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Hsu K. Erythroid anion transport, nitric oxide, and blood pressure. Front Physiol 2024; 15:1363987. [PMID: 38660536 PMCID: PMC11039876 DOI: 10.3389/fphys.2024.1363987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Glycophorin A and glycophorin B are structural membrane glycoproteins bound in the band 3 multiprotein complexes on human red blood cells (RBCs). Band 3 is an erythroid-specific anion exchanger (AE1). AE1-mediated HCO3 - transport provides the substrate for the enzyme-catalyzed conversion HCO3 - (aq) ⇌ CO2(g), which takes place inside the RBCs. Bicarbonate transport via AE1 supports intravascular acid-base homeostasis and respiratory excretion of CO2. In the past decade, we conducted several comparative physiology studies on Taiwanese people having the glycophorin variant GPMur RBC type (which accompanies greater AE1 expression). We found that increased anion transport across the erythrocyte membrane not only enhances gas exchange and lung functions but also elevates blood pressure (BP) and reduces nitric oxide (NO)-dependent vasodilation and exhaled NO fraction (FeNO) in healthy individuals with GP.Mur. Notably, in people carrying the GPMur blood type, the BP and NO-dependent, flow-mediated vasodilation (FMD) are both more strongly correlated with individual hemoglobin (Hb) levels. As blood NO and nitrite (NO2 -) are predominantly scavenged by intraerythrocytic Hb, and NO2 - primarily enters RBCs via AE1, could a more monoanion-permeable RBC membrane (i.e., GPMur/increased AE1) enhance NO2 -/NO3 - permeability and Hb scavenging of NO2 - and NO to affect blood pressure? In this perspective, a working model is proposed for the potential role of AE1 in intravascular NO availability, blood pressure, and clinical relevance.
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Affiliation(s)
- Kate Hsu
- The Laboratory of Immunogenetics, Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
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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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Ríos-González BE, Saldaña-Cruz AM, Gallardo-Moya SG, Brambila-Tapia AJL. Sex Differences in the Relationship between Personal, Psychological and Biochemical Factors with Blood Pressure in a Healthy Adult Mexican Population: A Cross-Sectional Study. J Clin Med 2024; 13:378. [PMID: 38256512 PMCID: PMC10816435 DOI: 10.3390/jcm13020378] [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: 11/22/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
Hypertension is one of the main risk factors related to cardiovascular mortality, being the levels of blood pressure (BP) related to a variety of personal, anthropometric, biochemical and psychological variables; however, the study evaluating the association of all these factors in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a sample of relatively healthy subjects has not been performed. The aim of the study was to determine the main variables associated with SBP and DPB in a sample of relatively healthy subjects. A total of 171 participants were included, in which personal, anthropometric, positive and negative psychological variables and biochemical variables were measured. We observed that men showed higher levels of SBP and DBP than women, with more differences for SBP. Among the biochemical factors and SBP, we found that albumin and monocytes were positively correlated with it, while potassium, phosphorus and eosinophils were negatively correlated with it. Additionally, schooling was a constant variable negatively correlated with SBP in all samples (global, men and women). Among psychological variables, we observed that emotional perception was negatively correlated with SBP in men's and women's samples, while autonomy was positively correlated with SBP in the men's sample; however, their association was less when compared with the personal and biochemical variables included in the multivariate model. With regard to DBP, we observed that the biochemical variables, hemoglobin, sodium, uric acid and glucose, were positively correlated with DBP in the global sample, while chloride and BUN were negatively correlated with it. In addition, many personal and behavioral variables, including BMI, age and smoking consumption frequency, also correlated with DBP in the global sample. In conclusion, BP is affected by different factors, and these affect each sex differently.
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Affiliation(s)
- Blanca Estela Ríos-González
- Unidad Médico Familiar #92, Instituto Mexicano del Seguro Social (IMSS), Guadalajara 44340, Mexico;
- Especialidad en Medicina Familiar, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Ana Míriam Saldaña-Cruz
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Sergio Gabriel Gallardo-Moya
- Programa de Doctorado en Farmacología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara 44340, Mexico;
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Liu X, Yang C, Zhang X, Ye R, Li X, Zhang Z, Jia S, Sun L, Meng Q, Chen X. Association between hemoglobin concentration and hypertension risk in native Tibetans at high altitude. J Clin Hypertens (Greenwich) 2024; 26:17-23. [PMID: 37724706 PMCID: PMC10795086 DOI: 10.1111/jch.14726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Previous studies examining the association between hemoglobin concentration and hypertension have yielded inconsistent results. There is still a lack of evidence regarding the association between hemoglobin concentration and hypertension risk in native Tibetans at high altitude. We performed this cross-sectional study in Luhuo County of Ganzi Tibetan Autonomous Prefecture (average altitude of 3500 m). In this study, we enrolled 1547 native Tibetans. The association between hemoglobin concentration and hypertension risk was examined by multivariate binary logistic regression and smooth curve fitting. Native Tibetans with hypertension had significantly higher hemoglobin concentrations than those without hypertension (165.9 ± 21.5 g/L vs. 157.7 ± 19.2 g/L, P < 0.001). An increase in hemoglobin concentration of 1 g/L was associated with hypertension (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.02) after confounder adjustment. The highest hemoglobin concentration group (exceeding 173 g/L) was associated with an increased hypertension risk compared with the bottom quartile of hemoglobin concentration (OR 2.39, 95% CI 1.48-3.85). Hemoglobin concentration (per 1 g/L change) exceeding 176 g/L was significantly associated with an increased hypertension risk (OR 1.04, 95% CI 1.03-1.06). Additionally, high-altitude polycythemia significantly increased the hypertension risk compared with a normal hemoglobin concentration (OR 2.92, 95% CI 1.25-6.86). A similar result was observed for mild polycythemia (OR 1.74, 95% CI 1.29-2.34). In conclusion, hemoglobin concentration was associated with hypertension risk in native Tibetans. When the hemoglobin concentration exceeded a certain value (approximately 176 g/L), the risk of hypertension was significantly increased.
