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Wu Q, Burley G, Li L, Lin S, Shi Y. The role of dietary salt in metabolism and energy balance: Insights beyond cardiovascular disease. Diabetes Obes Metab 2023; 25:1147-1161. [PMID: 36655379 PMCID: PMC10946535 DOI: 10.1111/dom.14980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
Dietary salt (NaCl) is essential to an organism's survival. However, today's diets are dominated by excessive salt intake, which significantly impacts individual and population health. High salt intake is closely linked to cardiovascular disease (CVD), especially hypertension, through a number of well-studied mechanisms. Emerging evidence indicates that salt overconsumption may also be associated with metabolic disorders. In this review, we first summarize recent updates on the mechanisms of salt-induced CVD, the effects of salt reduction and the use of salt substitution as a therapy. Next, we focus on how high salt intake can impact metabolism and energy balance, describing the mechanisms through which this occurs, including leptin resistance, the overproduction of fructose and ghrelin, insulin resistance and altered hormonal factors. A further influence on metabolism worth noting is the reported role of salt in inducing thermogenesis and increasing body temperature, leading to an increase in energy expenditure. While this result could be viewed as a positive metabolic effect because it promotes a negative energy balance to combat obesity, caution must be taken with this frame of thinking given the deleterious consequences of chronic high salt intake on cardiovascular health. Nevertheless, this review highlights the importance of salt as a noncaloric nutrient in regulating whole-body energy homeostasis. Through this review, we hope to provide a scientific framework for future studies to systematically address the metabolic impacts of dietary salt and salt replacement treatments. In addition, we hope to form a foundation for future clinical trials to explore how these salt-induced metabolic changes impact obesity development and progression, and to elucidate the regulatory mechanisms that drive these changes, with the aim of developing novel therapeutics for obesity and CVD.
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Affiliation(s)
- Qi Wu
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - George Burley
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
| | - Li‐Cheng Li
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Shu Lin
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yan‐Chuan Shi
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
- School of Clinical Medicine, St Vincent's Clinical CampusFaculty of Medicine and HealthSydneyNew South WalesAustralia
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Weaver AM, Wang Y, Wellenius GA, Bidulescu A, Sims M, Vaidyanathan A, Hickson DA, Shimbo D, Abdalla M, Diaz KM, Seals SR. Long-Term Air Pollution and Blood Pressure in an African American Cohort: the Jackson Heart Study. Am J Prev Med 2021; 60:397-405. [PMID: 33478866 PMCID: PMC10388406 DOI: 10.1016/j.amepre.2020.10.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 09/21/2020] [Accepted: 10/30/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION African Americans are disproportionately affected by high blood pressure, which may be associated with exposure to air pollutants, such as fine particulate matter and ozone. METHODS Among African American Jackson Heart Study participants, this study examined associations between 1-year and 3-year mean fine particulate matter and ozone concentrations with prevalent and incident hypertension at Visits 1 (2000-2004, n=5,191) and 2 (2005-2008, n=4,105) using log binomial regression. Investigators examined associations with systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure using linear regression and hierarchical linear models, adjusting for sociodemographic, behavioral, and clinical characteristics. Analyses were conducted in 2017-2019. RESULTS No associations were observed between fine particulate matter or ozone concentration and prevalent or incident hypertension. In linear models, an IQR increase in 1-year ozone concentration was associated with 0.67 mmHg higher systolic blood pressure (95% CI=0.27, 1.06), 0.42 mmHg higher diastolic blood pressure (95% CI=0.20, 0.63), and 0.50 mmHg higher mean arterial pressure (95% CI=0.26, 0.74). In hierarchical models, fine particulate matter was inversely associated with systolic blood pressure (-0.72, 95% CI= -1.31, -0.13), diastolic blood pressure (-0.69, 95% CI= -1.02, -0.36), and mean arterial pressure (-0.71, 95% CI= -1.08, -0.33). Attenuated associations were observed with 1-year concentrations and at Visit 1. CONCLUSIONS Positive associations were observed between ozone and systolic blood pressure, diastolic blood pressure, and mean arterial pressure, and inverse associations between fine particulate matter and systolic blood pressure, diastolic blood pressure, and mean arterial pressure in an African American population with high (56%) prevalence of hypertension. Effect sizes were small and may not be clinically relevant.
