analyzed in this cohort study (N = 3070 with HTN [female 62.47% and male 37.52%], N = 6634 without HTN [female 58.90% and male 41.09%]). Several variables were significantly different between the two groups, including age, smoking status, BMI, diabetes millitus, high sensitivity C-reactive protein (hs-CRP), uric acid, FBS, total cholesterol, HGB, LYM, WBC, PDW, RDW, RBC, sex, PLT, MCV, SBP, DBP, BUN, and HCT (P < 0.05). For unit odds ratio (OR) interpretation, females are more likely to have HTN (OR = 1.837, 95% CI = (1.620, 2.081)). Among the analyzed variables, age and WBC had the most significant associations with HTN OR = 1.087, 95% CI = (1.081, 1.094) and OR = 1.096, 95% CI = (1.061, 1.133), respectively (P-value < 0.05). In the DT model, age, followed by WBC, sex, and PDW, has the most significant impact on the HTN risk. Ninety-eight percent of patients had HTN in the subgroup with older age (≥58), high PDW (≥17.3), and low RDW (<46). Finally, we found that elevated WBC and PDW are the most associated factor with the severity of HTN in the Mashhad general population as well as female gender and older age.
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Affiliation(s)
- Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Leila Etemad
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohadeseh Poudineh
- Student of Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Rana Kolahi Ahari
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mobin Azami
- Student of Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical sciences, Birjand, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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12
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Liu X, Yang C, Zhang X, Ye R, Li X, Zhang Z, Jia S, Sun L, Meng Q, Chen X. Association between hemoglobin concentration and hypertension risk in native Tibetans at high altitude. J Clin Hypertens (Greenwich) 2024; 26:17-23. [PMID: 37724706 PMCID: PMC10795086 DOI: 10.1111/jch.14726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Previous studies examining the association between hemoglobin concentration and hypertension have yielded inconsistent results. There is still a lack of evidence regarding the association between hemoglobin concentration and hypertension risk in native Tibetans at high altitude. We performed this cross-sectional study in Luhuo County of Ganzi Tibetan Autonomous Prefecture (average altitude of 3500 m). In this study, we enrolled 1547 native Tibetans. The association between hemoglobin concentration and hypertension risk was examined by multivariate binary logistic regression and smooth curve fitting. Native Tibetans with hypertension had significantly higher hemoglobin concentrations than those without hypertension (165.9 ± 21.5 g/L vs. 157.7 ± 19.2 g/L, P < 0.001). An increase in hemoglobin concentration of 1 g/L was associated with hypertension (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.02) after confounder adjustment. The highest hemoglobin concentration group (exceeding 173 g/L) was associated with an increased hypertension risk compared with the bottom quartile of hemoglobin concentration (OR 2.39, 95% CI 1.48-3.85). Hemoglobin concentration (per 1 g/L change) exceeding 176 g/L was significantly associated with an increased hypertension risk (OR 1.04, 95% CI 1.03-1.06). Additionally, high-altitude polycythemia significantly increased the hypertension risk compared with a normal hemoglobin concentration (OR 2.92, 95% CI 1.25-6.86). A similar result was observed for mild polycythemia (OR 1.74, 95% CI 1.29-2.34). In conclusion, hemoglobin concentration was associated with hypertension risk in native Tibetans. When the hemoglobin concentration exceeded a certain value (approximately 176 g/L), the risk of hypertension was significantly increased.
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Affiliation(s)
- Xueting Liu
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Changqiang Yang
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xin Zhang
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Runyu Ye
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xinran Li
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Zhipeng Zhang
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Shanshan Jia
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Lirong Sun
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Qingtao Meng
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xiaoping Chen
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
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13
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Choudhary MK, Bouquin H, Hytönen J, Koskela JK, Niemelä O, Nevalainen PI, Mustonen J, Pörsti I. Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness. J Clin Med 2023; 12:7623. [PMID: 38137695 PMCID: PMC10743951 DOI: 10.3390/jcm12247623] [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: 10/16/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
High haemoglobin level has been associated with metabolic syndrome, elevated blood pressure (BP), and increased mortality risk. In this cross-sectional study, we investigated the association of blood haemoglobin with haemodynamics in 743 subjects, using whole-body impedance cardiography and pulse wave analysis. The participants were allocated to sex-stratified haemoglobin tertiles with mean values 135, 144, and 154 g/L, respectively. The mean age was similar in all tertiles, while body mass index was higher in the highest versus the lowest haemoglobin tertile. The highest haemoglobin tertile had the highest erythrocyte and leukocyte counts, plasma C-reactive protein, uric acid, renin activity, and aldosterone. The lipid profile was less favourable and insulin sensitivity lower in the highest versus the lowest haemoglobin tertile. Aortic BP, cardiac output, and systemic vascular resistance were similar in all tertiles, while the pulse wave velocity (PWV) was higher in the highest versus the lowest haemoglobin tertile. In linear regression analysis, age (Beta 0.478), mean aortic BP (Beta 0.178), uric acid (Beta 0.150), heart rate (Beta 0.148), and aldosterone-to-renin ratio (Beta 0.123) had the strongest associations with PWV (p < 0.001 for all). Additionally, haemoglobin concentration was an explanatory factory for PWV (Beta 0.070, p = 0.028). To conclude, blood haemoglobin concentration had a small direct and independent association with a measure of large artery stiffness.
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Affiliation(s)
- Manoj Kumar Choudhary
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Heidi Bouquin
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Jere Hytönen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Jenni K. Koskela
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland;
| | - Pasi I. Nevalainen
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
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14
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Alshuweishi Y, Basudan AM, Alfaifi M, Daghistani H, Alfhili MA. Association of the HALP Score with Dyslipidemia: A Large, Nationwide Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2002. [PMID: 38004051 PMCID: PMC10673399 DOI: 10.3390/medicina59112002] [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: 10/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Dyslipidemia is a major risk factor for cardiovascular disease (CVD). The identification of new biomarkers that may enhance the risk assessment of lipid abnormalities is a promising approach in improving risk prediction of CVD. There is no information on the association of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score with dyslipidemia. The aim of this study was to investigate the clinical utility of the HALP score in light of dyslipidemia. Materials and Methods: A retrospective analysis of 7192 subjects was initiated to assess the association between the HALP score and disturbed lipid markers. Medians were compared by Mann-Whitney U or Kruskal-Wallis tests and the diagnostic performance and risk assessment were calculated. Results: Median HALP score among all subjects was 53.3, with varying values between males and females. Notably, median HALP was significantly elevated in all forms of dyslipidemia and among males and females irrespective of age. The odds of having elevated HALP score values were significantly higher in all lipid abnormalities. Moreover, HALP score was significantly yet weakly correlated with lipid markers, while the highest diagnostic accuracy of the HALP score was observed with an elevated ratio of total cholesterol to high-density lipoprotein (TC/HDL) (area under the curve, AUC = 0.6411, p < 0.0001). The decision curve analysis (DCA) showed that the HALP score can reliably predict the presence of dyslipidemia. Conclusions: This study demonstrates that the HALP score is a novel, cost-effective index that is associated with a disturbed lipid profile. Further investigation of the nature of this association is needed.
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Affiliation(s)
- Yazeed Alshuweishi
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| | - Ahmed M. Basudan
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
| | - Mohammed Alfaifi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Hussam Daghistani
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Clinical Pathology, Al Borg Diagnostics, Jeddah 23437, Saudi Arabia
| | - Mohammad A. Alfhili
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia; (Y.A.)
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15
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Tapio J, Kiviniemi AM, Perkiömäki J, Junttila MJ, Huikuri HV, Ukkola O, Koivunen P, Tulppo MP. Lower hemoglobin levels associate with higher baroreflex sensitivity and heart rate variability. Am J Physiol Heart Circ Physiol 2023; 325:H629-H634. [PMID: 37566112 PMCID: PMC10659262 DOI: 10.1152/ajpheart.00415.2023] [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: 07/07/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
The aim of this study was to cross-sectionally examine whether hemoglobin (Hb) levels within the normal variation associate with heart rate variability (HRV) measures and baroreflex sensitivity (BRS). The study population included 733 Finnish subjects of the OPERA cohort (aged 41-59 yr, 53% males, 51.7% treated for hypertension) of whom HRV was measured from a standardized 45-min period and whose Hb levels were within the Finnish reference intervals. The low Hb tertile (mean Hb, 135 g/L) had an overall healthier metabolic profile compared with the high Hb tertile (mean Hb, 152 g/L). BRS was higher in the low Hb tertile compared with the high Hb tertile (P < 0.05). R-R interval (RRi) and standard deviation (SD) of the RRi (SDNN)index were the longest in the low Hb tertile regardless of posture. Of the spectral components of HRV, HF power was the highest in the low Hb tertile regardless of posture (P < 0.05). In a stepwise logistic regression model, BRS associated negatively with Hb levels after adjusting for covariates (B = -0.160 [-0.285; -0.035]). Similar associations were observed for SDNNindex when lying down (B = -0.105 [-0.207; -0.003]) and walking (B = -0.154 [-0.224; -0.083]). For HF power negative associations with Hb levels were observed when lying down (B = -0.110 [-0.180; -0.040]), sitting (B = -0.150 [-0.221; -0.079]), and in total analysis (B = -0.124 [-0.196; -0.053]). Overall, lower Hb levels associated independently with healthier cardiac autonomic function.NEW & NOTEWORTHY Heart rate variability (HRV) and baroreflex sensitivity (BRS), which can be measured noninvasively, can predict cardiac and metabolic diseases. Our findings show that within normal variation subjects with lower hemoglobin (Hb) levels have an overall healthier HRV profile and increased cardiac parasympathetic activity in middle age, independent of age, sex, smoking status, and key metabolic covariates. These findings support our previous findings that Hb levels can be used in assessing long-term risks for cardiometabolic diseases.
