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Cai H, Du Z, Lin X, Lawrence WR, Hopke PK, Rich DQ, Lin S, Xiao J, Deng X, Qu Y, Lin Z, Wang X, Ju X, Chen S, Zhang Y, Wu W, Wang Y, Gu J, Hao Y, Zhang W. Interactions between long-term ambient particle exposures and lifestyle on the prevalence of hypertension and diabetes: insight from a large community-based survey. J Epidemiol Community Health 2023; 77:440-446. [PMID: 37094940 PMCID: PMC10330163 DOI: 10.1136/jech-2023-220480] [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: 02/22/2023] [Accepted: 04/01/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Evidence on the interaction of lifestyle and long-term ambient particle (PM) exposure on the prevalence of hypertension, diabetes, particularly their combined condition is limited. We investigate the associations between PM and these outcomes and whether the associations were modified by various lifestyles. METHODS This was a large population-based survey during 2019-2021 in Southern China. The concentrations of PM were interpolated and assigned to participants by the residential address. Hypertension and diabetes status were from questionnaires and confirmed with the community health centres. Logistic regression was applied to examine the associations, followed by a comprehensive set of stratified analyses by the lifestyles including diet, smoking, drinking, sleeping and exercise. RESULTS A total of 82 345 residents were included in the final analyses. For each 1 μg/m3 increase in PM2.5, the adjusted OR for the prevalence of hypertension, diabetes and their combined condition were 1.05 (95% CI 1.05 to 1.06), 1.07 (95% CI 1.06 to 1.08) and 1.05 (95% CI 1.04 to 1.06), respectively. We observed that the association between PM2.5 and the combined condition was greatest in the group with 4-8 unhealthy lifestyles (OR=1.09, 95% CI 1.06 to 1.13) followed by the group with 2-3 and those with 0-1 unhealthy lifestyle (P interaction=0.026). Similar results and trends were observed in PM10 and/or in those with hypertension or diabetes. Individuals who consumed alcohol, had inadequate sleep duration or had poor quality sleep were more vulnerable. CONCLUSION Long-term PM exposure was associated with increased prevalence of hypertension, diabetes and their combined condition, and those with unhealthy lifestyles suffered greater risks of these conditions.
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Affiliation(s)
- Huanle Cai
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhicheng Du
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiao Lin
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wayne R Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Philip K Hopke
- Institute for a Sustainable Environment, Clarkson University, Potsdam, New York, USA
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Xinlei Deng
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xinran Wang
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xu Ju
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Shirui Chen
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yuqin Zhang
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wenjing Wu
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ying Wang
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jing Gu
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
| | - Wangjian Zhang
- School of Public Health/Sun Yat-sen Global Health Institute/Center for Health Information Research, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Yang J, Wang X, Jiang S. Development and validation of a nomogram model for individualized prediction of hypertension risk in patients with type 2 diabetes mellitus. Sci Rep 2023; 13:1298. [PMID: 36690699 PMCID: PMC9870905 DOI: 10.1038/s41598-023-28059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/12/2023] [Indexed: 01/24/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) with hypertension (DH) is the most common diabetic comorbidity. Patients with DH have significantly higher rates of cardiovascular disease morbidity and mortality. The objective of this study was to develop and validate a nomogram model for the prediction of an individual's risk of developing DH. A total of 706 T2DM patients who met the criteria were selected and divided into a training set (n = 521) and a validation set (n = 185) according to the discharge time of patients. By using multivariate logistic regression analysis and stepwise regression, the DH nomogram prediction model was created. Calibration curves were used to evaluate the model's accuracy, while decision curve analysis (DCA) and receiver operating characteristic (ROC) curves were used to evaluate the model's clinical applicability and discriminatory power. Age, body mass index (BMI), diabetic nephropathy (DN), and diabetic retinopathy (DR) were all independent risk factors for DH (P < 0.05). Based on independent risk factors identified by multivariate logistic regression, the nomogram model was created. The model produces accurate predictions. If the total nomogram score is greater than 120, there is a 90% or higher chance of developing DH. In the training and validation sets, the model's ROC curves are 0.762 (95% CI 0.720-0.803) and 0.700 (95% CI 0.623-0.777), respectively. The calibration curve demonstrates that there is good agreement between the model's predictions and the actual outcomes. The decision curve analysis findings demonstrated that the nomogram model was clinically helpful throughout a broad threshold probability range. The DH risk prediction nomogram model constructed in this study can help clinicians identify individuals at high risk for DH at an early stage, which is a guideline for personalized prevention and treatments.
