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WANG L, CAO TY, LI JQ, DING CC, LI JP, YING HB, LIU LS, HUANG X. Positive association between triglyceride glucose index and central systolic blood pressure among hypertensive adults. J Geriatr Cardiol 2022; 19:753-760. [PMID: 36338286 PMCID: PMC9618843 DOI: 10.11909/j.issn.1671-5411.2022.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND While studies have suggested the association between triglyceride-glucose (TyG) index, a reliable surrogate for insulin resistance and hypertension data are limited to the correlation of TyG and central blood pressure. This study aims to test the hypothesis that a higher TyG index is associated with elevated central systolic blood pressure (cSBP). METHODS A total of 9249 Chinese hypertensive adults from the H-type Hypertension and Stroke Prevention and Control Project were analyzed in this study. cSBP was measured noninvasively using an A-Pulse CASPro device. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Smoothing curve and multivariate linear regression models [beta coefficient (β) with 95% CI] were applied to analyze the association between TyG index and cSBP. Subgroup analyses were conducted to explore potential modifications to such a correlation. RESULTS The overall mean TyG index is 8.8 ± 0.7, and the total mean cSBP is 131.3 ± 12.8 mmHg. TyG index was observed to be independently and positively associated with cSBP among the total population (β = 0.92, 95% CI: 0.53-1.31, P < 0.001), and participants who do not use antihypertensive drugs (β = 1.03, 95% CI: 0.46-1.60, P < 0.001), which is in accordance with the result of the smoothing curve. The association between TyG index and cSBP appears robust in all tested subgroups. CONCLUSIONS TyG index is positively and independently associated with cSBP among hypertensive adults. Our study result suggests that TyG index might serve as an effective marker for vascular function.
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Affiliation(s)
- Li WANG
- Department of Nephrology, the Fourth Hospital of Harbin Medical University, Harbin, China
| | - Tian-Yu CAO
- Biological Anthropology, University of California Santa Barbara, California, USA
| | - Jin-Qiao LI
- Department of Urology Surgery, Graduate School of the Fourth Hospital of Harbin Medical University, Harbin, China
| | - Cong-Cong DING
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun-Pei LI
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hua-Bo YING
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li-Shun LIU
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- Institute of Biomedical and Health Engineering, Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xiao HUANG
- Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
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El Toony LF, Ramzy AN, Abozaid MAA. The effect of non-invasively obtained central blood pressure on cardiovascular outcome in diabetic patients in Assiut University Hospitals. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-021-00093-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated by the presence of hypertension. Therefore, proper control of BP in diabetic hypertensive patients is essential. Few studies have specifically investigated the prognostic significance of central BP in Egyptian populations with diabetes and hypertension and its relation with cardiovascular outcome. This study aims to evaluate relation between central BP and diabetic composite cardiovascular complications.
Results
Diabetic patients with CVD were significantly older (p value < 0.01), obese (p value < 0.01) with long duration of diabetes (p value < 0.001) and had significantly higher peripheral and central systolic and diastolic BP and higher AIx@75(p values < 0.01) than those without CVD. Regarding the metabolic parameters, they had significantly higher fasting blood glucose, HbA1c, and higher blood cholesterol levels (p values < 0.001), higher LDL (p value < 0.01), triglycerides levels (p value = 0.014), and microalbuminuria (p value = 0.028). Logistic regression analysis found increased BMI, central systolic BP, and AIx@75 were independent predictors of composite CVD (p values < 0.05).
Conclusions
There is a pattern of favorability towards central rather than peripheral BP indices to predict the occurrence of CVD in diabetic patients.
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Song C, Li X, Ning X, Song S. Nursing case management for people with hypertension: A randomized controlled trial protocol. Medicine (Baltimore) 2020; 99:e23850. [PMID: 33350776 PMCID: PMC7769350 DOI: 10.1097/md.0000000000023850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To explore the effect of management of nursing case on blood pressure control in hypertension patients. METHOD This is a randomized controlled study which will be carried out from May 2021 to May 2022. The experiment was granted through the Research Ethics Committee of the People's Hospital of Chengyang District (03982808). Our research includes 200 patients. Patients who meet the following conditions will be included in this experiment: the patients aged 18 to 60 years; the patients had the diagnosis of hypertension; and the urban residents. While patients with the following conditions will be excluded: having renal failure, liver failure, heart and respiratory failure; and known pregnancy. Primary result is blood pressure, while secondary results are treatment compliance, waist circumference, body mass index (BMI), type and number of antihypertensive agents used, and the existence of metabolic and cardiovascular comorbidities. RESULTS Table 1 shows the clinical outcomes between the two groups. CONCLUSION Nursing case management is effective to improve the prognosis of hypertension patients.