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Affiliation(s)
- Xueting Liu
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Changqiang Yang
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xin Zhang
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Runyu Ye
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xinran Li
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Zhipeng Zhang
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Shanshan Jia
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Lirong Sun
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Qingtao Meng
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xiaoping Chen
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
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Huang L, Song C, Liu Q, Liang X, Ren Y, Huang D, Guan X, An X, Liang X. The associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents: a prospective cohort study. Hypertens Res 2023; 46:2085-2099. [PMID: 37188752 DOI: 10.1038/s41440-023-01304-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
Uncontrolled pediatric hypertension may increase the risk of hypertension in adulthood. Several studies have reported an association between hematological parameters and blood pressure (BP) levels. However, epidemiologic evidence of this association in children and adolescents remains scarce. This study aims to explore the associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents. This longitudinal study was conducted with 1368 participants aged 6-8 years from baseline visit to follow-up visit. Compared with participants from the normal blood pressure (BP) group, participants from the elevated BP group had significantly higher baseline red blood cell (RBC) counts, hemoglobin (Hb) counts and hematocrit (Hct) levels (all P < 0.001). A multilevel linear mixed model was conducted to analyze the relationship between hematological parameters and BP levels. The results suggested that SBP, DBP and MAP increased significantly with a quartile increase of levels of hematological parameters (all P < 0.05). Furthermore, a multilevel mixed logistic regression model was used to analyze the risk of per interquartile range increase in hematological parameters on the incidence of prehypertension and hypertension. The risk of prehypertension and hypertension incidence increased by (1.34 (95%CIs: 1.20, 1.50)), (1.38 (95%CIs: 1.24,1.54)), (1.33 (95%CIs: 1.19,1.50)), (1.14 (95%CIs: 1.03,1.26)) fold with a one-quartile increase in levels of RBC, Hb, Hct and Fe, respectively (all P < 0.05). This longitudinal study showed that hematological parameters were positively associated with BP levels in healthy children and adolescents, which excluded the effect of antihypertensive drugs on BP levels that often appeared in adults.
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Affiliation(s)
- Lan Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Cui Song
- Department of Endocrinology and Genetic Metabolism disease, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Qin Liu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xiaoyue Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Daochao Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xianmin Guan
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xizhou An
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China.
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Liu YH, Chen SC, Lee WH, Chen YC, Huang JC, Wu PY, Hung CH, Kuo CH, Su HM. Components of the Complete Blood Count as a Risk Predictor for Incident Hypertension in a Large Taiwanese Population Follow-up Study. Circ J 2023; 87:456-462. [PMID: 36261331 DOI: 10.1253/circj.cj-22-0512] [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: 11/09/2022]
Abstract
BACKGROUND Previous studies investigating the relationship between hypertension (HT) and hematological parameters report inconsistent results, and most them included a small number of participants or only conducted a cross-sectional analysis of 1 or 2 hematological factors. Moreover, no large cohort follow-up studies have investigated this topic. The aim of this longitudinal study was to explore associations between components of the complete blood count (CBC) and incident HT using data from a large Taiwanese biobankMethods and Results: Hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin, hematocrit (HCT), and platelet count were evaluated. We included 21,293 participants who did not have HT at baseline and followed them for a mean period of 3.9 years. During follow-up, 3,002 participants with new-onset HT (defined as incident HT) were identified. Univariable analysis revealed that high WBC count, high RBC count, high hemoglobin, high HCT, and low platelet count were associated with incident HT. Multivariable analysis after adjusting potential confounding factors found high WBC count (odds ratio [OR], 1.057; 95% confidence interval [CI], 1.028 to 1.087; P<0.001) and high HCT (OR, 1.023; 95% CI, 1.010 to 1.036; P<0.001) were still significantly associated with incident HT. CONCLUSIONS High WBC count and high HCT were associated with incident HT.
