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Zhang T, Yang S, Liu W, Bai Q, Gao S. Tai Chi training as a primary care plan for the prevention and management of hypertension: an opinion and positioning article. Ann Med 2024; 56:2320863. [PMID: 38373214 PMCID: PMC10878327 DOI: 10.1080/07853890.2024.2320863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Abstract
Hypertension is a prevalent chronic condition worldwide that can impact patients' quality of life. Oral antihypertensive drugs are widely used to manage high blood pressure, primarily by regulating the renin-angiotensin-aldosterone system. Nevertheless, limited efficacy and low compliance represent significant obstacles, arising primarily from dose, duration, and medication type restrictions. Furthermore, the prolonged use of antihypertensive medication may result in dependence and adverse effects, without any substantial improvement in achieving targeted blood pressure leves. As a result, research has focused on using exercise therapy to treat hypertension. Tai Chi, a widely-practiced Chinese health exercise, has evolved into a form of exercise therapy that might help alleviate the risk associated with hypertension. Therefore, this article aims to outline the role of Tai Chi in preventing and managing hypertension.
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Affiliation(s)
- Ting Zhang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
- University Hospital, Zhejiang Normal University, Jinhua, China
| | - Shuman Yang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Wei Liu
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Qingping Bai
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Song Gao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Gibson R, Aljuraiban GS, Oude Griep LM, Vu TH, Steffen LM, Appel LJ, Rodriguez BL, Daviglus ML, Elliott P, Van Horn L, Chan Q. Relationship of calcium and magnesium intakes with the dietary approaches to stop hypertension score and blood pressure: the International Study of Macro/micronutrients and Blood Pressure. J Hypertens 2024; 42:789-800. [PMID: 38164982 PMCID: PMC10990009 DOI: 10.1097/hjh.0000000000003648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Research investigating calcium and magnesium intakes from the Dietary Approaches to Stop Hypertension (DASH) pattern and other sources in association with blood pressure is limited. We aimed to characterize sources/intake levels of calcium and magnesium in relation to overall diet quality (DASH-score) and determine modification effects with DASH score and blood pressure. METHODS Cross-sectional United States data (average dietary and supplement intake from four 24 h recalls and eight blood pressure measurements) from two separate visits, 2195 men and women (40-59 years) in the International Study of Macro/Micronutrients and Blood Pressure were analysed. Food-based adherence to the DASH diet was estimated. Linear models tested associations between each 1-point DASH score with blood pressure. Participants were stratified by adherence to sex-specific recommended allowance for magnesium and calcium intakes. Effect-modification was tested across DASH-score quintiles and median of urinary sodium. RESULTS DASH-score was inversely associated with SBP in fully adjusted models (-0.27; 95%CI: -0.38 to -0.15 mmHg). SBP was inversely associated with dietary calcium intake from DASH food groups: -1.54 (95% CI: -2.65 to -0.43) mmHg; calcium intake from other non-DASH food groups: -1.62 (95% CI: -2.94 to -0.29) mmHg. Dietary magnesium intake from DASH food groups (-1.59; 95% CI: -2.79, -0.40 mmHg) and from other non-DASH foods (-1.92; 95% CI: -3.31, -0.53 mmHg) was inversely associated with SBP. CONCLUSION A higher DASH score showed a consistent association with lower BP suggesting a relationship between intakes of calcium and Mg with BP regardless of whether the source is part of the DASH diet or not, even when adjusted for supplement intakes.The INTERMAP is registered as NCT00005271 at www.clinicaltrials.gov .