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Affiliation(s)
- Anne M Weaver
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Chapel Hill, North Carolina; Department of Environmental Health, Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Yi Wang
- Department of Environmental Health, Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Ambarish Vaidyanathan
- School of Civil & Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - DeMarc A Hickson
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, Mississippi
| | - Daichi Shimbo
- Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Marwah Abdalla
- Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Keith M Diaz
- Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Samantha R Seals
- Department of Mathematics and Statistics, University of West Florida, Pensacola, Florida
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Hidru TH, Yang X, Xia Y, Ma L, Li HH. The relationship between Plasma Markers and Essential Hypertension in Middle-aged and Elderly Chinese Population: A Community Based Cross-sectional Study. Sci Rep 2019; 9:6813. [PMID: 31048753 PMCID: PMC6497653 DOI: 10.1038/s41598-019-43278-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/16/2019] [Indexed: 12/16/2022] Open
Abstract
Plasma markers have been continuously advocated as pointers to estimate the long-term risk of cardiovascular disease in the general population. We examined the relationship between plasma high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), high-sensitivity cardiac troponin T (hs-cTnT), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), 25-Hydroxyvitamin D (25OHD), glycosylated hemoglobin A1c (HbA1c), and serum uric acid (SUA) levels and hypertension in middle and old aged population. A total of 2624 Chinese (62.02 ± 5.73 years old) were recruited into a population-based, cross-sectional study. Plasma hs-CRP, Hcy, HbA1c, and SUA levels were significantly higher in the hypertension group compared with control in the entire population and men (P = 0.05 for all). We observed a positive association between the highest quartiles of Hcy, NT-proBNP, HBA1c concentrations, and the prevalence of hypertension, OR (95% CI) = 1.48 (1.16–1.90), 1.62 (1.27–2.07) and 1.94 (1.49–2.52), respectively. The multivariable-adjusted OR of hypertension for the fourth versus the first quartile of homocysteine were 2.00 and 1.39 in men and women, respectively. In conclusion, our study found an independent and robust association between elevated Hcy, NT-ProBNP, and HBA1c levels and prevalence of hypertension in the middle-aged and elderly Chinese population. A follow-up study is necessary to endorse the observed association.
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Affiliation(s)
| | - Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yunlong Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, 116044, China.
| | - Hui-Hua Li
- School of Public Health, Dalian Medical University, Dalian, 116044, China. .,Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Ahued-Ortega JA, León-García PE, Hernández-Pérez E. Correlation of plasma B-type natriuretic peptide levels with metabolic risk markers. Med Clin (Barc) 2018; 151:481-486. [PMID: 29678316 DOI: 10.1016/j.medcli.2018.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 02/10/2018] [Accepted: 02/15/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Natriuretic peptide type B (BNP) is a marker of myocardium injury. This peptide has been associated with metabolic risk markers, although controversy exists in this regard. The aim of the present study was to determine the correlation of plasma BNP levels with metabolic risk parameters. MATERIALS AND METHODS A retrospective, observational study that included 152 patients, who were classified according to their clinical diagnosis as patients with metabolic syndrome. Plasma BNP levels and clinical metabolic parameters were assessed by using Spearmańs rank correlation coefficient. RESULTS A significant inverse association with weight (r=-.408; p<.0001) and BMI (r=-.443; p<.001) was obtained. While a positive significant association with systolic pressure (r=.324; p<.001) was observed. A significant decrease was found in BNP levels and components of metabolic syndrome. (p<.05). CONCLUSION Based on the results from this study, we can conclude that BNP determination could be an adequate metabolic marker.
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Affiliation(s)
- José Armando Ahued-Ortega
- Secretaría de Salud Pública del Distrito Federal, Servicios de Salud Pública del Distrito Federal, Ciudad de México, México
| | - Plácido Enrique León-García
- Departamento de Ciencias de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, México
| | - Elizabeth Hernández-Pérez
- Departamento de Ciencias de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Ciudad de México, México.