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Affiliation(s)
- Jing Yang
- Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830017, China
| | - Xuan Wang
- Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830017, China
| | - Sheng Jiang
- Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830017, China.
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Ottaiano A, Santorsola M, Circelli L, Perri F, Cascella M, Sabbatino F, Capuozzo M, Granata V, Zappavigna S, Lombardi A, Scrima M, Petrillo N, Ianniello M, Casillo M, Gualillo O, Nasti G, Caraglia M, Savarese G. Hypertension, type 2 diabetes, obesity, and p53 mutations negatively correlate with metastatic colorectal cancer patients' survival. Front Med (Lausanne) 2023; 10:1091634. [PMID: 36756182 PMCID: PMC9899824 DOI: 10.3389/fmed.2023.1091634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Introduction We studied the predictive and prognostic influences of hypertension (HT), type 2 diabetes (T2D), weight, and p53 mutations in metastatic colorectal cancer (CRC) patients. Patients and methods T2D was diagnosed according to the ADA criteria. HT was classified according to the ACC/AHA guidelines. BMI (body-mass index) was calculated and classified according to the WHO criteria. TruSigt™Oncology 500 kit was applied to construct the genomic libraries for Next Generation Sequencing (NGS) analysis. The Illumina NovaSeq 6000 technological platform and the Illumina TruSight Oncology 500 bioinformatics pipeline were applied to analyze results. Overall survival (OS) was calculated through Kaplan-Meier curves. Univariate and multivariate analyses were performed to assess the relationships between clinical and/or molecular covariates. Associations between HT, T2D, BMI, p53, and clinical variables were evaluated by the χ2 test. P < 0.05 were considered statistically significant. Results Two-hundred-forty-four patients were enrolled. One-hundred-twenty (49.2%), 110 (45.1%), and 50 (20.5%) patients were affected by overweight, HT, and T2D, respectively. DC (disease control) was achieved more frequently in patients without T2D (83.1%) compared to the diabetic ones (16.9%) (P = 0.0246). DC, KRAS mutational status, T2D, BMI, and concomitant presence of T2D, BMI, and HT associated with survival (P < 0.05). At multivariate analysis, age (≥65 vs. <65 years), response to first-line chemotherapy (DC vs. no DC), and concomitant presence of T2D, BMI, and HT (HR: 4.56; 95% CI: 2.40-8.67; P = 0.0217) emerged as independent prognostic variables. P53 was mutated in 31/53 analyzed cases (60.4%). The most frequent gene variants were p.Arg175His and p.Cys135Tyr. High BMI (>25 kg/m2) associated with occurrence of p53 mutations (P < 0.0001). P53 mutated patients presented a worse prognosis compared to the wild-type ones (HR: 3.21; 95% CI: 1.43-7.23; P = 0.0047). Conclusion Diabetic, hypertensive and overweight metastatic CRC patients are a negative prognostic subgroup deserving specific therapeutic strategies. P53 mutations associate with prognosis and BMI unrevealing complex and unexplored connections between metabolism and cancer occurrence.
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Affiliation(s)
- Alessandro Ottaiano
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Naples, Italy,*Correspondence: Alessandro Ottaiano,
| | | | - Luisa Circelli
- AMES, Centro Polidiagnostico Strumentale srl, Naples, Italy
| | - Francesco Perri
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Naples, Italy
| | - Marco Cascella
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Naples, Italy
| | - Francesco Sabbatino
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | | | - Vincenza Granata
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Naples, Italy
| | - Silvia Zappavigna
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Angela Lombardi
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Marianna Scrima
- Laboratory of Molecular and Precision Oncology, Biogem Scarl, Institute of Genetic Research, Ariano Irpino, Italy
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale srl, Naples, Italy
| | | | - Marika Casillo
- AMES, Centro Polidiagnostico Strumentale srl, Naples, Italy
| | - Oreste Gualillo
- Servizo Galego de Saude and Instituto de Investigación Sanitaria de Santiago, Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases, Research Laboratory 9, Santiago University Clinical Hospital, Santiago de Compostela, Spain,IDIS, Instituto de Investigación Sanitaria de Santiago de Compostela, Grupo C027 NEIRID, Santiago de Compostela, Spain
| | - Guglielmo Nasti
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Naples, Italy
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
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Farkas K, Kolossváry E, Ferenci T, Paksy A, Kiss I, Járai Z. Ankle Brachial Index is a strong predictor of mortality in hypertensive patients: results of a five-year follow-up study. INT ANGIOL 2022; 41:517-524. [PMID: 36326143 DOI: 10.23736/s0392-9590.22.04930-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In the hypertensive population, the peripheral arterial disease (PAD) is considered one of the target organ damages. Ankle Brachial Index (ABI) measurement represents the widely accepted clinical method that may objectively detect the presence of PAD. The study aimed to assess how PAD revealed by ABI predicts mortality in patients with hypertension. METHODS In the follow-up time (5 years period) of the Hungarian ERV Study, a large scale, multicenter observational study, recruiting hypertensive subjects between 50-75 years, the association of PAD with the survival time was analysed. Several multivariate, interval-censored survival models were developed to assess this association. RESULTS Among the 21892 enrolled hypertensive patients, the prevalence of PAD (ABI≤0.9) was 14.4%. The crude death rate was 5.44% (1190 cases) over the available observational period. In multivariate models male sex, myocardial infarction in patients' history, diabetes, renal failure, PAD and cardiovascular risk (SCORE risk) were significantly associated with mortality. Lower ABI showed a continuous, close to linear association with worse survival. PAD was predictive for mortality risk in all SCORE patient groups. CONCLUSIONS Low ABI is a strong predictor of mortality in hypertensive patients between the age 50-75, even after adjustment for several potential confounders. The association is linear, with no apparent cut-off, suggesting that ABI should be handled as a continuous variable. The detection of PAD in hypertensives may contribute to the determination of total cardiovascular risk in hypertensive population.