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Affiliation(s)
- Yi-Hsueh Liu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Szu-Chia Chen
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University.,Research Center for Environmental Medicine, Kaohsiung Medical University.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Wen-Hsien Lee
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Ying-Chih Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
| | - Jiun-Chi Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Chih-Hsing Hung
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University.,Research Center for Environmental Medicine, Kaohsiung Medical University
| | - Chao-Hung Kuo
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital
| | - Ho-Ming Su
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
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He Z, Yang P, Lin Q, Thio CHL, Zhang F, Wang R, Wang Y, Snieder H, Zhang Q. Blood biomarkers for new-onset hypertension in midlife women: a nested case-control study. Menopause 2023; 30:156-164. [PMID: 36696640 DOI: 10.1097/gme.0000000000002100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Midlife in women is associated with an increase in prevalence of hypertension. Little is known on the risk factors of new-onset hypertension among middle-aged women. METHODS In this nested case-control study, 1,430 women aged 40 to 60 years with repeated physical examinations between 2009 and 2019 were recruited. Data included age, body mass index, blood pressure (BP), and a series of blood biomarkers. Participants with hypertension were divided into two case-control samples: 388 cases with episodic new-onset hypertension (ie, one normal BP at the first visit and one abnormal BP during follow-up) each with two age-matched controls (n = 776) and 151 cases with regular new-onset hypertension (ie, normal BP at the first two visits and abnormal BP at two or more follow-up visits) each with three age-matched controls (n = 453). Multivariable-adjusted logistic regression was used to analyze the data. RESULTS Our data showed very consistent results for episodic and regular new-onset hypertension, respectively, and verified known associations (odds ratio [95% confidence interval], per SD increase) with obesity (body mass index, 1.72 [1.49-1.98] and 1.81 [1.45-2.26]), inflammation (white blood cell count, 1.39 [1.23-1.58] and 1.38 [1.13-1.69]), and metabolic dysregulation (triglycerides, 1.25 [1.09-1.44] and 1.31 [1.08-1.58]; glucose, 1.46 [1.23-1.73] and 1.27 [1.05-1.54]) but, more surprisingly, also revealed positive associations with red blood cell count (1.27 [1.11-1.44] and 1.38 [1.14-1.68]), hemoglobin (1.18 [1.03-1.35] and 1.31 [1.05-1.64]), and platelet count (1.39 [1.20-1.61] and 1.33 [1.09-1.63]). CONCLUSIONS In addition to obesity and metabolic dysregulation, increased hemoglobin and counts of platelets, and red and white blood cells are associated with hypertension in this period. Future study may verify whether these associations are causal in nature and whether these variables are useful in risk stratification.
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Affiliation(s)
| | - Peixuan Yang
- Department of Physical Examination, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Qiuqiang Lin
- Department of Internal Medicine, Chenghai People's Hospital, Shantou, China
| | - Chris H L Thio
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Ruifeng Wang
- Department of Physical Examination, Chenghai People's Hospital, Shantou, China
| | - Yue Wang
- From the Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Qingying Zhang
- From the Department of Public Health and Preventive Medicine, Shantou University Medical College, Shantou, China
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Positive Association between Hemoglobin Concentration and Blood Pressure in Adults: A Cross-Sectional Study Based on Rafsanjan Cohort Study. Int J Hypertens 2023; 2023:6283711. [PMID: 36777237 PMCID: PMC9908348 DOI: 10.1155/2023/6283711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Identification of factors associated with blood pressure (BP), including hemoglobin, can be used in diagnosing, controlling, and predicting the prognosis of patients. This study aims to investigate the cross-sectional association between hemoglobin concentration and BP in people aged 35-70 years in a cohort study of Rafsanjan, Iran. Method This cross-sectional study was conducted on 9398 urban and rural population of Rafsanjan adult cohort study as a part of the prospective epidemiological research studies in Iran (PERSIAN). Demographic information, medical history, history of smoking and alcohol intake, systolic and diastolic BP, and hemoglobin concentration were collected. A logistic regression test was performed to evaluate the relationship between hemoglobin concentration and BP in 4 unadjusted and adjusted models based on demographic indicators, clinical and laboratory findings using SPSS.24 software and SAS software version 9.2. Results The mean age of the participants was 49.78 ± 9.53 years, and 53.2% (5002 people) were women. Adjusted models 3 and 4 showed a positive association between BP and hemoglobin. For each unit increase in hemoglobin, the odds ratio (OR) of BP in the adjusted model 3 was 1.062 (95% CI: 1.005-1.121), and in the adjusted model 4, it was 1.090 (95% CI: 1.031-1.153). Conclusion Based on the results, the positive trend of BP and hemoglobin levels may indicate the need to pay more attention to these people as higher-risk groups for hypertension.