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Bikia V, Pagoulatou S, Trachet B, Soulis D, Protogerou AD, Papaioannou TG, Stergiopulos N. Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity. IEEE J Biomed Health Inform 2019; 24:1968-1981. [PMID: 31796418 DOI: 10.1109/jbhi.2019.2956604] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
GOAL We introduce a novel approach to estimate cardiac output (CO) and central systolic blood pressure (cSBP) from noninvasive measurements of peripheral cuff-pressure and carotid-to-femoral pulse wave velocity (cf-PWV). METHODS The adjustment of a previously validated one-dimensional arterial tree model is achieved via an optimization process. In the optimization loop, compliance and resistance of the generic arterial tree model as well as aortic flow are adjusted so that simulated brachial systolic and diastolic pressures and cf-PWV converge towards the measured brachial systolic and diastolic pressures and cf-PWV. The process is repeated until full convergence in terms of both brachial pressures and cf-PWV is reached. To assess the accuracy of the proposed framework, we implemented the algorithm on in vivo anonymized data from 20 subjects and compared the method-derived estimates of CO and cSBP to patient-specific measurements obtained with Mobil-O-Graph apparatus (central pressure) and two-dimensional transthoracic echocardiography (aortic blood flow). RESULTS Both CO and cSBP estimates were found to be in good agreement with the reference values achieving an RMSE of 0.36 L/min and 2.46 mmHg, respectively. Low biases were reported, namely -0.04 ± 0.36 L/min for CO predictions and -0.27 ± 2.51 mmHg for cSBP predictions. SIGNIFICANCE Our one-dimensional model can be successfully "tuned" to partially patient-specific standards by using noninvasive, easily obtained peripheral measurement data. The in vivo evaluation demonstrated that this method can potentially be used to obtain central aortic hemodynamic parameters in a noninvasive and accurate way.
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Jeong W, Joo SJ, Kim J, Lee JG, Choi JH. Presence of tophi is a predictive factor of arterial stiffness in patients with gout. Rheumatol Int 2019; 39:1249-1255. [PMID: 31154472 DOI: 10.1007/s00296-019-04313-9] [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: 03/22/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Abstract
The objective of this study is to determine whether the presence of tophi could predict an increase in arterial stiffness. Between June 2017 and June 2018, the augmentation index (AI) was measured using SphygmoCor® for patients with gout who visited the Jeju National University Hospital in South Korea. Patients were divided into the following groups: group with tophi and group without tophi. Medical records, laboratory data, and AI were retrospectively analyzed. One hundred and twenty patients with gout or participated in the study, with most (96.7%) of the patients being male. The mean duration of the disease was 7.0 years. At the time of the examination, 99 patients (82.5%) were treated with a uric acid-lowering agent. Of the total patients, 24 (19.7%) had tophi. Patients with tophi were significantly older (60.2 ± 11.6 years vs. 53.8 ± 13.0 years, p = 0.031), had longer disease duration (13.0 ± 6.5 years vs 5.5 ± 5.4 years, p < 0.001), and higher AI@75 (28.7 ± 7.8 vs 20.9 ± 10.0, p = 0.001) than those without tophi. In the multiple linear regression analysis, tophi was shown to be a significant predictor of high AI (p = 0.040). The presence of tophi is a predictor of increased arterial stiffness in patients with gout. Therefore, more strict control of cardiovascular disease risk factors is needed in the treatment of patients with tophi.
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Affiliation(s)
- WooSeong Jeong
- Division of Rheumatology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, South Korea
| | - Seung-Jae Joo
- Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Aran 13gil (Ara-1-dong), Jeju-Si, Jeju, 63241, South Korea
| | - Jinsoek Kim
- Division of Rheumatology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, South Korea
| | - Jae-Geun Lee
- Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Aran 13gil (Ara-1-dong), Jeju-Si, Jeju, 63241, South Korea
| | - Joon Hyouk Choi
- Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Aran 13gil (Ara-1-dong), Jeju-Si, Jeju, 63241, South Korea.
