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Woodiwiss AJ, Orchard A, Mels CMC, Uys AS, Nkeh-Chungag BN, Kolkenbeck-Ruh A, Ware LJ, Yates S, Jones ESW, Peterson VR, Poulter NR. High prevalence but lack of awareness of hypertension in South Africa, particularly among men and young adults. J Hum Hypertens 2023:10.1038/s41371-023-00873-3. [PMID: 37880326 DOI: 10.1038/s41371-023-00873-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of death in South Africa (SA) and high blood pressure (BP) is the primary risk factor. However, hypertension prevalence is high, BP control is poor and CV events occur at a younger age than in Europe or America. Increasing screening, raising awareness and improving management of hypertension are critical to prevent CVD in SA. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension aimed at raising awareness of high BP. As part of the MMM campaign, in SA (2017, 2018, 2019 and 2021), BP measurements and a cross-sectional survey of volunteers aged ≥ 18years were performed. Of 11,320 individuals (age 36.6 ± 16.8years) screened, 29.7% had hypertension (systolic BP/diastolic BP ≥ 140/90 mmHg or antihypertensive medication use) and the prevalence was higher (p < 0.0001) in men (35.6%) than in women (26.3%). Of those with hypertension, only 54.3% were aware and 46.8% were receiving antihypertensive medication, and 53.7% of these had controlled BP. In men with hypertension, awareness (45.2%, treatment (38.2%) and controlled BP on antihypertensive medication (45.2%) were lower (p < 0.0001) than in women (awareness: 60.8%; treatment: 53.5%; controlled BP: 58.3%). In young participants (age < 40years), 15.6% had hypertension, 18.6% of these were on treatment but 76.0% were not aware, and only 57.7% had controlled BP. The high prevalence of hypertension, but low levels of awareness, treatment, and BP control in SA, especially in young adults and men, highlight the need for systematic BP screening programmes and improvements in education and management of hypertension.
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Affiliation(s)
- Angela J Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Ane Orchard
- Clinical Pharmacy Division, Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
- SAMRC Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Aletta S Uys
- Hypertension in Africa Research Team (HART), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
- SAMRC Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Benedicta N Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Science, Walter Sisulu University, Mthatha, South Africa
| | - Andrea Kolkenbeck-Ruh
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- SAMRC-Wits Developmental Pathways to Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa J Ware
- SAMRC-Wits Developmental Pathways to Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Yates
- Department of Life and Consumer Sciences, University of South Africa (UNISA), Science Campus, Roodepoort, South Africa
| | - Erika S W Jones
- Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa
| | - Vernice R Peterson
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK
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2
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Kaur S, Rubal, Kaur S, Kaur A, Kaur S, Gupta S, Mittal S, Dhiman M. A cross-sectional study to correlate antioxidant enzymes, oxidative stress and inflammation with prevalence of hypertension. Life Sci 2023; 313:121134. [PMID: 36544300 DOI: 10.1016/j.lfs.2022.121134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/19/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Abstract
AIMS Hypertension a multifactorial consequence of environmental factors, life style and genetics is the well-recognized risk factor contributing to coronary heart diseases. The antioxidant imbalance, excessive reactive oxygen species (ROS) leads to oxidative stress which is pivotal in progression of hypertension. The present study aims to understand the complex interaction between oxidative stress, inflammation and antioxidant system which is crucial to maintain cellular homeostasis which further can exaggerate hypertension pathophysiology. MATERIALS AND METHODS The metabolic profile of hypertensive and normotensive subjects from Malwa region, Punjab was compared by estimating lipid profile, cardiac, hepatic and renal markers. The oxidative stress markers (protein carbonyls and lipid peroxidation), inflammatory markers (Nitric oxide, Myeloperoxidase and advanced oxygen protein products), and antioxidant enzymes (Superoxide Dismutase, Catalase, and Total Antioxidant Capacity) were analyzed. KEY FINDINGS It is observed that the metabolic markers are altered in hypertensive subjects which further these subjects showed increased oxidative, inflammatory profile and compromised antioxidant status when compared with normotensive subjects. Co-relation analysis validated the involvement of inflammation and oxidative stress in impaired endothelial function and vital organ damage. SIGNIFICANCE OF STUDY These markers may act as early indicators of hypertension which usually do not show any physical symptoms, thus can be diagnosed and treated at the earliest. The current study suggests that disturbed homeostasis, a consequence of altered interaction between antioxidant system and inflammatory events raises the oxidative stress levels which eventually leads to hypertension and associated complications. These indicators can serve as early indicators of future chronic complications of hypertension.