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Affiliation(s)
- Joona Tapio
- Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, Oulu, Finland
| | - Antti M Kiviniemi
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Juha Perkiömäki
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - M Juhani Junttila
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Heikki V Huikuri
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Olavi Ukkola
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Peppi Koivunen
- Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, Oulu, Finland
| | - Mikko P Tulppo
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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16
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He Z, Chen Z, de Borst MH, Zhang Q, Snieder H, Thio CHL. Observational and Genetic Evidence for Bidirectional Effects Between Red Blood Cell Traits and Diastolic Blood Pressure. Am J Hypertens 2023; 36:551-560. [PMID: 37432331 PMCID: PMC10502771 DOI: 10.1093/ajh/hpad061] [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: 03/28/2023] [Revised: 06/21/2023] [Accepted: 07/10/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Previous studies have found associations of red blood cell (RBC) traits (hemoglobin and RBC count) with blood pressure; whether these associations are causal is unknown. METHODS We performed cross-sectional analyses in the Lifelines Cohort Study (n = 167,785). Additionally, we performed bidirectional 2 sample Mendelian randomization (MR) analyses to explore the causal effect of the 2 traits on systolic (SBP) and diastolic blood pressure (DBP), using genetic instrumental variables regarding hemoglobin and RBC identified in UK Biobank (n = 350,475) and International Consortium of Blood Pressure studies for SBP and DBP (n = 757,601). RESULTS In cross-sectional analyses, we observed positive associations with hypertension and blood pressure for both hemoglobin (odds ratio [OR] = 1.18, 95% confidence interval [CI]: 1.16-1.20 for hypertension; B = 0.11, 95% CI: 0.11-0.12 for SBP; B = 0.11, 95% CI: 0.10-0.11 for DBP, all per SD) and RBC (OR = 1.14, 95% CI: 1.12-1.16 for hypertension; B = 0.11, 95% CI: 0.10-0.12 for SBP; B = 0.08, 95% CI: 0.08-0.09 for DBP, all per SD). MR analyses suggested that higher hemoglobin and RBC cause higher DBP (inverse-variance weighted B = 0.11, 95% CI: 0.07-0.16 for hemoglobin; B = 0.07, 95% CI: 0.04-0.10 for RBC, all per SD). Reverse MR analyses (all per SD) suggested causal effects of DBP on both hemoglobin (B = 0.06, 95% CI: 0.03-0.09) and RBC (B = 0.08, 95% CI: 0.04-0.11). No significant effects on SBP were found. CONCLUSIONS Our results suggest bidirectional causal relationships of hemoglobin and RBC with DBP, but not with SBP.
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Affiliation(s)
- Zhen He
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, PR China
| | - Zekai Chen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, PR China
| | | | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Chris H L Thio
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Huang L, Song C, Liu Q, Liang X, Ren Y, Huang D, Guan X, An X, Liang X. The associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents: a prospective cohort study. Hypertens Res 2023; 46:2085-2099. [PMID: 37188752 DOI: 10.1038/s41440-023-01304-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
Uncontrolled pediatric hypertension may increase the risk of hypertension in adulthood. Several studies have reported an association between hematological parameters and blood pressure (BP) levels. However, epidemiologic evidence of this association in children and adolescents remains scarce. This study aims to explore the associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents. This longitudinal study was conducted with 1368 participants aged 6-8 years from baseline visit to follow-up visit. Compared with participants from the normal blood pressure (BP) group, participants from the elevated BP group had significantly higher baseline red blood cell (RBC) counts, hemoglobin (Hb) counts and hematocrit (Hct) levels (all P < 0.001). A multilevel linear mixed model was conducted to analyze the relationship between hematological parameters and BP levels. The results suggested that SBP, DBP and MAP increased significantly with a quartile increase of levels of hematological parameters (all P < 0.05). Furthermore, a multilevel mixed logistic regression model was used to analyze the risk of per interquartile range increase in hematological parameters on the incidence of prehypertension and hypertension. The risk of prehypertension and hypertension incidence increased by (1.34 (95%CIs: 1.20, 1.50)), (1.38 (95%CIs: 1.24,1.54)), (1.33 (95%CIs: 1.19,1.50)), (1.14 (95%CIs: 1.03,1.26)) fold with a one-quartile increase in levels of RBC, Hb, Hct and Fe, respectively (all P < 0.05). This longitudinal study showed that hematological parameters were positively associated with BP levels in healthy children and adolescents, which excluded the effect of antihypertensive drugs on BP levels that often appeared in adults.
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Affiliation(s)
- Lan Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Cui Song
- Department of Endocrinology and Genetic Metabolism disease, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Qin Liu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xiaoyue Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Daochao Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xianmin Guan
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xizhou An
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China.
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Nakhaie S, Yazdani R, Shakibi M, Torabian S, Pezeshki S, Bazrafshani MS, Azimi M, Salajegheh F. The effects of antihypertensive medications on severity and outcomes of hypertensive patients with COVID-19. J Hum Hypertens 2023; 37:511-518. [PMID: 35790875 PMCID: PMC9255835 DOI: 10.1038/s41371-022-00716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 02/19/2022] [Accepted: 06/14/2022] [Indexed: 02/03/2023]
Abstract
In Covid-19 pandemic, specific comorbidities are associated with the increased risk of worse outcomes and increased severity of lung injury and mortality. the aim of this study was to investigate the effects of antihypertensive medications on the severity and outcomes of hypertensive patients with COVID-19. This retrospective observational study conducted on patients with COVID-19 who referred to Afzalipour Hospital, Kerman, Iran during the six months from 19 February 2020 to 20 July 2020. The data were collected through medical chart reviews. We assessed 265 patients with Covid-19 and they stratified based on hypertension and type of antihypertension medications. The data were described and Student's t-test, Mann-Whitney U and Fisher exact test were run to compare the patients 'demographical and clinical information. The qualitative variables were compared using the by SPSS software version 23. The results of the present study showed that hypertension was a prevalent comorbidity among patients with COVID-19 and hypertensive patients compared to other patients without any comorbidity who were older (P-value: 0.03). The oxygen saturation was higher for the patients in the control group than hypertensive patients (P-value: 0.01). The severity of COVID-19 and its outcome were not different between the patients who took or did not take antihypertensive medications and also the type of antihypertensive medications. Hypertensive patients did not show any significant difference in survival, hospital stay, ICU admission, disease severity, and invasive medical ventilation in other normotensive patients with COVID-19.
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Affiliation(s)
- Samira Nakhaie
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Rostam Yazdani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Shakibi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheila Torabian
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Pezeshki
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Maliheh Sadat Bazrafshani
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Azimi
- Department of Traditional Medicine, School of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Faranak Salajegheh
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
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Asres AW, Samuel S, Daga WB, Tena A, Alemu A, Workie SB, Alemayehu M, Messel H. Association between iron-folic acid supplementation and pregnancy-induced hypertension among pregnant women in public hospitals, Wolaita Sodo, Ethiopia 2021: a case- control study. BMC Public Health 2023; 23:843. [PMID: 37165342 PMCID: PMC10170668 DOI: 10.1186/s12889-023-15794-6] [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: 12/09/2022] [Accepted: 05/03/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Pregnancy-induced hypertension is the new onset of high blood pressure after 20 weeks of gestation in women with previously normal blood pressure. To the best of our knowledge, no study has been conducted in our country to investigate the association between this pregnancy problem and iron-folic acid supplementation. The aim of this study was to determine the association between iron-folic acid supplementation and pregnancy-induced hypertension (PIH) in pregnant women at public hospitals in the Wolaita Sodo zone. METHODS An institution-based case-control study was conducted among pregnant women who visited public hospitals in the Wolaita Sodo zone from March 3, 2022, to August 30, 2022. A consecutive sampling method was used to select the study participants. The total sample size was 492, of which 164 were cases and 328 were controls. The data were collected by conducting face-to-face interviews and measurements. The data were entered into EpiData version 4.6 and exported to STATA 14 for analysis. Those variables with a p-value less than 0.05 were considered statistically significant. Descriptive statistics and odds ratios were presented using texts, tables, and figures. RESULTS A total of 471 women participated in this study, yielding a response rate of 96%. The cases had a mean age of 25 ± 4.43, while the controls had a mean age of 25 ± 3.99. The mean age at first pregnancy among cases was 20 ± 2.82 and among controls was 20 ± 2.97. The average number of deliveries for cases and controls was 1.97 ± 1.41 and 1.95 ± 1.38, respectively. There is no significant association between iron-folic acid supplementation and PIH. Pregnant women with high hemoglobin levels had higher odds of PIH as compared to those without it (AOR = 3.65; 95% CI: 1.0-12.9). Eating kocho (AOR = 14.4; 95% CI: 1.2-16.7) was positively associated with PIH. CONCLUSIONS There is no association between iron-folic acid supplementation during pregnancy and pregnancy-induced hypertension. Pregnant women with high hemoglobin levels had higher odds of PIH as compared to those without it. There is an association between kocho consumption and PIH. More research should be done using stronger designs.
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Affiliation(s)
- Abiyot Wolie Asres
- Department of Epidemiology and Biostatistics, School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Serawit Samuel
- Department of Epidemiology and Biostatistics, School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Wakgari Binu Daga
- Department of Reproductive Health and Nutrition, School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Atsede Tena
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Afework Alemu
- Department of Pediatrics, School of Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Shimelash Bitew Workie
- Department of Epidemiology and Biostatistics, School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Mihiretu Alemayehu
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Habtamu Messel
- Health Professionals Education Partnership Initiative Project Office, Addis Ababa University, Addis Ababa, Ethiopia
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Liu YH, Chen SC, Lee WH, Chen YC, Huang JC, Wu PY, Hung CH, Kuo CH, Su HM. Components of the Complete Blood Count as a Risk Predictor for Incident Hypertension in a Large Taiwanese Population Follow-up Study. Circ J 2023; 87:456-462. [PMID: 36261331 DOI: 10.1253/circj.cj-22-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Previous studies investigating the relationship between hypertension (HT) and hematological parameters report inconsistent results, and most them included a small number of participants or only conducted a cross-sectional analysis of 1 or 2 hematological factors. Moreover, no large cohort follow-up studies have investigated this topic. The aim of this longitudinal study was to explore associations between components of the complete blood count (CBC) and incident HT using data from a large Taiwanese biobank. METHODS AND RESULTS Hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin, hematocrit (HCT), and platelet count were evaluated. We included 21,293 participants who did not have HT at baseline and followed them for a mean period of 3.9 years. During follow-up, 3,002 participants with new-onset HT (defined as incident HT) were identified. Univariable analysis revealed that high WBC count, high RBC count, high hemoglobin, high HCT, and low platelet count were associated with incident HT. Multivariable analysis after adjusting potential confounding factors found high WBC count (odds ratio [OR], 1.057; 95% confidence interval [CI], 1.028 to 1.087; P<0.001) and high HCT (OR, 1.023; 95% CI, 1.010 to 1.036; P<0.001) were still significantly associated with incident HT. CONCLUSIONS High WBC count and high HCT were associated with incident HT.
