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Letsou W. Settling the score: what composite measures of social determinants tell us about hypertension risk. JNCI Cancer Spectr 2024; 8:pkae065. [PMID: 39222406 PMCID: PMC11368122 DOI: 10.1093/jncics/pkae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Affiliation(s)
- William Letsou
- Department of Biological and Chemical Sciences, New York Institute of Technology, Old Westbury, NY, USA
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Cecchini M, Filippini T, Whelton PK, Iamandii I, Di Federico S, Boriani G, Vinceti M. Alcohol Intake and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Nonexperimental Cohort Studies. Hypertension 2024; 81:1701-1715. [PMID: 38864208 PMCID: PMC11251509 DOI: 10.1161/hypertensionaha.124.22703] [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] [Indexed: 06/13/2024]
Abstract
BACKGROUND Alcohol consumption has been associated with higher blood pressure and an increased risk of hypertension. However, the possible exposure thresholds and effect-modifiers are uncertain. METHODS We assessed the dose-response relationship between usual alcohol intake and hypertension incidence in nonexperimental cohort studies. After performing a systematic literature search through February 20, 2024, we retrieved 23 eligible studies. We computed risk ratios and 95% CI of hypertension incidence using a nonlinear meta-analytic model based on restricted cubic splines, to assess the dose-response association with alcohol consumption. RESULTS We observed a positive and almost linear association between alcohol intake and hypertension risk with risk ratios of 0.89 (0.84-0.94), 1.11 (1.07-1.15), 1.22 (1.14-1.30), and 1.33 (1.18-1.49) for 0, 24, 36 and 48 g/d, respectively, using 12 g alcohol/d as the reference value. In sex-specific analyses, the association was almost linear in men over the entire range of exposure but only observed above 12 g/d in women, although with a steeper association at high levels of consumption compared with men. The increased risk of hypertension above 12 to 24 g alcohol/d was similar in Western and Asian populations and considerably greater in White than in Black populations, mainly due to the positive association in women at moderate-to-high intake. CONCLUSIONS Overall, our results lend support to a causal association between alcohol consumption and risk of hypertension, especially above an alcohol intake of 12 g/d, and are consistent with recommendations to avoid or limit alcohol intake. Sex and ethnicity appear to be major effect-modifiers of such association.
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Affiliation(s)
- Marta Cecchini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences (M.C., T.F., I.I., S.D.F., M.V.), University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences (M.C., T.F., I.I., S.D.F., M.V.), University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA (T.F.)
| | - Paul K. Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (P.K.W.)
| | - Inga Iamandii
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences (M.C., T.F., I.I., S.D.F., M.V.), University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Di Federico
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences (M.C., T.F., I.I., S.D.F., M.V.), University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Boriani
- Unit of Cardiology, Department of Biomedical, Metabolic and Neural Sciences (G.B.), University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences (M.C., T.F., I.I., S.D.F., M.V.), University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA (M.V.)
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3
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Jareebi MA. The Association Between Smoking Behavior and the Risk of Hypertension: Review of the Observational and Genetic Evidence. J Multidiscip Healthc 2024; 17:3265-3281. [PMID: 39006872 PMCID: PMC11246652 DOI: 10.2147/jmdh.s470589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024] Open
Abstract
Background Cigarette smoking is one of the world's largest avoidable risk factors for morbidity and mortality. Numerous studies have investigated the association between smoking and hypertension (HTN). Although observational data and cross-sectional research often exhibit a link between smoking and HTN, establishing causation remains challenging owing to potential confounding variables. Mendelian randomization (MR), a genetic epidemiological technique that employs genetic variants as instrumental variables, offers a more robust approach for evaluating causal links. This review aimed to explore both the observational and causal relationships between smoking and the risk of HTN. Methodology A comprehensive literature search across major electronic databases was conducted to identify relevant observational and Mendelian randomization (MR) studies on smoking and HTN risk. Various characteristics were included during study selection, such as study design, exposure assessment, and age range. Standardized processes were used for data retrieval and quality evaluation. Results Analysis of observational data revealed a paradoxical association between smoking and the risk of HTN, where a lower risk was observed among current smokers when compared to non-smokers. However, observational analysis also presented a dose-response effect with greater smoking intensity showed a modest linear increase in HTN risk, and older smoking initiation was associated with a slight increase in HTN risk (compared with younger). In contrast, MR-based causal estimates provide inconsistent evidence regarding the causal relationship between smoking behavior and HTN. Some MR analyses indicated a potential causal link between smoking and HTN; but this was not consistent. Conclusion Observational studies suggest a paradoxical association between smoking and HTN. However, MR studies do not provide sufficient evidence to establish a causal relationship. Regardless, lifestyle variables remain crucial for overall health. Healthcare professionals should regularly assess smoking status and provide counseling for quitting. Further research is needed to clarify the underlying processes, identify mediators, and evaluate the interventions.
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Affiliation(s)
- Mohammad A Jareebi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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4
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Satoh M, Murakami T, Metoki H. Detailed cross-sectional association between traditional risk factors and high systolic blood pressure in a Japanese population. Hypertens Res 2024; 47:1573-1575. [PMID: 38467798 DOI: 10.1038/s41440-024-01639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
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5
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Takase M, Nakaya N, Tanno K, Kogure M, Hatanaka R, Nakaya K, Chiba I, Kanno I, Nochioka K, Tsuchiya N, Nakamura T, Hirata T, Obara T, Ishikuro M, Kotozaki Y, Uruno A, Kobayashi T, Kodama EN, Hamanaka Y, Orui M, Ogishima S, Nagaie S, Ohmomo H, Fuse N, Sugawara J, Shimizu A, Izumi Y, Kuriyama S, Hozawa A. Relationship between traditional risk factors for hypertension and systolic blood pressure in the Tohoku Medical Megabank Community-based Cohort Study. Hypertens Res 2024; 47:1533-1545. [PMID: 38424250 PMCID: PMC11150157 DOI: 10.1038/s41440-024-01582-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/20/2023] [Accepted: 12/24/2023] [Indexed: 03/02/2024]
Abstract
Risk factors for hypertension have been emphasized in the Japanese Society of Hypertension Guidelines for the Management of Hypertension. However, large-scale studies on the association of smoking, potassium excretion, and gamma-glutamyl transferase level with BP in the Japanese population are limited. We conducted a cross-sectional study to examine the association between hypertension risk factors and systolic blood pressure in the Tohoku Medical Megabank Community-based Cohort Study (23,446 men and 38,921 women aged ≥20 years). A model adjusted for age, body mass index, smoking status, drinking status, estimated daily salt intake, potassium excretion, (or urinary sodium-to-potassium ratio), gamma-glutamyl transferase, physical activity, education level, status of damage to homes during the Great East Japan Earthquake, and residential areas was used. The average age and systolic blood pressure were 62.5 (10.3) years for men and 59.6 (11.3) years for women, 128.9 (16.7) mmHg for men and 124.7 (17.5) mmHg for women, respectively. Body mass index estimated daily salt intake, urinary sodium-to-potassium ratio and gamma-glutamyl transferase levels were positively associated with systolic blood pressure. Compared with never-drinkers, current drinkers who consumed 23-45 g/day and ≥46.0 g/day had significantly increased systolic blood pressure. Conversely, current smokers (1-10 cigarettes/day and 11-20 cigarettes/day) were inversely associated with systolic blood pressure compared to never-smokers. Overall, systolic blood pressure was associated with gamma-glutamyl transferase and hypertension risk factors, including body mass index, alcohol consumption, estimated daily salt intake, urinary sodium-to-potassium ratio, and potassium excretion. Our findings support the notion that lifestyle modifications should be attempted to prevent hypertension.
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Affiliation(s)
- Masato Takase
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kozo Tanno
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
- School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Mana Kogure
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ippei Chiba
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Kyoto Women's University, Kyoto, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Institute for Clinical and Translational Science, Nara Medical University, Shijo-cho, Kashihara, Nara, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yuka Kotozaki
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Masatsugu Orui
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Soichi Ogishima
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Satoshi Nagaie
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hideki Ohmomo
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
- School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Nobuo Fuse
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Suzuki Memorial Hospital, Satonomori, Iwanumashi, Miyagi, Japan
| | - Atsushi Shimizu
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
- School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Yoko Izumi
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
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6
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Lee HJ, Choi JW. Association between waist circumference change after smoking cessation and incidence of hypertension in Korean adults. Public Health 2024; 229:73-79. [PMID: 38402666 DOI: 10.1016/j.puhe.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/14/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study investigates the association between smoking cessation and hypertension incidence, as well as the association between waist circumference change after smoking cessation and hypertension incidence. STUDY DESIGN This was a nationwide population-based cohort study. METHODS We used the Korean Health Screening Cohort data and included 158,505 participants who had undergone two or more health examinations between 2008 and 2011, with follow-ups throughout 2019. Smoking cessation and waist changes were captured based on difference between first and follow-up screening dates. Hazard ratio (HR) and 95% confidence interval (CI) for hypertension risk were estimated using multivariable Cox proportional hazard regression models. RESULTS There were 31,270 cases of hypertension during a median follow-up of 8.50 years. After adjusting for potential confounding factors, HR for hypertension were 1.01 (95% CI: 0.97-1.05), 0.91 (95% CI: 0.87-0.95), and 0.88 (95% CI: 0.85-0.91) for recent quitters, long-term quitters, and non-smokers, respectively, compared with current smokers. HR for hypertension, compared with current smokers, were 0.89 (95% CI: 0.84-0.94), 0.91 (95% CI: 0.85-0.97), and 0.99 (95% CI: 0.91-1.08) for long-term quitters with no waist gain, long-term quitters with waist gain of 0.1-5.0 cm, and long-term quitters with waist gain of ≥5.0 cm, respectively. CONCLUSIONS Long-term smoking cessation was significantly associated with decreased risk of hypertension, and long-term smoking cessation with no waist gain or less than 5.0 cm of waist gain was significantly associated with decreased risk of hypertension. However, more than 5.0 cm of waist gain can attenuate the effect of long-term smoking cessation on lowering the risk of hypertension.
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Affiliation(s)
- H J Lee
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - J W Choi
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Republic of Korea.
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Mansoori A, Farizani Gohari NS, Etemad L, Poudineh M, Ahari RK, Mohammadyari F, Azami M, Rad ES, Ferns G, Esmaily H, Ghayour Mobarhan M. White blood cell and platelet distribution widths are associated with hypertension: data mining approaches. Hypertens Res 2024; 47:515-528. [PMID: 37880498 DOI: 10.1038/s41440-023-01472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
In this paper, we are going to investigate the association between Hypertension (HTN) and routine hematologic indices in a cohort of Iranian adults. The data were obtained from a total population of 9704 who were aged 35-65 years, a prospective study was designed. The association between hematologic factors and HTN was assessed using logistic regression (LR) analysis and a decision tree (DT) algorithm. A total of 9704 complete datasets were analyzed in this cohort study (N = 3070 with HTN [female 62.47% and male 37.52%], N = 6634 without HTN [female 58.90% and male 41.09%]). Several variables were significantly different between the two groups, including age, smoking status, BMI, diabetes millitus, high sensitivity C-reactive protein (hs-CRP), uric acid, FBS, total cholesterol, HGB, LYM, WBC, PDW, RDW, RBC, sex, PLT, MCV, SBP, DBP, BUN, and HCT (P < 0.05). For unit odds ratio (OR) interpretation, females are more likely to have HTN (OR = 1.837, 95% CI = (1.620, 2.081)). Among the analyzed variables, age and WBC had the most significant associations with HTN OR = 1.087, 95% CI = (1.081, 1.094) and OR = 1.096, 95% CI = (1.061, 1.133), respectively (P-value < 0.05). In the DT model, age, followed by WBC, sex, and PDW, has the most significant impact on the HTN risk. Ninety-eight percent of patients had HTN in the subgroup with older age (≥58), high PDW (≥17.3), and low RDW (<46). Finally, we found that elevated WBC and PDW are the most associated factor with the severity of HTN in the Mashhad general population as well as female gender and older age.