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Affiliation(s)
- Rachel Gibson
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
- Department of Nutritional Sciences, King's College London, United Kingdom
| | - Ghadeer S. Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Linda M. Oude Griep
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
- NIHR Biomedical Research Centre, Diet, Anthropometry, and Physical Activity (DAPA), MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Thanh-Huyen Vu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Lawrence J. Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Beatriz L. Rodriguez
- Department of Geriatric Medicine, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London
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Pérez-Gimeno G, Seral-Cortes M, Sabroso-Lasa S, Esteban LM, Widhalm K, Gottrand F, Stehle P, Meirhaeghe A, Muntaner M, Kafatos A, Gutierrez A, Manios Y, Anastasiou CA, Gonzalez-Gross M, Breidenassel C, Censi L, de Henauw S, Labayen I, Bueno-Lozano G, Rupérez AI, Moreno LA. Interplay of the Mediterranean diet and genetic hypertension risk on blood pressure in European adolescents: Findings from the HELENA study. Eur J Pediatr 2024; 183:2101-2110. [PMID: 38349423 PMCID: PMC11035432 DOI: 10.1007/s00431-024-05435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 04/23/2024]
Abstract
Early-life onset of high blood pressure is associated with the development of cardiovascular diseases in adulthood. In adolescents, limited evidence exists regarding the association between adherence to the Mediterranean Diet (MedDiet) and normal blood pressure (BP) levels, as well as its potential to modulate genetic predisposition to HTN. This study investigated the interaction between a MedDiet score and a recently developed HTN-genetic risk score (HTN-GRS) on blood pressure levels in a European adolescent cohort. The MedDiet score was derived from two non-consecutive 24-h dietary recalls and ranged from 0 (indicating low adherence) to 9 (indicating high adherence). Multiple linear regression models, adjusted for covariates, were employed to examine the relationship between the MedDiet score and BP z-scores and to assess the interaction effects between the MedDiet score and HTN-GRS on BP z-scores. MedDiet score showed a negative association with z-systolic BP (SBP) (ß = -0.40, p < 0.001) and z-diastolic BP (DBP) (ß = -0.29, p = 0.001). Additionally, a significant interaction effect was identified between the MedDiet score and HTN-GRS on z-SBP (ß = 0.02, p < 0.001) and z-DBP (ß = 0.02, p < 0.001). The modulatory effect of the MedDiet was more pronounced in females than in males, and HTN-GRS exhibited a stronger influence on DBP than on SBP. Conclusion: The study suggests that higher adherence to the MedDiet is associated with reduced BP levels in adolescents and provides evidence of a genetic-diet interaction influencing BP in adolescents. What is Known: • Adherence to the Mediterranean diet may reduce BP levels. What is New: • It is the first study to assess the connection between adherence to a Mediterranean diet, a hypertension genetic risk score, and how they interact in influencing blood pressure. • It is conducted within a multicenter cohort of European adolescents.
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Affiliation(s)
- Gloria Pérez-Gimeno
- Growth, Exercise, NUtrition and Development (GENUD), Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón) Universidad de Zaragoza, Zaragoza, Spain
| | - Miguel Seral-Cortes
- Growth, Exercise, NUtrition and Development (GENUD), Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón) Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Sabroso-Lasa
- Genetic and Molecular Epidemiology Group (GMEG), Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | | | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, 1090, Vienna, Austria
| | - Frederic Gottrand
- Univ. Lille, Inserm, CHU Lille, - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Aline Meirhaeghe
- Risk Factors and Molecular Determinants of Aging-Related Diseases (RID-AGE), Centre Hosp. Univ Lille, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Manon Muntaner
- Risk Factors and Molecular Determinants of Aging-Related Diseases (RID-AGE), Centre Hosp. Univ Lille, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Anthony Kafatos
- University of Crete School of Medicine, Heraklion, Crete, Greece
| | | | - Yannis Manios
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Costas A Anastasiou
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Marcela Gonzalez-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Christina Breidenassel
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Granada, Italy
| | - Laura Censi
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Granada, Italy
| | - Stefaan de Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Idoia Labayen
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Health Sciences, Institute for Sustainability & Food Chain Innovation, Public University of Navarra, Pamplona, Spain
| | - Gloria Bueno-Lozano
- Growth, Exercise, NUtrition and Development (GENUD), Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón) Universidad de Zaragoza, Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Azahara I Rupérez
- Growth, Exercise, NUtrition and Development (GENUD), Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón) Universidad de Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development (GENUD), Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón) Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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Liang Y, Lin Y, Jiao B. Health Interventions May Have Divergent Impacts on Health and Economic Equity: A Case Study of the Community-Based Hypertension Improvement Project in Ghana. Appl Health Econ Health Policy 2024; 22:353-362. [PMID: 38267804 DOI: 10.1007/s40258-024-00871-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Improving health and economic equity are key objectives in priority setting, particularly in low-income and middle-income countries. This study aims to assess the distributional impacts of the Community-based Hypertension Improvement Project (ComHIP) on health and economic outcomes across wealth quintiles in Ghana. METHODS We developed a decision analytical model to simulate a 30 million cohort of Ghanaians aged 15-49 years. The study specified health outcomes as the prevention of stroke cases and averting deaths among those with hypertension. Furthermore, we explored economic impacts, including savings in out-of-pocket costs for stroke patients and government spending. Financial risk protection against catastrophic and impoverishing health expenditures was also examined. We assessed these outcomes across wealth quintiles, and the corresponding concentration indexes (CIXs) were determined. RESULTS It was estimated that ComHIP could prevent 1450 stroke cases and 564 related deaths annually. Health benefits were observed to be more significant among the wealthier quintiles (CIX 0.217), mainly attributed to a higher occurrence of hypertension within these groups. ComHIP was also projected to result in an annual saving of USD 49,885 in individuals' out-of-pocket costs (CIX 0.262) and USD 37,578 in government spending (CIX 0.146). These savings correspond to the prevention of 335 catastrophic health expenditure cases (CIX - 0.239) and 11 impoverishing health expenditure cases (CIX - 0.600). CONCLUSIONS While ComHIP provides greater health benefits to wealthier groups, it offers substantial financial risk protection for the less wealthy. This study highlights the importance of considering equity in both health and financial risk when making priority-setting decisions.