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Affiliation(s)
- Katalin Farkas
- Department of Angiology, Szent Imre University Teaching Hospital, Budapest, Hungary -
| | - Endre Kolossváry
- Department of Angiology, Szent Imre University Teaching Hospital, Budapest, Hungary
| | - Tamás Ferenci
- Óbuda University, Physiological Controls Research Center, Budapest, Hungary.,Corvinus University of Budapest, Department of Statistics, Budapest, Hungary
| | - András Paksy
- Hungarian Society of Hypertension, Budapest, Hungary
| | - István Kiss
- Hungarian Society of Hypertension, Budapest, Hungary.,Department Nephrology, Szent Imre University Teaching Hospital, Budapest, Hungary
| | - Zoltán Járai
- Hungarian Society of Hypertension, Budapest, Hungary.,Department of Cardiology, Szent Imre University Teaching Hospital, Budapest, Hungary
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Barsasella D, Bah K, Mishra P, Uddin M, Dhar E, Suryani DL, Setiadi D, Masturoh I, Sugiarti I, Jonnagaddala J, Syed-Abdul S. A Machine Learning Model to Predict Length of Stay and Mortality among Diabetes and Hypertension Inpatients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1568. [PMID: 36363525 PMCID: PMC9694021 DOI: 10.3390/medicina58111568] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 08/18/2023]
Abstract
Background and Objectives: Taiwan is among the nations with the highest rates of Type 2 Diabetes Mellitus (T2DM) and Hypertension (HTN). As more cases are reported each year, there is a rise in hospital admissions for people seeking medical attention. This creates a burden on hospitals and affects the overall management and administration of the hospitals. Hence, this study aimed to develop a machine learning (ML) model to predict the Length of Stay (LoS) and mortality among T2DM and HTN inpatients. Materials and Methods: Using Taiwan's National Health Insurance Research Database (NHIRD), this cohort study consisted of 58,618 patients, where 25,868 had T2DM, 32,750 had HTN, and 6419 had both T2DM and HTN. We analyzed the data with different machine learning models for the prediction of LoS and mortality. The evaluation was done by plotting descriptive statistical graphs, feature importance, precision-recall curve, accuracy plots, and AUC. The training and testing data were set at a ratio of 8:2 before applying ML algorithms. Results: XGBoost showed the best performance in predicting LoS (R2 0.633; RMSE 0.386; MAE 0.123), and RF resulted in a slightly lower performance (R2 0.591; RMSE 0.401; MAE 0.027). Logistic Regression (LoR) performed the best in predicting mortality (CV Score 0.9779; Test Score 0.9728; Precision 0.9432; Recall 0.9786; AUC 0.97 and AUPR 0.93), closely followed by Ridge Classifier (CV Score 0.9736; Test Score 0.9692; Precision 0.9312; Recall 0.9463; AUC 0.94 and AUPR 0.89). Conclusions: We developed a robust prediction model for LoS and mortality of T2DM and HTN inpatients. Linear Regression showed the best performance for LoS, and Logistic Regression performed the best in predicting mortality. The results showed that ML algorithms can not only help healthcare professionals in data-driven decision-making but can also facilitate early intervention and resource planning.