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Parikh NI, Norberg M, Ingelsson E, Cnattingius S, Vasan RS, Domellöf M, Jansson JH, Edstedt Bonamy AK. Association of Pregnancy Complications and Characteristics With Future Risk of Elevated Blood Pressure: The Västerbotten Intervention Program. Hypertension 2017; 69:475-483. [PMID: 28137991 DOI: 10.1161/hypertensionaha.116.08121] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/10/2016] [Accepted: 01/03/2017] [Indexed: 11/16/2022]
Abstract
Pregnancy characteristics are associated with risk of cardiovascular diseases, but their independent associations with hypertension or blood pressure (BP) levels remain uncertain. We linked the Swedish Medical Birth Register with Västerbotten Intervention Program data (Northern Sweden). Using linear and logistic regression, we related pregnancy factors in any prior pregnancy with BP and hypertension at 40 years of age in 15 896 parous women free of prepregnancy hypertension. Pregnancy factors included parity, age at first delivery, preeclampsia, gestational diabetes mellitus, placental abruption, shortest gestational age small for gestational age baby (<third percentile for birth weight) or stillbirth. We defined hypertension as systolic BP ≥140 mm Hg and diastolic BP ≥90 mm Hg or antihypertensive use. Multivariable models were adjusted for all pregnancy factors and potential lifestyle and sociodemographic confounders. At 40 years of age, 1535 women (9.6%) had hypertension. In multivariable models, lower parity, younger age at first birth, preeclampsia, small for gestational age, and placental abruption were independently associated with higher systolic and diastolic BP levels at 40 years of age. Younger age at first birth, preeclampsia, gestational age <32 versus ≥37 weeks, and small for gestational age were independently associated with hypertension. Our findings raise the possibility that earlier and more frequent BP screening may be desirable in women with these pregnancy characteristics.
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Affiliation(s)
- Nisha I Parikh
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.).
| | - Margareta Norberg
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
| | - Erik Ingelsson
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
| | - Sven Cnattingius
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
| | - Ramachandran S Vasan
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
| | - Magnus Domellöf
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
| | - Jan Håkan Jansson
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
| | - Anna-Karin Edstedt Bonamy
- From the Division of Cardiology, Department of Medicine, University of California San Francisco (N.I.P.); Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden (M.N.); Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (E.I.); Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Sweden (E.I.); Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (S.C., A.-K.E.B.); Preventive Medicine and Cardiology Sections, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (R.S.V.); Department of Clinical Sciences, Unit of Pediatrics (M.D.) and Department of Public Health and Clinical Medicine, Research Unit Skellefteå (J.H.J.), Umeå University, Sweden; and Department of Women's Children's Health, Karolinska Institutet, Stockholm, Sweden (A.-K.E.B.)
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Ford CD, Sims M, Higginbotham JC, Crowther MR, Wyatt SB, Musani SK, Payne TJ, Fox ER, Parton JM. Psychosocial Factors Are Associated With Blood Pressure Progression Among African Americans in the Jackson Heart Study. Am J Hypertens 2016; 29:913-24. [PMID: 26964661 DOI: 10.1093/ajh/hpw013] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/22/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Research that examines the associations of psychosocial factors with incident hypertension among African Americans (AA) is limited. Using Jackson Heart Study (JHS) data, we examined associations of negative affect and stress with incident hypertension and blood pressure (BP) progression among AA. METHODS Our sample consisted of 1,656 normotensive participants at baseline (2000-2004) (mean age 47±12; 61% women). We investigated associations of negative affect (cynical distrust, anger-in, anger-out, and depressive symptoms) and stress (perceived stress, weekly stress inventory (WSI)-event, WSI-impact, and major life events) with BP progression (an increase by one BP stage as defined by JNC VII) and incident hypertension by examination 2 (2005-2008). Poisson regression analysis was utilized to examine the prevalence ratios (PRs; 95% confidence interval (CI)) of BP tracking and incident hypertension with psychosocial factors, adjusting for baseline age, sex, socioeconomic status (SES), and hypertension risk factors. RESULTS Fifty-six percentage of the sample (922 cases) had BP progression from 2005 to 2008. After adjustment for age, sex, and SES, a high anger-out score was associated with a 20% increased risk of BP progression compared to a low anger-out score (PR 1.20; 95% CI 1.05-1.36). High depressive symptoms score was associated with BP progression in the age, sex, and SES-adjusted model (PR 1.14; 95% CI 1.00-1.30). High WSI-event scores were associated with BP progression in the fully adjusted model (PR 1.21; 95% CI 1.04-1.40). We did not observe significant associations with any of the psychosocial measures and incident hypertension. CONCLUSIONS Psychosocial factors were associated with BP progression, with the strongest evidence for number of stressful events that occurred.