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Affiliation(s)
- Yizhi Liang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA
| | - Yuqian Lin
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA
| | - Boshen Jiao
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA.
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Pelgrims I, Devleesschauwer B, Vandevijvere S, De Clercq EM, Van der Heyden J, Vansteelandt S. The potential impact fraction of population weight reduction scenarios on non-communicable diseases in Belgium: application of the g-computation approach. BMC Med Res Methodol 2024; 24:87. [PMID: 38616261 PMCID: PMC11016220 DOI: 10.1186/s12874-024-02212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 04/04/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Overweight is a major risk factor for non-communicable diseases (NCDs) in Europe, affecting almost 60% of all adults. Tackling obesity is therefore a key long-term health challenge and is vital to reduce premature mortality from NCDs. Methodological challenges remain however, to provide actionable evidence on the potential health benefits of population weight reduction interventions. This study aims to use a g-computation approach to assess the impact of hypothetical weight reduction scenarios on NCDs in Belgium in a multi-exposure context. METHODS Belgian health interview survey data (2008/2013/2018, n = 27 536) were linked to environmental data at the residential address. A g-computation approach was used to evaluate the potential impact fraction (PIF) of population weight reduction scenarios on four NCDs: diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) disease. Four scenarios were considered: 1) a distribution shift where, for each individual with overweight, a counterfactual weight was drawn from the distribution of individuals with a "normal" BMI 2) a one-unit reduction of the BMI of individuals with overweight, 3) a modification of the BMI of individuals with overweight based on a weight loss of 10%, 4) a reduction of the waist circumference (WC) to half of the height among all people with a WC:height ratio greater than 0.5. Regression models were adjusted for socio-demographic, lifestyle, and environmental factors. RESULTS The first scenario resulted in preventing a proportion of cases ranging from 32.3% for diabetes to 6% for MSK diseases. The second scenario prevented a proportion of cases ranging from 4.5% for diabetes to 0.8% for MSK diseases. The third scenario prevented a proportion of cases, ranging from 13.6% for diabetes to 2.4% for MSK diseases and the fourth scenario prevented a proportion of cases ranging from 36.4% for diabetes to 7.1% for MSK diseases. CONCLUSION Implementing weight reduction scenarios among individuals with excess weight could lead to a substantial and statistically significant decrease in the prevalence of diabetes, hypertension, cardiovascular disease (CVD), and musculoskeletal (MSK) diseases in Belgium. The g-computation approach to assess PIF of interventions represents a straightforward approach for drawing causal inferences from observational data while providing useful information for policy makers.
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Affiliation(s)
- Ingrid Pelgrims
- Department of Chemical and Physical Health Risks, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium.