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Affiliation(s)
- Diana Barsasella
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
- Department of Medical Record and Health Information, Health Polytechnic of the Ministry of Health Tasikmalaya, Tasikmalaya 46115, West Java, Indonesia
| | - Karamo Bah
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
| | | | - Mohy Uddin
- Research Quality Management Section, King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
| | - Eshita Dhar
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
| | - Dewi Lena Suryani
- Department of Medical Record and Health Information, Health Polytechnic of the Ministry of Health Tasikmalaya, Tasikmalaya 46115, West Java, Indonesia
| | - Dedi Setiadi
- Department of Medical Record and Health Information, Health Polytechnic of the Ministry of Health Tasikmalaya, Tasikmalaya 46115, West Java, Indonesia
| | - Imas Masturoh
- Department of Medical Record and Health Information, Health Polytechnic of the Ministry of Health Tasikmalaya, Tasikmalaya 46115, West Java, Indonesia
| | - Ida Sugiarti
- Department of Medical Record and Health Information, Health Polytechnic of the Ministry of Health Tasikmalaya, Tasikmalaya 46115, West Java, Indonesia
| | - Jitendra Jonnagaddala
- School of Population Health, University of New South Wales, Kensington, NSW 2033, Australia
| | - Shabbir Syed-Abdul
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, Taipei Medical University, Taipei 106, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 106, Taiwan
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Manosroi W, Tacharearnmuang N, Atthakomol P. Clinical and biochemical predictors and predictive model of primary aldosteronism. PLoS One 2022; 17:e0272049. [PMID: 35930535 PMCID: PMC9355203 DOI: 10.1371/journal.pone.0272049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Primary aldosteronism (PA) is the most common cause of secondary hypertension. The diagnosis of PA currently requires multiple complicated measures. The aims of this study were to identify easy-to-obtain clinical and biochemical predictors, and to create predictive model to facilitate the identification of a patient at high risk of having PA.
Materials and methods
This 2-year retrospective cohort study was conducted at a tertiary care medical center. A total of 305 patients who had been tested for plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were identified. Patients with incomplete results of PAC and PRA and those who had an established diagnosis of Cushing’s syndrome or pheochromocytoma were excluded. Logistic regression analysis was used to identify significant predictors and to create predictive model of PA.
Results
PA was diagnosed in 128 of the patients (41.96%). Significant predictive factors for PA were age >60 years (OR 2.12, p = 0.045), female (OR 1.65, p<0.001), smoking (OR 2.79, p<0.001), coronary artery disease (OR 2.29, p<0.001), obstructive sleep apnea (OR 1.50, p = 0.017), systolic blood pressure >160 mmHg (OR 1.15, P<0.001), serum potassium <3 mEq/L (OR 3.72, p = 0.030), fasting blood glucose >126 mg/dL (OR 0.48, p = 0.001) and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 (OR 1.79, p = 0.001). Predictive model was created with a total score ranged from 0 to 42. A score above 7.5 indicated a higher probability of having PA with a sensitivity of 72% and a specificity of 70%. The diagnostic performance of the predictive model based on area under the curve was 71%.
Conclusions
The clinical and biochemical predictive factors including predictive model identified in this study can be employed as an additional tool to help identify patients at risk of having PA and could help reduce the number of screening and confirmation tests required for PA.
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Affiliation(s)
- Worapaka Manosroi
- Endocrine and Metabolism Unit, Internal Medicine Department, Faculty of Medicine, Chiang Mai University, Muang Chiang Mai, Chiang Mai, Thailand
- * E-mail:
| | | | - Pichitchai Atthakomol
- Orthopedics Department, Faculty of Medicine, Chiang Mai University, Muang Chiang Mai, Chiang Mai, Thailand
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Willame H, Wacquier B, Point C, Dosogne M, Al Faker M, Loas G, Hein M. The association between type 2 diabetes and anhedonic subtype of major depression in hypertensive individuals. J Clin Hypertens (Greenwich) 2022; 24:156-166. [PMID: 35023283 PMCID: PMC8845468 DOI: 10.1111/jch.14411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
Given the limited data in the literature, the aim of this study was to investigate the association between type 2 diabetes and anhedonic subtype of major depression in hypertensive individuals. Demographic and polysomnographic data from 323 hypertensive individuals recruited from the database of the Erasme Hospital Sleep Laboratory were analysed. Only individuals with a diagnosis of type 2 diabetes according to the diagnostic criteria of the American Diabetes Association at admission were included in the "diabetes group". Logistic regression analyses were used to study the association between type 2 diabetes and anhedonic subtype of major depression in hypertensive individuals. The rate of type 2 diabetes was 18.9% in our sample of hypertensive individuals. After adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that unlike the non-anhedonic subtype of major depression, only the anhedonic subtype of major depression was significantly associated with higher likelihood of having type 2 diabetes in hypertensive individuals. In this study, the authors demonstrated that the anhedonic subtype of major depression is significantly associated with type 2 diabetes in hypertensive individuals, which could potentially open up new perspectives for the development of therapeutic strategies complementary to conventional treatments for type 2 diabetes in this subpopulation at high risk of complications related to the co-occurrence of this metabolic disorder.