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Affiliation(s)
- Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Leila Etemad
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohadeseh Poudineh
- Student of Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Rana Kolahi Ahari
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mobin Azami
- Student of Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical sciences, Birjand, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ma LL, Xiao HB, Zhang J, Liu YH, Hu LK, Chen N, Chu X, Dong J, Yan YX. Association between systemic immune inflammatory/inflammatory response index and hypertension: A cohort study of functional community. Nutr Metab Cardiovasc Dis 2024; 34:334-342. [PMID: 38000992 DOI: 10.1016/j.numecd.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS In prospective studies, there is limited evidence of the association between inflammation and hypertension. We aimed to explore the relationship between systemic immune inflammatory index (SII)/systemic inflammatory response index (SIRI) and hypertension in a prospective cohort study to identify the best inflammatory cell markers that predict hypertension. METHODS AND RESULTS This study was conducted in a functional community cohort in Beijing. In 2015, a total of 6003 individuals without hypertension were recruited and followed up until 2021. Using a restriction cubic spline with baseline SII/SIRI as a continuous variable, the dose-response relationship between hypertension and SII/SIRI was explored. Logistic regression was used to analyze the correlation between hypertension and SII/SIRI trajectory groups. At a mean follow-up of 6 years, 970 participants developed hypertension. SII showed a significant nonlinear dose-response relationship with hypertension (P < 0.05). Higher SII/SIRI was associated with an increased risk of hypertension (SII: RR = 1.003, 95%CI: 1.001-1.004; SIRI: RR = 1.228, 95%CI: 1.015-1.486). Both SII and SIRI were more predictive in males than females (SII: 0.698 vs. 0.695; SIRI: 0.686 vs. 0.678). CONCLUSION Both systemic immune inflammatory index (SII) and systemic inflammatory response Index (SIRI) independently increased the risk of hypertension, and both were effective inflammatory cell indicators that predict the risk of hypertension.
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Affiliation(s)
- Lin-Lin Ma
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Huan-Bo Xiao
- Department of Preventive Medicine, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Jie Zhang
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yu-Hong Liu
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Li-Kun Hu
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xi Chu
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Dong
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, and Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
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Kanamori K, Suzuki T, Tatsuta N, Ota C. Environments affect blood pressure in toddlers: The Japan Environment and Children's Study. Pediatr Res 2024; 95:367-376. [PMID: 37634037 PMCID: PMC10798899 DOI: 10.1038/s41390-023-02796-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND The primary objective of this study was to examine risk factors for toddler's hypertension. METHODS Subjects of this study were children and parents participating in a national birth cohort study in Japan, the Japan Environment and Children's Study. We measured the children's blood pressure (BP) at 2 and 4 years old. We obtained children's and parents' backgrounds from the questionnaire. We investigated the factors that affect BP elevation. RESULTS Within 4988 participants, the mean systolic BP at 2 years old was 91.2 mmHg for boys and 90.0 mmHg for girls. The mean systolic BP at 4 years old was 93.8 mmHg for boys and 93.1 mmHg for girls. Parental smoking was associated with elevated values of BP at 2 and 4 years old. Obesity, gestational hypertension, and parental lower education were associated with elevated values of BP at 4 years old. Hypertensive group had a significantly higher obesity rate. The mother's lower education and parental smoking were involved in hypertensive groups. CONCLUSION Parental smoking had a significant effect on BP even in early toddlers. We emphasize the importance of avoiding second-hand smoking from early infancy to prevent future lifestyle-related illnesses including hypertension. IMPACT The mean systolic BP at 2 years old was 91.2 mmHg for boys and 90.0 mmHg for girls. The mean systolic BP at 4 years old was 93.8 mmHg for boys and 93.1 mmHg for girls. Obesity, parental smoking, and lower education were associated with hypertension at 4 years old. Parental smoking was associated with hypertension at 2 and 4 years old. We emphasize the importance of avoiding second-hand smoking from early infancy.
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Affiliation(s)
- Keita Kanamori
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
- Department of Pediatrics, Iwate Prefectural Iwai Hospital, Ichinoseki, Japan.
| | - Tomohisa Suzuki
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Nozomi Tatsuta
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Chiharu Ota
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
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10
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Lone A, Othman Albotuaiba A. Association Between Big Five Personality Traits and Hypertension in Saudi Patients: A Case Control Study. Psychol Res Behav Manag 2023; 16:3427-3435. [PMID: 37664136 PMCID: PMC10473415 DOI: 10.2147/prbm.s416828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/05/2023] [Indexed: 09/05/2023] Open
Abstract
Background The association between personality traits and hypertension is complex and has so far not been studied in depth. Objective The present study aims to explore the connection between the Big Five personality traits and hypertension. Methods This case control study includes 310 participants, and the relationship between personality traits and hypertension was investigated in normotensive and hypertensive patients by the Big Five Inventory-10. We examined the association of each of the Big Five personality traits in hypertensive patients and a control group using binary logistic regression analysis. Results The findings of the study revealed that amongst the Big Five personality factors, low conscientiousness (OR: 1.09, 95% CI: 0.92-1.29, P<0.005) and high neuroticism (OR: 0.54, 95% CI: 0.45-0.66, P<0.001) were related with high risk of hypertension. Male, older people, and physically inactive individuals have been found to be at a higher risk of hypertension. No significant relationship was found between hypertension and marital status, education, or smoking habits. Conclusion These results suggested that a low score in conscientiousness trait and a high neuroticism score may be an additional risk factor of hypertension. Thus, it may be worthy to investigate further in order to identify patients at risk and develop a more individual treatment strategy. Cognitive behavioral therapy and pharmacological options can be used preemptively in high-risk patients.
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Affiliation(s)
- Ayoob Lone
- Department of Clinical Neurosciences, College of Medicine, King Faisal University, AlHasa, 31982, Saudi Arabia
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11
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Kressler J, Mendez A, Betancourt L, Nash M. Salsalate Improves Postprandial Glycemic and Some Lipid Responses in Persons With Tetraplegia: A Randomized Clinical Pilot Trial With Crossover Design. Top Spinal Cord Inj Rehabil 2023; 29:1-13. [PMID: 38076289 PMCID: PMC10644859 DOI: 10.46292/sci22-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objectives To investigate the effects of salsalate on fasting and postprandial (PP) glycemic, lipidemic, and inflammatory responses in persons with tetraplegia. Methods This study was a randomized, double-blind, cross-over design. It was conducted at a university laboratory. Ten males aged 25 to 50 years with SCI at C5-8 levels for ≥1 year underwent 1 month of placebo and salsalate (4 g/day) treatment. Blood samples were drawn before and 4 hours after breakfast and lunch fast-food meal consumption. Results Descriptive statistics indicate that fasting and PP glucose values were reduced with salsalate (pre-post mean difference, 4 ± 5 mg/dL and 8 ± 8 mg/dL, respectively) but largely unchanged with placebo (0 ± 6 mg/dL and -0 ± 7 mg/dL, respectively). Insulin responses were generally reciprocal to glucose, however less pronounced. Fasting free fatty acids were significantly reduced with salsalate (191 ± 216 mg/dL, p = .021) but not placebo (-46 ± 116 mg/dL, p = .878). Results for triglycerides were similar (25 ± 34 mg/dL, p =.045, and 7 ± 29 mg/dL, p = .464). Fasting low-density lipoprotein (LDL) levels were higher after salsalate (-10 ± 12 mg/dL, p = .025) but not placebo (2 ± 9 mg/dL, p = .403) treatment. Inflammatory markers were largely unchanged. Conclusion In this pilot trial, descriptive values indicate that salsalate decreased fasting and PP glucose response to fast-food meal challenge at regular intervals in persons with tetraplegia. Positive effects were also seen for some lipid but not for inflammatory response markers. Given the relatively "healthy" metabolic profiles of the participants, it is possible that salsalate's effects may be greater and more consistent in people with less favorable metabolic milieus.
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Affiliation(s)
- Jochen Kressler
- The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California
| | - Armando Mendez
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Luisa Betancourt
- The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida
| | - Mark Nash
- The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida
- Department of Rehabilitation Medicine, Miller School of Medicine, University of Miami, Miami, Florida
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12
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Watso JC, Fancher IS, Gomez DH, Hutchison ZJ, Gutiérrez OM, Robinson AT. The damaging duo: Obesity and excess dietary salt contribute to hypertension and cardiovascular disease. Obes Rev 2023; 24:e13589. [PMID: 37336641 PMCID: PMC10406397 DOI: 10.1111/obr.13589] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
Hypertension is a primary risk factor for cardiovascular disease. Cardiovascular disease is the leading cause of death among adults worldwide. In this review, we focus on two of the most critical public health challenges that contribute to hypertension-obesity and excess dietary sodium from salt (i.e., sodium chloride). While the independent effects of these factors have been studied extensively, the interplay of obesity and excess salt overconsumption is not well understood. Here, we discuss both the independent and combined effects of excess obesity and dietary salt given their contributions to vascular dysfunction, autonomic cardiovascular dysregulation, kidney dysfunction, and insulin resistance. We discuss the role of ultra-processed foods-accounting for nearly 60% of energy intake in America-as a major contributor to both obesity and salt overconsumption. We highlight the influence of obesity on elevated blood pressure in the presence of a high-salt diet (i.e., salt sensitivity). Throughout the review, we highlight critical gaps in knowledge that should be filled to inform us of the prevention, management, treatment, and mitigation strategies for addressing these public health challenges.
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Affiliation(s)
- Joseph C. Watso
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Ibra S. Fancher
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Dulce H. Gomez
- School of Kinesiology, Auburn University, Auburn, Alabama, USA
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Orlando M. Gutiérrez
- Division of Nephrology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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13
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Behl TA, Stamford BA, Moffatt RJ. The Effects of Smoking on the Diagnostic Characteristics of Metabolic Syndrome: A Review. Am J Lifestyle Med 2023; 17:397-412. [PMID: 37304742 PMCID: PMC10248373 DOI: 10.1177/15598276221111046] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Metabolic syndrome is a growing epidemic that increases the risk for cardiovascular disease, diabetes, stroke, and mortality. It is diagnosed by the presence of three or more of the following risk factors: 1) obesity, with an emphasis on central adiposity, 2) high blood pressure, 3) hyperglycemia, 4) dyslipidemia, with regard to reduced high-density lipoprotein concentrations, and 5) dyslipidemia, with regard to elevated triglycerides. Smoking is one lifestyle factor that can increase the risk for metabolic syndrome as it has been shown to exert negative effects on abdominal obesity, blood pressure, blood glucose concentrations, and blood lipid profiles. Smoking may also negatively affect other factors that influence glucose and lipid metabolism including lipoprotein lipase, adiponectin, peroxisome proliferator-activated receptors, and tumor necrosis factor-alpha. Some of these smoking-related outcomes may be reversed with smoking cessation, thus reducing the risk for metabolic disease; however, metabolic syndrome risk may initially increase post cessation, possibly due to weight gain. Therefore, these findings warrant the need for more research on the development and efficacy of smoking prevention and cessation programs.
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Affiliation(s)
- Taylor A. Behl
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| | - Bryant A. Stamford
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
| | - Robert J. Moffatt
- Department of Nutrition and Integrative Physiology, Florida State
University, Tallahassee, FL, USA (TAB); School of Business, Education,
and Mathematics, Flagler College, St Augustine, FL, USA (TAB); Department of Kinesiology and
Integrative Physiology, Hanover College, Hanover, IN, USA (BAS); and Human Performance Development
Group, Tallahassee, FL, USA (BAS, RJM)
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14
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Cook S, Hirschtick JL, Barnes G, Arenberg D, Bondarenko I, Patel A, Jiminez Mendoza E, Jeon J, Levy D, Meza R, Fleischer NL. Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study. BMJ Open 2023; 13:e062297. [PMID: 37085311 PMCID: PMC10124226 DOI: 10.1136/bmjopen-2022-062297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE Electronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study was to examine the prospective association between cigarette and ENDS use on self-reported incident hypertension. DESIGN Longitudinal cohort study. SETTING Nationally representative sample of the civilian, non-institutionalised population in the USA. PARTICIPANTS 17 539 adults aged 18 or older who participated at follow-up and had no self-reported heart condition or previous diagnosis of hypertension or high cholesterol at baseline. MEASURES We constructed a time-varying tobacco exposure, lagged by one wave, defined as no use, exclusive established use (every day or some days) of ENDS or cigarettes, and dual use. We controlled for demographics (age, sex, race/ethnicity and household income), clinical risk factors (family history of heart attack, obesity, diabetes and binge drinking) and smoking history (cigarette pack-years). OUTCOMES Self-reported incident hypertension diagnosis. RESULTS The self-reported incidence of hypertension was 3.7% between wave 2 and wave 5. At baseline, 18.0% (n=5570) of respondents exclusively smoked cigarettes; 1.1% (n=336) exclusively used ENDS; and 1.7% (n=570) were dual users. In adjusted models, exclusive cigarette use was associated with an increased risk of self-reported incident hypertension compared with non-use (adjusted HR (aHR) 1.21, 95% CI 1.06 to 1.38), while exclusive ENDS use (aHR 1.00, 95% CI 0.68 to 1.47) and dual use (aHR 1.15, 95% CI 0.87 to 1.52) were not. CONCLUSIONS We found that smoking increased the risk of self-reported hypertension, but ENDS use did not. These results highlight the importance of using prospective longitudinal data to examine the health effects of ENDS use.