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Chen N, Xing C, Niu J, Liu B, Fu J, Zhao J, Ni Z, Wang M, Liu W, Zhao J, Zhong L, Wu X, Li W, Chen Y, Shi W, Chen J, Yin A, Fu P, Wang R, Jiang G, Hou F, Ding G, Chen J, Xu G, Kondo Y, Su Y, Mei C. Darbepoetin alfa injection versus epoetin alfa injection for treating anemia of Chinese hemodialysis patients with chronic kidney failure: A randomized, open-label, parallel-group, non-inferiority Phase III trail. Chronic Dis Transl Med 2022; 8:59-70. [PMID: 35620165 PMCID: PMC9128564 DOI: 10.1002/cdt3.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023] Open
Abstract
Background Erythropoietin is a glycoprotein that mainly regulates erythropoiesis. In patients with chronic renal failure with anemia, darbepoetin alfa can stimulate erythropoiesis, correct anemia, and maintain hemoglobin levels. This study was designed to demonstrate the efficacy and safety of darbepoetin alfa injections as being not inferior to epoetin alfa injections (Recombinant Human Erythropoietin injection, rHuEPO) when maintaining hemoglobin (Hb) levels within the target range (10.0-12.0 g/dL) for the treatment of renal anemia. Methods Ninety-five patients were enrolled in this study from April 15, 2013 to April 10, 2014 at 25 sites. In this study, patients (n = 95) aged 18-70 years were randomized into a once per week intravenous darbepoetin alfa group (n = 56) and a twice or three times per week intravenous epoetin alfa group (n = 39) for 28 weeks, who had anemia with hemoglobin levels between 6 g/dL and 10 g/dL due to chronic kidney disease (CKD) and were undergoing hemodialysis or hemofiltration with ESA-naive (erythropoiesis stimulating agent-naive). The primary efficacy profile was the mean Hb level (the non-inferiority margin was -1.0 g/dL, week 21-28); the secondary efficacy profiles were the Hb increase rate (week 0-4), the target Hb achievement cumulative rate and time, the change trends of the Hb levels, and the target Hb maintenance ratio. Adverse events (AEs) were observed and compared, and the efficacy and safety were analyzed between the two treatment groups. Additionally, the frequencies of dose adjustments between the darbepoetin alfa and epoetin alfa groups were compared during the treatment period. SAS® software version 9.2 was used to perform all statistical analyses. Descriptive statistics were used for all efficacy, safety, and demographic variable analyses, including for the primary efficacy indicators. Results The mean Hb level was 11.3 g/dL in the darbepoetin alfa group and 10.7 g/dL in the epoetin alfa group, respectively; the difference of the lower limits of the 95% confidence intervals (CI) between the two groups was 0.1 g/dL (>-1.0 g/dL), and non-inferiority was proven; the Hb levels started to increase in the first four weeks at a similar increase rate; no obvious differences were observed between the groups in the target Hb achievement cumulative rates, and the Hb levels as well as the target Hb level maintenance rate changed over time. The incidence of AEs was 62.5% in the darbepoetin alfa group and 76.9% in the epoetin alfa group. All the adverse events observed in the study were those commonly associated with hemodialysis. Conclusion Darbepoetin alfa intravenously once per week can effectively increase Hb levels and maintain the target Hb levels well, which makes it not inferior to epoetin alfa intravenously twice or three times per week. Darbepoetin alfa shows an efficacy and safety comparable to epoetin alfa for the treatment of renal anemia.
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Affiliation(s)
- Nan Chen
- Department of NephrologyRuijin Hospital Shanghai Jiaotong University School of MedicineShanghai200025China
| | - Changying Xing
- Department of NephrologyJiangsu Provincial HospitalNanjingJiangsu210036China
| | - Jianying Niu
- Department of Nephrology, Shanghai Fifth People's HospitalFudan UniversityShanghai200240China
| | - Bicheng Liu
- Department of NephrologyZhongda Hospital Southeast UniversityNanjingJiangsu210009China
| | - Junzhou Fu
- Department of NephrologyGuangzhou First People's HospitalGuangzhouGuangdong510180China
| | - Jiuyang Zhao
- Department of NephrologyThe Second Hospital of Dalian Medical UniversityDalianLiaoning116027China
| | - Zhaohui Ni
- Department of NephrologyRenji Hospital Shanghai Jiaotong University School of MedicineShanghai200001China
| | - Mei Wang
- Department of NephrologyPeking University People's HospitalBeijing100044China
| | - Wenhu Liu
- Department of Nephrology, Beijing Friendship HospitalCapital Medical UniversityBeijing100050China
| | - Jinghong Zhao
- Department of NephrologyXinqiao Hospital of Army Medical UniversityChongqing400037China
| | - Ling Zhong
- Department of NephrologyThe Second Affiliated Hospital of Chongqing Medical UniversityChongqing400010China
| | - Xiongfei Wu
- Department of NephrologySouthwest Hospital of Army Medical UniversityChongqing400039China