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Affiliation(s)
- Hadrien Willame
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Benjamin Wacquier
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Camille Point
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Marjorie Dosogne
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Mohammed Al Faker
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwenolé Loas
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Matthieu Hein
- Department of Psychiatry and Sleep Laboratory, Erasme Hospital, Université libre de Bruxelles, ULB, Brussels, Belgium
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Wuhib Shumye M, Tegegne B, Ademe S, Workneh M, Abera M, Nemera G, Balcha F. The Magnitude of Diabetes Mellitus in Adult Hypertensive Patients in Northeast Ethiopia. Diabetes Metab Syndr Obes 2021; 14:37-45. [PMID: 33442280 PMCID: PMC7797297 DOI: 10.2147/dmso.s283158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/24/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hypertension and diabetes mellitus are the most common comorbid non-communicable chronic diseases that threaten human beings worldwide. Hypertension is associated with an increased risk of diabetes mellitus and vis-a-vis. However, there is limited information on the magnitude of diabetes mellitus in hypertensive patients in sub-Saharan countries. Hence, this study assessed the magnitude of diabetes mellitus and its associated factors among adult hypertensive patients attending a hypertension clinic in Northeast Ethiopia. METHODS Institution-based cross-sectional study conducted on 407 participants from April to June 2019. The participants were included in the study using systematic random sampling. Data were collected using the WHO STEPwise method. We run descriptive statistics to determine the magnitude of diabetes mellitus in hypertensive patients and logistic regression to identify factors associated with diabetes, and statistically significant associations were declared at a P-value of less than 0.05. RESULTS The magnitude of diabetes mellitus among hypertensive patients was 29.1%, of whom 24% were newly diagnosed. Respondents with a family history of diabetes mellitus (AOR: 4.6, CI: 2.2, 9.48), increased waist-to-height ratio (AOR: 21.5, CI: 5.62,43.67), increased waist circumference (AOR: 3.2, CI: 1.58, 6.53) and primary school educational status (AOR: 3.2, CI: 1.41, 7.25) were more likely to have diabetes. Similarly, respondents with longer hypertension duration (AOR: 4.09, CI: 1.22, 13.64), past daily smoking history (AOR: 10.46, CI: 1.59,6.8), increased diastolic blood pressure (AOR: 4.15, CI: 1.51, 11.37), and increased waist circumference (AOR: 7.5, CI: 4.47,14.95) were more likely to be diagnosed newly for diabetes. CONCLUSION Our study indicated around one-third of hypertensive patients had diabetes. Family history of diabetes mellitus, primary educational status and increased waist-to-height ratio and waist circumference were significant predictors of diabetes among hypertensive patients. The finding suggests the need for regular diabetic screening among hypertensive patients.
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Affiliation(s)
- Mekuriaw Wuhib Shumye
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- Correspondence: Mekuriaw Wuhib Shumye Tel +251 92 126 8193 Email
| | - Belachew Tegegne
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Sewunet Ademe
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Moges Workneh
- School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Million Abera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Gugsa Nemera
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fikadu Balcha
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Wubishet BL, Harris ML, Forder PM, Byles JE. Age and cohort rise in diabetes prevalence among older Australian women: Case ascertainment using survey and healthcare administrative data. PLoS One 2020; 15:e0234812. [PMID: 32555738 PMCID: PMC7302694 DOI: 10.1371/journal.pone.0234812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/02/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Due to the absence and or costliness of biological measures such as glycated haemoglobin, diabetes case ascertainment and prevalence studies are usually conducted using surveys or routine health service use databases. However, the use of each of these sources is associated with its limitations potentially impacting the quality of the case ascertainment and prevalence estimation. This study aimed at ascertaining diabetes cases and estimating prevalence among mid- and older-age women through simultaneous use of a longitudinal survey and multiple healthcare administrative data sources. METHODS Data were available for 12,432 and 13,714 women born in 1921-26 and 1946-51 from the Australian Longitudinal Study on Women's Health (ALSWH). Diabetes was ascertained using the ALSWH survey, health service use, and cause of death data. Parsimonious multiple logistic regression analyses tested associations between sociodemographic and health variables and the presence of diabetes. RESULTS In both cohorts, two or more of the sources captured more than 80% of the women with diabetes. The point prevalence of diabetes increased from 8.4% when the mean age of the women were aged 73, to 22.0% of surviving women at age 90 in the 1921-26 cohort; and from 2.6% at age 48 to 15.8% at age 68 in the 1946-51 cohort. In the 1921-26 cohort, women who were obese (OR: 3.56; 95 CI: 3.04-4.17) and women who were sedentary (OR: 1.18; 95 CI: 1.09-1.40) were more likely to have diabetes compared to those who had a normal weight and engaged in a moderate level of physical activity. In the 1946-51 cohort, the odds of diabetes increased three times (OR: 2.99; 95 CI: 2.54-3.52) for overweight women and nine times (OR: 8.78; 95 CI: 7.46-10.33) for obese women compared to those who had normal weight. CONCLUSIONS The simultaneous use of multiple data sources improved the validity of diabetes case ascertainment. Application of this methodology in future studies may have important benefits including estimation of disease burden, health service needs, and resource allocation with improved precision. Diabetes prevalence increased with age, was much higher in the 1946-51 cohort than in 1921-26 at similar ages, and was significantly associated with physical inactivity and obesity. Interventions to promote physical activity and a healthy weight are needed to prevent the rising prevalence of diabetes across successive generations.