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Affiliation(s)
- Sukhchain Kaur
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India
| | - Rubal
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India
| | - Satveer Kaur
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India
| | - Amandeep Kaur
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India
| | - Sandeep Kaur
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India
| | - Sushil Gupta
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India
| | - Sunil Mittal
- Department of Environmental Science and Technology, School of Environment and Earth Sciences, Central University of Punjab Bathinda, India
| | - Monisha Dhiman
- Department of Microbiology, School of Basic Sciences, Central University of Punjab Bathinda, India.
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3
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Meloni A, Cadeddu C, Cugusi L, Donataccio MP, Deidda M, Sciomer S, Gallina S, Vassalle C, Moscucci F, Mercuro G, Maffei S. Gender Differences and Cardiometabolic Risk: The Importance of the Risk Factors. Int J Mol Sci 2023; 24:ijms24021588. [PMID: 36675097 PMCID: PMC9864423 DOI: 10.3390/ijms24021588] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/29/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Metabolic syndrome (Mets) is a clinical condition characterized by a cluster of major risk factors for cardiovascular disease (CVD) and type 2 diabetes: proatherogenic dyslipidemia, elevated blood pressure, dysglycemia, and abdominal obesity. Each risk factor has an independent effect, but, when aggregated, they become synergistic, doubling the risk of developing cardiovascular diseases and causing a 1.5-fold increase in all-cause mortality. We will highlight gender differences in the epidemiology, etiology, pathophysiology, and clinical expression of the aforementioned Mets components. Moreover, we will discuss gender differences in new biochemical markers of metabolic syndrome and cardiovascular risk.
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Affiliation(s)
- Antonella Meloni
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
| | - Christian Cadeddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | | | - Martino Deidda
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Susanna Sciomer
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome “Sapienza”, Policlinico Umberto I, 00185 Roma, Italy
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Cristina Vassalle
- Medicina di Laboratorio, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
| | - Federica Moscucci
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome “Sapienza”, Policlinico Umberto I, 00185 Roma, Italy
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Silvia Maffei
- Endocrinologia Cardiovascolare Ginecologica ed Osteoporosi, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-050-315-2216
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4
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Postigo A, Martínez-Sellés M. Sex Influence on Heart Failure Prognosis. Front Cardiovasc Med 2020; 7:616273. [PMID: 33409293 PMCID: PMC7779486 DOI: 10.3389/fcvm.2020.616273] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/30/2020] [Indexed: 01/06/2023] Open
Abstract
Heart failure (HF) affects 1-2% of the population in developed countries and ~50% of patients living with it are women. Compared to men, women are more likely to be older and suffer hypertension, valvular heart disease, and non-ischemic cardiomyopathy. Since the number of women included in prospective HF studies has been low, much information regarding HF in women has been inferred from clinical trials observations in men and data obtained from registries. Several relevant sex-related differences in HF patients have been described, including biological mechanisms, age, etiology, precipitating factors, comorbidities, left ventricular ejection fraction, treatment effects, and prognosis. Women have greater clinical severity of HF, with more symptoms and worse functional class. However, females with HF have better prognosis compared to males. This survival advantage is particularly impressive given that women are less likely to receive guideline-proven therapies for HF than men. The reasons for this better prognosis are unknown but prior pregnancies may play a role. In this review article we aim to describe sex-related differences in HF and how these differences might explain why women with HF can expect to survive longer than men.