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Affiliation(s)
- Steven Cook
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jana L Hirschtick
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Geoffrey Barnes
- Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan, USA
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas Arenberg
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Irina Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Akash Patel
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Levy
- Georgetown University, Washington, DC, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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15
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Batte A, Gyagenda JO, Otwombe K, Muhindo R, Bagasha P, Kiggundu D, Aujo JC, Atuhe DM, Kansiime G, Hussein R, Namuyimbwa L, Mukasa SL, Kabuye A, Mukasa J, Sekasanvu E, Kalyesubula R. Prevalence and predictors of hypertension among adults in Mbarara City, Western Uganda. Chronic Illn 2023; 19:132-145. [PMID: 34786975 DOI: 10.1177/17423953211058408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The study aim was to evaluate the prevalence and predictors of hypertension among an urban adult population in Mbarara city, Western Uganda. METHODS We evaluated blood pressure measurements, social demographic and clinical parameters of adults living in Mbarara city, Uganda. These parameters were extracted from medical records of adults who participated in the Uganda World Kidney Day 2020 health screening activities. A total of 302 adults were evaluated for hypertension using the American College of Cardiology/American Heart Association 2017 (blood pressure threshold 130/80 mmHg) and International Society of Hypertension 2020 guidelines (threshold 140/90 mmHg). RESULTS The mean age of the participants was 42.5 years (standard deviation: 15.1) and majority were male 195/302 (64.6%). Using American College of Cardiology/American Heart Association 2017 guidelines, 156/302 (51.7%) adults were newly diagnosed with hypertension compared to 68/302 (22.5%) newly diagnosed with hypertension using International Society of Hypertension 2020 guidelines. Only 23/302 (7.6%) were on treatment. Based on American College of Cardiology/American Heart Association 2017 guidelines, age ≥40 years and overweight/obesity were statistically significant predictors of hypertension (p < 0.05 for all) at multivariate analysis. Using the International Society of Hypertension 2020 guidelines, age ≥40 years predicted hypertension. DISCUSSION The prevalence of hypertension is high among this urban adult population irrespective of the guidelines used, highlighting the need for hypertension prevention interventions.
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Affiliation(s)
- Anthony Batte
- Child Health and Development Centre, College of Health Sciences, Makerere University Kampala, Kampala, Uganda
| | - Joseph Ogavu Gyagenda
- Nephrology Unit, Department of Medicine, 281437St Francis Hospital Nsambya Kampala, Kampala, Uganda.,Uganda Martyrs University School of Medicine, Kampala, Uganda
| | - Kennedy Otwombe
- School of Public Health, Faculty of Health Sciences, 37708University of the Witwatersrand, Johannesburg, South Africa.,Perinatal HIV Research Unit, Faculty of Health Sciences, 37708University of the Witwatersrand, South Africa
| | - Rose Muhindo
- Department of Internal Medicine, 108123Mbarara University of Science and Technology, Mbarara, Uganda
| | - Peace Bagasha
- Department of Nephrology, 249321Mulago National Referral Hospital, Kampala, Uganda
| | - Daniel Kiggundu
- Department of Nephrology, 249321Mulago National Referral Hospital, Kampala, Uganda
| | - Judith Caroline Aujo
- Department of Nephrology, 249321Mulago National Referral Hospital, Kampala, Uganda
| | - David Martin Atuhe
- Nephrology Unit, Department of Medicine, 281437St Francis Hospital Nsambya Kampala, Kampala, Uganda
| | - Grace Kansiime
- Department of Nephrology, 249321Mulago National Referral Hospital, Kampala, Uganda
| | | | - Lydia Namuyimbwa
- Department of Physiology, 323124Kabale University, Kabale, Uganda
| | | | | | - Joseph Mukasa
- 585446Health Life promotion Africa, Limited, Kampala, Uganda
| | | | - Robert Kalyesubula
- Department of Physiology, 58589Makerere University College of Health Sciences, Kampala, Uganda
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16
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Namgung HK, Woo HW, Shin J, Shin MH, Koh SB, Kim HC, Kim YM, Kim MK. Development and validation of hypertension prediction models: The Korean Genome and Epidemiology Study_Cardiovascular Disease Association Study (KoGES_CAVAS). J Hum Hypertens 2023; 37:205-212. [PMID: 35181762 DOI: 10.1038/s41371-021-00645-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 12/12/2022]
Abstract
This study aimed to develop and validate the hypertension risk prediction models of the CArdioVascular disease Association Study (CAVAS). Overall, 6,186 participants without hypertension at baseline were randomly divided into derivation and internal validation sets in a 6:4 ratio. We derived two prediction models: the first used the Framingham hypertension risk prediction factors (F-CAVAS-HTN); the second considered additional risk factors identified using stepwise Weibull regression analysis (CAVAS-HTN). These models were externally evaluated among Ansan and Ansung (A&A) participants, and the external validity of the Framingham and A&A prediction models (F-HTN and A&A-HTN) were assessed using the internal validation set of CAVAS. The discrimination, calibration, and net reclassification were determined. During the 4-year follow-up, 777 new cases of hypertension were diagnosed. All four models showed good discrimination (C-statistic ≥ 0.7). Internal calibrations were good for both the coefficient-based and the risk score-based F-CAVAS-HTN models, respectively (Hosmer-Lemeshow chi-square, H-L χ2 < 20, P ≥ 0.05). However, the two CAVAS models (H-L χ2 ≥ 20, P < 0.05, both) as well as the F-HTN and the A&A-HTN prediction models (H-L χ2 = 155.39, P < 0.0001; H-L χ2 = 209.72, P < 0.0001, respectively) were not externally calibrated. The F-CAVAS-HTN may be better than models with additional risk factors or derived for another population in the view of the findings of the internal validation in the present study, although future studies to improve the external validity of the F-CAVAS-HTN are needed.
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Affiliation(s)
- Hyun Kyung Namgung
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, Korea.,Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Hye Won Woo
- Institute for Health and Society, Hanyang University, Seoul, Korea.,Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University, College of Medicine, Seoul, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University, Medical School, Gwangju, South Korea
| | - Sang Baek Koh
- Department of Preventive Medicine and Institute of Occupational Medicine, Yonsei Wonju College of Medicine, Wonju, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine and Public Health, Yonsei University, College of Medicine, Seoul, South Korea
| | - Yu-Mi Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, Korea. .,Institute for Health and Society, Hanyang University, Seoul, Korea. .,Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, Korea.
| | - Mi Kyung Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, Korea. .,Institute for Health and Society, Hanyang University, Seoul, Korea. .,Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, Korea.
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17
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Li C, Wang Y, Wang S, Huang L. Smoke Exposure Reduces the Protective Effect of Physical Activity on Hypertension: Evidence from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2532. [PMID: 36767898 PMCID: PMC9915007 DOI: 10.3390/ijerph20032532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The joint effects between smoke exposure (SE) and physical activity (PA) on hypertension are still unclear, and the effect of SE is still debated. To explore associations and joint effects of SE and PA on hypertension, the data of 14,456 selected participants from the NHANES (2013-2018) were used for analyses. SE status was divided by serum cotinine concentrations. Moderate-to-vigorous intensity PA (MVPA) and insufficient or no PA (INPA) were divided by the Global Physical Activity Questionnaire. Hypertension was assessed by blood pressure and questionnaires. Survey logistic multivariable regression models were conducted for data analyses. In fully adjusted models, hypertension risk among SE participants increased (OR = 1.175, 95% CI: 1.036-1.332), especially those who were <40 years or female. However, the risk among MVPA participants decreased (OR = 0.747, 95% CI: 0.663-0.841), especially those who were ≥40 years. Additionally, the OR for MVPA participants without SE when compared with INPA ones without SE was 0.740 (95% CI: 0.654-0.837), especially those who were <60 years. However, the OR for MVPA participants with SE was 0.880 (95% CI: 0.747-1.037). For INPA participants, we did not observe significant ORs for SE compared with non-SE participants (p > 0.150). In conclusion, SE increased the risk of hypertension and MVPA reduced it, but SE could reduce such protective effect.
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Affiliation(s)
- Chen Li
- Center for Public Health Research, Medical School of Nanjing University, Nanjing 210093, China
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Nanjing University (Suzhou) High-Tech Institute, Suzhou 215123, China
| | - Yiyi Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Nanjing University (Suzhou) High-Tech Institute, Suzhou 215123, China
| | - Shouyu Wang
- Center for Public Health Research, Medical School of Nanjing University, Nanjing 210093, China
| | - Lei Huang
- Center for Public Health Research, Medical School of Nanjing University, Nanjing 210093, China
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Nanjing University (Suzhou) High-Tech Institute, Suzhou 215123, China
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18
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Cao Y, Li P, Zhang Y, Qiu M, Li J, Ma S, Yan Y, Li Y, Han Y. Association of systemic immune inflammatory index with all-cause and cause-specific mortality in hypertensive individuals: Results from NHANES. Front Immunol 2023; 14:1087345. [PMID: 36817427 PMCID: PMC9932782 DOI: 10.3389/fimmu.2023.1087345] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
Background The relationship between the systemic immune inflammatory index (SII) and the prognosis of hypertensive patients is unclear. This study aims to explore the association of SII with all-cause and cause-specific mortality in patients with hypertension. Methods This study included 8524 adults with hypertension from the National Health and Nutritional Examination Surveys (NHANES) 2011-2018, and followed for survival through December 31, 2019. Cox proportional hazards models were used to investigate the associations between SII and mortality from all causes, cardiovascular disease (CVD), and cancer. Restricted cubic spline, piecewise linear regression, subgroup and sensitivity analyses were also used. Results During a median follow-up of 4.58 years, 872 all-cause deaths occurred. After adjusting for covariates, higher SII was significantly associated with an elevated risk of CVD mortality. There was a 102% increased risk of CVD mortality per one-unit increment in natural log-transformed SII (lnSII) (P < 0.001). Consistent results were also observed when SII was examined as categorical variable (quartiles). The associations of SII with all-cause and cancer mortality were detected as U-shaped with threshold values of 5.97 and 6.18 for lnSII respectively. Below thresholds, higher SII was significantly associated with lower all-cause mortality (HR=0.79, 95%CI=0.64-0.97) and cancer mortality (HR=0.73, 95%CI=0.53-1.00). Above thresholds, SII was significantly positive associated with all-cause mortality (HR=1.93, 95%CI=1.55-2.40) and cancer mortality (HR=1.93, 95%CI=1.22-3.05). The results were robust in subgroup and sensitivity analyses. Conclusion Higher SII (either as a continuous or categorical variable) were significantly associated with a higher risk of CVD mortality. The U-shaped associations were observed between SII and all-cause and cancer mortality.