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Affiliation(s)
- Yi-Hsueh Liu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Szu-Chia Chen
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Research Center for Environmental Medicine, Kaohsiung Medical University
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Wen-Hsien Lee
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Ying-Chih Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Jiun-Chi Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Chih-Hsing Hung
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Research Center for Environmental Medicine, Kaohsiung Medical University
| | - Chao-Hung Kuo
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Ho-Ming Su
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
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21
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He Z, Yang P, Lin Q, Thio CHL, Zhang F, Wang R, Wang Y, Snieder H, Zhang Q. Blood biomarkers for new-onset hypertension in midlife women: a nested case-control study. Menopause 2023; 30:156-164. [PMID: 36696640 DOI: 10.1097/gme.0000000000002100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Midlife in women is associated with an increase in prevalence of hypertension. Little is known on the risk factors of new-onset hypertension among middle-aged women. METHODS In this nested case-control study, 1,430 women aged 40 to 60 years with repeated physical examinations between 2009 and 2019 were recruited. Data included age, body mass index, blood pressure (BP), and a series of blood biomarkers. Participants with hypertension were divided into two case-control samples: 388 cases with episodic new-onset hypertension (ie, one normal BP at the first visit and one abnormal BP during follow-up) each with two age-matched controls (n = 776) and 151 cases with regular new-onset hypertension (ie, normal BP at the first two visits and abnormal BP at two or more follow-up visits) each with three age-matched controls (n = 453). Multivariable-adjusted logistic regression was used to analyze the data. RESULTS Our data showed very consistent results for episodic and regular new-onset hypertension, respectively, and verified known associations (odds ratio [95% confidence interval], per SD increase) with obesity (body mass index, 1.72 [1.49-1.98] and 1.81 [1.45-2.26]), inflammation (white blood cell count, 1.39 [1.23-1.58] and 1.38 [1.13-1.69]), and metabolic dysregulation (triglycerides, 1.25 [1.09-1.44] and 1.31 [1.08-1.58]; glucose, 1.46 [1.23-1.73] and 1.27 [1.05-1.54]) but, more surprisingly, also revealed positive associations with red blood cell count (1.27 [1.11-1.44] and 1.38 [1.14-1.68]), hemoglobin (1.18 [1.03-1.35] and 1.31 [1.05-1.64]), and platelet count (1.39 [1.20-1.61] and 1.33 [1.09-1.63]). CONCLUSIONS In addition to obesity and metabolic dysregulation, increased hemoglobin and counts of platelets, and red and white blood cells are associated with hypertension in this period. Future study may verify whether these associations are causal in nature and whether these variables are useful in risk stratification.
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Affiliation(s)
| | - Peixuan Yang
- Department of Physical Examination, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Qiuqiang Lin
- Department of Internal Medicine, Chenghai People's Hospital, Shantou, China
| | - Chris H L Thio
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Ruifeng Wang
- Department of Physical Examination, Chenghai People's Hospital, Shantou, China
| | - Yue Wang
- From the Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Qingying Zhang
- From the Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, China
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22
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Positive Association between Hemoglobin Concentration and Blood Pressure in Adults: A Cross-Sectional Study Based on Rafsanjan Cohort Study. Int J Hypertens 2023; 2023:6283711. [PMID: 36777237 PMCID: PMC9908348 DOI: 10.1155/2023/6283711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Identification of factors associated with blood pressure (BP), including hemoglobin, can be used in diagnosing, controlling, and predicting the prognosis of patients. This study aims to investigate the cross-sectional association between hemoglobin concentration and BP in people aged 35-70 years in a cohort study of Rafsanjan, Iran. Method This cross-sectional study was conducted on 9398 urban and rural population of Rafsanjan adult cohort study as a part of the prospective epidemiological research studies in Iran (PERSIAN). Demographic information, medical history, history of smoking and alcohol intake, systolic and diastolic BP, and hemoglobin concentration were collected. A logistic regression test was performed to evaluate the relationship between hemoglobin concentration and BP in 4 unadjusted and adjusted models based on demographic indicators, clinical and laboratory findings using SPSS.24 software and SAS software version 9.2. Results The mean age of the participants was 49.78 ± 9.53 years, and 53.2% (5002 people) were women. Adjusted models 3 and 4 showed a positive association between BP and hemoglobin. For each unit increase in hemoglobin, the odds ratio (OR) of BP in the adjusted model 3 was 1.062 (95% CI: 1.005-1.121), and in the adjusted model 4, it was 1.090 (95% CI: 1.031-1.153). Conclusion Based on the results, the positive trend of BP and hemoglobin levels may indicate the need to pay more attention to these people as higher-risk groups for hypertension.
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23
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Controls of Central and Peripheral Blood Pressure and Hemorrhagic/Hypovolemic Shock. J Clin Med 2023; 12:jcm12031108. [PMID: 36769755 PMCID: PMC9917827 DOI: 10.3390/jcm12031108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 02/04/2023] Open
Abstract
The pressure exerted on the heart and blood vessels because of blood flow is considered an essential parameter for cardiovascular function. It determines sufficient blood perfusion, and transportation of nutrition, oxygen, and other essential factors to every organ. Pressure in the primary arteries near the heart and the brain is known as central blood pressure (CBP), while that in the peripheral arteries is known as peripheral blood pressure (PBP). Usually, CBP and PBP are correlated; however, various types of shocks and cardiovascular disorders interfere with their regulation and differently affect the blood flow in vital and accessory organs. Therefore, understanding blood pressure in normal and disease conditions is essential for managing shock-related cardiovascular implications and improving treatment outcomes. In this review, we have described the control systems (neural, hormonal, osmotic, and cellular) of blood pressure and their regulation in hemorrhagic/hypovolemic shock using centhaquine (Lyfaquin®) as a resuscitative agent.
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24
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Wang H, Qi Q, Song S, Zhang D, Feng L. Association between soluble transferrin receptor and systolic hypertension in adults: National Health and Nutrition Examination Survey (2007-2010 and 2015-2018). Front Cardiovasc Med 2022; 9:1029714. [PMID: 36407469 PMCID: PMC9671951 DOI: 10.3389/fcvm.2022.1029714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Hypertension increases the global burden of disease and mortality. Iron metabolism is considered to be an important factor in hypertension. However, as an indicator of iron metabolism, little is known about the associations of soluble transferrin receptor (sTfR) with hypertension. We studied the relationship between sTfR and hypertension. Materials and methods We studied 7,416 adults aged 20 years old or above from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional, population-based study. Weighted logistic regression was used to examine the association between markers of iron metabolism and hypertension. The restricted cubic spline (RCS) was used to characterize the association between sTfR and blood pressure. Results Weighted logistic regression showed that higher sTfR level was associated with higher odds of hypertension (OR = 1.05; 95% CI: 1.01-1.05; p = 0.001) after adjustment for all the potential confounding factors. Meanwhile, weighted logistic regression analyses indicated independent associations of high sTfR (p = 0.009) with systolic hypertension after adjusting for various different confounders. The result of restricted cubic splines showed a non-linear association between sTfR and systolic blood pressure among U.S. adults. Conclusion Soluble transferrin receptor was found to be an independent factor in systolic hypertension. And, a non-linear relationship between sTfR and systolic blood pressure was discovered.
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Affiliation(s)
- Haoran Wang
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Qianjin Qi
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shuaihua Song
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Di Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Li Feng
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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25
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Ltaief Z, Ben-Hamouda N, Rancati V, Gunga Z, Marcucci C, Kirsch M, Liaudet L. Vasoplegic Syndrome after Cardiopulmonary Bypass in Cardiovascular Surgery: Pathophysiology and Management in Critical Care. J Clin Med 2022; 11:6407. [PMID: 36362635 PMCID: PMC9658078 DOI: 10.3390/jcm11216407] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 09/13/2023] Open
Abstract
Vasoplegic syndrome (VS) is a common complication following cardiovascular surgery with cardiopulmonary bypass (CPB), and its incidence varies from 5 to 44%. It is defined as a distributive form of shock due to a significant drop in vascular resistance after CPB. Risk factors of VS include heart failure with low ejection fraction, renal failure, pre-operative use of angiotensin-converting enzyme inhibitors, prolonged aortic cross-clamp and left ventricular assist device surgery. The pathophysiology of VS after CPB is multi-factorial. Surgical trauma, exposure to the elements of the CPB circuit and ischemia-reperfusion promote a systemic inflammatory response with the release of cytokines (IL-1β, IL-6, IL-8, and TNF-α) with vasodilating properties, both direct and indirect through the expression of inducible nitric oxide (NO) synthase. The resulting increase in NO production fosters a decrease in vascular resistance and a reduced responsiveness to vasopressor agents. Further mechanisms of vasodilation include the lowering of plasma vasopressin, the desensitization of adrenergic receptors, and the activation of ATP-dependent potassium (KATP) channels. Patients developing VS experience more complications and have increased mortality. Management includes primarily fluid resuscitation and conventional vasopressors (catecholamines and vasopressin), while alternative vasopressors (angiotensin 2, methylene blue, hydroxocobalamin) and anti-inflammatory strategies (corticosteroids) may be used as a rescue therapy in deteriorating patients, albeit with insufficient evidence to provide any strong recommendation. In this review, we present an update of the pathophysiological mechanisms of vasoplegic syndrome complicating CPB and discuss available therapeutic options.