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Affiliation(s)
- Andrea Postigo
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER-CV, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Manuel Martínez-Sellés
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER-CV, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain.,Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea, Madrid, Spain
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5
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박지은, 김홍수, Sung-il Cho, 류연희. Factors Associated with Controlled Hypertension by Sex and Macro Level: A Systematic Review. ACTA ACUST UNITED AC 2016. [DOI: 10.15709/hswr.2016.36.2.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Bachir Cherif A, Bouamra A, Taleb A, Bouraghda A, Rabia S, Imouloudene N, Temmar M, Bouafia MT. [The characteristics of arterial hypertension in postmenopausal women in the area of Blida (Algeria)]. Ann Cardiol Angeiol (Paris) 2016; 65:146-51. [PMID: 27207267 DOI: 10.1016/j.ancard.2016.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Assess the prevalence, the degree of control, and the comorbidities of hypertension in postmenopausal women. DESIGNS AND METHODS This is a cohort descriptive and prospective study conducted in 2years in a population with hypertension treated for arterial hypertension in specialized university hospital in Blida, which included one thousand seven hundred and twenty-one postmenopausal women with amenorrhea fore more than 12 consecutive months. All anthropometric data were recorded. All cardiovascular complications were sought. All calculations and statistical analysis are processed by the SPSS 20.0. RESULTS The mean age of onset menopause is 50.7±6.2yearsold. The prevalence of hypertension is 71%, significantly higher in postmenopausal women aged 65 and over. Among women, 82.3% had a systolic arterial pressure>150mmHg and 42.2% had a diastolic arterial pressure>90mmHg. The prevalence of diabetes was 34.8%, and 88.4% presented type 2 diabetes. Tobacco in 1.3%, hypoHDLmia in 52%, the hypertriglyceridemia in 43.5%, obesity in 31.7%. The metabolic syndrome in 57.8%. The major cardiovascular complications observed are: stroke in 26.4%, heart failure in 14.8%, myocardial infarction in 13.2%, renal failure in 10.1%. The control of high blood pressure is achieved only in 31.7%. CONCLUSIONS The systolic blood pressure is more important than the diastolic blood pressure in postmenopausal women. The cerebral vascular accident remains the most feared complication. The control of hypertension remains not enough and the balance of arterial pressure figures is highly recommended to avoid morbidity and fatal complications.
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Affiliation(s)
- A Bachir Cherif
- Service de médecine interne et cardiologie CHU Blida, université de Blida 1, 9000 Blida, Algérie.
| | - A Bouamra
- Service d'épidémiologie CHU Blida, 9000 Blida, Algérie
| | - A Taleb
- Service de médecine interne et cardiologie CHU Blida, université de Blida 1, 9000 Blida, Algérie
| | - A Bouraghda
- Service de médecine interne et cardiologie CHU Blida, université de Blida 1, 9000 Blida, Algérie
| | - S Rabia
- Service de médecine interne et cardiologie CHU Blida, université de Blida 1, 9000 Blida, Algérie
| | - N Imouloudene
- Service de médecine interne et cardiologie CHU Blida, université de Blida 1, 9000 Blida, Algérie
| | - M Temmar
- Centre de cardiologie et d'angiologie, 47000 Ghardaïa, Algérie
| | - M T Bouafia
- Service de médecine interne et cardiologie CHU Blida, université de Blida 1, 9000 Blida, Algérie
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7
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Cadeddu C, Franconi F, Cassisa L, Campesi I, Pepe A, Cugusi L, Maffei S, Gallina S, Sciomer S, Mercuro G. Arterial hypertension in the female world. J Cardiovasc Med (Hagerstown) 2016; 17:229-36. [DOI: 10.2459/jcm.0000000000000315] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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8
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Boivin JM, Koch C, Vigié L, Meppiel L. [Prevalence of target organ damage in patients treated for primary arterial hypertension: Comparison between men and women. ESSENTIELLE study]. Ann Cardiol Angeiol (Paris) 2015; 64:150-157. [PMID: 26049900 DOI: 10.1016/j.ancard.2015.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To compare the percentages of men and women treated for primary arterial hypertension presenting with at least one target organ damage; to identify factors associated with target organ damage and/or blood pressure control. METHODS Observational, transverse study carried out between March 2012 and July 2013 on a representative sample of 2666 outpatients (including 1343 men) consulting general practitioners (n=469) or cardiologists (n=250) in routine follow-up. RESULTS Characteristics "men vs. women" were: mean age (62.6 ± 11.6 vs. 57.4 ± 14.7 years; P<0.0001); ≥ 60 years (61.1% vs. 43.9%; P<0.0001); waist circumference (98.9 ± 12.2 vs. 89.4 ± 14.3 cm; P<0.0001); SBP (146.5 ± 16.1 vs. 145.8 ± 17.0 mmHg; NS); DBP (85.1 ± 10.3 vs. 84.2 ± 10.4; P=0,03). Target organ damage was more frequent in men (37.6% vs. 22.9%; P<0.0001), whether it was subclinical (20.4% vs. 13.6%; P<0.0001) or documented (26.3% vs. 13.5%; P<0.0001); some patients presented with both types of damages. Men developed more often microalbuminuria (6.5% vs. 4.3%; P=0.01) and LVH (16.3% vs. 10.5%; P<0.0001); some patients presented with both types of subclinical injuries. Target organ damage was more common in men without regular physical activity than in those exercising regularly (42.1% vs. 32.5%; P=0.0004). Regular exercises had no effect in women (24.1% vs. 21.3%). For both sexes, other factors associated with target organ damage were: age ≥ 60 years, myocardial infarction/sudden death in family history, LDL-cholesterol ≥ 1.60 g/L, HDL-cholesterol ≤ 0.40 g/L. Stroke before 45 years in family history was a predictive factor in women. Hypertension was controlled in one third of patients without difference between sexes. In women, hypertension was less often controlled in case of excessive alcohol consumption compared to normal alcohol intake (17.9% vs. 36.1%; P=0.0007); this factor had no effect in men (28.1% vs. 32.6%). Other factors associated with poor blood pressure control were: BMI (P=0.002), LDL-cholesterol ≥ 1.60 g/L in women. In men, the factors were: tobacco, presence of LVH, absence of physical activity, HDL-cholesterol ≤ 0.40 g/L, absence of diet. CONCLUSION In a hypertensive population, target organ damage is more common among men despite similar blood pressure control rates for both sexes.