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Affiliation(s)
- Yang Cao
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.,The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, Shanxi, China
| | - Pengxiao Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.,The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, Shanxi, China
| | - Yan Zhang
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, Shanxi, China
| | - Miaohan Qiu
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Jing Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Sicong Ma
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yudong Yan
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.,The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, Shanxi, China
| | - Yi Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yaling Han
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
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19
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Jones EJ, Schreier HMC. First-Generation College Students, Emotional Support, and Systemic Inflammation Following the College Transition. J Adolesc Health 2023; 72:36-43. [PMID: 36220685 PMCID: PMC10456970 DOI: 10.1016/j.jadohealth.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/11/2022] [Accepted: 08/12/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To examine whether emotional support moderates the association between college generation status and concurrent and prospective levels of systemic inflammation during the college transition among a sample of older U.S. adolescents. METHODS At an undergraduate tertiary institution, 41 first-generation college students (first-gens) and 46 continuing-generation college students (continuing-gens) in their first semester of college reported on basic demographic information and perceived emotional support. They also had their blood drawn midway through both the first and second semester to measure C-reactive protein and interleukin-6. An inflammatory composite for each semester was created by averaging the standardized scores for log-transformed C-reactive protein and interleukin-6. RESULTS Compared to continuing-gens, first-gens had greater systemic inflammation in the first semester regardless of their level of emotional support (B = 0.515, p = .003). However, emotional support moderated the association between college generation status and prospective systemic inflammation in the second semester (B = -0.525, p = .007) such that first-gens had greater systemic inflammation compared to continuing-gens, but only if they reported lower levels of emotional support (B = 0.826, p = .002). This moderation effect held after further adjusting for systemic inflammation in the first semester (B = -0.374, p = .022). Also discussed are results of secondary analyses examining sources of support. DISCUSSION Compared to continuing-gens, first-gens had greater systemic inflammation in the first semester irrespective of emotional support, suggesting all first-gens may stand to benefit from college resources provided early in the college transition. Furthermore, first-gens who reported lower levels of emotional support may benefit from additional college resources provided beyond the first semester.
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Affiliation(s)
- Emily J Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Hannah M C Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
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20
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Liang X, Chou OHI, Cheung CL, Cheung BMY. Is hypertension associated with arthritis? The United States national health and nutrition examination survey 1999-2018. Ann Med 2022; 54:1767-1775. [PMID: 35786117 PMCID: PMC9258429 DOI: 10.1080/07853890.2022.2089911] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Hypertension and arthritis are two common diseases in the general population, with multiple common risk factors. This study aimed to assess the association between hypertension (HTN) and arthritis. PATIENTS AND METHODS This cohort study included 48,372 eligible non-pregnant participants aged ≥ 20 years who had valid data on hypertension and arthritis from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The association between hypertension and arthritis was studied by logistic regression, adjusting for demographics, socioeconomic factors, excess sodium intake, physical activity, ever smoking, diabetes status and body mass index (BMI). RESULTS Among the participants, 48.0% (95% CI: 47.2-48.9) had hypertension and 24.5% (95% CI: 23.8-25.3) had self-reported arthritis. Hypertension was associated with arthritis [OR = 2.90, (95% CI: 2.74-3.07), p < 0.01], which remained significant [OR = 1.27, (95% CI:1.18-1.37), p < 0.01] after adjustments. Stratified by the types of arthritis, the association remained significant in rheumatoid arthritis (RA) [OR = 1.25, (95% CI: 1.11-1.41), p < 0.01] and osteoarthritis (OA) [OR = 1.32, (95% CI: 1.16-1.50); p < 0.01]. There was no clear association between hypertension and OA in participants aged 60 years old and above [OR = 1.08, (95% CI: 0.92-1.26); p = 0.37]. CONCLUSIONS In this large nationally representative survey over 20 years, arthritis, including both RA and OA, was strongly associated with hypertension. Our study demonstrates a need for hypertension screening and blood control among patients with arthritis.Key MessagesArthritis was associated with hypertension.Both rheumatoid arthritis and osteoarthritis are strongly associated with hypertension.There is an urgency for hypertension screening and blood control among patients with arthritis.
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Affiliation(s)
- Xiaopeng Liang
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Oscar Hou In Chou
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Ching Lung Cheung
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong, China.,Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, China
| | - Bernard M Y Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong, China.,Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, China
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21
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Sekine T, Tsuchiya K, Uchinuma H, Horiuchi S, Kushima M, Otawa S, Yokomichi H, Miyake K, Akiyama Y, Ooka T, Kojima R, Shinohara R, Yamagata Z. Association between maternal gestational diabetes mellitus and high-sensitivity C-reactive protein levels in 8-year-old children: The Yamanashi Adjunct Study of the Japan Environment and Children's Study (JECS). J Diabetes Investig 2022; 13:1444-1447. [PMID: 35348295 PMCID: PMC9340882 DOI: 10.1111/jdi.13796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most common pregnancy-related complications; it is associated with adverse pregnancy outcomes and metabolic disorders in offspring, consistent with the concept of the developmental origins of health and disease. This cohort study of women without diabetes (n = 761), who were part of the Yamanashi Adjunct Study of the Japan Environment and Children's Study, aimed to explore the associations between maternal GDM and their offspring's level of high-sensitivity C-reactive protein (hsCRP), a biomarker of inflammatory and cardiovascular diseases. We analyzed the associations between GDM and the offspring's hsCRP levels using a multiple logistic regression model. A mother with GDM significantly increased the risk for high hsCRP level by 4.07-fold (≥2.0 mg/L) in the child. As such, maternal GDM was significantly associated with increased serum hsCRP levels in 8-year-old children.
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Affiliation(s)
- Tetsuo Sekine
- Interdisciplinary Graduate School of Medicine and EngineeringUniversity of YamanashiChuo CityJapan
| | - Kyoichiro Tsuchiya
- Interdisciplinary Graduate School of Medicine and EngineeringUniversity of YamanashiChuo CityJapan
| | - Hiroyuki Uchinuma
- Interdisciplinary Graduate School of Medicine and EngineeringUniversity of YamanashiChuo CityJapan
| | - Sayaka Horiuchi
- Center for Birth Cohort StudiesUniversity of YamanashiChuo CityJapan
| | - Megumi Kushima
- Center for Birth Cohort StudiesUniversity of YamanashiChuo CityJapan
| | - Sanae Otawa
- Center for Birth Cohort StudiesUniversity of YamanashiChuo CityJapan
| | - Hiroshi Yokomichi
- Department of Health SciencesSchool of MedicineUniversity of YamanashiChuo CityJapan
| | - Kunio Miyake
- Department of Health SciencesSchool of MedicineUniversity of YamanashiChuo CityJapan
| | - Yuka Akiyama
- Department of Health SciencesSchool of MedicineUniversity of YamanashiChuo CityJapan
| | - Tadao Ooka
- Department of Health SciencesSchool of MedicineUniversity of YamanashiChuo CityJapan
| | - Reiji Kojima
- Department of Health SciencesSchool of MedicineUniversity of YamanashiChuo CityJapan
| | - Ryoji Shinohara
- Center for Birth Cohort StudiesUniversity of YamanashiChuo CityJapan
| | - Zentaro Yamagata
- Center for Birth Cohort StudiesUniversity of YamanashiChuo CityJapan
- Department of Health SciencesSchool of MedicineUniversity of YamanashiChuo CityJapan
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22
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Mechanisms underlying the effects of caloric restriction on hypertension. Biochem Pharmacol 2022; 200:115035. [DOI: 10.1016/j.bcp.2022.115035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 11/20/2022]
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23
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Kawasoe M, Kawasoe S, Kubozono T, Ojima S, Kawabata T, Ikeda Y, Oketani N, Miyahara H, Tokushige K, Miyata M, Ohishi M. Development of a risk prediction score for hypertension incidence using Japanese health checkup data. Hypertens Res 2022; 45:730-740. [PMID: 34961790 DOI: 10.1038/s41440-021-00831-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/06/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022]
Abstract
Hypertension is a risk factor for cardiovascular disease. We developed a simple scoring method for predicting future hypertension using health checkup data. A total of 41,902 participants aged 30-69 years without baseline hypertension who underwent annual health checkups (mean age, 52.3 ± 10.2 years; male, 47.7%) were included. They were randomly assigned to derivation (n = 27,935) and validation cohorts (n = 13,967) at a ratio of 2:1. In the derivation cohort, we performed multivariable logistic regression analysis and assigned scores to each factor significantly associated with 5-year hypertension. We evaluated the predictive ability of the scores using area under the curve (AUC) analysis and then applied them to the validation cohort to assess their validity. The score including items requiring blood sampling ranged from 0 to 14 and included seven indicators (age, body mass index, blood pressure, current smoking, family history of hypertension, diabetes, and hyperuricemia). The score not including items requiring blood sampling ranged from 0 to 12 and included five indicators (the above indicators, except diabetes and hyperuricemia). The score not including items requiring blood sampling was better; blood sampling did not improve diagnostic ability. The AUC of the score not including items requiring blood sampling was 0.76, with a sensitivity and specificity of 0.82 and 0.60, respectively, for scores ≥6 points. The incidence of hypertension gradually and constantly increased (from 0.9 to 49.6%) as the score increased from 0 to ≥10. Analysis in the validation cohort yielded similar results. We developed a simple and useful clinical prediction model to predict the 5-year incidence of hypertension among a general Japanese population. The model had reasonably high predictive ability and reproducibility.
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Affiliation(s)
- Mariko Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Kagoshima City Hospital, Kagoshima, Japan
| | - Shin Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Satoko Ojima
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takeko Kawabata
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | | | | | - Masaaki Miyata
- School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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24
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Grover S, Brandt JS, Reddy UM, Ananth CV. Chronic hypertension, perinatal mortality and the impact of preterm delivery: a population-based study. BJOG 2022; 129:572-579. [PMID: 34536318 PMCID: PMC9214277 DOI: 10.1111/1471-0528.16932] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/30/2021] [Accepted: 07/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To estimate the association between chronic hypertension and perinatal mortality and to evaluate the extent to which risks are impacted by preterm delivery. DESIGN Cross-sectional analysis. SETTING United States, 2015-18. POPULATION Singleton births (20-44 weeks of gestation). EXPOSURE Chronic hypertension, defined as elevated blood pressure diagnosed before pregnancy or recognised before 20 weeks of gestation. MAIN OUTCOMES AND MEASURES We derived the risk of perinatal mortality in relation to chronic hypertension from Poisson models, adjusted for confounders. The impacts of misclassification and unmeasured confounding were assessed. Causal mediation analysis was performed to quantify the impact of preterm delivery on the association. RESULTS Of the 15 090 678 singleton births, perinatal mortality rates were 22.5 and 8.2 per 1000 births in chronic hypertensive and normotensive pregnancies, respectively (adjusted risk ratio 2.05, 95% CI 2.00-2.10). Corrections for exposure misclassification and unmeasured confounding biases substantially increased the risk estimate. Although causal mediation analysis revealed that most of the association of chronic hypertension on perinatal mortality was mediated through preterm delivery, the perinatal mortality rates were highest at early term, term and late term gestations, suggesting that a planned early term delivery at 37-386/7 weeks may optimally balance risk in these pregnancies. Additionally, 87% (95% CI 84-90%) of perinatal deaths could be eliminated if preterm deliveries, as a result of chronic hypertension, were preventable. CONCLUSIONS Chronic hypertension is associated with increased risk for perinatal mortality. Planned early term delivery and targeting modifiable risk factors for chronic hypertension may reduce perinatal mortality rates. TWEETABLE ABSTRACT Maternal chronic hypertension is associated with increased risk for perinatal mortality, largely driven by preterm birth.
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Affiliation(s)
- S Grover
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - JS Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - UM Reddy
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
| | - CV Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA,Cardiovascular Institute of New Jersey and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA,Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
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25
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Association of High-Sensitivity C-Reactive Protein and Alcohol Consumption on Metabolic Syndrome in Korean Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052571. [PMID: 35270264 PMCID: PMC8909415 DOI: 10.3390/ijerph19052571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022]
Abstract
Background: This study aimed to examine the effect of both alcohol consumption and high-sensitivity C-reactive protein (hsCRP) on metabolic syndrome (MetS) in Korean men. Methods: A cohort of 364 men included in this study was divided into four groups according to the amount of alcohol they consumed: the nondrinkers (ND), low moderate drinkers (LM, ≤7 standard drinks per week), high moderate drinkers (HM, 7 to 14 drinks per week), and heavy drinkers (HD, >14 drinks per week). Logistic regression analyses were performed after adjusting for age, exercise, and smoking. Results: The risk of MetS in the LM group with a high hsCRP level (1.0 or more mg/dL) was not significant. However, the risks of MetS were significantly higher in the HM and HD groups with high hsCRP levels than that in the ND group. The odds ratios of MetS in the HM and HD groups with high hsCRP levels were 3.44 (95% confidence interval (CI), 1.25−9.52) and 3.14 (95% CI, 1.07−9.23), respectively. Conclusion: This study suggests that the risk of MetS is higher in men who consume more than seven drinks a week with high hsCRP levels than that in nondrinkers.