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Affiliation(s)
- Befikadu L. Wubishet
- Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
- School of Pharmacy, Mekelle University, Mekelle, Tigray, Ethiopia
- * E-mail:
| | - Melissa L. Harris
- Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Peta M. Forder
- Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Julie E. Byles
- Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
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Song H, Feng D, Wang R, Yang J, Li Y, Gao J, Wang Z, Yan Z, Long C, Zhou J, Feng Z. The urban-rural disparity in the prevalence and risk factors of hypertension among the elderly in China-a cross-sectional study. PeerJ 2019; 7:e8015. [PMID: 31850155 PMCID: PMC6916758 DOI: 10.7717/peerj.8015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/09/2019] [Indexed: 01/14/2023] Open
Abstract
Introduction This study aimed to assess the prevalence of hypertension and to explore the disparities of its risk factors among urban and rural elderly. Method Data of hypertensive patients were collected from the China Health and Retirement Longitudinal Study (CHARLS) 2015. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Multivariable logistic regression was performed to analyze the factors correlated with hypertension. Results Prevalence of HBP was 47.6% (95% CI [45.2%-50.1%]) in total and it was close between urban and rural population (48.6% vs 47.2%). Factors associated with HBP were different between urban and rural areas. In urban areas, hypertension was significantly associated with literacy and diabetes in both genders, high BMI level and smoke quitters in males, and physical activity and dyslipidemia in females. In rural areas, hypertension was significantly associated with older age, higher BMI level in both males and females, and dyslipidemia in males. Conclusions The prevalence are about the same among urban and rural residents, but their risk factors vary from each other. Disparity in the risk factors between urban and rural population should be taken into consideration for further intervention.
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Affiliation(s)
- Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Jian Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Yuanqing Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Junliang Gao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Zi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Ziqi Yan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Chengxu Long
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Jiawei Zhou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, People's Republic of China, Department of Health Management, Wuhan, Hubei, China
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Wang T, Zhong H, Lian G, Cai X, Gong J, Ye C, Xie L. Low-Grade Albuminuria Is Associated with Left Ventricular Hypertrophy and Diastolic Dysfunction in Patients with Hypertension. Kidney Blood Press Res 2019; 44:590-603. [PMID: 31387099 DOI: 10.1159/000500782] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/22/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Microalbuminuria is a risk factor for cardiovascular morbidity and mortality in hypertensive patients. However, the relationship between low-grade albuminuria, a higher level of albuminuria below microalbuminuria threshold, and hypertension-related organ damage is unclear. Left ventricular (LV) hypertrophy (LVH) is well recognized to be a subclinical organ damage of hypertension, and LV diastolic dysfunction is also reported to be an early functional cardiac change of hypertension that predicts heart failure. The present study aimed to investigate the association of low-grade albuminuria with LVH and LV diastolic dysfunction in hypertensive patients. METHODS This cross-sectional observational clinical study was retrospectively performed in 870 hypertensive patients admitted to our hospital. Urinary albumin to creatinine ratio (UACR) was calculated to assess the levels of albuminuria: macroalbuminuria (≥300 mg/g), microalbuminuria (≥30 mg/g, but <300 mg/g), and normal albuminuria (<30 mg/g). Low-grade albuminuria was defined as sex-specific highest tertile within normal albuminuria (8.1-29.6 mg/g in males and 11.8-28.9 mg/g in females). LVH and LV diastolic dysfunction were identified as recommended by American Society of Echocardiography. RESULTS Of the 870 patients, 765 (87.9%) had normal albuminuria, 77 (8.9%) had microalbuminuria, and 28 (3.2%) had macroalbuminuria. Percentage of LVH and LV diastolic dysfunction was increased with ascending UACR. UACR was independently associated with LVH and LV diastolic dysfunction, even in patients with normal albuminuria. Multivariable logistic regression showed that the patients with the highest tertile within normal albuminuria had nearly 80% increase in LVH and nearly 60% increase in LV diastolic dysfunction (adjusted OR for LVH 1.788, 95% CI 1.181-2.708, p = 0.006; adjusted OR for LV diastolic dysfunction 1.567, 95% CI 1.036-2.397, p = 0.034). After further stratification analyses in patients with normal albuminuria, it was shown that this independent association persisted in female patients, those who were younger than 70 years old, and those with duration of hypertension <15 years. CONCLUSION Low-grade albuminuria was associated with LVH and LV diastolic dysfunction in hypertensive patients, especially in patients younger than 70 years old, and those with duration of hypertension <15 years.