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Affiliation(s)
- J-M Boivin
- Département de médecine générale de Nancy, université de Lorraine, 54505 Vandœuvre-lès-Nancy cedex, France; CIC-P Inserm, Meurthe et Moselle, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France.
| | - C Koch
- Daiichi Sankyo, 92500 Rueil-Malmaison, France
| | - L Vigié
- Daiichi Sankyo, 92500 Rueil-Malmaison, France
| | - L Meppiel
- Département biométrie, ITEC Services, 33150 Cenon, France
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9
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Abramson BL, Melvin RG. Cardiovascular risk in women: focus on hypertension. Can J Cardiol 2014; 30:553-9. [PMID: 24786446 DOI: 10.1016/j.cjca.2014.02.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 02/22/2014] [Accepted: 02/23/2014] [Indexed: 11/30/2022] Open
Abstract
Hypertension is a major concern in women, contributing to the risk for morbidity and mortality and the development of cardiovascular disease (CVD), heart attack, and stroke. A woman's risk for the development of hypertension increases with age. Although it also affects younger women, hypertension is prevalent in approximately 60% of women >65 years of age. In addition to age, there are specific risk factors and lifestyle contributors for the development of hypertension in women, including obesity, ethnicity, diabetes, and chronic kidney disease. Risk reduction strategies need to be used to help reduce hypertension; maintaining a healthy body weight through diet and exercise, reduced sodium intake, and lower alcohol intake are a few of the approaches for hypertension risk reduction in women. There are several proposed mechanisms for the development of hypertension that are unique to women and pertain to the aging-related elevated risk for hypertension resulting from falling estrogen levels during menopause. Oral contraceptives, pre-eclampsia and polycystic ovary syndrome are special considerations concerning the development and progression of hypertension in women. There are significant awareness issues and care gaps in the treatment of hypertension in women. Therefore, these problems must be faced and efforts need to be taken to resolve the issues surrounding the treatment and control of hypertension in women.
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Affiliation(s)
- Beth L Abramson
- University of Toronto, Cardiac Prevention Centre and Women's Cardiovascular Health, St Michael's Hospital, Toronto, Ontario, Canada.
| | - Rochelle G Melvin
- University of Toronto, Cardiac Prevention Centre and Women's Cardiovascular Health, St Michael's Hospital, Toronto, Ontario, Canada
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10
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Abstract
Cardiovascular disease is the most common cause of death in women in the United States, and hypertension is a major contributor to cardiovascular mortality. The incidence of hypertension in women is steadily increasing, paralleling the epidemics of obesity and diabetes. Blood pressure control rates among women are suboptimal, even when secondary causes are identified and treated. There are few high-quality data describing specific hypertension-related outcomes in women. Some data comparing hypertensive women to age-matched men suggest advantages to sex-specific strategies, but further study is needed to determine optimal regimens for women throughout their lives. Pregnancy and menopause present unique, complex challenges in hypertension management.