| | - Wenge Li
- Department of NephrologyChina‐Japan Friendship HospitalBeijing100029China
| | - Yuqing Chen
- Department of NephrologyPeking University First HospitalBeijing100034China
| | - Wei Shi
- Department of NephrologyGuangdong Provincial People's HospitalGuangzhouGuangdong510080China
| | - Jianghua Chen
- Department of NephrologyThe First Affiliated Hospital, Zhejiang University School of MedicineHangzhouZhejiang310003China
| | - Aiping Yin
- Department of NephrologyFirst Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxi710061China
| | - Ping Fu
- Department of Nephrology, West China HospitalSichuan UniversityChengduSichuan610041China
| | - Rong Wang
- Department of NephrologyShandong Provincial HospitalJinanShandong250021China
| | - Gengru Jiang
- Department of NephrologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai200092China
| | - Fanfan Hou
- Department of NephrologyNanfang Hospital Southern Medical UniversityGuangzhouGuangdong510510China
| | - Guohua Ding
- Department of NephrologyRenmin Hospital of Wuhan UniversityWuhanHubei430060China
| | - Jing Chen
- Department of Nephrology, Huashan HospitalFudan UniversityShanghai200040China
| | - Gang Xu
- Department of NephrologyTongji Hospital Tongji Medical College Huazhong University of Science and TechnologyWuhanHubei430030China
| | - Yuichiro Kondo
- R&D Planning DepartmentR&D Division, Kyowa Kirin Co., LtdTokyo520‐5292Japan
| | - Yuliang Su
- D&R office, Kyowa Kirin China Pharmaceutical Co., LtdShanghai201203China
| | - Changlin Mei
- Department of NephrologyShanghai Changzheng HospitalShanghai200003China
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10
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Hemoglobin and hematocrit levels are positively associated with blood pressure in children and adolescents 10 to 18 years old. Sci Rep 2021; 11:19052. [PMID: 34561491 PMCID: PMC8463603 DOI: 10.1038/s41598-021-98472-0] [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: 01/25/2021] [Accepted: 09/08/2021] [Indexed: 02/08/2023] Open
Abstract
To investigate the associations between hemoglobin (Hb) concentration and hematocrit (Hct), and blood pressure (BP) in children and adolescents. The study population consisted of 7950 subjects total (4229 boys and 3721 girls) aged 10-18 years who participated in the Korea National Health and Nutrition Examination Surveys conducted between 2007 and 2017. The prevalence of hypertension was 19.19% (21.51% for boys and 16.5% for girls) among the study population, and the prevalence of obesity was 9.59% (10.5% for boys and 8.6% for girls). Hb count and Hct tended to increase with the degree of obesity and BP elevation. Systolic BP (SBP) and diastolic BP (DBP) positively correlated with Hb count and Hct in both sexes. Following multiple linear regression analysis, Hb count and Hct presented a positive association with SBP and DBP after adjusting for age, BMI SDS, alcohol consumption, smoking status, physical activity, rural residence, household income, diagnosis of T2DM, hypertension, and dyslipidemia. Hb count and Hct were positively associated with SBP and DBP in children and adolescents 10-18 years old.
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11
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The Impact of Beta Blockers on Survival in Heart Transplant Recipients: Insights from the Zabrze HTx Registry. Cardiol Res Pract 2020; 2020:5190248. [PMID: 32774914 PMCID: PMC7396039 DOI: 10.1155/2020/5190248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction The data assessing the impact of beta blocker (BB) medication on survival in patients after heart transplantation (HTx) are scarce and unequivocal; therefore, we investigated this population. Methods We retrospectively analyzed the HTx Zabrze Registry of 380 consecutive patients who survived the 30-day postoperative period. Results The percentage of patients from the entire cohort taking BBs was as follows: atenolol 24 (17%), bisoprolol 67 (49%), carvedilol 11 (8%), metoprolol 28 (20%), and nebivolol 8 (6%). The patients receiving BBs were older (56.94 ± 14.68 years vs. 52.70 ± 15.35 years, p=0.008) and experienced an onset of HTx earlier in years (11.65 ± 7.04 vs. 7.24 ± 5.78 p ≤ 0.001). They also had higher hematocrit (0.40 ± 0.05 vs. 0.39 ± 0.05, p=0.022) and red blood cells (4.63 (106/μl) ± 0.71 vs. 4.45 (106/μl) ± 0.68, p=0.015). Survival according to BB medication did not differ among the groups (p=0.655) (log-rank test). Univariate Cox proportional hazard regression analysis revealed that the following parameters were associated with unfavorable diagnosis: serum concentration of albumin (g/l) HR: 0.87, 95% CI (0.81–0.94), p=0.0004; fibrinogen (mg/dl) HR: 1.006, 95% CI (1.002–1.008), p=0.0017; and C-reactive protein (mg/l) HR: 1.014, 95% CI (1.004–1.023), p=0.0044. Conclusions The use of BBs in our cohort of patients after HTx was not associated with survival benefits.