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Affiliation(s)
- Zied Ltaief
- Service of Adult Intensive Care, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
| | - Nawfel Ben-Hamouda
- Service of Adult Intensive Care, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
| | - Valentina Rancati
- Service of Anesthesiology, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
| | - Ziyad Gunga
- Service of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
| | - Carlo Marcucci
- Service of Anesthesiology, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
| | - Matthias Kirsch
- Service of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
| | - Lucas Liaudet
- Service of Adult Intensive Care, Lausanne University Hospital and University of Lausanne, 1010 Lausanne, Switzerland
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Positive or U-Shaped Association of Elevated Hemoglobin Concentration Levels with Metabolic Syndrome and Metabolic Components: Findings from Taiwan Biobank and UK Biobank. Nutrients 2022; 14:nu14194007. [PMID: 36235661 PMCID: PMC9572591 DOI: 10.3390/nu14194007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
Iron overnutrition has been implicated with a higher risk of developing metabolic and cardiovascular diseases, including metabolic syndrome (MetS), whereas iron deficiency anemia exacerbates many underlying chronic conditions. Hemoglobin (Hb) concentration in the blood, which reflects a major functional iron (i.e., heme iron) in the body, may serve as a surrogate of the nutritional status of iron. We conducted sex-specific observational association studies in which we carefully titrated the association between Hb deciles and MetS and its components among the Taiwanese Han Chinese (HC) from the Taiwan Biobank and Europeans of White ancestry from the UK Biobank, representing two large ethnicities. Our data show that at higher-than-normal levels of Hb, increasing deciles of Hb concentration were significantly associated with MetS across all sex subgroups in both ethnicities, with the highest deciles resulting in up to three times greater risk than the reference group [Taiwanese HC: OR = 3.17 (95% CI, 2.75-3.67) for Hb ≥ 16.5 g/dL in men, OR = 3.11 (2.78-3.47) for Hb ≥ 14.5 g/dL in women; European Whites: OR = 1.89 (1.80-1.98) for Hb ≥ 16.24 g/dL in men, OR = 2.35 (2.24-2.47) for Hb ≥ 14.68 g/dL in women]. The association between stronger risks and increasing Hb deciles was similarly observed with all metabolic components except diabetes. Here we found that both the highest Hb decile groups and contrarily the lowest ones, with respect to the reference, were associated with higher odds of diabetes in both ethnic groups [e.g., Taiwanese HC men: OR = 1.64 (1.33-2.02) for Hb ≥ 16.5 g/dL, OR = 1.71 (1.39-2.10) for Hb ≤ 13.5 g/dL; European Whites women: OR = 1.39 (1.26-1.45) for Hb ≥ 14.68 g/dL, OR = 1.81 (1.63-2.01) for Hb ≤ 12.39 g/dL]. These findings confirm that elevated Hb concentrations, a potential indicator of iron overnutrition, may play a role in the pathophysiology of MetS and metabolic components.
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27
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Zhu Z, Hu H, Benmarhnia T, Ren Z, Luo J, Zhao W, Chen S, Wu K, Zhang X, Wang L, Di J, Huang C, Wang Q. Gestational PM 2.5 exposure may increase the risk of small for gestational age through maternal blood pressure and hemoglobin: A mediation analysis based on a prospective cohort in China, 2014-2018. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113836. [PMID: 35841656 DOI: 10.1016/j.ecoenv.2022.113836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Maternal gestational PM2.5 exposure was associated with small for gestational age (SGA). Identifying potential mediating factors may help design preventive strategies to reduce this risk. OBJECTIVE This study aimed to explore the roles of maternal blood pressure and hemoglobin may play in the PM2.5 exposure and SGA relationship among 117,162 births in 16 counties across China during 2014-2018. METHODS Daily PM2.5 concentration was collected from China National Environmental Monitoring Center. According to maternal residency during pregnancy, the PM2.5 exposure for each trimester and the whole pregnancy was assessed using an inverse-distance weighting approach. Repeated measurements of maternal blood pressure and hemoglobin during pregnancy were collected for each woman. We estimated the total effect of gestational PM2.5 exposure on SGA, and further tested the mediation effects of maternal blood pressure and hemoglobin concentration during pregnancy. RESULTS Of 117,162 included mother-infant pairs, 11,361 (9.7 %) were SGA. The odds ratios of SGA associated with PM2.5 exposure (per 10 μg/m3 increase) in the second trimester and the whole pregnancy were 1.023 (95 % CI: 1.009, 1.037) and 1.024 (1.001, 1.048), respectively. We identified the independent mediating effect of blood pressure and hemoglobin in the second and third trimesters, with the proportion of mediation ranging from 1.64 % to 5.78 % and 2.40 % to 8.70 %, respectively. When considering the mediators jointly, we found a stronger mediating effect with a proportion of mediation ranging from 3.93 % to 13.69 %. DISCUSSION Increases in maternal blood pressure and hemoglobin in the second and third trimesters can independently and jointly mediate the effects of gestational PM2.5 exposure on SGA. Monitoring and managing maternal blood pressure and hemoglobin during prenatal care may constitute a promising avenue to reducing SGA risk associated with gestational PM2.5 exposure.
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Affiliation(s)
- Zhenghong Zhu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huanqing Hu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Jiajun Luo
- Institute for Population and Precision Health, the University of Chicago, Chicago, USA
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sidi Chen
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kaipu Wu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxin Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liyun Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Cunrui Huang
- Wanke School of Public Health, Tsinghua University, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Ma Y, Lin J, Xia P, Zheng H, Cheng X, Ji P, Wu W, Hou L, Wang L, Zhu G, Qiu L, Zheng Y, Chen L. Comparison between the profiles of patients defined by age-adapted and fixed threshold CKD criteria, a national-wide, cross-sectional study. Clin Kidney J 2022; 15:2312-2321. [PMID: 36381365 PMCID: PMC9664565 DOI: 10.1093/ckj/sfac188] [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: 03/24/2022] [Indexed: 12/05/2022] Open
Abstract
Background Kidney function declines naturally with advancing age. Therefore an age-adapted estimated glomerular filtration rate (eGFR) threshold has been proposed instead of the fixed threshold for CKD definition. This study aims to describe and compare the profile of CKD patients defined by these two criteria in a Chinese population. Method We recruited adult participants with selected biochemical tests from the Chinese Physiological Constant and Health Condition survey conducted from 2007 to 2011, with the GFR estimated by the Chronic Kidney Disease Epidemiology Collaboration formula. The age-adapted threshold of eGFR is 75, 60 and 45 ml/min/1.73 m2 for the population <40 years of age, 40–64 years and >64 years, respectively. The fixed threshold is 60 ml/min/1.73 m2 for all ages. Results Among the recruited 23 438 participants, 480 were diagnosed with CKD by fixed threshold criteria, while 391 were diagnosed with CKD by age-adapted criteria. Patients diagnosed by fixed threshold criteria were significantly older (66.4 versus 43.4 years; P < .001) and had a higher prevalence of all CVD risk factors compared with the non-CKD population. In contrast, age-adapted criteria defined a younger patient group and were not significantly associated with diabetes or obesity. When adjusted by age and gender, fixed threshold–defined CKD was not significantly associated with the number of coexisting CVD risk factors, while age-adapted-defined CKD was significantly associated. We also found that the CKD patients defined by age-adapted criteria matched well with the 2.5th percentile of eGFR in Chinese individuals. When compared with their age- and gender-matched controls, patients included by age-adapted criteria but excluded by fixed threshold criteria had a significantly higher prevalence of hypertension (23.2% versus 7.7%; P < .001) and hyperuricaemia (25.0% versus 5.5%; P < .001), while patients included only by the fixed threshold criteria were not significantly different in the prevalence of CVD risk factors and CKD-related disturbance except for hyperuricaemia (41.2% versus 14.0%; P < .001). Conclusion An age-adapted criterion is more closely associated with CVD risk factors and CKD-related diseases compared with fixed threshold criteria.
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Affiliation(s)
- Yixin Ma
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Jianfeng Lin
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Peng Xia
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Hua Zheng
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Xinqi Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Peili Ji
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Wei Wu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Lian Hou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Li Wang
- Department of Epidemiology and Biostatistics, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Guangjin Zhu
- Department of Pathophysiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Yali Zheng
- Department of Nephrology, Affiliated Ningxia People's Hospital of Ningxia Medical University , Yinchuan , China
| | - Limeng Chen
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
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Chen X, Wang Y, Zhang L, Xu X. Construction and Evaluation of Neural Network Correlation Model between Syndrome Elements and Physical and Chemical Indexes of Unstable Angina Pectoris Complicated with Anxiety. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6217186. [PMID: 36045947 PMCID: PMC9420622 DOI: 10.1155/2022/6217186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/20/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
Objective Syndrome elements are regarded as the smallest unit of syndrome differentiation, which is characterized by indivisibility and random combination. Therefore, it can well fit the goal of syndrome differentiation and unity. Methods Clinical physicochemical indicators are important references for disease diagnosis, but they are often not used too much in the process of TCM syndrome differentiation. In the era of intelligence, communicating TCM syndrome differentiation at the macro level with physiological and pathological processes at the micro level (i.e., these clinical physicochemical indicators) is an effective tool to realize intelligent medicine. Taking the collected relevant clinical physical and chemical indexes as the research object, on the basis of routine t-test and nonparametric test, logistic regression model is used to mine the main syndrome elements, and neural network multilayer perceptron is used to predict the feature model. Results Compared with non-blood stasis patients, there were significant differences in HGB, PLT, Pt, PTA, Na+, TG, LDL, BNP, LVEDd, and EF in blood stasis patients. Taking blood stasis as the dependent variable and the above physical and chemical indexes with statistical significance (P < 0.05) as independent variables. Compared with non-qi depression patients, there were significant differences in atpp, TG, TC, LDL, LVESD, and FS in qi depression patients (P < 0.05). Taking Yin deficiency as dependent variable and the above physical and chemical indexes (Hgb, APTT, CKMB, LVEDd, and LVPW) with statistical significance (P < 0.05) as independent variables, binary logistic regression analysis was carried out. Conclusion The combination pattern of physical and chemical indexes obtained from the neural network model provides a clinical reference basis for identifying the syndrome elements of unstable angina pectoris complicated with anxiety, such as blood stasis, qi depression, Qi deficiency, yin deficiency, phlegm turbidity, and qi stagnation.