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11
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Qiao GF, Qian Z, Sun HL, Xu WX, Yan ZY, Liu Y, Zhou JY, Zhang HC, Wang LJ, Pan XD, Fu Y. Remodeling of hyperpolarization-activated current, Ih, in Ah-type visceral ganglion neurons following ovariectomy in adult rats. PLoS One 2013; 8:e71184. [PMID: 23951107 PMCID: PMC3741359 DOI: 10.1371/journal.pone.0071184] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 06/27/2013] [Indexed: 12/21/2022] Open
Abstract
Hyperpolarization-activated currents (Ih) mediated by hyperpolarization-activated cyclic nucleotide-gated (HCN) channels modulate excitability of myelinated A− and Ah-type visceral ganglion neurons (VGN). Whether alterations in Ih underlie the previously reported reduction of excitability of myelinated Ah-type VGNs following ovariectomy (OVX) has remained unclear. Here we used the intact nodose ganglion preparation in conjunction with electrophysiological approaches to examine the role of Ih remodeling in altering Ah-type neuron excitability following ovariectomy in adult rats. Ah-type neurons were identified based on their afferent conduction velocity. Ah-type neurons in nodose ganglia from non-OVX rats exhibited a voltage ‘sag’ as well as ‘rebound’ action potentials immediately following hyperpolarizing current injections, which both were suppressed by the Ih blocker ZD7288. Repetitive spike activity induced afterhyperpolarizations lasting several hundreds of milliseconds (termed post-excitatory membrane hyperpolarizations, PEMHs), which were significantly reduced by ZD7288, suggesting that they resulted from transient deactivation of Ih during the preceding spike trains. Ovariectomy reduced whole-cell Ih density, caused a hyperpolarizing shift of the voltage-dependence of Ih activation, and slowed Ih activation. OVX-induced Ih remodeling was accompanied by a flattening of the stimulus frequency/response curve and loss of PEMHs. Also, HCN1 mRNA levels were reduced by ∼30% in nodose ganglia from OVX rats compared with their non-OVX counterparts. Acute exposure of nodose ganglia to 17beta-estradiol partly restored Ih density and accelerated Ih activation in Ah-type cells. In conclusion, Ih plays a significant role in modulating the excitability of myelinated Ah-type VGNs in adult female rats.
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Affiliation(s)
- Guo-Fen Qiao
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, Heilongjiang, China
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhao Qian
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hong-Li Sun
- Department of Pharmacology, Da-Qing Campus of Harbin Medical University, Da-Qing, Heilongjiang, China
| | - Wen-Xiao Xu
- Department of Orthopedics, the First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhen-Yu Yan
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yang Liu
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jia-Ying Zhou
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hao-Cheng Zhang
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Li-Juan Wang
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiao-Dong Pan
- Department of Pharmacology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yili Fu
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, Heilongjiang, China
- * E-mail:
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12
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Sabbadini G, Travan L, Toigo G. Elderly women with heart failure: unseen, unheard or simply forgotten? ACTA ACUST UNITED AC 2012. [DOI: 10.2217/ahe.12.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In developed countries, cardiovascular disease is the leading cause of death among women; one-third of these deaths are directly or indirectly related to heart failure. Women already constitute the majority of heart failure patients and, given their longer life expectancy, the proportion of elderly women with heart failure is likely to increase further. These figures alone should make elderly women with heart failure a medical research and public health priority. On the contrary, they have received, and continue to receive, very little attention. Elderly women have been largely excluded from heart failure clinical trials and, compared with their male counterparts, are under-recognized and less intensively investigated and treated in clinical practice. Elderly women with heart failure are at increased risk for adverse outcomes because of higher comorbidity, psychological distress and socioeconomic disadvantage. Yet, they are often left alone to deal with these problems, which can negatively affect their ability to carry out basic self-care tasks.
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Affiliation(s)
- Gastone Sabbadini
- Department of Medical, Surgical & Health Sciences, University of Trieste, Trieste, Italy
| | - Luciana Travan
- Department of Experimental & Clinical Medicine, University of Udine, Udine, Italy
| | - Gabriele Toigo
- Department of Medical, Surgical & Health Sciences, University of Trieste, Trieste, Italy
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Salem RM, Pandey B, Richard E, Fung MM, Garcia EP, Brophy VH, Schork NJ, O'Connor DT, Bhatnagar V. The VA Hypertension Primary Care Longitudinal Cohort: Electronic medical records in the post-genomic era. Health Informatics J 2012; 16:274-86. [PMID: 21216807 DOI: 10.1177/1460458210380527] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Veterans Affairs Hypertension Primary Care Longitudinal Cohort (VAHC) was initiated in 2003 as a pilot study designed to link the VA electronic medical record system with individual genetic data. Between June 2003 and December 2004, 1,527 hypertensive participants were recruited. Protected health information (PHI) was extracted from the regional VA data warehouse. Differences between the clinic and mail recruits suggested that clinic recruitment resulted in an over-sampling of African Americans. A review of medical records in a random sample of study participants confirmed that the data warehouse accurately captured most selected diagnoses. Genomic DNA was acquired non-invasively from buccal cells in mouthwash; ~ 96.5 per cent of samples contained DNA suitable for genotyping, with an average DNA yield of 5.02 ± 0.12 micrograms, enough for several thousand genotypes. The coupling of detailed medical databases with genetic information has the potential to facilitate the genetic study of hypertension and other complex diseases.