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Affiliation(s)
- Tingjun Wang
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hongbin Zhong
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Guili Lian
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiaoqi Cai
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jin Gong
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chaoyi Ye
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Liangdi Xie
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China,
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Feng L, Naheed A, de Silva HA, Jehan I, Raqib R, Islam MT, Luke N, Kasturiratne A, Farazdaq H, Senan S, Jafar TH. Regional Variation in Comorbid Prediabetes and Diabetes and Associated Factors among Hypertensive Individuals in Rural Bangladesh, Pakistan, and Sri Lanka. J Obes 2019; 2019:4914158. [PMID: 31183214 PMCID: PMC6515018 DOI: 10.1155/2019/4914158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/16/2019] [Indexed: 11/17/2022] Open
Abstract
We aimed to explore the cross-country variation in the prevalence of comorbid prediabetes or diabetes and determine the sociodemographic, lifestyle, and clinical factors, especially body mass index (BMI) and waist circumference, associated with comorbid diabetes in individuals with hypertension in rural South Asia. We analyzed cross-sectional data of 2426 hypertensive individuals of ≥40 years from 30 randomly selected rural communities in Bangladesh, Pakistan, and Sri Lanka. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL without use of antidiabetic treatment and diabetes as FPG ≥126 mg/dL or use of antidiabetic medication. The prevalence (95% CI) of prediabetes or diabetes (53.5% (51.5%, 55.5%)) and diabetes (27.7% (25.9%, 29.5%)) was high in the overall hypertensive study population in rural communities in 3 countries. Rural communities in Sri Lanka had the highest crude prevalence of prediabetes or diabetes and diabetes (73.1% and 39.3%) with hypertension, followed by those in Bangladesh (47.4% and 23.1%) and Pakistan (39.2% and 20.5%). The factors independently associated with comorbid diabetes and hypertension were residing in rural communities in Sri Lanka, higher education, international wealth index, waist circumference, pulse pressure, triglyceride, and lower high-density lipoprotein. The association of diabetes with waist circumference was stronger than with BMI in hypertensive individuals. Prediabetes or diabetes are alarmingly common among adults with hypertension and vary among countries in rural South Asia. The high prevalence of comorbid diabetes in Sri Lanka among hypertensives is not fully explained by conventional risk factors and needs further etiological research. Urgent public health efforts are needed to integrate diabetes control within hypertension management programs in rural South Asia, including screening waist circumference.