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12
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Hong K, Yu ES, Chun BC. Risk factors of the progression to hypertension and characteristics of natural history during progression: A national cohort study. PLoS One 2020; 15:e0230538. [PMID: 32182265 PMCID: PMC7077816 DOI: 10.1371/journal.pone.0230538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/02/2020] [Indexed: 11/26/2022] Open
Abstract
Background Although the high disease burden that results from cardiovascular complications of hypertension, factors related to the progression to hypertension in the normotensive population are not actively reported. The purpose of this study was to estimate the rate of the progression to hypertension and to reveal the associated risk factors. Methods The study included normotensive participants from the National Health Insurance Service-National Health Screening Cohort, and contained a 10% sample of all adults who received a national health screening test in either 2002 or 2003. At the end of the study in 2015, the patients were divided into two groups based on whether or not they progressed to hypertension. Cox proportional hazard modeling was performed to identify risk factors for progression. Subgroup analysis using logistic regression was employed to reveal factors influencing the different natural history of the progression. Results Among the 75,335 included participants, the progression rate to hypertension was 66.39% (50,013), with an adjusted incidence rate of 8.62 per 100 person-year in the aged 40–64 group and 12.68 in the aged 65 or above group. Age, BMI, hemoglobin, and family history of hypertension and other diseases were related to the progression. Among the progression group, 78.21% (39,116) participants skipped a pre-hypertensive status; this group consisted of older females with lower pulse pressure and more alcohol consumption compared to people who had pre-hypertensive status before the progression. Conclusion Substantial risk factors for the progression to hypertension should be carefully managed even in normotensive participants who receive health screening tests.
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Affiliation(s)
- Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Korea University, Seoul, Korea
| | - Eun Sun Yu
- Graduate School of Public Health, Korea University, Seoul, Korea
- National Health Insurance Service, Wonju-si, Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Graduate School of Public Health, Korea University, Seoul, Korea
- * E-mail:
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13
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Zhu Y, Chen G, Bo Y, Liu Y. Markers of iron status, blood pressure and incident hypertension among Chinese adults. Nutr Metab Cardiovasc Dis 2019; 29:830-836. [PMID: 31255378 DOI: 10.1016/j.numecd.2019.04.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS The evidence on the relationship between markers of iron, blood pressure and hypertension are limited and inconsistent. This prospective cohort study aimed to investigate the relationship of serum ferritin (SF), transferrin, soluble transferrin receptor (sTFR) and haemoglobin on blood pressure and incident hypertension in the China Health and Nutrition Survey (CHNS) study. METHODS AND RESULTS We studied 8337 adults aged 18 years old or above from CHNS in 2009 to investigate the association of markers of iron and blood pressure (BP). Among them, 4509 non-hypertensive participants who completed follow up were included to investigate the association of markers of iron and hypertension development. Linear regression model was used to assess the association between markers of iron and BP. Cox regression model was used to examine the association of markers of iron and hypertension development. SF and serum sTFR concentration had a non-significant effect on incident hypertension. Transferrin and haemoglobin concentrations were positively associated with incident hypertension. Compared to the participants with the lowest tertile of transferrin, those with the highest tertile had a higher risk of developing hypertension [HR: 1.26, 95% CI (1.04, 1.53), P = 0.017]. Similarly, participants with the highest tertile of haemoglobin had a significantly higher risk of incident hypertension [HR: 1.27, 95% CI (1.01, 1.59), P = 0.038]. CONCLUSION The current study found that haemoglobin and transferrin levels were positively associated with blood pressure and incident hypertension. Further research in different ethnic groups is required to confirm the association of the full range of markers of iron with BP and incident hypertension.
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Affiliation(s)
- Yongjian Zhu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, China
| | - Gaiyun Chen
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, China
| | - Yacong Bo
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, China.
| | - Yanhua Liu
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, China.
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14
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Martin-Lorenzo M, Martinez PJ, Baldan-Martin M, Lopez JA, Minguez P, Santiago-Hernandez A, Vazquez J, Segura J, Ruiz-Hurtado G, Vivanco F, Barderas MG, Ruilope LM, Alvarez-Llamas G. Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension. Hypertension 2019; 73:794-802. [PMID: 30712426 DOI: 10.1161/hypertensionaha.118.12242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Resistant hypertension prevalence is progressively increasing, and prolonged exposure to suboptimal blood pressure control results in higher cardiovascular risk and end-organ damage. Among various antihypertensive agents, spironolactone seems the most effective choice to treat resistant hypertension once triple therapy including a diuretic fails. However success in blood pressure control is not guaranteed, adverse effects are not negligible, and no clinical tools are available to predict patient's response. Complementary to our previous study of resistant hypertension metabolism, here we investigated urinary proteome changes with potential capacity to predict response to spironolactone. Twenty-nine resistant hypertensives were included. A prospective study was conducted and basal urine was collected before spironolactone administration. Patients were classified in responders or nonresponders in terms of blood pressure control. Protein quantitation was performed by liquid chromatography-mass spectrometry; ELISA and target mass spectrometry analysis were performed for confirmation. Among 3310 identified proteins, HP (haptoglobin) and HPR (haptoglobin-related protein) showed the most significant variations, with increased levels in nonresponders compared with responders before drug administration (variation rate, 5.98 and 7.83, respectively). Protein-coordinated responses were also evaluated by functional enrichment analysis, finding oxidative stress, chronic inflammatory response, blood coagulation, complement activation, and regulation of focal adhesions as physiopathological mechanisms in resistant hypertension. In conclusion, protein changes able to predict patients' response to spironolactone in basal urine were here identified for the first time. These data, once further confirmed, will support clinical decisions on patients' management while contributing to optimize the rate of control of resistant hypertensives with spironolactone.