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Hidru TH, Yang X, Xia Y, Ma L, Li HH. The relationship between Plasma Markers and Essential Hypertension in Middle-aged and Elderly Chinese Population: A Community Based Cross-sectional Study. Sci Rep 2019; 9:6813. [PMID: 31048753 PMCID: PMC6497653 DOI: 10.1038/s41598-019-43278-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/16/2019] [Indexed: 12/16/2022] Open
Abstract
Plasma markers have been continuously advocated as pointers to estimate the long-term risk of cardiovascular disease in the general population. We examined the relationship between plasma high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), high-sensitivity cardiac troponin T (hs-cTnT), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), 25-Hydroxyvitamin D (25OHD), glycosylated hemoglobin A1c (HbA1c), and serum uric acid (SUA) levels and hypertension in middle and old aged population. A total of 2624 Chinese (62.02 ± 5.73 years old) were recruited into a population-based, cross-sectional study. Plasma hs-CRP, Hcy, HbA1c, and SUA levels were significantly higher in the hypertension group compared with control in the entire population and men (P = 0.05 for all). We observed a positive association between the highest quartiles of Hcy, NT-proBNP, HBA1c concentrations, and the prevalence of hypertension, OR (95% CI) = 1.48 (1.16–1.90), 1.62 (1.27–2.07) and 1.94 (1.49–2.52), respectively. The multivariable-adjusted OR of hypertension for the fourth versus the first quartile of homocysteine were 2.00 and 1.39 in men and women, respectively. In conclusion, our study found an independent and robust association between elevated Hcy, NT-ProBNP, and HBA1c levels and prevalence of hypertension in the middle-aged and elderly Chinese population. A follow-up study is necessary to endorse the observed association.
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Affiliation(s)
| | - Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yunlong Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, 116044, China.
| | - Hui-Hua Li
- School of Public Health, Dalian Medical University, Dalian, 116044, China. .,Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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McKenzie LM, Crooks J, Peel JL, Blair BD, Brindley S, Allshouse WB, Malin S, Adgate JL. Relationships between indicators of cardiovascular disease and intensity of oil and natural gas activity in Northeastern Colorado. ENVIRONMENTAL RESEARCH 2019; 170:56-64. [PMID: 30557692 PMCID: PMC6360130 DOI: 10.1016/j.envres.2018.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND Oil and natural gas (O&G) extraction emits pollutants that are associated with cardiovascular disease, the leading cause of mortality in the United States. OBJECTIVE We evaluated associations between intensity of O&G activity and cardiovascular disease indicators. METHODS Between October 2015 and May 2016, we conducted a cross-sectional study of 97 adults living in Northeastern Colorado. For each participant, we collected 1-3 measurements of augmentation index, systolic and diastolic blood pressure (SBP and DBP), and plasma concentrations of interleukin (IL)- 1β, IL-6, IL-8 and tumor necrosis factor alpha (TNF-α). We modelled the intensity of O&G activity by weighting O&G well counts within 16 km of a participant's home by intensity and distance. We used linear models accounting for repeated measures within person to evaluate associations. RESULTS Adjusted mean augmentation index differed by 6.0% (95% CI: 0.6, 11.4%) and 5.1% (95%CI: -0.1, 10.4%) between high and medium, respectively, and low exposure tertiles. The greatest mean IL-1β, and α-TNF plasma concentrations were observed for participants in the highest exposure tertile. IL-6 and IL-8 results were consistent with a null result. For participants not taking prescription medications, the adjusted mean SBP differed by 6 and 1 mm Hg (95% CIs: 0.1, 13 mm Hg and -6, 8 mm Hg) between the high and medium, respectively, and low exposure tertiles. DBP results were similar. For participants taking prescription medications, SBP and DBP results were consistent with a null result. CONCLUSIONS Despite limitations, our results support associations between O&G activity and augmentation index, SBP, DBP, IL-1β, and TNF-α. Our study was not able to elucidate possible mechanisms or environmental stressors, such as air pollution and noise.
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Affiliation(s)
- Lisa M McKenzie
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
| | - James Crooks
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Jennifer L Peel
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Benjamin D Blair
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Stephen Brindley
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - William B Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - Stephanie Malin
- Department of Sociology & Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
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