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26
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Long DL, Guo B, McClure LA, Jaeger BC, Tison S, Howard G, Judd SE, Howard VJ, Plante TB, Zakai NA, Koh I, Cheung KL, Cushman M. Biomarkers as MEDiators of racial disparities in risk factors (BioMedioR): Rationale, study design, and statistical considerations. Ann Epidemiol 2022; 66:13-19. [PMID: 34742867 PMCID: PMC8920757 DOI: 10.1016/j.annepidem.2021.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/06/2021] [Accepted: 10/26/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Relative to White adults, Black adults have a substantially higher prevalence of hypertension and diabetes, both key risk factors for stroke, cardiovascular disease, cognitive impairment, and dementia. Blood biomarkers have shown promise in identifying contributors to racial disparities in many chronic diseases. METHODS We outline the study design and related statistical considerations for a nested cohort study, the Biomarker Mediators of Racial Disparities in Risk Factors (BioMedioR) study, within the 30,239-person biracial REasons for Geographic And Racial Differences in Stroke (REGARDS) study (2003-present). Selected biomarkers will be assessed for contributions to racial disparities in risk factor development over median 9.4 years of follow-up, with initial focus on hypertension, and diabetes. Here we outline study design decisions and statistical considerations for the sampling of 4,400 BioMedioR participants. RESULTS The population for biomarker assessment was selected using a random sample study design balanced across race and sex to provide the optimal opportunity to describe association of biomarkers with the development of hypertension and diabetes. Descriptive characteristics of the BioMedioR sample and analytic plans are provided for this nested cohort study. CONCLUSIONS This nested biomarker study will examine pathways with the target to help explain racial differences in hypertension and diabetes incidence.
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Affiliation(s)
- D. Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Boyi Guo
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Leslie A. McClure
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania
| | - Byron C. Jaeger
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Stephanie Tison
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Suzanne E. Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Virginia J. Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Timothy B. Plante
- Department of Medicine, Larner College of Medicine at the University of Vermont
| | - Neil A. Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont,Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont
| | - Insu Koh
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont
| | - Katharine L. Cheung
- Department of Medicine, Larner College of Medicine at the University of Vermont
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont,Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont
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27
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van Apeldoorn JA, van der Linden EL, Bahendeka S, Beune E, Meeks KA, Klipstein-Grobusch K, van den Born BJ, Agyemang C. C-reactive protein and hypertension among Ghanaian migrants and their homeland counterparts: the Research on Obesity and Diabetes among African Migrants study. J Hypertens 2022; 40:283-291. [PMID: 34478414 PMCID: PMC8728758 DOI: 10.1097/hjh.0000000000003006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hypertension (HTN) is a growing public health problem in sub-Saharan Africa (SSA) and SSA migrants in Europe. Elevated levels of inflammatory marker C-reactive protein (CRP) have been linked to HTN but the relationship of CRP and HTN among SSA populations has not been studied. To address this knowledge gap, we studied the association between CRP and HTN in migrant and nonmigrant SSA populations residing in different settings. METHODS Cross-sectional data from the multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study were analysed including 5683 Ghanaians aged at least 18 years, residing in rural and urban Ghana, and Europe. Multivariate logistic regression analyses were used to assess the association between high levels of CRP (≥3 mg/l) and HTN (SBP ≥140 mmHg and/or DBP ≥90 mmHg and/or use of antihypertensive medication) per geographical site and sex. RESULTS The association between CRP levels and HTN varied by sex and geographical location. In age-adjusted models, there was an association between high CRP levels and HTN in urban-Ghanaian women (odds ratio 1.50, 95% confidence interval 1.10-2.03), and European-Ghanaian men (1.68, 1.16-2.43) and women (1.63, 1.28-2.07). However, these associations were attenuated after adjustment for conventional risk factors, especially BMI. No association was found in rural-Ghanaians or urban-Ghanaian men. CONCLUSION Our findings show an association between CRP and HTN among Ghanaian migrants and urban-Ghanaian women, however, this was largely explained by conventional risk factors. Thus, prevention of conventional risk factors, in particular obesity, may help to reduce the potentially low-grade inflammatory mechanism underlying HTN.
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Affiliation(s)
- Joshua A.N. van Apeldoorn
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
| | - Eva L. van der Linden
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | | | - Erik Beune
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
| | - Karlijn A.C. Meeks
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bert-Jan van den Born
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
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28
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The association between socioeconomic status and prevalence, awareness, treatment and control of hypertension in different ethnic groups. J Hypertens 2022; 40:897-907. [DOI: 10.1097/hjh.0000000000003092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Jing Y, Zhou H, Lu H, Chen X, Zhou L, Zhang J, Wu J, Dong C. Associations Between Peripheral Blood Microbiome and the Risk of Hypertension. Am J Hypertens 2021; 34:1064-1070. [PMID: 34105723 DOI: 10.1093/ajh/hpab084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/29/2021] [Accepted: 06/08/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Although previous studies have reported the gut microbiome is closely related to hypertension development, whether the change in blood microbiome is associated with the risk of hypertension remains unclear. METHODS One hundred and fifty incident hypertension cases and 150 age (± 2 years) and gender (1:1) matched nonhypertension controls included in this nested case-control study were recruited from a prospective cohort study of "135." The composition of the blood microbiome was characterized using bacterial 16S ribosomal RNA gene sequencing. The relative abundance of detected bacteria was converted to a negative logarithm of 10 for the statistical analysis. RESULTS Totally, 10,689,961 high-quality sequences were acquired. The Chao1 index of the blood microbiome in nonhypertension controls was significantly higher than in hypertensive group (2,302.08 ± 752.78 vs. 1,598.21 ± 500.88, P < 0.001). Compared with the nonhypertension controls, the relative abundance of Proteobacteria phylum was significantly increased (P < 0.001), whereas the relative abundance of phyla Firmicutes and Bacteroidetes were significantly reduced in the hypertensive cases (P < 0.001 and P = 0.039, respectively). At genus level, the risk of hypertension was directly associated with the relative abundance of Acinetobacter (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.01-2.03), Sphingomonas (OR: 1.84, 95% CI: 1.32-2.56), and Staphylococcus (OR: 0.51, 95% CI: 0.36-0.73), respectively. In addition, the relative abundance of Pseudomonas was minor positively correlated with the total cholesterol level. However, the relative Staphylococcus level was minor positively correlated with high-density lipoprotein cholesterol level. CONCLUSIONS The composition of the blood microbiome is significantly associated with the development of hypertension.
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Affiliation(s)
- Yang Jing
- Department of Epidemiology and Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, China
- Department of noncommunicable disease control and prevention, Suzhou Industrial Park Centers for Disease Control and Prevention, Soochow, China
| | - Hui Zhou
- Department of noncommunicable disease control and prevention, Suzhou Industrial Park Centers for Disease Control and Prevention, Soochow, China
| | - Honghong Lu
- Department of endocrinology, Suzhou Shili Hospital, Soochow, China
| | - Xiaofang Chen
- Department of noncommunicable disease control and prevention, Suzhou Industrial Park Centers for Disease Control and Prevention, Soochow, China
| | - Liangyue Zhou
- Department of noncommunicable disease control and prevention, Suzhou Industrial Park Centers for Disease Control and Prevention, Soochow, China
| | - Jingqi Zhang
- Department of Epidemiology and Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, China
| | - Jing Wu
- Department of Epidemiology and Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, China
| | - Chen Dong
- Department of Epidemiology and Statistics, School of Public Health, Medical College of Soochow University, Soochow, Jiangsu, China
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30
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McClung JA, Levy L, Garcia V, Stec DE, Peterson SJ, Abraham NG. Heme-oxygenase and lipid mediators in obesity and associated cardiometabolic diseases: Therapeutic implications. Pharmacol Ther 2021; 231:107975. [PMID: 34499923 DOI: 10.1016/j.pharmthera.2021.107975] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023]
Abstract
Obesity-mediated metabolic syndrome remains the leading cause of death worldwide. Among many potential targets for pharmacological intervention, a promising strategy involves the heme oxygenase (HO) system, specifically its inducible form, HO-1. This review collects and updates much of the current knowledge relevant to pharmacology and clinical medicine concerning HO-1 in metabolic diseases and its effect on lipid metabolism. HO-1 has pleotropic effects that collectively reduce inflammation, while increasing vasodilation and insulin and leptin sensitivity. Recent reports indicate that HO-1 with its antioxidants via the effect of bilirubin increases formation of biologically active lipid metabolites such as epoxyeicosatrienoic acid (EET), omega-3 and other polyunsaturated fatty acids (PUFAs). Similarly, HO-1and bilirubin are potential therapeutic targets in the treatment of fat-induced liver diseases. HO-1-mediated upregulation of EET is capable not only of reversing endothelial dysfunction and hypertension, but also of reversing cardiac remodeling, a hallmark of the metabolic syndrome. This process involves browning of white fat tissue (i.e. formation of healthy adipocytes) and reduced lipotoxicity, which otherwise will be toxic to the heart. More importantly, this review examines the activity of EET in biological systems and a series of pathways that explain its mechanism of action and discusses how these might be exploited for potential therapeutic use. We also discuss the link between cardiac ectopic fat deposition and cardiac function in humans, which is similar to that described in obese mice and is regulated by HO-1-EET-PGC1α signaling, a potent negative regulator of the inflammatory adipokine NOV.
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Affiliation(s)
- John A McClung
- Department of Medicine, New York Medical College, Valhalla, NY 10595, United States of America
| | - Lior Levy
- Department of Medicine, New York Medical College, Valhalla, NY 10595, United States of America
| | - Victor Garcia
- Department of Pharmacology, New York Medical College, Valhalla, NY 10595, United States of America
| | - David E Stec
- Department of Physiology and Biophysics, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, MS 39216, United States of America.
| | - Stephen J Peterson
- Department of Medicine, Weill Cornell Medicine, New York, NY 10065, United States of America; New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 11215, United States of America
| | - Nader G Abraham
- Department of Medicine, New York Medical College, Valhalla, NY 10595, United States of America; Department of Pharmacology, New York Medical College, Valhalla, NY 10595, United States of America.
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Plante TB, Long DL, Guo B, Howard G, Carson AP, Howard VJ, Judd SE, Jenny NS, Zakai NA, Cushman M. C-Reactive Protein and Incident Hypertension in Black and White Americans in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort Study. Am J Hypertens 2021; 34:698-706. [PMID: 33326556 PMCID: PMC8351501 DOI: 10.1093/ajh/hpaa215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/16/2020] [Accepted: 12/14/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND More inflammation is associated with greater risk incident hypertension, and Black United States (US) adults have excess burden of hypertension. We investigated whether increased inflammation as quantified by higher C-reactive protein (CRP) explains the excess incidence in hypertension experienced by Black US adults. METHODS We included 6,548 Black and White REasons for Geographic and Racial Differences in Stroke (REGARDS) participants without hypertension at baseline (2003-2007) who attended a second visit (2013-2016). Sex-stratified risk ratios (RRs) for incident hypertension at the second exam in Black compared to White individuals were estimated using Poisson regression adjusted for groups of factors known to partially explain the Black-White differences in incident hypertension. We calculated the percent mediation by CRP of the racial difference in hypertension. RESULTS Baseline CRP was higher in Black participants. The Black-White RR for incident hypertension in the minimally adjusted model was 1.33 (95% confidence interval 1.22, 1.44) for males and 1.15 (1.04, 1.27) for females. CRP mediated 6.6% (95% confidence interval 2.7, 11.3%) of this association in females and 19.7% (9.8, 33.2%) in males. In females, CRP no longer mediated the Black-White RR in a model including waist circumference and body mass index, while in males the Black-White difference was fully attenuated in models including income, education and dietary patterns. CONCLUSIONS Elevated CRP attenuated a portion of the unadjusted excess risk of hypertension in Black adults, but this excess risk was attenuated when controlling for measures of obesity in females and diet and socioeconomic factors in males. Inflammation related to these risk factors might explain part of the Black-White disparity in hypertension.