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Affiliation(s)
- Marta Martin-Lorenzo
- From the Laboratory of Immunoallergy and Proteomics, Department of Immunology (M.M.-L., P.J.M., A.S.-H., G.A.-L.), IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
| | - Paula J Martinez
- From the Laboratory of Immunoallergy and Proteomics, Department of Immunology (M.M.-L., P.J.M., A.S.-H., G.A.-L.), IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
| | - Montserrat Baldan-Martin
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos SESCAM, Toledo, Spain (M.B.-M., M.G.B.)
| | - Juan A Lopez
- Laboratory of Cardiovascular Proteomics CNIC, Madrid, Spain (J.A.L., J.V.)
| | - Pablo Minguez
- Department of Genetics (P.M.), IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
| | - Aranzazu Santiago-Hernandez
- From the Laboratory of Immunoallergy and Proteomics, Department of Immunology (M.M.-L., P.J.M., A.S.-H., G.A.-L.), IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain
| | - Jesus Vazquez
- Laboratory of Cardiovascular Proteomics CNIC, Madrid, Spain (J.A.L., J.V.)
| | - Julian Segura
- Department of Nephrology, Hypertension Unit, Hospital Universitario 12 de Octubre, Madrid, Spain (J.S., L.M.R.)
| | - Gema Ruiz-Hurtado
- Cardiorenal Translational Laboratory, Instituto de Investigación I+12 Hospital Universitario 12 de Octubre/CIBER-CV, Madrid, Spain (G.R.-H., L.M.R.)
| | - Fernando Vivanco
- Department of Biochemistry and Molecular Biology, I Universidad Complutense, Madrid, Spain (F.V.)
| | - Maria G Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos SESCAM, Toledo, Spain (M.B.-M., M.G.B.)
| | - Luis M Ruilope
- Department of Nephrology, Hypertension Unit, Hospital Universitario 12 de Octubre, Madrid, Spain (J.S., L.M.R.).,Cardiorenal Translational Laboratory, Instituto de Investigación I+12 Hospital Universitario 12 de Octubre/CIBER-CV, Madrid, Spain (G.R.-H., L.M.R.).,School of Doctoral Studies and Research, Universidad Europea de Madrid, Spain (L.M.R.)
| | - Gloria Alvarez-Llamas
- From the Laboratory of Immunoallergy and Proteomics, Department of Immunology (M.M.-L., P.J.M., A.S.-H., G.A.-L.), IIS-Fundación Jiménez Díaz-UAM, Madrid, Spain.,REDINREN, Madrid, Spain (G.A.-L.)
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15
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Guo D, Zhu Z, Zhong C, Peng H, Xu T, Wang A, Peng Y, Xu T, Chen CS, Li Y, Ju Z, Chen J, Zhang Y, He J. Hemoglobin level and three-month clinical outcomes among ischemic stroke patients with elevated systolic blood pressure. J Neurol Sci 2018; 396:256-261. [PMID: 30530284 DOI: 10.1016/j.jns.2018.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/19/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Previous studies have reported that extreme low and high hemoglobin levels are positively associated with the risk of ischemic stroke. However, there are few reports on the relationship between hemoglobin at acute phase and clinical outcomes after ischemic stroke and the results of their association to date are inconsistent. We aimed to investigate the association between them in a large prospective cohort of ischemic stroke patients. METHODS Baseline hemoglobin levels were measured in 3881 patients with acute ischemic stroke. The primary outcome was defined as composite outcome of major disability and death (modified Rankin Scale score ≥ 3) at 3 months after stroke onset. Secondary outcomes were separately those of major disability and death. RESULTS Compared with the lowest quartile of hemoglobin, the multivariate adjusted odds ratios (95% confidence intervals) associated with the highest quartile were 1.38 (1.03-1.86), 1.49 (1.11-1.99), 0.79 (0.41-1.52) for primary outcome, major disability and death, respectively. Multiple-adjusted spline regression model showed linear associations of hemoglobin levels with primary outcome (P for linearity =0.037) and major disability (P for linearity =0.004). Subgroup analyses further confirmed the positive association between high hemoglobin and poor prognosis of ischemic stroke. CONCLUSIONS Elevated hemoglobin levels in the acute phase were associated with poor prognosis at 3 months after ischemic stroke. Further prospective studies from other samples of ischemic stroke patients are needed to validate our findings.