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Salisburylaan 133, Hoogbouw, B-9820, Merelbeke, Belgium
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Eva M De Clercq
- Department of Chemical and Physical Health Risks, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Stijn Vansteelandt
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium
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Vergallo R, Volpe M. Lowering dietary sodium intake to reduce blood pressure: cum grano salis. Eur Heart J 2024; 45:1301-1302. [PMID: 38320239 DOI: 10.1093/eurheartj/ehae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Affiliation(s)
- Rocco Vergallo
- Interventional Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Internal Medicine and Medical Specialties (DiMI), Università di Genova, Genova, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa, 1035-1039, Rome 00189, Italy
- IRCCS San Raffaele Roma, Via della Pisana, 235, 00163 Rome, Italy
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7
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Oliveira AC, Mariosa NDF, Caetano MP, Correia MC. Intermittent Fasting in the Control of Hypertension: Do We Have Enough Evidence? Arq Bras Cardiol 2024; 121:e20230607. [PMID: 38597557 DOI: 10.36660/abc.20230607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/11/2023] [Indexed: 04/11/2024] Open
Affiliation(s)
- Adriana Camargo Oliveira
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO - Brasil
- Liga de Hipertensão Arterial, Hospital das Clínicas da UFG, Goiânia, GO - Brasil
| | - Natália de Filippo Mariosa
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO - Brasil
| | - Marcos Pereira Caetano
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO - Brasil
- Faculdade de Farmácia, Universidade Federal de Goiás UFG, Goiânia, GO - Brasil
| | - Mikaelle Costa Correia
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO - Brasil
- Liga de Hipertensão Arterial, Hospital das Clínicas da UFG, Goiânia, GO - Brasil
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Duckie CL, Boston KA, Champagne B, Thompson J, Halpern DJ, Granger BB. Improving Hypertension Control in the Black Patient Population: A Quality Improvement Study of Workflow Redesign Using the Electronic Health Record to Integrate Self-Monitoring, Education, and Reporting. J Nurs Care Qual 2024; 39:175-182. [PMID: 37782914 DOI: 10.1097/ncq.0000000000000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
BACKGROUND Nearly half of American adults have hypertension (HTN), and non-Hispanic Black patients are diagnosed at a higher rate than others. LOCAL PROBLEM Our local clinic population reflected disproportionate rates of uncontrolled HTN among Black patients. METHODS A quality improvement pre-/postintervention design was used to evaluate an educational intervention to reduce blood pressure (BP) and improve self-monitoring of BP in Black patients using the Chronic Care Model. INTERVENTIONS A team-based approach was used to redesign clinic workflows and patient education, prescribe self-paced videos from an electronic health record (EHR) patient portal, and provide home BP cuffs. RESULTS Black participants (n = 79) improved viewing of prescribed videos (7.9% to 68.5%), knowledge scores (67.9 to 75.2), and mean systolic BP (-20.3 mm Hg; P > .001). CONCLUSIONS This team-based approach enhanced patient engagement, self-monitoring skills, EHR-reported BP, and overall BP control for a cohort of Black patients with uncontrolled BP.
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Affiliation(s)
- Charmaine L Duckie
- Author Affiliations: Duke Primary Care Riverview, Durham, North Carolina (Drs Duckie, Champagne, Boston, and Halpern); Duke Primary Care Croasdaile and Riverview, Duke Population Health Management Office, Durham, North Carolina (Dr Champagne); Duke University School of Nursing, Durham, North Carolina (Drs Thompson and Granger); Quality & Population Health, Duke Primary Care, Durham, North Carolina (Dr Halpern); and Duke Heart Center Nursing Research Program, Durham, North Carolina (Dr Granger)
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Yarmand S, Abdollahi N, Nejad ET, Souni F, Vali M, Nouri M, Shateri Z, Rashidkhani B. Association between adherence to a dietary approach to stop hypertension and the Mediterranean diets and risk of colorectal cancer: A matched case-control study. Clin Nutr ESPEN 2024; 60:195-202. [PMID: 38479910 DOI: 10.1016/j.clnesp.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common cancers and is currently the third leading cause of cancer-related deaths worldwide. This study aimed to evaluate whether the dietary approach to stop hypertension (DASH) and Mediterranean (MED) diets are associated with CRC in Iranian adults. METHODS This hospital-based case-control study was conducted on 71 cases and 142 controls (40-75 years old) in three general hospitals in Tehran, Iran. The dietary intakes of individuals were collected through face-to-face interviews using a semi-quantitative food frequency questionnaire (FFQ) that included 125 food items. The DASH and MED diet scores were calculated according to food items based on guidelines. Two logistic regression models were applied to evaluate the association between DASH and MED score adherence. RESULTS After adjusting for confounding factors, a negative association between DASH diet adherence and CRC risk was observed in the second and last tertile compared to the first tertile (T) (T2: odds ratio (OR) = 0.33; 95% confidence interval (CI): 0.14-0.77 - T3: OR = 0.09; 95% CI: 0.03-0.27). There was no significant association between the MED diet and the risk of CRC. CONCLUSIONS In conclusion, the current study's findings presented that adherence to a DASH diet could reduce the odds of CRC.