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Abstract
BACKGROUND Blood pressure (BP) awareness is a main focus of public health efforts. In Austria, an increase of knowledge and perception regarding hypertension was seen after a nationwide educational campaign in 1978, but subsequent surveys documented only short-term impact. We report results of the latest survey in 2009 in comparison to 1978 and 1998. METHODS Balanced for Austrian demographic characteristics 1,005 men and women older than 15 years of age were randomly selected for face-to-face interviews about BP awareness, risk factors, and hazards of hypertension and treatment options including life-style interventions. RESULTS Overall, 15% identified themselves as hypertensive, which is similar to results from 1978 (14%) but significantly higher than 1998 (12%; P < 0.01). The proportion of hypertensives not undertaking any measure (i.e., pharmacotherapy or life-style changes) significantly decreased since 1998 (5% vs. 10%; P < 0.0001). Thirty-three percent recalled to have measured their BP within the last 3 months, which is comparable to 1998 (34%) but lower than in 1978 (49%) after the nationwide educational BP campaign (P < 0.0001). Alarmingly, an unchanged proportion of 8% reported no BP measurement ever (1978 and 1998: 8%, respectively). Sixty-one percent believed they would be able to clearly identify symptoms of hypertension, while only 19% knew that hypertension might not be noticeable. Heart attack and stroke were considered the most common sequelae of hypertension. CONCLUSION Despite a high understanding of the risks of hypertension among the Austrian population, a widespread misconception regarding BP symptoms and infrequent personal checks are worrisome and might also be valid in other Western countries.
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15
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Van der Niepen P, Verbeelen D. Gender and hypertension management: A sub-analysis of the I-inSYST survey. Blood Press 2010; 20:69-76. [DOI: 10.3109/08037051.2010.532304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Patricia Van der Niepen
- Department of Nephrology and Hypertension, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Dierik Verbeelen
- Department of Nephrology and Hypertension, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Caban-Martinez AJ, Davila EP, Zhao W, Arheart K, Hooper MW, Byrne M, Messiah A, Dietz N, Huang Y, Fleming LE, Lee DJ. Disparities in hypertension control advice according to smoking status. Prev Med 2010; 51:302-6. [PMID: 20600258 PMCID: PMC2939289 DOI: 10.1016/j.ypmed.2010.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 05/25/2010] [Accepted: 06/11/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Hypertension is the most common modifiable cardiovascular risk factor. Blood pressure (BP) reduction, particularly among smokers, is highly effective at preventing cardiovascular diseases. We examined the association between patient smoking status and hypertension management advice. METHODS Adults who participated in the 2007 Behavioral Risk Factor Surveillance System with self-reported hypertension were examined (n=51,063). Multivariable logistic regression analysis controlling for age, gender, race/ethnicity, education, marital status, insurance status, body mass index, alcohol use, self-reported general health and survey design were conducted to examine the association between smoking status (never, former, or current) and receipt of hypertension control advice. RESULTS After controlling for potential confounders, being a current smoker was significantly associated with lower odds of receiving advice to lower salt intake (Adjusted Odds Ratio, AOR, 0.91 [95% confidence interval=0.84-0.99]), exercise (AOR 0.89 [0.80-0.98]), and to take hypertensive medication (AOR 0.80 [0.66-0.98]) compared to never smokers. However, hypertensive smokers had greater odds of receiving advice to reduce alcohol consumption (AOR 1.23 [1.10-1.45]). CONCLUSIONS Although healthcare providers are in an optimal position to provide patient education to improve BP control, hypertensive smokers may be less likely to receive important BP control lifestyle modification messages from their healthcare provider than non-smokers.
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Affiliation(s)
- Alberto J Caban-Martinez
- Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
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