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Affiliation(s)
- Daoxia Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Tian Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of Hebei United University, Hebei, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Chung-Shiuan Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Yongqiu Li
- Department of Neurology, Tangshan Worker's Hospital, Hebei, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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16
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Blood Pressure and Haematological Indices in Twelve Communities in Ashanti, Ghana. Int J Hypertens 2018; 2018:5952021. [PMID: 29850225 PMCID: PMC5907475 DOI: 10.1155/2018/5952021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/21/2018] [Accepted: 03/05/2018] [Indexed: 11/17/2022] Open
Abstract
Hypertension is the most important risk factor for cardiovascular mortality and morbidity in Sub-Saharan Africa. In western populations, high haemoglobin levels are associated with raised BP unlike in Sub-Saharan Africa where there is a paucity of data. Our study examines the association between haematological indices with BP variables. Weight, height, BP, and whole blood indices of viscosity (Hb, haematocrit, RBC count, and MCV) were measured in 921 adults (340 men, 581 women; aged 40-75) in 12 communities in Ghana. Mean values for Hb (12.3 g/dl ± 1.7 SD), haematocrit (36.7% ± 5.2), RBC (4.10 million/μL ± 0.64), and MCV were lower than reference values used in Sub-Saharan Africa. Mean BMI was 21.1 ± 4.1 indicating a lean population. Systolic BP increased by 1.0 mmHg (95% CI 0.5-1.5), p < 0.001, for women and 0.5 (0.1-1.0), p = 0.027, for men per unit increase in haematocrit. Similar relationships were found for Hb and RBC but not for MCV or platelets. The relationships were weaker when adjusted for BMI, 0.7 mmHg (0.2-1.2) in women and 0.5 (0.0-1.0) in men. Findings for diastolic BP were similar. Overall haematological indices were low. We have found a significant, positive relationship between BP, Hb, Haematocrit, and RBC count in our population.
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17
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Emamian M, Hasanian SM, Tayefi M, Bijari M, Movahedian Far F, Shafiee M, Avan A, Heidari-Bakavoli A, Moohebati M, Ebrahimi M, Darroudi S, Zamani P, Azarpazhooh MR, Nematy M, Safarian M, Ferns GA, Esmaeili H, Parizadeh MR, Ghayour-Mobarhan M. Association of hematocrit with blood pressure and hypertension. J Clin Lab Anal 2017; 31. [PMID: 28105697 DOI: 10.1002/jcla.22124] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 12/01/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. OBJECTIVE The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. MATERIALS AND METHODS A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects. Univariate and multivariate logistic regression analysis were performed to determine the association of biochemical and hematological parameters with HTN. RESULTS Several biochemical parameters including fasting plasma glucose (FBG), serum high-sensitivity C-reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and uric acid were increased in hypertensive participants. In contrast, serum high-density lipoprotein cholesterol (HDL-C) was lower in hypertensive individuals. Furthermore, we demonstrated that hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) were higher in the hypertensive group compared to the control group. But mean corpuscular volume (MCV), and red cell distribution width (RDW), were decreased in the hypertensive group. Furthermore, our results strongly suggested that among these parameters, hematocrit was the independent risk factor for hypertension in the population. CONCLUSION We demonstrated the association of altered biochemical and hematological factors with hypertension supporting the value of emerging markers for early prediction of high blood pressure in prone individuals.
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Affiliation(s)
- Marzieh Emamian
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hasanian
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Microanatomy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moniba Bijari
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Faeze Movahedian Far
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Shafiee
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari-Bakavoli
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ebrahimi
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sousan Darroudi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Zamani
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safarian
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - Habibollah Esmaeili
- Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Parizadeh
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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18
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Kim NH, Lee JM, Kim HC, Lee JY, Yeom H, Lee JH, Suh I. Cross-sectional and longitudinal association between hemoglobin concentration and hypertension: A population-based cohort study. Medicine (Baltimore) 2016; 95:e5041. [PMID: 27741113 PMCID: PMC5072940 DOI: 10.1097/md.0000000000005041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
We investigated the cross-sectional and longitudinal associations between hemoglobin concentration and hypertension in a Korean population.Between 2006 and 2013, we examined 4899 participants with mean age of 56.6 years (range 35-88 years) from a rural community. We excluded 298 participants with a history of myocardial infarction or stroke and 264 participants with very low hemoglobin levels (men: <13.3 g/dL; women: <11.6 g/dL). Finally, we performed a cross-sectional analysis on 1629 men and 2708 women. Longitudinal associations were evaluated in 654 men and 1099 women, after excluding 2584 people with hypertension at baseline and those who did not participate in follow-up examinations. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive treatment.The mean hemoglobin level was significantly higher in people with hypertension than in those without hypertension (P = 0.002 for men, P = 0.006 for women). On cross-sectional analysis, the odds ratio (95% confidence interval) for hypertension per 1 standard deviation increase in hemoglobin concentration (1.2 g/dL) was 1.11 (1.05-1.18) before adjustment and 1.20 (1.09-1.32) after adjusting for age, sex, body mass index, kidney markers, lifestyle factors, and comorbidities. On longitudinal analysis, the relative risk (95% confidence interval) for incident hypertension per 1 standard deviation increase in hemoglobin concentration was 1.09 (0.96-1.23) before adjustment and 0.91 (0.78-1.08) after adjusting for age, sex, body mass index, lifestyle factors, baseline blood pressure, baseline comorbidities, and baseline kidney markers.This study suggests that hemoglobin per se does not cause hypertension development.
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Affiliation(s)
- Na Hyun Kim
- Department of Public Health, Yonsei University Graduate School
| | | | - Hyeon Chang Kim
- Department of Preventive Medicine
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea
- Correspondence: Hyeon Chang Kim, Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea (e-mail: )
| | | | | | - Jung Hyun Lee
- Department of Public Health, Yonsei University Graduate School
| | - Il Suh
- Department of Preventive Medicine
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