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Affiliation(s)
- Sazin Yarmand
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nooshin Abdollahi
- Nutrition and Food Security Research Center, Department of Nutrition, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Elham Tavassoli Nejad
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fateme Souni
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran; Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Neupane D, Mukhtar Q, Krajan Pardo EK, Acharya SD, Delles C, Sharman JE, Cobb L, Lackland DT, Moran A, Weber MA, Olsen MH. Emerging Authors Program for building cardiovascular disease prevention and management research capacity in low- and middle-income countries: a collaboration of the U.S. Centers for Disease Control and Prevention, the Lancet Commission on Hypertension Group, Resolve to Save Lives, and the World Hypertension League. J Hum Hypertens 2024; 38:380-381. [PMID: 38082183 DOI: 10.1038/s41371-023-00880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 04/10/2024]
Affiliation(s)
- Dinesh Neupane
- Lancet Commission on Hypertension Group, London, UK.
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Qaiser Mukhtar
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Christian Delles
- Lancet Commission on Hypertension Group, London, UK
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - James E Sharman
- Lancet Commission on Hypertension Group, London, UK
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Laura Cobb
- Resolve to Save Lives, New York, NY, USA
| | - Daniel T Lackland
- World Hypertension League, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Michael A Weber
- World Hypertension League, Charleston, SC, USA
- State University of New York, New York, NY, USA
| | - Michael H Olsen
- Lancet Commission on Hypertension Group, London, UK
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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11
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de Cássia Vilhena da Silva R, Dada A, Lucietti Dick S, Odebrecht Cavichiolo M, Zanovello M, Cechinel Filho V, de Souza P. Naringen's Effects on Diuresis and Prevention of Urolithiasis in Hypertensive Rats. Chem Biodivers 2024; 21:e202400175. [PMID: 38345349 DOI: 10.1002/cbdv.202400175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
This research demonstrates the diuretic effect of naringenin, a flavanone aglycone found in citrus, on spontaneously hypertensive female and male rats (SHR). The data reinforces existing literature findings that male SHR exhibits higher systolic blood pressure than age-matched females. Urine volume assessed over 8 hours was lower when obtained from SHR males than females. When these animals were orally treated with different doses of naringenin (0.1-1 mg/kg), this increased urinary volume in both genders at the highest dose tested. In contrast, the lowest dose promoted a significant natriuretic effect. The other electrolytes analyzed in urine were not significantly altered, except potassium excretion, which was shown to be increased in the urine of SHR males. Furthermore, naringenin showed promise in reducing calcium oxalate (CaOx) crystal formation in an in vitro model, presenting potential advantages in lithiasis prevention.
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Affiliation(s)
- Rita de Cássia Vilhena da Silva
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Anelize Dada
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Sabrina Lucietti Dick
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Martina Odebrecht Cavichiolo
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Mariana Zanovello
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Valdir Cechinel Filho
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
| | - Priscila de Souza
- Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Rua Uruguai, 458, Centro, 88302-901, Itajaí, Santa Catarina, Brazil
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Ordunez P, Campbell NRC, DiPette DJ, Jaffe MG, Rosende A, Martinez R, Gamarra A, Lombardi C, Parra N, Rodriguez L, Rodriguez Y, Brettler J. HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control. Curr Hypertens Rep 2024; 26:141-156. [PMID: 38041725 PMCID: PMC10904446 DOI: 10.1007/s11906-023-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE OF REVIEW HEARTS in the Americas is the regional adaptation of Global Hearts, the World Health Organization initiative for cardiovascular disease (CVD) prevention and control. Its overarching goal is to drive health services to change managerial and clinical practice in primary care settings to improve hypertension control and CVD risk management. This review describes the HEARTS in the Americas initiative. First, the regional epidemiological situation of CVD mortality and population hypertension control trends are summarized; then the rationale for its main intervention components: the primary care-oriented management system and the HEARTS Clinical Pathway are described. Finally, the key factors for accelerating the expansion of HEARTS are examined: medicines, team-based care, and a system for monitoring and evaluation. RECENT FINDINGS Thus far, 33 countries in Latin America and the Caribbean have committed to integrating this program across their primary healthcare network by 2025. The increase in hypertension coverage and control in primary health care settings compared with the traditional model is promising and confirms that the interventions under the HEARTS umbrella are feasible and acceptable to communities, patients, providers, decision-makers, and funders. This review highlights some cases of successful implementation. Scaling up effective treatment for hypertension and optimization of CVD risk management is a pragmatic way to accelerate the reduction of CVD mortality while strengthening primary healthcare systems to respond effectively, with quality, and equitably, to the challenge of non-communicable diseases, not only in low-middle income countries but in all communities globally.