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Affiliation(s)
- Xiaoyang Chen
- Guangzhou University of Chinese Medicine, Guangzhou 510016, China
- Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Yifei Wang
- Cardiovascular department, Zhengzhou Hospital of Chinese Medicine, Zhengzhou 450007, China
| | - Li Zhang
- Cardiovascular department, Zhengzhou Hospital of Chinese Medicine, Zhengzhou 450007, China
| | - Xuegong Xu
- Cardiovascular department, Zhengzhou Hospital of Chinese Medicine, Zhengzhou 450007, China
- Laboratory of Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou 450007, China
- Key Laboratory of traditional Chinese medicine for cardiovascular diseases of Henan Province, Zhengzhou 450007, China
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Integrating Health Data-Driven Machine Learning Algorithms to Evaluate Risk Factors of Early Stage Hypertension at Different Levels of HDL and LDL Cholesterol. Diagnostics (Basel) 2022; 12:diagnostics12081965. [PMID: 36010315 PMCID: PMC9407063 DOI: 10.3390/diagnostics12081965] [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: 07/14/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose: Cardiovascular disease (CVD) is a major worldwide health burden. As the risk factors of CVD, hypertension, and hyperlipidemia are most mentioned. Early stage hypertension in the population with dyslipidemia is an important public health hazard. This study was the application of data-driven machine learning (ML), demonstrating complex relationships between risk factors and outcomes and promising predictive performance with vast amounts of medical data, aimed to investigate the association between dyslipidemia and the incidence of early stage hypertension in a large cohort with normal blood pressure at baseline. Methods: This study analyzed annual health screening data for 71,108 people from 2005 to 2017, including data for 27 risk-related indicators, sourced from the MJ Group, a major health screening center in Taiwan. We used five machine learning (ML) methods—stochastic gradient boosting (SGB), multivariate adaptive regression splines (MARS), least absolute shrinkage and selection operator regression (Lasso), ridge regression (Ridge), and gradient boosting with categorical features support (CatBoost)—to develop a multi-stage ML algorithm-based prediction scheme and then evaluate important risk factors at the early stage of hypertension, especially for groups with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels within or out of the reference range. Results: Age, body mass index, waist circumference, waist-to-hip ratio, fasting plasma glucose, and C-reactive protein (CRP) were associated with hypertension. The hemoglobin level was also a positive contributor to blood pressure elevation and it appeared among the top three important risk factors in all LDL-C/HDL-C groups; therefore, these variables may be important in affecting blood pressure in the early stage of hypertension. A residual contribution to blood pressure elevation was found in groups with increased LDL-C. This suggests that LDL-C levels are associated with CPR levels, and that the LDL-C level may be an important factor for predicting the development of hypertension. Conclusion: The five prediction models provided similar classifications of risk factors. The results of this study show that an increase in LDL-C is more important than the start of a drop in HDL-C in health screening of sub-healthy adults. The findings of this study should be of value to health awareness raising about hypertension and further discussion and follow-up research.
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Laha S, Bandopadhyay A, Chakraborty S. Smartphone-Integrated Label-Free Rapid Screening of Anemia from the Pattern Formed by One Drop of Blood on a Wet Paper Strip. ACS Sens 2022; 7:2028-2036. [PMID: 35802863 DOI: 10.1021/acssensors.2c00806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Screening of anemic patients poses demanding challenges in extreme point-of-care settings where the gold standard diagnostic technologies are not pragmatic and the alternative point-of-care technologies suffer from compromised accuracy, prohibitive cost, process complexity, or reagent stability issues. As a disruption to this paradigm, here, we report the development of a smartphone-based sensor for rapid screening of anemic patients by exploiting the patterns formed by a spreading drop of blood on a wet paper strip wherein blood attempts to displace a more viscous fluid, on the porous matrix of a paper, leading to "finger-like" projections at the interface. We analyze the topological features of the pattern via smartphone-enabled image analytics and map the same with the relative occupancy of the red blood cells in the blood sample, allowing for label-free screening and classification of blood samples corresponding to moderate to severe anemic conditions. The accuracy of detection is verified by comparing with gold standard reports of hematology analyzer, showing a strong correlation coefficient (R2) of 0.975. This technique is likely to provide a crucial decision-making tool that obviates delicate reagents and skilled technicians for supreme functionality in resource-limited settings.
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Affiliation(s)
- Sampad Laha
- Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
| | - Aditya Bandopadhyay
- Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
| | - Suman Chakraborty
- Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
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Alsultan M, Basha K. Resistant hypertension and PRES syndrome induced by carbamazepine in a patient with SLE: A case report and literature review. Ann Med Surg (Lond) 2022; 78:103767. [PMID: 35600172 PMCID: PMC9117529 DOI: 10.1016/j.amsu.2022.103767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mohammad Alsultan
- Department of Nephrology, Al Assad and Al Mouwasat University Hospitals, Damascus University- Faculty of Medicine, Damascus, Syria
- Corresponding author.
| | - Kassem Basha
- Nephrology Department, Al Mouwasat University Hospitals, Damascus University- Faculty of Medicine, Damascus, Syria
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Yalcin EE, Doganer YC, Aydogan U, Karasahin KE, Demirkose H. Evaluation of Anemia and Related Factors in Pregnancy: A Cross-Sectional Study. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Anemia is a public health problem in developing countries. In our study, it is aimed to evaluate the relationship between the presence of anemia in pregnancy and the factors which influence anemia.
Methods: Our study was conducted with 567 voluntary pregnant contributors who attended as outpatients to Gulhane Education and Research Hospital Obstetrics Polyclinics between December 2018 and February 2019. The assessment questionnaire included questions about sociodemographic information, obstetric history and medication adherence, and the Patient Health Questionnaire-9.
Results: Mean age of 567 voluntary pregnants was 28.1±5.0 (18-43) years and mean hemoglobin values were 12.4±1.3 (6.1-15.6) g/dL. Of the contributors, 12.3% had hemoglobin values
Conclusion: Anemia was more frequent in pregnant women who experienced anemia in their previous pregnancy, and women having chronic disease and becoming pregnant were less likely to have anemia. Early diagnosis and treatment of anemia, which significantly affects maternal and infant health, can be possible during pregnancy, since it should be evaluated in all women planning and conceiving a pregnancy.
Keywords: anemia, depression, pregnancy, family medicine
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Affiliation(s)
| | | | - Umit Aydogan
- University of Health Sciences Gülhane Faculty of Medicine
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Sheikhhassani V, Evers TMJ, Lamba S, Shokri F, Mashaghi A. Single cell force spectroscopy of erythrocytes at physiological and febrile temperatures reveals mechano-modulatory effects of atorvastatin. SOFT MATTER 2022; 18:2143-2148. [PMID: 35201243 DOI: 10.1039/d1sm01715b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
RBCs are mechanically active cells and constantly deform as they circulate through vasculature. Their mechanical properties can be significantly altered by various pathophysiological conditions, and the alterations in RBC mechanics can, in turn, have functional consequences. Although numerous mechanical studies have been conducted on RBCs, surprisingly, strain-rate and temperature dependent mechanics of RBCs have not been systematically examined, and current data is primarily based on measurements at room temperature. Here, we have used state-of-the-art single-cell optical tweezers to probe atorvastatin-induced changes of RBC mechanics and its strain-rate dependency at physiologically and medically relevant temperatures. Our data indicate that RBC mechanics is strain-rate and temperature dependent, and atorvastatin treatment softens RBCs at physiological temperature, but not at febrile temperature. The observed mechanical change is a notable side effect of the drug in some therapeutic applications. However, the mechano-modulatory effects of atorvastatin on erythrocytes at physiological temperature might offer new therapeutic possibilities for diseases related to blood cell mechanics.
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Affiliation(s)
- Vahid Sheikhhassani
- Medical Systems Biophysics and Bioengineering, Leiden Academic Centre for Drug Research, Faculty of Science, Leiden University, 2333 CC Leiden, The Netherlands.
| | - Tom M J Evers
- Medical Systems Biophysics and Bioengineering, Leiden Academic Centre for Drug Research, Faculty of Science, Leiden University, 2333 CC Leiden, The Netherlands.
| | - Sanjeevani Lamba
- Medical Systems Biophysics and Bioengineering, Leiden Academic Centre for Drug Research, Faculty of Science, Leiden University, 2333 CC Leiden, The Netherlands.
| | - Fereshteh Shokri
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Alireza Mashaghi
- Medical Systems Biophysics and Bioengineering, Leiden Academic Centre for Drug Research, Faculty of Science, Leiden University, 2333 CC Leiden, The Netherlands.
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Pappelis K, Jansonius NM. Retinal Oxygen Delivery and Extraction in Ophthalmologically Healthy Subjects With Different Blood Pressure Status. Transl Vis Sci Technol 2022; 11:9. [PMID: 35119472 PMCID: PMC8819358 DOI: 10.1167/tvst.11.2.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare retinal oxygen delivery (DO2) and oxygen extraction (VO2) in ophthalmologically healthy subjects with different blood pressure (BP) status. Methods In this case-control study, we prospectively included 93 eyes of 93 subjects (aged 50-65 years) from a Dutch cohort (n = 167,000) and allocated them to four groups (low BP, normal BP [controls], treated arterial hypertension [AHT], untreated AHT). We estimated vascular calibers from fundus images and fractal dimension from optical coherence tomography angiography scans. We combined calibers, fractal dimension, BP, and intraocular pressure measurements in a proxy of retinal blood flow (RBF), using a Poiseuille-based model. We measured arterial and venous oxygen saturations (SaO2, SvO2) with a scanning laser ophthalmoscope. We calculated the DO2 and VO2 from the RBF, SaO2, and SvO2. We compared the DO2 and VO2 between groups and investigated the DO2-VO2 association. Results DO2 and VO2 were different between groups (P = 0.009, P = 0.036, respectively). In a post hoc analysis, the low BP group had lower DO2 than the untreated AHT group (P = 4.9 × 10-4). The low BP group and the treated AHT group had a lower VO2 than the untreated AHT group (P = 0.021 and P = 0.034, respectively). There was a significant DO2-VO2 correlation (Robs = 0.65, bobs = 0.51, P = 2.4 × 10-12). After correcting for shared measurement error, the slope was not significant. Conclusions The DO2 and VO2 were altered in ophthalmologically healthy subjects with different BP status. Future studies could elucidate whether these changes can explain the increased risk of ophthalmic pathologies in those subjects. Translational Relevance Understanding the baseline interplay between BP, retinal perfusion, and oxygenation allows for improved evaluation of retinal disease manifestation.