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Affiliation(s)
- Cassandra D Ford
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA;
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - John C Higginbotham
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Martha R Crowther
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Sharon B Wyatt
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA; School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Solomon K Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Thomas J Payne
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ervin R Fox
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jason M Parton
- Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa, Alabama, USA
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Increasing aminoterminal-pro-B-type natriuretic peptide precedes the development of arterial hypertension: the multiethnic study of atherosclerosis. J Hypertens 2016; 33:966-74. [PMID: 25909698 DOI: 10.1097/hjh.0000000000000500] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Longitudinal associations between the aminoterminal pro-B-type natriuretic peptide (NT-proBNP) and incident hypertension are lacking. METHODS We tested associations between baseline NT-proBNP (bNT-proBNP) and change in NT-proBNP (ΔNT-proBNP) (visit 3 NT-proBNP - bNT-proBNP, 3.2 years apart) with incident hypertension (SBP ≥ 140 and/or DBP ≥90 mmHg or taking antihypertensive medications). Incident hypertension was evaluated in 5596 individuals in the Multi-Ethnic Study of Atherosclerosis without hypertension at baseline (53% women, age range 45-84 years without overt cardiovascular disease) and follow-up for 9.5 years and in a subgroup (1550) who had bNT-proBNP less than 100 pg/ml and no hypertension at visit 3. Incident hypertension was regressed (proportional hazards) on quintiles of bNT-proBNP (range) (reference <19.2, 19.3-40.8, 40.9-70.9, 71-135.2, and >135.5) and also on ΔNT-proBNP categories (reference <-10, -10 to 10, >10 to 50, and >50 pg/ml). Hazard ratios were adjusted for age, race, sex, education, diabetes, obesity, left ventricle mass/height, SBP and DBP, interleukin-6, salt intake, estimated glomerular filtration rate, and exercise. RESULTS Compared with the reference category, hazard ratios (95% confidence interval) for incident hypertension compared with the first quintile of bNT-proBNP were 1.47 (1.13-1.93), 1.57 (1.18-2.09), 1.52 (1.12-2.06), and 2.36 (1.62-3.41). Hazard ratios for incident hypertension by categories of ΔNT-proBNP from 3.2 to 9.5 years follow-up were 0.98 (0.62-1.56), 1.13 (0.72-1.79), and 1.82 (1.07-3.12). CONCLUSION The development of hypertension tended to be preceded by elevated levels of bNT-proBNP or a substantial positive ΔNT-proBNP.
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Seven E, Husemoen LLN, Ibsen H, Friedrich N, Nauck M, Wachtell K, Linneberg A, Jeppesen JL. Higher serum concentrations of N-terminal pro-B-type natriuretic peptide associate with prevalent hypertension whereas lower associate with incident hypertension. PLoS One 2015; 10:e0117864. [PMID: 25658326 PMCID: PMC4320109 DOI: 10.1371/journal.pone.0117864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 01/02/2015] [Indexed: 12/16/2022] Open
Abstract
Background The role of the natriuretic peptides (NPs) in hypertension is complex. Thus, a higher blood NP concentration is a robust marker of pressure-induced cardiac damage in patients with hypertension, whereas genetically elevated NP concentrations are associated with a reduced risk of hypertension and overweight individuals presumably at high risk of hypertension have lower NP concentrations. Objective To investigate the associations between serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), used as a surrogate marker for active BNP, and prevalent as well as 5-year incident hypertension in a Danish general population sample. Methods Cross-sectional and prospective population-based study. Results At baseline, among 5,307 participants (51.3% women, mean age 46.0±7.9 years) with a complete set of data, we recorded 1,979 cases with prevalent hypertension (PHT). Among 2,389 normotensive participants at baseline with a complete set of data, we recorded 324 cases with incident hypertension (IHT) on follow-up 5 years later. In models adjusted for age, sex, lifestyle, social, dietary, anthropometric, pulmonic, lipid, metabolic and renal risk factors, as well as heart rate and baseline blood pressure (only incident model), one standard deviation increase in baseline log-transformed NT-proBNP concentrations was on one side associated with a 21% higher risk of PHT (odds ratio [OR]: 1.21 [95% confidence interval (CI): 1.13-1.30], P<0.001), and on the other side with a 14% lower risk of IHT (OR: 0.86 [95%CI:0.76-0.98], P = 0.020). Conclusions Higher serum concentrations of NT-proBNP associate with PHT whereas lower concentrations associate with IHT. This suggests that a lower amount of circulating BNP, resulting in diminished vasodilation and natriuresis, could be involved in the pathogenesis of hypertension in its early stages.