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Affiliation(s)
- Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.
| | - Norm R C Campbell
- Department of Medicine, Libin Cardiovascular Institute, The University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Donald J DiPette
- University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA
| | - Marc G Jaffe
- Department of Endocrinology, The Permanente Medical Group, Kaiser San Francisco Medical Center, San Francisco, CA, USA
| | - Andres Rosende
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Ramon Martinez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Angelo Gamarra
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Cintia Lombardi
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Natalia Parra
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Libardo Rodriguez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Yenny Rodriguez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Jeffrey Brettler
- Southern California Permanente Medical Group, Department of Health Systems Science, Regional Hypertension Program, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, USA
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Campbell NRC, McKay DW, Petrella R, Kaczorowski J. The Urgent Need to Re-establish a Health Coalition Focused on Hypertension Prevention and Control in Canada. Can J Cardiol 2024; 40:610-612. [PMID: 38416078 DOI: 10.1016/j.cjca.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 02/29/2024] Open
Affiliation(s)
- Norm R C Campbell
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Donald W McKay
- Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Robert Petrella
- Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia. Canada
| | - Janusz Kaczorowski
- Department of Family and Emergency Medicine, University of Montréal, Montréal, Québec, Canada
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Ghammam R, Maatoug J, Harrabi I, Ben Fredj S, Zammit N, Laatikainen T, Vartiainen E, Neupane D, Ghannem H. Effectiveness of a 3-year community-based intervention for blood pressure reduction among adults: a repeated cross-sectional study with a comparison area. J Hum Hypertens 2024; 38:336-344. [PMID: 35396538 PMCID: PMC11001574 DOI: 10.1038/s41371-022-00672-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/15/2022] [Accepted: 03/04/2022] [Indexed: 11/09/2022]
Abstract
Raised blood pressure is the leading risk factor for cardiovascular diseases. We aimed to demonstrate the effectiveness of a 3-year community-based healthy lifestyle promotion intervention at a neighbourhood level for blood pressure reduction among adults in the context of a political transition. We conducted repeated cross-sectional surveys including 1880 (940 from each area) participants at baseline and 1977 (1001 in the intervention area; 976 comparison area) participants at follow-up. Data collection was conducted through home visits. Multiple linear regression models were used to identify the intervention effect and factors associated with blood pressure change in each area. The prevalence of hypertension was 4.4% lower (35.8% vs. 31.4%) in the intervention area after 3 years (p = 0.044). The mean systolic and diastolic blood pressures changed significantly in the intervention area, from 132.4 ± 19.2 mmHg at baseline to 130.6 ± 17.7 mmHg at follow-up (p = 0.035) and from 78.7 ± 11.8 mmHg to 76.9 ± 11.1 mmHg (p < 10-3), respectively. In the control group, the mean systolic blood pressure increased from 129.4 ± 17.8 mmHg to 130.4 ± 17.9 mmHg (p = 0.38). A significant protective effect of the intervention on systolic (β = -0.4; 95% CI: -0.76; -0.06) and diastolic blood pressures (β = -0.22; 95% CI: -0.38; -0.07) was found in the intervention area. In the control area, the effect was not significant for systolic blood pressure. Lifestyle intervention at the neighbourhood level, in the context of a sociopolitical transition, was found to be effective for reducing blood pressure in Sousse, Tunisia. This approach could be scaled up and applied in other similar settings. Future research also needs to focus on designing, implementing, and evaluating multisectoral action plans and legislative measures.
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Affiliation(s)
- Rim Ghammam
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie.