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Affiliation(s)
- Konstantinos Pappelis
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, the Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, the Netherlands
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Higher hemoglobin levels are an independent risk factor for gestational diabetes. Sci Rep 2022; 12:1686. [PMID: 35102239 PMCID: PMC8803843 DOI: 10.1038/s41598-022-05801-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/19/2022] [Indexed: 11/08/2022] Open
Abstract
Incidence of gestational diabetes (GDM) has increased rapidly. It poses significant risks for both mother and fetus affecting also negatively their longer-term metabolic heath. We asked whether early pregnancy maternal hemoglobin (Hb) levels, indicative for tissue oxygenation, would affect mother's metabolic health and fetal outcome. We assessed in FinnGeDi, a Finnish multicenter case-control study for GDM (n = 1828), association of maternal 1st trimester Hb levels with metabolic parameters and perinatal outcome. Our data show that mothers with GDM had higher Hb levels compared to controls (mean difference 1.746 g/L). Hb levels associated positively with pre-pregnancy body mass index (BMI), fasting glucose levels and glucose levels in a glucose tolerance test and systolic and diastolic blood pressure (bp) levels. When assessed in quartiles the highest Hb quartile had more chronic and gestational hypertension and the most adverse outcome of the metabolic parameters, dose-dependency seen in bp, BMI and glucose levels. In a multivariable regression analysis Hb levels remained an independently associated parameter for GDM after adjusting for key covariates (OR 1.019, 95% CI [1.007; 1.031]). In conclusion, higher maternal Hb levels within the normal variation are an independent risk factor for GDM in this population but have little effect on perinatal outcome.
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Positive Associations between Body Mass Index and Hematological Parameters, Including RBCs, WBCs, and Platelet Counts, in Korean Children and Adolescents. CHILDREN 2022; 9:children9010109. [PMID: 35053734 PMCID: PMC8774222 DOI: 10.3390/children9010109] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/21/2022]
Abstract
We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and 3738 girls) aged 10–18 years were recorded. The parameters were compared among participants with normal weight, overweight, and obesity. Significantly higher mean levels of WBCs (7.16 vs. 6.16 × 103/mm3, p < 0.001), RBCs (4.90 vs. 4.82 × 106/mm3, p < 0.001), Hb (14.07 vs. 13.99 g/dL, p < 0.05), Hct (42.31 vs. 41.91%, p < 0.001), and platelets (311.87 vs. 282.66 × 103/mm3, p < 0.001) were found in the obese than normal weight group, respectively, after adjusting for body mass index (BMI) and sex. BMI SDS had significant positive associations with the levels of WBCs (β = 0.275, p < 0.001), RBCs (β = 0.028, p < 0.001), Hb (β = 0.034, p < 0.001), Hct (β = 0.152, p < 0.001), and platelets (β = 8.372, p < 0.001) after adjusting for age, sex, and socioeconomic factors in a multiple linear regression analysis. A higher BMI was associated with elevated WBC, RBC, Hb, Hct, and platelet counts in children and adolescents. Because higher levels of hematological parameters are potential risk factors for obesity-related diseases, hematological parameters should be evaluated in obese children and adolescents.
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Chen YC, Hsu KN, Lai JCY, Chen LY, Kuo MS, Liao CC, Hsu K. Influence of hemoglobin on blood pressure among people with GP.Mur blood type ☆. J Formos Med Assoc 2022; 121:1721-1727. [PMID: 35000824 DOI: 10.1016/j.jfma.2021.12.014] [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: 09/21/2021] [Revised: 12/06/2021] [Accepted: 12/16/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND/PURPOSE GP.Mur is a clinically important red blood cell (RBC) type. GP.Mur and band 3 interact on the RBCs. We previously observed that healthy adults with GP.Mur type present slightly higher blood pressure (BP). Because band 3 and Hb comodulate nitric oxide (NO)-dependent vasodilation and hemoglobin (Hb) is positively associated with BP, we aimed to test whether these could contribute to higher BP in GP.Mur+ people. METHODS We recruited 989 non-elderly adults (21% GP.Mur) free of catastrophic illness and not on cardiovascular or anti-hypertensive medication. Their body indices, blood lab data and lifestyle data were collected for analyses of potential BP-related factors (BMI, age, smoking, Hb, and GP.Mur). RESULTS BMI and age remained the most significant contributors to BP. GP.Mur slightly increased systolic BP (SBP). The direct correlation between Hb and BP was only found in Taiwanese non-anemic men, not women. After age and BMI adjusted, we estimated an increase of 1.8 mmHg and 2.6 mmHg of SBP by 1 g/dL Hb among men without and with GP.Mur type, respectively. Hb was generally lower among people expressing GP.Mur, which likely limited their larger impact on BP. CONCLUSION GP.Mur contributed to BP in both Hb-dependent and Hb-independent fashion. A pronounced impact of hemoglobin on BP likely requires sufficient Hb, as GP.Mur increased the sensitivity of SBP to Hb only in non-anemic Taiwanese men, and not in Taiwanese women or anemic men. The mechanism through which GP.Mur affected BP independent of Hb is unknown.
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Affiliation(s)
- Yung-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Kuang-Nan Hsu
- Department of Neurology, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Jerry Cheng-Yen Lai
- Department of Medical Research, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Li-Yang Chen
- The Laboratory of Immunogenetics, Department of Medical Research, MacKay Memorial Hospital, Tamsui, New Taipei City, Taiwan
| | - Mei-Shin Kuo
- The Department of Laboratory Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Chiu-Chu Liao
- The Department of Laboratory Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Kate Hsu
- The Laboratory of Immunogenetics, Department of Medical Research, MacKay Memorial Hospital, Tamsui, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan; Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan.
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Kernel-based gene-environment interaction tests for rare variants with multiple quantitative phenotypes. PLoS One 2022; 17:e0275929. [PMID: 36223383 PMCID: PMC9555665 DOI: 10.1371/journal.pone.0275929] [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: 04/16/2022] [Accepted: 09/26/2022] [Indexed: 11/19/2022] Open
Abstract
Previous studies have suggested that gene-environment interactions (GEIs) between a common variant and an environmental factor can influence multiple correlated phenotypes simultaneously, that is, GEI pleiotropy, and that analyzing multiple phenotypes jointly is more powerful than analyzing phenotypes separately by using single-phenotype GEI tests. Methods to test the GEI for rare variants with multiple phenotypes are, however, lacking. In our work, we model the correlation among the GEI effects of a variant on multiple quantitative phenotypes through four kernels and propose four multiphenotype GEI tests for rare variants, which are a test with a homogeneous kernel (Hom-GEI), a test with a heterogeneous kernel (Het-GEI), a test with a projection phenotype kernel (PPK-GEI) and a test with a linear phenotype kernel (LPK-GEI). Through numerical simulations, we show that correlation among phenotypes can enhance the statistical power except for LPK-GEI, which simply combines statistics from single-phenotype GEI tests and ignores the phenotypic correlations. Among almost all considered scenarios, Het-GEI and PPK-GEI are more powerful than Hom-GEI and LPK-GEI. We apply Het-GEI and PPK-GEI in the genome-wide GEI analysis of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the UK Biobank. We analyze 18,101 genes and find that LEUTX is associated with SBP and DBP (p = 2.20×10-6) through its interaction with hemoglobin. The single-phenotype GEI test and our multiphenotype GEI tests Het-GEI and PPK-GEI are also used to evaluate the gene-hemoglobin interactions for 22 genes that were previously reported to be associated with SBP or DBP in a meta-analysis of genetic main effects. MYO1C shows nominal significance (p < 0.05) by the Het-GEI test. NOS3 shows nominal significance in DBP and MYO1C in both SBP and DBP by the single-phenotype GEI test.
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Ghosh T, Rehman T, Ahamed F. Relationship Between Hemoglobin and Blood Pressure Levels in the Context of Chronic Morbidity Among Older Adults Residing in a Developing Country: A Community-Level Comparative Cross-Sectional Study. Cureus 2021; 13:e19540. [PMID: 34934558 PMCID: PMC8667963 DOI: 10.7759/cureus.19540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/12/2022] Open
Abstract
Objectives: The objective of this study is to assess the association between hemoglobin (Hb) and blood pressure (BP) levels among community-dwelling older adults. Materials and Methods: This comparative cross-sectional study was conducted in April 2021 in West Bengal, India. Individuals who are receiving treatment for hypertension, or had a history of blood transfusion, or had a history of intake of iron and vitamins were excluded from the study. A total of 81 and 106 individuals were recruited in “Group 1” (no self-reported comorbidity) and “Group 2” (self-reported comorbidity present), respectively. Results: The mean (SD) age of the participants (n = 187) was 67.4 (7.4) years; 54% (n = 101) were males; and 45.4% (n = 85) were obese. We found a significant association of Hb level with systolic blood pressure (SBP) (r = 0.22, p = 0.04) and mean arterial pressure (MAP) (r = 0.22, p = 0.04) in “Group 1”. The quantum of increases in SBP, diastolic blood pressure (DBP), pulse pressure (PP), and MAP with one gram/dl change in Hb level were 3.24 (95% CI: -0.75 to 7.24) mmHg, 1.17 (95% CI: -0.84 to 3.20) mmHg, 2.06 (95% CI: -0.67 to 4.81) mmHg, and 1.87 (95% CI: -0.65 to 4.39) mmHg, respectively, in “Group 1” after adjustment for age, gender, and body mass index. The findings were inconsistent in “Group 2”, and the changes in Hb level were 0.5 (95% CI: -3.77 to 2.77) mmHg, 0.92 (95% CI: -0.72 to 2.75) mmHg, -1.42 (95% CI: -4.09 to 1.24) mmHg, and 0.45 (95% CI: -1.05 to 2.40) mmHg, respectively. Conclusion: Hb level has a positive correlation with SBP and MAP only in those without comorbidities.