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Affiliation(s)
- Liang Feng
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Aliya Naheed
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | - H. Asita de Silva
- Clinical Trials Unit, Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Imtiaz Jehan
- Department of Community Health Science, Aga Khan University, Karachi, Pakistan
| | - Rubhana Raqib
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr, b, Dhaka, Bangladesh
| | - Md Tauhidul Islam
- Initiative for Non-Communicable Diseases, Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | - Nathasha Luke
- Clinical Trials Unit, Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Anuradhani Kasturiratne
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Hamida Farazdaq
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Sahar Senan
- Department of Community Health Science, Aga Khan University, Karachi, Pakistan
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Department of Renal Medicine, Singapore General Hospital, Singapore
- Duke Global Health Institute, Duke University, Durham, NC, USA
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Bachir Cherif A, Bennouar S, Bouamra A, Taleb A, Hamida F, Temmar M, Bouafia MT. Prevalence of diabetes and dyslipidemia in hypertensive patients in the area of Blida (Algeria). Ann Cardiol Angeiol (Paris) 2018; 67:198-203. [PMID: 29753422 DOI: 10.1016/j.ancard.2018.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with an increased risk of cardiovascular complications requiring follow-up and more aggressive therapeutic strategies. The main objective of this study was to describe the prevalence of DM and LD in adult hypertensive patients followed in specialized consultation of hypertension in the region of Blida (North Algeria) during the period from January 2013 to June 2017. MATERIALS AND METHODS We included 3268 hypertensive patients (1453 men and 1815 women), mean age of 58.3±13.8years. Descriptive statistics were used to estimate means by sex and age for subgroups [under 30, 30-39, 40-49, 50-60, over 70]. A linear regression was used to determine annual trends. The age and sex specific results were adjusted to the general population data of the city of Blida for a period of 4years and each year studied. RESULTS The mean prevalence of diabetes was 21.8% and glucose tolerance was 10.9% without significant trend of increase during the study period in the overall population and according to sex, while in the subgroup of hypertensive patients over 60, there has been an increase in the prevalence of diabetes and a decrease in glucose tolerance over the 4 years (R2=0.78, P=0.05 and R2=0.95, P=0.005, respectively). The mean prevalence of LD for the study period was 16.1% without significant trend at 4years. The increase in total cholesterol combined with the increase in low-density lipoprotein (LDL) levels was the most common disorder (32.2%). There was no significant difference in LD prevalence and characteristics in subgroups by sex. Age group analysis showed a greater increase in the frequency of lipid disorders in patients over 60years of age (R2=0.80, P=0.001). CONCLUSIONS Over the 4years of study, age over 60 was associated with an increase in the prevalence of metabolic disorders in hypertensive patients. This trend may explain the poor control of BP. Above all, it must be taken into account for the requirement to achieve therapeutic objectives that effectively reduce the risk of cardiovascular complications occurring in these high-risk patients whose number is becoming increasingly important.
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Affiliation(s)
- A Bachir Cherif
- Clinic of internal medicine and cardiology, university hospital center of Blida, 9000 Blida, Algeria.
| | - S Bennouar
- Central laboratory of biochemistry, university hospital of Blida, 9000 Blida, Algeria
| | - A Bouamra
- Epidemiology department, university hospital of Blida, 9000 Blida, Algeria
| | - A Taleb
- Clinic of internal medicine and cardiology, university hospital center of Blida, 9000 Blida, Algeria
| | - F Hamida
- Clinic of internal medicine and cardiology, university hospital center of Blida, 9000 Blida, Algeria
| | - M Temmar
- Cardiology and angiology center, 47000 Ghardaia, Algeria
| | - M T Bouafia
- Clinic of internal medicine and cardiology, university hospital center of Blida, 9000 Blida, Algeria
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Functional status of microvascular vasomotion is impaired in spontaneously hypertensive rat. Sci Rep 2017; 7:17080. [PMID: 29213078 PMCID: PMC5719042 DOI: 10.1038/s41598-017-17013-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/20/2017] [Indexed: 12/17/2022] Open
Abstract
Accumulating evidence demonstrates that microcirculation plays a role in the pathogenesis of hypertension. In the current study, we demonstrated that pancreatic islet microvascular vasomotion of spontaneously hypertensive rats (SHRs) lost the ability to regulate blood flow perfusion and exhibited a lower microvascular blood perfusion pattern which was negative correlated with blood glucose level. SHRs administrated with insulin revealed an improvement of pancreatic islet microvascular vasomotion and blood perfusion pattern. In vitro, the expressions of endothelial nitric oxide synthase (eNOS) and phospho-eNOSser1177 (p-eNOSser1177) were significantly decreased in high glucose exposed islet endothelial cells (iECs), accompanied with a higher ratio of eNOS monomer to eNOS dimer and a significantly increased malondialdehyde and nitrite levels. Meanwhile, barrier function, tube formation and migration capacities of high glucose exposed iECs were significantly inhibited. In contrast, iECs dysfunction induced by glucose toxicity and oxidative stress was attenuated or improved by supplement with insulin, L-arginine and β-mercaptoethanol. In summary, our findings suggest that functional status of pancreatic islet microvascular vasomotion is impaired in SHRs and provide evidence that treatment with insulin, L-arginine and β-mercaptoethanol improves endothelium-dependent microvascular vasomotion and meliorates iECs function due to anti-hyperglycemic and anti-oxidative effects, partly through mechanism involving regulation of eNOS and p-eNOSser1177.
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