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie.
| | - Jihene Maatoug
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | - Imed Harrabi
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | - Sihem Ben Fredj
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | - Nawel Zammit
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | | | - Erkki Vartiainen
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Dinesh Neupane
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hassen Ghannem
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
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Zhang P, Zhang D, Lu D. The efficacy of Tai Chi for essential hypertension: A systematic review and meta-analysis. Int J Nurs Pract 2024; 30:e13211. [PMID: 37798948 DOI: 10.1111/ijn.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
AIM We aimed to assess the impact of Tai Chi interventions on individuals with essential hypertension and to compare the effects of Tai Chi versus control in this population. BACKGROUND Tai Chi has been extensively utilized in the prevention of essential hypertension. Nevertheless, there is a lack of consensus regarding its benefits for treating essential hypertension. DESIGN A systematic review and meta-analysis was conducted. DATA SOURCES We conducted a systematic literature search of the Medline, Scholar, Elsevier, Wiley Online Library, Chinese Academic Journal (CNKI) and Wanfang databases from January 2003 to August 2023. REVIEW METHODS Using the methods of the Cochrane Collaboration Handbook, a meta-analysis was conducted to assess the collective impact of Tai Chi exercise in controlling hypertension. The primary outcomes measured included blood pressure and nitric oxide levels. RESULTS The participants consisted of adults with an average age of 57.1 years who had hypertension (mean ± standard deviation systolic blood pressure at 148.2 ± 12.1 mmHg and diastolic blood pressure at 89.2 ± 8.3 mmHg). Individuals who practiced Tai Chi experienced reductions in systolic blood pressure of 10.6 mmHg, diastolic blood pressure of 4.7 mmHg and an increase in nitric oxide levels. CONCLUSIONS Tai Chi can be a viable lifestyle intervention for managing hypertension. Greater promotion of Tai Chi by medical professionals could extend these benefits to a larger patient population.
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Affiliation(s)
- Pengchao Zhang
- Chongqing Metropolitan College of Science and Technology, Chongqing, China
| | - Dan Zhang
- Chongqing Metropolitan College of Science and Technology, Chongqing, China
| | - Deyi Lu
- University of Illinois at Chicago, Chicago, Illinois, USA
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Neupane D, Hall B, Mukhtar Q, Delles C, Sharman JE, Cobb LK, Lackland DT, Moran AE, Weber MA, Olsen MH. Emerging Authors Program for Global Cardiovascular Disease Research-A collaboration of the U.S. Centers for Disease Control and Prevention, the Lancet Commission on Hypertension Group, Resolve to Save Lives, and the World Hypertension League. J Hum Hypertens 2024; 38:293-294. [PMID: 35322180 PMCID: PMC8942057 DOI: 10.1038/s41371-022-00678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Dinesh Neupane
- Lancet Commission on Hypertension Group, London, UK.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Bethany Hall
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Qaiser Mukhtar
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christian Delles
- Lancet Commission on Hypertension Group, London, UK
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - James E Sharman
- Lancet Commission on Hypertension Group, London, UK
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | - Daniel T Lackland
- World Hypertension League, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Michael A Weber
- World Hypertension League, Charleston, SC, USA
- State University of New York, New York, NY, USA
| | - Michael Hecht Olsen
- Lancet Commission on Hypertension Group, London, UK
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Su D, Chen H, Guo Y, Feng Q, Yang M, Cai C, Zhang Y, Wu Y, Wang Y, Zeng G. Effects of the Chinese Heart-Healthy Diet (Sichuan Cuisine Version) on the 10-year CVD risk and vascular age: a randomised controlled feeding trial. Br J Nutr 2024; 131:997-1006. [PMID: 37926909 PMCID: PMC10876454 DOI: 10.1017/s0007114523002416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/08/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
Sichuan cuisine was previously fitted into the Chinese Heart-Healthy Diet (CHH) trial to verify the antihypertensive effect. Whether the modified Sichuan diet lessens cardiovascular disease (CVD) is not fully explored. We aimed to estimate the effects of the Sichuan version of CHH diet (CHH diet-SC) on the 10-year risk of CVD and vascular age. A single-blinded randomised controlled feeding trial was conducted. General CVD prediction model was used in manners of intention-to-treat and per-protocol set. After a 7-d run-in period, fifty-three participants with pre- and grade I hypertension from local communities were randomised and provided with either CHH diet-SC (n 27) or a control diet (n 26) for 4 weeks. Mean absolute and relative estimated CVD risks were reduced by 4·5 % and 27·9 % in the CHH diet-SC group, and the between-group relative risk reduction was 19·5 % (P < 0·001) using linear mixed-effects models. The sensitivity analysis with datasets and models showed consistent results, and pre-specified factors were not associated with the intervention effects. The vascular age of CHH-SC group was theoretically 4·4 years younger than that of the control group after intervention. Compared with a typical diet, adopting the CHH diet-SC over 1 month significantly reduced 10-year CVD risks and vascular ages among local adults with mild hypertension.