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Affiliation(s)
- Tandra Ghosh
- Physiology, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
| | - Tanveer Rehman
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
| | - Farhad Ahamed
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
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Lai SW, Tsai KZ, Wang SH, Lin YK, Lin YP, Lin GM. Erythrocyte Indices and Long-term Blood Pressure Variability in Military Males. Cardiovasc Hematol Disord Drug Targets 2021; 21:217-224. [PMID: 34906064 DOI: 10.2174/1871529x21666211214154545] [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: 07/01/2021] [Revised: 08/24/2021] [Accepted: 10/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUNDS Severe microcytic anemia has been associated with BP changes. AIMS AND OBJECTIVES Whether the erythrocyte indices are associated with long-term BPV is unknown. This study aimed to investigate the association of hemoglobin levels and erythrocyte size with long-term blood pressure variability (BPV) in young males. METHODS This study included 1,112 healthy military males, averaging 32 years of age, in Taiwan. All participants took a measurement of systolic and diastolic BP (SBP and DBP) every two-year from 2012 to 2018 (2012-14, 2014-15, 2015-16, 2016-18). Lev-els of hemoglobin and mean corpuscular volume (MCV) of erythrocytes were obtained at the first visit. Long-term BPV was assessed by the standard deviation (SD) and aver-age real variability (ARV). Multivariate linear regression analysis with adjustment for the baseline BP levels and other covariates was used to elucidate the association. RESULTS Hemoglobin levels were borderline positively correlated with SD DBP (β and standard errors = 0.016 (0.009), P =0.06). In those with hemoglobin levels of 10.0-13.9 g/dL, hemoglobin was negatively correlated with SDSBP (β= -0.039 (0.018), P =0.03). In contrast, MCV levels were borderline positively correlated with SDSBP (β =0.085 (0.052), P =0.09). In those with MCV levels <80 fL, MCV was positively correlated with SDSBP and ARVSBP (β= 0.445 (0.210) and 0.286 (0.149), p = 0.03 and 0.05, re-spectively). CONCLUSION There were inconsistent patterns for the associations of erythrocyte indices with long-term BPV. We found a U-shaped relationship of hemoglobin levels with sys-tolic BPV, whereas there was a positive linear relationship of hemoglobin and MCV levels with diastolic BPV, respectively.
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Affiliation(s)
- Shiue-Wei Lai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City 970. Taiwan
| | - Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City 970. Taiwan
| | - Shen-Huei Wang
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City 970. Taiwan
| | - Yu-Kai Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City 970. Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu-Chi General Hospital, New Tai-pei City 231. Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City 970. Taiwan
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Sun JY, Hua Y, Zou HYY, Qu Q, Yuan Y, Sun GZ, Sun W, Kong XQ. Association Between Waist Circumference and the Prevalence of (Pre) Hypertension Among 27,894 US Adults. Front Cardiovasc Med 2021; 8:717257. [PMID: 34712705 PMCID: PMC8545886 DOI: 10.3389/fcvm.2021.717257] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/08/2021] [Indexed: 12/20/2022] Open
Abstract
Aims: This study aimed to investigate the association between waist circumference and the prevalence of (pre) hypertension. Methods: Cross-sectional data from the 2007–2018 National Health and Nutrition Examination Survey were analyzed. The historical trend of abdominal obesity was assessed by the Cochran–Armitage trend test. After preprocessed by the multiple imputation strategy, we used generalized additive models to assess the association of waist circumference with systolic/diastolic blood pressure and performed correlation analysis by the Spearman correlation coefficient. Moreover, we used multivariable logistic regression (non-adjusted, minimally adjusted, and fully adjusted models), restricted cubic spline, and sensitivity analysis to investigate the association between waist circumference and (pre) hypertension. Results: A total of 27,894 participants were included in this study. In the fully adjusted model, waist circumference was positively associated with (pre) hypertension with odds ratios (95% confidence intervals) of 1.28 (1.18–1.40) in the young group and 1.23 (1.15–1.33) in the old group. Restricted cubic spline showed a higher prevalence of (pre) hypertension with the increase of waist circumference. In the subgroup analysis, waist circumference showed a robust trend across all BMI categories with odds ratios (95% confidence intervals) of 3.33 (1.29–8.85), 1.35 (1.17–1.57), 1.27 (1.13–1.41), and 1.09 (1.01–1.17) in underweight, normal weight, overweight, and obese individuals, respectively. Conclusion: This study highlighted waist circumference as a significant biomarker to evaluate the risk of (pre) hypertension. Our results supported the measure of waist circumference regardless of BMI when evaluating the cardiometabolic risk related to fat distribution.
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Affiliation(s)
- Jin-Yu Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yang Hua
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hua-Yi-Yang Zou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Yuan
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo-Zhen Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang-Qing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Tapio J, Vähänikkilä H, Kesäniemi YA, Ukkola O, Koivunen P. Higher hemoglobin levels are an independent risk factor for adverse metabolism and higher mortality in a 20-year follow-up. Sci Rep 2021; 11:19936. [PMID: 34620927 PMCID: PMC8497471 DOI: 10.1038/s41598-021-99217-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/21/2021] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to cross-sectionally and longitudinally examine whether higher hemoglobin (Hb) levels within the normal variation associate with key components of metabolic syndrome and total and cardiovascular mortality. The study included 967 Finnish subjects (age 40-59 years) followed for ≥ 20 years. The focus was on Hb levels, cardiovascular diseases (CVDs) and mortality rates. Higher Hb levels associated positively with key anthropometric and metabolic parameters at baseline. At the follow-up similar associations were seen in men. The highest Hb quartile showed higher leptin levels and lower adiponectin levels at baseline and follow-up (p < 0.05) and lower plasma ghrelin levels at baseline (p < 0.05). Higher baseline Hb levels associated independently with prevalence of type 2 diabetes at follow-up (p < 0.01). The highest Hb quartile associated with higher serum alanine aminotransferase levels (p < 0.001) and independently with increased risk for liver fat accumulation (OR 1.63 [1.03; 2.57]) at baseline. The highest Hb quartile showed increased risk for total (HR = 1.48 [1.01; 2.16]) and CVD-related mortality (HR = 2.08 [1.01; 4.29]). Higher Hb levels associated with an adverse metabolic profile, increased prevalence of key components of metabolic syndrome and higher risk for CVD-related and total mortality.
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Affiliation(s)
- Joona Tapio
- Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, P.O. Box 5400, 90014, Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90014, Oulu, Finland
| | - Y Antero Kesäniemi
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Olavi Ukkola
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
| | - Peppi Koivunen
- Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, P.O. Box 5400, 90014, Oulu, Finland.
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Abumohsen H, Bustami B, Almusleh A, Yasin O, Farhoud A, Safarini O, Thabaleh A, Sukhon M, Nazzal Z, Damiri B. The Association Between High Hemoglobin Levels and Pregnancy Complications, Gestational Diabetes and Hypertension, Among Palestinian Women. Cureus 2021; 13:e18840. [PMID: 34804695 PMCID: PMC8594858 DOI: 10.7759/cureus.18840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the principal causes of maternal morbidity and mortality. The maternal morbidity and mortality burden for Palestinian women is relatively high, suggesting a substandard quality of care. Therefore, an early diagnosis of GDM and gestational hypertension (GH) can improve prenatal care for pregnant women and improve pregnancy outcomes. Previous studies demonstrated that elevated Hb levels in the first trimester indicate possible pregnancy complications and should not only be considered as good iron status. However, ethnic differences could play a role in determining the magnitude of the association. We hypothesized that high Hb levels (≥12.5 g/dl) in the first trimester (6-13 gestational weeks, GW) are associated with increased risk of fasting blood sugar (FBS) ≥126 mg/dl, systolic blood pressure (SBP) ≥140 mmHg, and diastolic blood pressure (DBP) ≥90 mmHg among pregnant Palestinian women visiting prenatal clinics in Palestine. METHODS Medical records (N=5263) were reviewed for singleton pregnancies who had their first maternity care clinic visit (6-13 GW) at primary healthcare centers of the Palestinian Ministry of Health in the north of the West Bank in 2018 and 2019. Women were excluded if they had FBS ≥92 mg/dl, SBP ≥140 mmHg, DBP ≥90 mmHg, ultrasound-based gestational age >13 weeks, or who were previously diagnosed with diabetes mellites, GDM, hypertension, GH, taking drugs for these conditions, or were smoking during pregnancy. Hb levels in g/dl were divided to low (<11.0), normal (11-12.49), and high (≥12.5). The associations between high hemoglobin levels and pregnancy complications in pregnant women were assessed by calculating the odds ratios (OR) and their 95% confidence intervals (CIs) using logistic regression. P-values of <0.05 were considered significant. RESULTS The final number of eligible records was 2565. Pregnant women with high Hb levels in the first trimester were at higher risk of high FBS (≥126 mg/dl; OR=2.99, 95%CI, [1.675-5.368]) and high systolic blood pressure (≥140 mmHg; OR=3.048, 95%CI, [1.252-7.421]) at 24 GW. Gravidity was significantly associated with decreased risk of high FBS (OR=0.838, 95%CI [0.704-0.991]). CONCLUSION Our findings suggest that Hb level at registration could be utilized in predicting the risk of GDM and HP among Palestinian women who never had a previous history of these conditions. The results of this study could have important clinical implications for early screening, which could improve preventive and curative health services to promote the health of pregnant women and children.
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Affiliation(s)
| | | | | | - Osama Yasin
- Medicine, An-Najah National University, Nablus, PSE
| | | | | | | | | | - Zaher Nazzal
- Community and Family Medicine, An-Najah National University, Nablus, PSE
| | - Basma Damiri
- Faculty of Medicine and Health Sciences - Drug and Toxicology Division, An-Najah National University, Nablus, PSE
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Hemoglobin and hematocrit levels are positively associated with blood pressure in children and adolescents 10 to 18 years old. Sci Rep 2021; 11:19052. [PMID: 34561491 PMCID: PMC8463603 DOI: 10.1038/s41598-021-98472-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/08/2021] [Indexed: 02/08/2023] Open
Abstract
To investigate the associations between hemoglobin (Hb) concentration and hematocrit (Hct), and blood pressure (BP) in children and adolescents. The study population consisted of 7950 subjects total (4229 boys and 3721 girls) aged 10-18 years who participated in the Korea National Health and Nutrition Examination Surveys conducted between 2007 and 2017. The prevalence of hypertension was 19.19% (21.51% for boys and 16.5% for girls) among the study population, and the prevalence of obesity was 9.59% (10.5% for boys and 8.6% for girls). Hb count and Hct tended to increase with the degree of obesity and BP elevation. Systolic BP (SBP) and diastolic BP (DBP) positively correlated with Hb count and Hct in both sexes. Following multiple linear regression analysis, Hb count and Hct presented a positive association with SBP and DBP after adjusting for age, BMI SDS, alcohol consumption, smoking status, physical activity, rural residence, household income, diagnosis of T2DM, hypertension, and dyslipidemia. Hb count and Hct were positively associated with SBP and DBP in children and adolescents 10-18 years old.
