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Musameh MD, Nelson CP, Gracey J, Tobin M, Tomaszewski M, Samani NJ. Determinants of day-night difference in blood pressure, a comparison with determinants of daytime and night-time blood pressure. J Hum Hypertens 2016; 31:43-48. [PMID: 26984683 PMCID: PMC5144126 DOI: 10.1038/jhh.2016.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 01/05/2016] [Accepted: 02/10/2016] [Indexed: 12/26/2022]
Abstract
Blunted day–night difference in blood pressure (BP) is an independent cardiovascular risk factor, although there is limited information on determinants of diurnal variation in BP. We investigated determinants of day–night difference in systolic (SBP) and diastolic (DBP) BP and how these compared with determinants of daytime and night-time SBP and DBP. We analysed the association of mean daytime, mean night-time and mean day–night difference (defined as (mean daytime−mean night-time)/mean daytime) in SBP and DBP with clinical, lifestyle and biochemical parameters from 1562 adult individuals (mean age 38.6) from 509 nuclear families recruited in the GRAPHIC Study. We estimated the heritability of the various BP phenotypes. In multivariate analysis, there were significant associations of age, sex, markers of adiposity (body mass index and waist–hip ratio), plasma lipids (total and low-density lipoprotein cholesterol and triglycerides), serum uric acid, alcohol intake and current smoking status on daytime or night-time SBP and/or DBP. Of these, only age (P=4.7 × 10−5), total cholesterol (P=0.002), plasma triglycerides (P=0.006) and current smoking (P=3.8 × 10−9) associated with day–night difference in SBP, and age (P=0.001), plasma triglyceride (P=2.2 × 10−5) and current smoking (3.8 × 10−4) associated with day–night difference in DBP. 24-h, daytime and night-time SBP and DBP showed substantial heritability (ranging from 18–43%). In contrast day–night difference in SBP showed a lower heritability (13%) while heritability of day–night difference in DBP was not significant. These data suggest that specific clinical, lifestyle and biochemical factors contribute to inter-individual variation in daytime, night-time and day–night differences in SBP and DBP. Variation in day–night differences in BP is largely non-genetic.
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Affiliation(s)
- M D Musameh
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - C P Nelson
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - J Gracey
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - M Tobin
- Department of Health Sciences, University of Leicester, University Road, Leicester, UK
| | - M Tomaszewski
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - N J Samani
- Department of Cardiovascular Sciences, University of Leicester, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK.,National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
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Braund P, Kharodia S, Moore J, Gracey J, Codd V, Webb T, Samani N. The coronary artery disease associated variant at 10q23.31 is associated with increased lysosomal acid lipase A activity. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Payne C, Larkin P, McIlfatrick S, Dunwoody L, Gracey J. Exercise and nutrition interventions in advanced lung cancer: a systematic review. Curr Oncol 2013; 20:e321-37. [PMID: 23904771 PMCID: PMC3728061 DOI: 10.3747/co.20.1431] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED In this systematic review, we sought to evaluate the effect of physical activity or nutrition interventions (or both) in adults with advanced non-small-cell lung cancer (nsclc). METHODS A systematic search for relevant clinical trials was conducted in 6 electronic databases, by hand searching, and by contacting key investigators. No limits were placed on study language. Information about recruitment rates, protocol adherence, patient-reported and clinical outcome measures, and study conclusions was extracted. Methodologic quality and risk of bias in each study was assessed using validated tools. MAIN RESULTS Six papers detailing five studies involving 203 participants met the inclusion criteria. Two of the studies were single-cohort physical activity studies (54 participants), and three were controlled nutrition studies (149 participants). All were conducted in an outpatient setting. None of the included studies combined physical activity with nutrition interventions. CONCLUSIONS Our systematic review suggests that exercise and nutrition interventions are not harmful and may have beneficial effects on unintentional weight loss, physical strength, and functional performance in patients with advanced nsclc. However, the observed improvements must be interpreted with caution, because findings were not consistent across the included studies. Moreover, the included studies were small and at significant risk of bias. More research is required to ascertain the optimal physical activity and nutrition interventions in advanced inoperable nsclc. Specifically, the potential benefits of combining physical activity with nutrition counselling have yet to be adequately explored in this population.