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Affiliation(s)
- Timothy B Plante
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Boyi Guo
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - April P Carson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nancy Swords Jenny
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Neil A Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
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Sri Hari TY, Sree Sudha TY, Varghese AM, Krishna Sasanka KSBS, Thangaraju P. A study of risk factors and complications in elderly hypertensive subjects. J Family Med Prim Care 2021; 10:2230-2234. [PMID: 34322417 PMCID: PMC8284235 DOI: 10.4103/jfmpc.jfmpc_1959_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hypertension among the elderly is a major, highly prevalent yet treatable cardiovascular disease. AIMS & OBJECTIVES Study aims to highlight the risk factors for hypertension in the elderly in an urban setup for the benefit of improving quality of life and also reduce the incidence of the cardiovascular related complications. METHODOLOGY This is a Cross-sectional observational study. Included 125 study subjects based on selection criteria. The selected patients were subjected to a preformed and pretested schedule of questions pertaining to the risk factors. RESULTS Among the known hypertensive patients above 60 years of age, 125 subjects were included in the study. Smoking (62%), alcohol consumption (21%), family history of hypertension (26%), family history of diabetes (70%) were statistically significant risk factors observed for the development of hypertension. CONCLUSION Sedentary lifestyle (physically less active) and anthropometric measures like overweight and obesity, abnormal waist circumference, and abnormal waist hip ratio were all identified as remarkable risk for hypertension. Myocardial infarction (20%), stroke (14%), and heart failure (12%) were the chart buster complications of hypertension in the vulnerable geriatric population.
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Affiliation(s)
- TY. Sri Hari
- Senior Registrar (MICU-I), Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - TY Sree Sudha
- Senior Resident, Department of Pharmacology, AIIMS, Raipur, Chhattisgarh, India
| | - Anjaly Mary Varghese
- Assistant Professor, Department of Pharmacology, Santhiram Medical College, Nandyal, Andhra Pradesh, India
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Sabuncu T, Sonmez A, Eren MA, Sahin I, Çorapçioğlu D, Üçler R, Akin Ş, Haymana C, Demirci İ, Atmaca A, Ersöz HÖ, Satman I, Bayram F. Characteristics of patients with hypertension in a population with type 2 diabetes mellitus. Results from the Turkish Nationwide SurvEy of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Hypertension Study). Prim Care Diabetes 2021; 15:332-339. [PMID: 33277201 DOI: 10.1016/j.pcd.2020.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/05/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The present survey aimed to find out the demographical and clinical characteristics of patients with hypertension in a population with type 2 diabetes mellitus (T2DM) in Turkey. METHODS Patients with T2DM who were followed-up in tertiary endocrine units for at least last one year were recruited. Demographic, clinical and biochemical data of the patients were collected. Hypertension was defined as taking anti-hypertensive medications or having office arterial blood pressure (ABP) ≥140/90 mmHg or home ABP ≥ 130/80 mmHg. RESULTS A total of 4756 (58.9% women) diabetic patients were evaluated. The percentage of patients with hypertension was 67.5% (n = 3212). Although 87.4% (n = 2808) of hypertensive patients were under treatment, blood pressure was on target in 52.7% (n = 1479) of patients. Hypertension proportions were higher in woman (p = 0.001), older, more obese, and those who had longer diabetes duration, lower education levels, higher frequency of hypoglycemic events (all p < 0.001) and higher triglyceride levels (p = 0.003). LDL cholesterol level and the percentage of smokers were lower in hypertensive group than in non-hypertensive group (both p < 0.001). The percentage of macro and microvascular complications was higher in the hypertensive group than in the normotensive one (both p < 0.001). In multivariate logistic regression analysis, being a woman (OR: 1.26, 95% CI: 1.04-1.51, p = 0.016), smoking (OR: 1.38, 95% CI: 1.05-1.80, p = 0.020), regular physical activity (OR: 1.24, 95% CI: 1.01-1.53, p = 0.039) and the presence of macrovascular complications (OR: 1.38 95% CI: 1.15-1.65, p = 0.001) were the significant predictors of good ABP regulation. The ratios of masked and white coat hypertension were 41.2% and 5.7%, respectively. CONCLUSION Our findings indicate that two-thirds (67.5%) of adult patients with T2DM have hypertension. Co-existence of hypertension increases the frequency of macro and microvascular diabetic complications in these patients. Despite the critical role of hypertension in morbidity and mortality, only half of the patients have favorable ABP levels. Masked hypertension seems to be another important issue in this population.
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Affiliation(s)
- Tevfik Sabuncu
- Harran University, Faculty of Medicine, Department of Endocrinology and Metabolism, Sanliurfa, Turkey
| | - Alper Sonmez
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Mehmet Ali Eren
- Harran University, Faculty of Medicine, Department of Endocrinology and Metabolism, Sanliurfa, Turkey.
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Endocrinology and Metabolism, Malatya, Turkey
| | - Demet Çorapçioğlu
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Rıfkı Üçler
- Van Yüzüncü Yıl University, Faculty of Medicine, Department of Endocrinology and Metabolism, Van, Turkey
| | - Şafak Akin
- Ankara Memorial Hospital, Ankara, Turkey
| | - Cem Haymana
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - İbrahim Demirci
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ayşegül Atmaca
- On Dokuz Mayıs University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey
| | - Halil Önder Ersöz
- Karadeniz Teknik University, Faculty of Medicine, Department of Endocrinology and Metabolism, Trabzon, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkey
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Showande SJ, Odukoya IO. Prevalence and clusters of modifiable cardiovascular disease risk factors among intra-city commercial motor vehicle drivers in a Nigerian metropolitan city. Ghana Med J 2021; 54:100-109. [PMID: 33536680 PMCID: PMC7829044 DOI: 10.4314/gmj.v54i2.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Commercial motor vehicle drivers (CMVDs) have worst health profiles among different occupations, yet the presence of clusters of cardiovascular disease (CVD) risk factors in this group have not been described in a resource-limited setting. Objectives The prevalence of CVD risk factors and the clusters among CMVDs was evaluated. Design A cross-sectional descriptive study. Setting Four motor parks in three local government areas of Ibadan city, Nigeria. Participants Consented and conveniently sampled 152 intra-city CMVDs aged ≥ 18 years. Main outcome measures Prevalence of CVD risk factors (hypertension, diabetes, high triglyceride, low HDLc, high waist-hip ratio, central obesity, physical inactivity, smoking, alcohol, and overweight/obesity) and their clusters were determined. Results All participants were male from 20 – 77 years old. Most of the CMVDs were physically inactive (80, 52.6%), take alcohol (78, 51.3%), and few smokes (35, 12.4%). The prevalence of hypertension, diabetes, hypertriglyceridemia, obesity, and central obesity were 36.2%, 5.9%, 23.7%, 4.6%, and 5.3%, respectively. Four clusters of CVD risk factors in the CMVDs with the prevalence of 36.2%. 33.5%, 17.1% and 13.2% were identified with significant differences (p<0.05) in the risk factors. Conclusion The prevalence of diabetes, obesity, central obesity, and smoking was low while the prevalence of hypertension and hypertriglyceridemia was moderate among the CMVDs, but the prevalence of alcohol intake and physical inactivity were high. Four distinct clusters of CVD risk factors were observed among the drivers. Funding The study was self-funded.
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Affiliation(s)
- Segun J Showande
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Ibimolade O Odukoya
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
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Clinically relevant high levels of human C-reactive protein induces endothelial dysfunction and hypertension by inhibiting the AMPK-eNOS axis. Clin Sci (Lond) 2021; 134:1805-1819. [PMID: 32639009 DOI: 10.1042/cs20200137] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022]
Abstract
Successful treatment of resistant hypertension accompanied by elevated human C-reactive protein (hCRP) remains a key challenge in reducing the burden of cardiovascular diseases. It is still unclear whether clinically relevant high-level hCRP is merely a marker or a key driver of hypertension. Here, we investigated the role and mechanism of clinically relevant high level of hCRP in hypertension. Elevated blood pressure was observed in all three hCRP overexpression models, including adeno-associated virus 9 (AAV9)-transfected mice, AAV9-transfected rats and hCRP transgenic (hCRPtg) rats. hCRPtg rats expressing clinically relevant high-level hCRP developed spontaneous hypertension, cardiac hypertrophy, myocardial fibrosis and impaired endothelium-dependent relaxation. Mechanistically, studies in endothelial nitric oxide (NO) synthase (eNOS) knockout mice transfected with AAV9-hCRP and phosphoproteomics analysis of hCRP-treated endothelial cells revealed that hCRP inhibited AMP-activated protein kinase (AMPK)-eNOS phosphorylation pathway. Further, activation of AMPK by metformin normalized endothelial-dependent vasodilation and decreased the blood pressure of hCRPtg rats. Our results show that clinically relevant high-level hCRP induces hypertension and endothelial dysfunction by inhibiting AMPK-eNOS signaling, and highlight hCRP is not only an inflammatory biomarker but also a driver of hypertension. Treatment with metformin or a synthetic AMPK activator may be a potential strategy for vaso-dysfunction and hypertension in patients with high hCRP levels.
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Exercise and food supplement of vitamin C ameliorate hypertension through improvement of gut microflora in the spontaneously hypertensive rats. Life Sci 2021; 269:119097. [PMID: 33482189 DOI: 10.1016/j.lfs.2021.119097] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/04/2021] [Accepted: 01/14/2021] [Indexed: 12/20/2022]
Abstract
AIMS Exercise and food supplement of vitamin C (VC) are beneficial to human health, especially for those who suffer from hypertension. Here we tend to explore if gut microflora is involved in the anti-hypertensive effects of exercise and VC-supplement therapies. MATERIALS AND METHODS With the spontaneously hypertensive rat (SHR) model, the small intestine pathology and the fecal microbiota was analyzed along with the pro- and anti-inflammatory cytokines (PICs and AICs) and reactive oxygen species (ROS) in the hypothalamus paraventricular nucleus (PVN) and intestine. KEY FINDINGS We found that both exercise and VC intake, individually or combined, were able to alleviate the blood pressure in the SHRs comparing to the normotensive control Wistar-kyoto (WKY) rats. The expression level of PICs in the PVN and intestine of the SHRs was down-regulated while the AICs were up-regulated after treatments, together with down-regulation of ROS in the PVN. At meantime, the gut pathology was dramatically improved in the SHRs with exercise training or VC intake. Analysis of the gut microflora revealed significant changes in their composition. Several important micro-organisms that were deficient in the SHRs were found up-regulated by the treatments, including Turicibacter and Romboutsia which are involved in the short-chain fatty acid production. SIGNIFICANCE Exercise training and VC intake individually can modify the gut microflora composition and improve the inflammatory state in both PVN and intestine, which contribute to their anti-hypertensive function. Combination of the two treatments enhanced their effects and worth to be considered as a non-medical aid for the hypertensive patients.
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Zhang Y, Feng Y, Chen S, Liang S, Wang S, Xu K, Ning D, Yuan X, Zhu H, Pan H, Shan G. Relationship between the duration of smoking and blood pressure in Han and ethnic minority populations: a cross-sectional study in China. BMC Public Health 2021; 21:135. [PMID: 33446177 PMCID: PMC7807505 DOI: 10.1186/s12889-020-09975-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background Evidence for correlation between the cigarette use and blood pressure change remains ambiguous. This study modelled relationship between the duration of smoking and systolic blood pressure in a large national multi-ethnic cross-sectional survey in China. Methods Participants were selected through a multi-stage probability sampling procedure from 2012 to 2017. Former or current smokers were included in this study, whose smoking behaviour, blood pressure, and other demographic information were collected and measured through a face-to-face interview. Linear and non-linear relationships between the duration of smoking and systolic blood pressure were analysed and differences of the association between Han and minority populations were specially checked. Results A total of 8801 participants were enrolled in this study. Prevalence of hypertension was 41.3 and 77.8% were current smokers. For every additional year of smoking duration, systolic blood pressure raised by 0.325 mmHg (95% CI 0.296 to 0.354 mmHg, P < 0.001). The Chinese minority populations may suffer more from the elevated blood pressure in long-term smoking than Han populations (0.283 mmHg (95% CI 0.252 to 0.314 mmHg, P < 0.001) versus 0.450 mmHg (95% CI 0.380 to 0.520 mmHg, P < 0.001) raise in systolic blood pressure with each additional year of smoking in minority and Han populations). Conclusions Smoking is associated with raised systolic blood pressure in Chinese population. This association is notedly stronger in Chinese minority populations.