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46
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Wen J, Zhang Q, Yang Q, Hu F. The levels of hemoglobin are positively associated with arterial stiffness in community-dwelling Chinese adults. Nutr Metab Cardiovasc Dis 2021; 31:2929-2934. [PMID: 34364772 DOI: 10.1016/j.numecd.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/02/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Hemoglobin (Hb) concentrations are known to be related to cardiovascular diseases. This study investigated the association between Hb levels and arterial stiffness, as assessed by measurement of the brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS 3576 adults (2139 males and 1437 females) from the general Chinese population who had their physical check-ups in the health examination centers of Jiangmen Central Hospital were enrolled into the study. The anthropometrics and laboratory data as well as the baPWV and Hb levels were subsequently obtained. Age-adjusted partial correlation and multivariable stepwise linear regression analyses were used to evaluate the relationships between Hb and baPWV for men and women separately. In both sexes, Hb levels were positively associated with body mass index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, glutamic-pyruvic transaminase, γ-glutamyltranspeptidase, uric acid and baPWV, but negatively correlated with the estimated glomerular filtration rate. Multivariable linear regression analysis showed that Hb was significantly and independently associated with arterial stiffness in men (β = 0.043, 95% CI 0.010-0.077, p < 0.05) and women (β = 0.035, 95% CI 0.001-0.069, P < 0.05), after adjustment for confounding factors. CONCLUSION The data indicate that high Hb concentration significantly correlate with increased baPWV in general Chinese population.
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Affiliation(s)
- Jianghua Wen
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, 529070, Guangdong, China
| | - Qinqin Zhang
- Department of Thyroid and Breast Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, Guangxi, China.
| | - Qiong Yang
- Department of Endocrinology, Guilin Medical University Affiliated Hospital, Guilin 541001, Guangxi, China.
| | - Fang Hu
- Department of Endocrinology, The Fifth Affiliated Hospital, Sun Yat-Sen University, 52 Meihua East Road, Zhuhai 519000, Guangdong, China
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Karand JC, Reis K, Stephano PF, Gargurevich N, Zhou J, Desderius B, Fadhil S, Ladha Y, Rosengard R, Kowal DR, Peck RN. Sex-dependent correlates of arterial stiffness in Tanzanian adults. Trop Med Int Health 2021; 26:1494-1502. [PMID: 34478605 DOI: 10.1111/tmi.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Arterial stiffness is a known indicator for cardiovascular disease. However, the factors that lead to arterial stiffening have primarily been studied in participants from high-income countries. Here, we examine clinical and lifestyle metrics in relation to arterial stiffness in Tanzanian adults. METHODS We performed pulse wave velocity (PWV), the gold standard measure of arterial stiffness, on 808 Tanzanian adults (ages 18-65) enrolled in a longitudinal cohort studying trends in blood pressure. RESULTS As expected, PWV was strongly associated with age, blood pressure and sex. We controlled for these factors in our statistical analysis. Lifestyle metrics were compared across multiple PWV quantiles. We found that determinants of PWV varied by sex: in female participants, PWV was associated with common obesity metrics and menopause, while in male participants, PWV was associated with HIV status and duration of anti-retroviral therapy (ART). Further clinical and lifestyle factors such as marriage status and type of occupation were also significantly associated with PWV and moderated by sex. CONCLUSION Together, our data demonstrate the importance of studying sex-specific causal pathways for arterial stiffness and of including under-represented populations in these studies.
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Affiliation(s)
- Julie C Karand
- Fulbright U.S. Scholar Program, Washington, DC, USA.,University of Delaware, Newark, DE, USA
| | - Karl Reis
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.,Weill Bugando School of Medicine, Mwanza, Tanzania
| | | | | | | | | | | | - Yumna Ladha
- Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Rachel Rosengard
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | | | - Robert N Peck
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.,Weill Bugando School of Medicine, Mwanza, Tanzania
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Pappelis K, Jansonius NM. U-Shaped Effect of Blood Pressure on Structural OCT Metrics and Retinal Perfusion in Ophthalmologically Healthy Subjects. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 34499704 PMCID: PMC8434757 DOI: 10.1167/iovs.62.12.5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose We wanted to investigate the association of blood pressure (BP) status with the ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thickness of nonglaucomatous eyes and to elucidate whether this effect is related to vascular metrics proxying retinal perfusion. Methods For this case-control study, we prospectively included 96 eyes of 96 healthy subjects (age 50–65) from a large-scale population-based cohort in the northern Netherlands (n = 167,000) and allocated them to four groups (low BP, normal BP [controls], treated arterial hypertension [AHT], untreated AHT). We measured macular GCIPL and RNFL (mRNFL) and peripapillary RNFL (pRNFL) thicknesses with optical coherence tomography (OCT). We estimated retinal blood flow (RBF), retinal vascular resistance (RVR), and autoregulatory reserve (AR) from quantitative OCT-angiography, fundus imaging, BP, and intraocular pressure. We compared structural and vascular metrics across groups and performed mediation analysis. Results Compared to controls, GCIPL was thinner in the low BP group (P = 0.013), treated hypertensives (P = 0.007), and untreated hypertensives (P = 0.007). Treated hypertensives exhibited the thinnest mRNFL (P = 0.001), temporal pRNFL (P = 0.045), and inferior pRNFL (P = 0.034). The association of GCIPL thickness with BP was mediated by RBF within the combined low BP group and controls (P = 0.003), by RVR and AR within the combined treated hypertensives and controls (P = 0.001, P = 0.032), and by RVR within the combined untreated antihypertensives and controls (P = 0.022). Conclusions Inner retinal thinning was associated with both tails of the BP distribution and with ineffective autoregulation. Longitudinal studies could clarify whether these defects can explain the reported glaucomatous predisposition of these population groups.
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Affiliation(s)
- Konstantinos Pappelis
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
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Incidence and risk factors for progression from prehypertension to hypertension: a 12-year Korean Cohort Study. J Hypertens 2021; 38:1755-1762. [PMID: 32398468 DOI: 10.1097/hjh.0000000000002494] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study evaluated the incidence and risk factors for progression from prehypertension to hypertension among middle-aged and elderly Korean adults. METHODS A total of 115 456 participants with prehypertension in 2003-2004 were selected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) Program. All participants were followed until 2015. Potential risk factors for progression to hypertension were evaluated using the chi-squared test or t-test. A Cox proportional hazards model was used to predict the risk of progression to hypertension according to sex. The incidence of hypertension in the prehypertension group was evaluated by calculating the incidence density during the entire follow-up period. RESULTS During the follow-up period, 48 919 participants experienced progression to hypertension, which corresponded to incidence densities of 45.82/1000 person-years among men and 53.57/1000 person-years among women. Among both men and women, progression to hypertension was predicted by an elevated BMI, family history of hypertension, history of diabetes mellitus, and older age. Among men, progression to hypertension was associated with frequent drinking and high alanine aminotransferase levels. Among women, progression to hypertension was associated with high hemoglobin levels and low household income. CONCLUSION This study identified various risk factors for progression from prehypertension to hypertension among middle-aged and elderly Korean adults. This information may help researchers develop comprehensive and effective strategies for managing prehypertension.
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Qian M, Zhou X, Gao B, Huang H, Yang C, Zeng T, Shen J, Hu J, Sun F, Li S, Huang X, Chen G. Red cell index: A novel biomarker for 3-month mortality in acute ischemic stroke patients treated with intravenous thrombolysis. Brain Behav 2021; 11:e02170. [PMID: 33943024 PMCID: PMC8213941 DOI: 10.1002/brb3.2170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/09/2021] [Accepted: 04/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The red cell index (RCI) was described as a biomarker for evaluating respiratory function in previous studies, but the relationship between RCI and stroke, remained a mystery. The present study aimed to probe the association between RCI at 24-hr and 3-month mortality and functional outcomes among acute ischemic stroke (AIS) patients treated with recombinant tissue plasminogen activator (r-tPA). METHODS A total of 217 AIS patients between January 2016 and January 2019 were recruited in this retrospective study. AIS patients were grouped in terms of RCI tertiles. Predictive factors were confirmed via multivariate logistic regression analysis. The receiver operating characteristic (ROC) was used to assess the ability of RCI in predicting mortality. In addition, the risk of 3-month all-cause mortality was evaluated by Cox proportional hazard model. RESULTS We grouped AIS patients into tertiles with the purpose of comparing clinical factors and RCI levels. Multivariate logistic regression analysis presented that RCI (odds ratio [OR] = 1.443, 95% confidence interval [CI] [1.167-1.786], p = 0.001) was an independent biomarker for 3-month all-cause mortality. The best cutoff value of RCI was 2.41 (area under the curve [AUC] = 0.639, 95% CI [0.501-0.778], p = .032), with a sensitivity of 40.9% and a specificity of 89.7%. Cox survival analysis demonstrated a positive significant correlation between RCI (hazard ratio [HR] = 1.332, 95% CI [1.148-1.545], p < .001) and mortality risk. CONCLUSION RCI, a potential predictor, was significantly associated with 3-month mortality in AIS patients with r-tPA.
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Affiliation(s)
- Meizi Qian
- Department of Anesthesia, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xinbo Zhou
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Beibei Gao
- Department of Internal Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Honghao Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Chenguang Yang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Tian Zeng
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jiamin Shen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jingyu Hu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Fangyue Sun
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shengqi Li
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xuerong Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guangyong Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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