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Affiliation(s)
- C. Payne
- All Ireland Institute of Hospice and Palliative Care, and the HSC R&D Division, Public Health Agency, Northern Ireland
- Institute of Nursing and Health Research, University of Ulster, Northern Ireland
| | - P.J. Larkin
- Clinical Nursing (Palliative Care), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin and Our Lady’s Hospice and Care Services, Dublin, Republic of Ireland
| | - S. McIlfatrick
- Institute of Nursing and Health Research, University of Ulster, Northern Ireland
| | - L. Dunwoody
- Psychology Research Institute, University of Ulster, Northern Ireland
| | - J.H. Gracey
- Institute of Nursing and Health Research, University of Ulster, Northern Ireland
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Abstract
This aim of this systematic review was to determine the prevalence and pattern of cancer-related fatigue (CRF), and identify factors associated with its development. Relevant literature was identified through an electronic database search using specified keywords. Included studies investigated CRF in adult cancer patients using a multidimensional fatigue measure. The methodological quality was assessed using six published standards. CRF is apparent both during and after anti-cancer therapy, however, the prevalence of CRF varied between studies. The variables associated with the development and persistence of CRF remain to be identified. Inconsistencies were evident in the pattern of CRF and its associated factors. This is likely to have arisen from the inherent difficulties in the measurement of a subjective sensation, further complicated by the myriad of outcome measures used. More methodologically sound research; assessing CRF from the commencement of therapy, considering all pertinent variables is needed.
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Affiliation(s)
- G Prue
- Health and Rehabilitation Sciences Research Institute, University of Ulster, Room 14J17, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland BT37 0QB, United Kingdom
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Prue G, Rankin J, Cramp F, Allen J, Gracey J. Fatigue in gynaecological cancer patients: a pilot study. Support Care Cancer 2005; 14:78-83. [PMID: 15883794 DOI: 10.1007/s00520-005-0830-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2004] [Accepted: 04/20/2005] [Indexed: 10/25/2022]
Abstract
RATIONALE Fatigue is a frequent complaint of women with cancer. However, the incidence of fatigue has not been well studied, in particular gynaecological cancer, which despite its prevalence has received minimal investigation. GOALS OF WORK The study aims were (1) to explore the symptoms experienced in a gynaecological cancer population, primarily fatigue and (2) to determine the acceptability of a fatigue questionnaire for use in a longitudinal survey. PATIENTS AND METHODS Over the course of 1 month, women with gynaecological cancer attending a Regional Cancer Centre completed a demographic and symptom questionnaire and the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). MAIN RESULTS Of the 32 individuals approached, 30 agreed to participate (mean age, 61 years; the most common treatment received was surgery followed by chemotherapy n=11; mean time from commencement of treatment, including surgery = 3 months). All participants completed the MFSI-SF. Tiredness was the most commonly reported symptom, experienced by 90% of subjects and the most frequently stated worst symptom, reported by 23.3%. Furthermore, 23 of 27 subjects reported that tiredness interfered completely with their daily living. The MFSI-SF mean total fatigue score was 14.4 (SD 15.9), ranging from -15 to 50. The possible total fatigue score ranges from -24 to 96. CONCLUSION Despite the heterogeneous nature of the group, all participants completed the MFSI-SF. The study suggests that fatigue could be a problem for this population group. Thus, a longitudinal survey using the MFSI-SF to investigate the phenomenon further would appear feasible and justified.
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Affiliation(s)
- G Prue
- Health and Rehabilitation Sciences Research Institute, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland, BT37 0QB, UK
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