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Affiliation(s)
- Yuelun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunying Feng
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shi Chen
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyu Liang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shirui Wang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Xu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongping Ning
- Department of Pediatrics, Linfen Central Hospital, Linfen, China
| | - Xianxian Yuan
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Pan
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
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Wang JM, Yang MX, Wu QF, Chen J, Deng SF, Chen L, Wei DN, Liang FR. Improvement of intestinal flora: accompany with the antihypertensive effect of electroacupuncture on stage 1 hypertension. Chin Med 2021; 16:7. [PMID: 33413552 PMCID: PMC7792359 DOI: 10.1186/s13020-020-00417-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increasing evidence have indicated the relationship between intestinal dysbiosis and hypertension. We aimed to evaluate the effect of the electroacupuncture (EA) on intestinal microbiota in patients with stage 1 hypertension. METHODS 93 hypertensive patients and 15 healthy subjects were enrolled in this study. Applying a highly accurate oscillometric device to evaluate the antihypertensive effect of EA. 16S rRNA sequencing was used to profile stool microbial communities from Healthy group, Before treatment (BT) group and After treatment (AT) group, and various multivariate analysis approaches were used to assess diversity, composition and abundance of intestinal microbiota. RESULTS In this study, EA significantly decreased the blood pressure (BP) of hypertensive patients. Higher abundance of Firmicutes and lower Bacteroidetes abundance were observed in the BT group compared to the Healthy group. And EA treatment significantly decreased the Firmicutes/Bacteroidetes ratio compared to the BT group. Moreover, at the genus level, there was an increased abundance of Escherichia-Shigella in patients with hypertension, while Blautia were decreased, and EA reversed these changes. CONCLUSIONS Our study indicates that EA can effectively lower BP and improve the structure of intestinal microbiota which are correlate with the alteration of blood pressure by electroacupuncture. TRIAL REGISTRATION Clinicaltrial.gov, NCT01701726. Registered 5 October 2012, https://clinicaltrials.gov/ct2/show/study/NCT01701726.
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Affiliation(s)
- Jun-Meng Wang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Ming-Xiao Yang
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, SAR, China.,Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Hai yuan Road, Futian District, Shenzhen, 518053, Guangdong, China
| | - Qiao-Feng Wu
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China. .,Institute of Acupuncture and Homeostasis Regulation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
| | - Ji Chen
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Shu-Fang Deng
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Lin Chen
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Da-Neng Wei
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China
| | - Fan-Rong Liang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, No.37, Road Shi-Er-Qiao, Jinniu District, Chengdu, 610075, Sichuan, China.
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van Oort S, Beulens JW, van Ballegooijen AJ, Grobbee DE, Larsson SC. Association of Cardiovascular Risk Factors and Lifestyle Behaviors With Hypertension. Hypertension 2020; 76:1971-1979. [DOI: 10.1161/hypertensionaha.120.15761] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hypertension is a major risk factor for cardiovascular disease and mortality. To identify targets for the prevention of hypertension and its associated disease burden, we used the 2-sample Mendelian randomization method to investigate the causal associations of 18 cardiovascular risk factors and lifestyle behaviors with hypertension. From European-descent genome-wide association studies, we selected genetic variants (P<5×10−8) for type 2 diabetes, fasting glucose, lipids, body mass index, smoking, alcohol and coffee consumption, physical activity, sleep duration, insomnia, and educational level. We extracted the genetic associations with hypertension from 2 European cohorts: the FinnGen Study (15 870 cases and 74 345 controls) and UK Biobank (54 358 cases and 408 652 controls). The inverse-variance weighted method was used as main analysis method. Genetically predicted triglycerides (pooled odds ratio [OR] per 1 SD, 1.17 [1.10–1.25]), body mass index (OR per 1 SD, 1.42 [1.37–1.48]), alcohol dependence (OR, 1.10 [1.06–1.13]), and insomnia (OR, 1.17 [1.13–1.20]) were associated with a higher odds of hypertension. Higher genetically predicted high-density lipoprotein cholesterol (OR per 1 SD, 0.88 [0.83–0.94]) and educational level (OR per 1 SD, 0.56 [0.54–0.59]) were associated with a lower odds of hypertension. Suggestive evidence was obtained for type 2 diabetes, smoking initiation and alcohol consumption with a higher hypertension odds, and longer sleep duration with a lower hypertension odds. This Mendelian randomization study identified high-density lipoprotein cholesterol, triglycerides, body mass index, alcohol dependence, insomnia, and educational level as causal risk factors for hypertension. This implicates that these modifiable risk factors are important targets in the prevention of hypertension.
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Affiliation(s)
- Sabine van Oort
- From the Department of Surgical Sciences, Uppsala University, Sweden (S.v.O., S.C.L.)
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam Cardiovascular Sciences Research Institute, the Netherlands (S.v.O., J.W.J.B., A.J.v.B.)
| | - Joline W.J. Beulens
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam Cardiovascular Sciences Research Institute, the Netherlands (S.v.O., J.W.J.B., A.J.v.B.)
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (J.W.J.B., D.E.G.)
| | - Adriana J. van Ballegooijen
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam Cardiovascular Sciences Research Institute, the Netherlands (S.v.O., J.W.J.B., A.J.v.B.)
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, department of Nephrology, Amsterdam, the Netherlands (A.J.v.B.)
| | - Diederick E. Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (J.W.J.B., D.E.G.)
| | - Susanna C. Larsson
- From the Department of Surgical Sciences, Uppsala University, Sweden (S.v.O., S.C.L.)
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (S.C.L.)
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Dehghan M, Dehghan-Nayeri N, Iranmanesh S. The psychometric properties of the Hypertensive Treatment Adherence Scale. ARYA ATHEROSCLEROSIS 2020; 16:55-71. [PMID: 33133204 PMCID: PMC7578522 DOI: 10.22122/arya.v16i2.1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Hypertension (HTN) is a public concern and treatment adherence has a key role in its management. This study was conducted to develop and test the reliability and validity of the Hypertensive Treatment Adherence scale (HTA-scale). METHODS This was a cross-sectional and methodological study. After item generation using a qualitative study and literature review, the scale was developed. The psychometric properties of the scale were evaluated using face, content, construct, and criterion validity and reliability. RESULTS Data analysis showed that the HTA-scale had acceptable face and content validity. The scale had excellent stability [Intraclass correlation coefficient (ICC) = 0.74] and good acceptability and internal consistency (Cronbach's a = 0.76). Exploratory factor analysis (EFA) showed that the HTA-scale consisted of 6 meaningful subscales including medication adherence and monitoring, adherence to safe diets, avoiding unsafe diets, self-medication, activity, and smoking. Participants in the controlled blood pressure group had significantly higher HTA-scale scores than the uncontrolled blood pressure group. At the cut-off point of 86, the scale had significant sensitivity and specificity. CONCLUSION All of the psychometric properties of the HTA-scale achieved the standard level and were sufficient to recommend this scale for patients with HTN.
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Affiliation(s)
- Mahlagha Dehghan
- Assistant Professor, Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Nahid Dehghan-Nayeri
- Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Iranmanesh
- Associate Professor, Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Gordon JH, LaMonte MJ, Zhao J, Genco RJ, Cimato TR, Hovey KM, Andrews CA, Wactawski-Wende J. The association between serum inflammatory biomarkers and incident hypertension among postmenopausal women in the Buffalo OsteoPerio Study. J Hum Hypertens 2020; 35:791-799. [PMID: 33028995 PMCID: PMC8024412 DOI: 10.1038/s41371-020-00422-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/27/2020] [Accepted: 09/24/2020] [Indexed: 11/30/2022]
Abstract
Several serum inflammatory biomarkers have been associated with blood pressure and hypertension prevalence in cross-sectional studies. Few of these associations have been evaluated prospectively. We examined associations for 10 serum inflammatory biomarkers with incident hypertension among 471 postmenopausal women (mean age = 65) in the Buffalo OsteoPerio Study. Concentrations of C-reactive protein, interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, adiponectin, and leptin were measured using multiplexed sandwich immunoassays on fasting serum samples collected at baseline (1997–2001). Incident hypertension (195 cases) was defined as physician-diagnosed hypertension and treatment with medication identified on annual mailed health surveys during follow-up (mean 10 years). Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between log-transformed biomarkers (per 1-SD) and hypertension. When adjusted for age, leptin was significantly associated with hypertension risk (HR=1.55, 95% CI: 1.04, 2.29), however, the association was attenuated and not significant after adjustment for demographic and lifestyle factors, including BMI. Significant (P<0.10) interactions were observed for smoking (never, ever) with CRP (HR: Never, 1.31; Ever, 0.91; P=0.06) and MCP-1 (HR: Never, 0.59; Ever, 5.11; P=0.004); for BMI (<25, ≥25) with MCP-1(HR: <25, 3.45; ≥25, 0.95; P=0.07); for systolic BP with IL-10 (HR: <120, 0.85; 120–139, 1.11; P=0.07); and for diastolic BP with MCP-1 (HR: <80, 1.29; 80–89, 0.84; P=0.03) and with adiponectin (HR: <80, 0.86; 80–89, 1.50; P=0.03). This study adds needed understanding on prospective associations between several serum inflammatory biomarkers and hypertension risk in older postmenopausal women, among whom hypertension burden is substantial.
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Affiliation(s)
- Joshua H Gordon
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA.,Medical Scientist Training Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA.
| | - Jiwei Zhao
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert J Genco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA.,Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Thomas R Cimato
- Department of Medicine, Division of Cardiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Christopher A Andrews
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
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Yin X, Chen M, He R, Wu S, Xia H, Xie F, Wang H. Association of leisure sedentary time with common chronic disease risk factors: A longitudinal study of China Health and Nutrition Surveys. Int J Health Plann Manage 2020; 36:100-112. [PMID: 32909306 DOI: 10.1002/hpm.3070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Although the common risk factors were identified and controlled for many years, the overall prevalence of chronic diseases continued to increase in China. OBJECTIVE We presumed the leisure sedentariness as a latent but pivotal factor of chronic diseases, and examined its distribution and changing trend, analysed its interaction effects on common risk factors, which could provide a new perspective for the prevention and management. METHODS A total of 5013 participants were screened out from China Health and Nutrition Survey. Random-effects ordered logistic models were used for ordinal dependent variables, and fixed-effects or random-effects logit models were used for binary dependent variables. RESULTS From 2004 to 2011, the prevalence of high leisure sedentary time (LSED) increased by 58.58%. Members of the high LSED group were likely to choose fast food, salty snacks, soft drinks and more likely to smoke or drink alcohol compared with those of the low LSED group. However, they preferred walking, sports and body building more than those of the low LSED group. CONCLUSIONS For the unhealthy dietary, tobacco and alcohol consumption, more targeted introduction and guidance related to sedentary time should be promoted. Meanwhile, the appeal for physical exercise as well as adequate facilities should be initiated.
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Affiliation(s)
- Xiaolu Yin
- Department of Medical Insurance Management, Renmin Hospital of Wuhan University, Wuhan, China
| | - Minfang Chen
- Department of Medical Insurance Management, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ruibo He
- School of Finance and Public Administration, Hubei University of Economics, Wuhan, China
| | - Song Wu
- Department of Medical Insurance Management, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongjie Xia
- Department of Medical Insurance Management, Renmin Hospital of Wuhan University, Wuhan, China
| | - Feili Xie
- Department of Medical Insurance Management, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huajing Wang
- Department of Medical Insurance Management, Renmin Hospital of Wuhan University, Wuhan, China
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The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res 2020; 42:1235-1481. [PMID: 31375757 DOI: 10.1038/s41440-019-0284-9] [Citation(s) in RCA: 1058] [Impact Index Per Article: 264.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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N-glycans as functional effectors of genetic and epigenetic disease risk. Mol Aspects Med 2020; 79:100891. [PMID: 32861467 DOI: 10.1016/j.mam.2020.100891] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/19/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022]
Abstract
N-glycosylation is a frequent modification of proteins, essential for all domains of life. N-glycan biosynthesis is a dynamic, complex, non-templated process, wherein specific glycoforms are modulated by various microenvironmental cues, cellular signals and local availability of dedicated enzymes and sugar precursors. This intricate regulatory network comprises hundreds of proteins, whose activity is dependent on both sequence of implicated genes and the regulation of their expression. In this regard, variation in N-glycosylation patterns stems from either gene polymorphisms or from stable epigenetic regulation of gene expression in different individuals. Moreover, epigenome alters in response to various environmental factors, representing a direct link between environmental exposure and changes in gene expression, that are subsequently reflected through altered N-glycosylation. N-glycosylation itself has a fundamental role in numerous biological processes, ranging from protein folding, cellular homeostasis, adhesion and immune regulation, to the effector functions in multiple diseases. Moreover, specific modification of the glycan structure can modulate glycoprotein's biological function or direct the faith of the entire cell, as seen on the examples of antibodies and T cells, respectively. Since immunoglobulin G is one of the most profoundly studied glycoproteins in general, the focus of this review will be on its N-glycosylation changes and their functional implications. By deepening the knowledge on the mechanistic roles that certain glycoforms exert in differential pathological processes, valuable insight into molecular perturbations occurring during disease development could be obtained. The prospect of resolving the exact biological pathways involved offers a potential for the development of new therapeutic interventions and molecular tools that would aid in prognosis, early referral and timely treatment of multiple disease conditions.