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Affiliation(s)
- Ekim Seven
- Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
- Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, Denmark
- * E-mail:
| | - Lise L. N. Husemoen
- Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, Denmark
| | - Hans Ibsen
- Department of Internal Medicine, Holbæk Hospital, University of Copenhagen, Holbæk, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Kristian Wachtell
- Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Experimental Research, Glostrup Hospital, Glostrup, Denmark
| | - Jørgen L. Jeppesen
- Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Musani SK, Fox ER, Kraja A, Bidulescu A, Lieb W, Lin H, Beecham A, Chen MH, Felix JF, Fox CS, Kao WHL, Kardia SLR, Liu CT, Nalls MA, Rundek T, Sacco RL, Smith J, Sun YV, Wilson G, Zhang Z, Mosley TH, Taylor HA, Vasan RS. Genome-wide association analysis of plasma B-type natriuretic peptide in blacks: the Jackson Heart Study. ACTA ACUST UNITED AC 2015; 8:122-30. [PMID: 25561047 DOI: 10.1161/circgenetics.114.000900] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Numerous experimental studies suggest that B-type natriuretic peptide (BNP) is cardioprotective; however, in clinical studies, higher plasma BNP concentrations have been associated with incident cardiovascular disease and higher left ventricular mass. Genetic association studies may allow us to determine the true causal directions without confounding by compensatory mechanisms. METHODS AND RESULTS We performed a meta-analysis of 2 genome-wide association results from a total of 2790 blacks. We assumed an additive genetic model in an association analysis of imputed 2.5 million single-nucleotide polymorphism dosages with residuals generated from multivariable-adjusted logarithmically transformed BNP controlling for relevant covariates and population stratification. Two loci were genome-wide significant, a candidate gene locus NPPB (rs198389, P=1.18×10(-09)) and a novel missense variant in the KLKB1 locus (rs3733402, P=1.75×10(-11)) that explained 0.4% and 1.9% of variation in log BNP concentration, respectively. The observed increase in BNP concentration was proportional to the number of effect allele copies, and an average of 8.1 pg/mL increase was associated with 2 allele copies. In a companion study, single-nucleotide polymorphisms in this loci were cross-checked with genome-wide association results for the aldosterone/renin ratio in individuals of European ancestry, and rs3733402 was genome-wide significant (P<5.0×10(-8)), suggesting possible shared genetic architecture for these 2 pathways. Other statistically significant relations for these single-nucleotide polymorphisms included the following: rs198389 with systolic blood pressure in blacks (COGENT consortium) and rs198389 and rs3733402 with left ventricular mass in whites (EchoGEN consortium). CONCLUSIONS These findings improve our knowledge of the genetic basis of BNP variation in blacks, demonstrate a possible shared allelic architecture for BNP with aldosterone-renin ratio, and motivate further studies of underlying mechanisms.
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Musani SK, Vasan RS, Bidulescu A, Liu J, Xanthakis V, Sims M, Gawalapu RK, Samdarshi TE, Steffes M, Taylor HA, Fox ER. Aldosterone, C-reactive protein, and plasma B-type natriuretic peptide are associated with the development of metabolic syndrome and longitudinal changes in metabolic syndrome components: findings from the Jackson Heart Study. Diabetes Care 2013; 36:3084-92. [PMID: 23757435 PMCID: PMC3781556 DOI: 10.2337/dc12-2562] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 04/15/2013] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Several pathomechanisms are implicated in the pathogenesis of metabolic syndrome (MetS), most of which have not been investigated in African Americans (AAs). We examined the contribution of a selected panel of biomarkers to the development of MetS in Jackson Heart Study (JHS) participants in this investigation. RESEARCH DESIGN AND METHODS We evaluated 3,019 JHS participants (mean age, 54 years; 64% women) with measurements for seven biomarkers representing inflammation (high-sensitivity C-reactive protein [CRP]), adiposity (leptin), natriuretic pathway (B-natriuretic peptide [BNP]), adrenal pathway (cortisol and aldosterone), and endothelial function (endothelin and homocysteine). We related the biomarker panel to the development of MetS on follow-up and to longitudinal changes in MetS components. RESULTS There were 278 (22.9%) of 1,215 participants without MetS at baseline who had development of new-onset MetS at follow-up. The incidence of MetS was significantly associated with serum aldosterone (P=0.004), CRP (P=0.03), and BNP (P for trend=0.005). The multivariable-adjusted odds ratios (95% CI) per SD increment of log biomarker were as follows: 1.25 (1.07-1.45) for aldosterone, 1.20 (1.02-1.43) for CRP, and 1.54 (1.07-2.23) and 1.91 (1.31-2.80) for low and high BNP quartiles, respectively. Aldosterone was positively associated with change in all MetS risk components, except low HDL cholesterol and waist circumference. CRP concentration was significantly and directly associated with change in systolic blood pressure (SBP) and waist circumference but inversely associated with HDL cholesterol. For BNP, we observed a U-shape relation with SBP and triglycerides. CONCLUSIONS Our analysis confirms that, in AAs, higher circulating aldosterone and CRP concentrations predict incident MetS. The nonlinear U-shape relation of BNP with MetS and its components has not been reported before and thus warrants replication.
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