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Liu F, Liu Y, Sun X, Yin Z, Li H, Deng K, Zhao Y, Wang B, Ren Y, Liu X, Zhang D, Chen X, Cheng C, Liu L, Liu D, Chen G, Hong S, Wang C, Zhang M, Hu D. Race- and sex-specific association between alcohol consumption and hypertension in 22 cohort studies: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2020; 30:1249-1259. [PMID: 32446870 DOI: 10.1016/j.numecd.2020.03.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/08/2020] [Accepted: 03/18/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS The alcohol-hypertension relation has been well documented, but whether women have protective effect or race and type of beverage consumed affect the association remain unclear. To quantify the relation between total or beverage-specific alcohol consumption and incident hypertension by considering the effect of sex and race. METHODS AND RESULTS Articles were identified in PubMed and Embase databases with no restriction on publication date. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random effects models. Restricted cubic splines were used to model the dose-response association. This study involved 22 articles (31 studies) and included 414,477 participants. The hypertension risk was different among liquor, wine, and beer at 5.1-10 g/d of ethanol consumption (P-across subgroups = 0.002). The hypertension risk differed between men (RR: 1.14, 95% CI: 1.07, 1.20) and women (RR: 0.98, 95% CI: 0.89, 1.06) at 10 g/d (P-across subgroups = 0.005). We found a linear alcohol-hypertension association among white (P-linearity = 0.017), black people (P-linearity = 0.035), and Asians (P-linearity<0.001). With 10 g/d increment of consumption, the RRs for hypertension were 1.06 (95% CI: 1.04, 1.08), 1.14 (95% CI: 1.01, 1.28), and 1.06 (95% CI: 1.01, 1.10) for Asians, black, and white people, respectively. CONCLUSION Sex modifies the alcohol-hypertension association at low level of alcohol consumption and we did not find evidence of a protective effect of alcohol consumption among women. Black people may have higher hypertension risk than Asians and white people at the same ethanol consumption.
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Affiliation(s)
- Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Zhaoxia Yin
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xuejiao Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xu Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Cheng Cheng
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Leilei Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dechen Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Guozhen Chen
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Shihao Hong
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
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Wei W, Xiao X, Li J, Ding H, Pan W, Deng S, Yin W, Xue L, Lu Q, Yue Y, Tian Y, Wang M, Hao L. Activation of the STAT1 Pathway Accelerates Periodontitis in Nos3-/- Mice. J Dent Res 2020; 98:1027-1036. [PMID: 31329047 DOI: 10.1177/0022034519858063] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Early studies on the etiology and pathogenesis of hypertension have shown that it has a considerable association with inflammation and the immune response as well as periodontitis. Clinical studies have also shown that hypertension can promote the periodontal tissue destruction caused by periodontitis. However, the underlying mechanisms remain unclear. This study aimed to explore the possible mechanisms of how hypertension aggravates periodontitis. Treatment with or without the signal transducer and activator of transcription 1 (STAT1) inhibitor fludarabine was performed in an endothelial nitric oxide synthase gene knockout-related (Nos3-/-) mouse model with the hypertension phenotype of periodontitis induced by bacteria. Micro-computed tomography, immunohistochemistry, Western blot, quantitative reverse transcription polymerase chain reaction, immunofluorescence, and ELISA were performed. We demonstrated that Nos3-/--related hypertension increases bone resorption and periodontal destruction in periodontitis lesion areas, which can be inhibited by the STAT1 inhibitor. Experimental data also showed that Nos3-/- significantly increased macrophage infiltration and proinflammatory cytokine expression in the periodontitis lesion area, which is dependent on the angiotensin II-induced STAT1 pathway. Inhibition of STAT1 in vivo can decrease the expression of proinflammatory cytokines and macrophage infiltration. Furthermore, data in this study showed that Nos3-/--related hypertension further downregulated the STAT3 anti-inflammatory function and its downstream chemokine expression in a STAT1-dependent manner. By applying RAW 264.7 and L929 cell lines and monocytes isolated from Nos3-/- mice, we confirmed that activation of the STAT1 pathway inhibits STAT3 and its downstream pathway and promotes inflammatory cytokine expression in vitro. Collectively, our current study demonstrated that STAT1 plays an indispensable role in the Nos3-/--related hypertension with aggravation of periodontitis, suggesting that STAT1 may be a key target for the treatment of periodontitis with hypertension.
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Affiliation(s)
- W Wei
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - X Xiao
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - J Li
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - H Ding
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - W Pan
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - S Deng
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - W Yin
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - L Xue
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - Q Lu
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - Y Yue
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - Y Tian
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - M Wang
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
| | - L Hao
- 1 The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, People's Republic of China
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Cured ham consumption and incidence of hypertension: The "Seguimiento Universidad de Navarra" (SUN) cohort. Med Clin (Barc) 2020; 155:9-17. [PMID: 31791802 DOI: 10.1016/j.medcli.2019.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/05/2019] [Accepted: 09/05/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Cured ham is one of the most characteristic foods in the Spanish diet. Because it is a red processed meat and due to its nutritional composition, including high sodium content, a potential association between cured ham consumption and a higher risk of hypertension could be expected. However, epidemiological studies evaluating this association are scarce. We prospectively assessed the association between cured ham consumption and the incidence of hypertension. METHODS The "Seguimiento Universidad de Navarra" (SUN) study is a cohort of Spanish middle-aged adult university graduates (average age: 38 (SD: 12) years, 60% women). We included 13,900 participants of the SUN cohort free of hypertension at baseline. One serving of cured ham is 50g. They were classified into 4 categories of cured ham consumption: <1; 1; 2-4 and ≥5servs/week. Multivariable-adjusted Cox regression models were fitted to assess the association between cured ham consumption and subsequent hypertension risk using the category of lowest consumption as the reference. RESULTS After a median follow-up of 10.9 years, 1465 incident self-reported cases of hypertension were identified. After adjusting for potential confounders, including dietary confounders, a high consumption of cured ham (≥5servs/week vs. <1serv/week) was not significantly associated with hypertension risk in this prospective cohort (HR=0.88, 95% CI: 0.70-1.10, p linear trend=0.40). CONCLUSIONS Our results showed that cured ham consumption was not associated with a significantly higher or lower risk of hypertension in a prospective cohort of Spanish middle-aged adult university graduates. Further longitudinal and experimental studies are needed to disentangle the association between cured ham consumption and the risk of hypertension.
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GOWDA SGB, GAO ZJ, CHEN Z, ABE T, HORI S, FUKIYA S, ISHIZUKA S, YOKOTA A, CHIBA H, HUI SP. Untargeted Lipidomic Analysis of Plasma from High-fat Diet-induced Obese Rats Using UHPLC–Linear Trap Quadrupole–Orbitrap MS. ANAL SCI 2020; 36:821-828. [DOI: 10.2116/analsci.19p442] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Zi-Jun GAO
- Faculty of Health Sciences, Hokkaido University
| | - Zhen CHEN
- Faculty of Health Sciences, Hokkaido University
| | - Takayuki ABE
- Graduate School of Agriculture, Hokkaido University
| | - Shota HORI
- Graduate School of Agriculture, Hokkaido University
| | | | | | | | - Hitoshi CHIBA
- Department of Nutrition, Sapporo University of Health Sciences
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Al-Sumaih I, Johnston B, Donnelly M, O'Neill C. The relationship between obesity, diabetes, hypertension and vitamin D deficiency among Saudi Arabians aged 15 and over: results from the Saudi health interview survey. BMC Endocr Disord 2020; 20:81. [PMID: 32503594 PMCID: PMC7275458 DOI: 10.1186/s12902-020-00562-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/28/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Obesity and diabetes are related conditions, the prevalence of which has increased globally in recent years. These conditions have been linked to hypertension and vitamin D deficiency though the nature of the relationship remains unclear and is likely to vary between identifiable groups and specific contexts. The aim of this paper is to examine the relationships between obesity, type 2 diabetes, hypertension and vitamin D, among Saudis citizens aged 15 and over. METHODS Self-reported and measured data were taken from the 2013 Saudi Health Interview Survey and analysed using a series of seemingly unrelated bivariate probit regression (SURBVP) analyses. Sensitivity analyses were undertaken in which the selection and specification of covariates and outcomes were varied. RESULTS In the main analysis data on 957 women and 1127 men were analysed. Differences were evident between men and women in the prevalence of type 2 diabetes, obesity, central obesity, hypertension and vitamin D deficiency. While men were more likely to experience diabetes and hypertension, women were more likely to experience obesity, central obesity and vitamin D deficiency. In multivariable analyses obesity and age were found to significantly predict hypertension risk in women; central obesity to predict diabetes risk in men and women, as well as hypertension risk in men. Vitamin D was not found to predict diabetes risk nor hypertension risk in either sex. Milk consumption and sun exposure were found to predict vitamin D deficiency in women but not men. While there was evidence of unobserved heterogeneity in models predicting diabetes and hypertension, there was no evidence of unobserved heterogeneity between these and those predicting vitamin D deficiency. Results did not materially change over a range of sensitivity analyses. CONCLUSION While there is strong evidence of distinct patterns in the relationship between diabetes, hypertension and obesity among men and women in Saudi Arabia and in the risk of vitamin D deficiency, we found no evidence of a relationship between vitamin D levels and risk of either diabetes or hypertension.
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Affiliation(s)
- Ibrahim Al-Sumaih
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Brian Johnston
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
- Belfast Health and Social Care Trust, Belfast, UK
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
- Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
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Saarinen AIL, Keltikangas-Järvinen L, Hintsa T, Pulkki-Råback L, Ravaja N, Lehtimäki T, Raitakari O, Hintsanen M. Does Compassion Predict Blood Pressure and Hypertension? The Modifying Role of Familial Risk for Hypertension. Int J Behav Med 2020; 27:527-538. [PMID: 32347444 PMCID: PMC7497423 DOI: 10.1007/s12529-020-09886-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background This study investigated (i) whether compassion is associated with blood pressure or hypertension in adulthood and (ii) whether familial risk for hypertension modifies these associations. Method The participants (N = 1112–1293) came from the prospective Young Finns Study. Parental hypertension was assessed in 1983–2007; participants’ blood pressure in 2001, 2007, and 2011; hypertension in 2007 and 2011 (participants were aged 30–49 years in 2007–2011); and compassion in 2001. Results High compassion predicted lower levels of diastolic and systolic blood pressure in adulthood. Additionally, high compassion was related to lower risk for hypertension in adulthood among individuals with no familial risk for hypertension (independently of age, sex, participants’ and their parents’ socioeconomic factors, and participants’ health behaviors). Compassion was not related to hypertension in adulthood among individuals with familial risk for hypertension. Conclusion High compassion predicts lower diastolic and systolic blood pressure in adulthood. Moreover, high compassion may protect against hypertension among individuals without familial risk for hypertension. As our sample consisted of comparatively young participants, our findings provide novel implications for especially early-onset hypertension. Electronic supplementary material The online version of this article (10.1007/s12529-020-09886-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aino I L Saarinen
- Research Unit of Psychology, University of Oulu, P.O. Box 2000 (Erkki Koiso-Kanttilan katu 1), 90014, Oulu, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Taina Hintsa
- Department of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Niklas Ravaja
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mirka Hintsanen
- Research Unit of Psychology, University of Oulu, P.O. Box 2000 (Erkki Koiso-Kanttilan katu 1), 90014, Oulu, Finland.
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