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Affiliation(s)
- Danping Su
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Hong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Yishan Guo
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Qiuyu Feng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Mengtong Yang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Congjie Cai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Yiqi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing100032, People’s Republic of China
| | - Yanfang Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing100032, People’s Republic of China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu610041, People’s Republic of China
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Loizou P, Taylor CM, Buckland G. The dietary approaches to stop hypertension (DASH) dietary pattern in childhood in relation to cardiometabolic risk in adolescence and early adulthood in the ALSPAC birth cohort. Public Health Nutr 2024; 27:e86. [PMID: 38511334 DOI: 10.1017/s136898002400048x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE To investigate the relationship between the dietary approaches to stop hypertension (DASH)-style dietary patterns in childhood and cardiometabolic risk (CMR) in adolescence/early adulthood. DESIGN Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) prospective cohort. Diet diary data collected at 7, 10 and 13 years were used to calculate DASH-style diet scores (DDS). Multivariable linear regression models were used to investigate the associations between the DDS at 7, 10 and 13 years and CMR scores, calculated at 17 and 24 years. SETTING The ALSPAC cohort included children born in south-west England in 1991-1992. PARTICIPANTS Children with complete dietary, covariate and cardiometabolic data at 17 (n 1,526) and 24 years (n 1,524). RESULTS A higher DDS at 7 and 10 years was negatively associated with CMR scores at 17 years (β = -0·64 (95 % CI -1·27, -0·006), Ptrend=0·027 for fifth v. first DDS quintile at 7 years; β = -0·73 (95 % CI -1·35, -0·12) and Ptrend=0·037 for fifth v. first DDS quintile at 10 years) and at 24 years (β = -0·92 (95 % CI -1·49, -0·34) Ptrend = 0·001 for fifth v. first DDS quintile at 7 years; β = -0·60 (95 % CI -1·20, -0·05) Ptrend = 0·092 for fifth v. first DDS quintile at 10 years). No associations were found between the DDS at 13 years and CMR score at 17 and 24 years. CONCLUSION Greater adherence with a DASH-style diet during childhood was associated with better cardiometabolic health in adolescence/adulthood in the ALSPAC cohort. The components of the DASH diet could be recommended to improve children's cardiometabolic health.
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Affiliation(s)
| | - Caroline M Taylor
- Centre for Academic Child Health, Canynge Hall, 39 Whatley Road, Bristol Medical School, University of Bristol, BristolBS8 2PS, UK
| | - Genevieve Buckland
- Centre for Academic Child Health, Canynge Hall, 39 Whatley Road, Bristol Medical School, University of Bristol, BristolBS8 2PS, UK
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Zhu Y, Wang Z. Association between joint physical activity and healthy dietary patterns and hypertension in US adults: cross-sectional NHANES study. BMC Public Health 2024; 24:855. [PMID: 38504199 PMCID: PMC10953194 DOI: 10.1186/s12889-024-18346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults. METHODS We used data collected from the 2007-2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension. RESULTS A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65-0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76-1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76-1.06) were not associated with hypertension. CONCLUSION In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.
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Affiliation(s)
- Yanzhou Zhu
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China
| | - Zhigang Wang
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China.
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Nie T, Huang S, Yang Y, Hu A, Wang J, Cheng Z, Liu W. A review of the world's salt reduction policies and strategies - preparing for the upcoming year 2025. Food Funct 2024; 15:2836-2859. [PMID: 38414443 DOI: 10.1039/d3fo03352j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Excessive consumption of dietary sodium is a significant contributor to non-communicable diseases, including hypertension and cardiovascular disease. There is now a global consensus that regulating salt intake is among the most cost-effective measures for enhancing public health. More than half of the countries worldwide have implemented multiple strategies to decrease salt consumption. Nevertheless, a report on sodium intake reduction published by the World Health Organization revealed that the world is off-track to meet its targeted reduction of 30% by 2025. The global situation regarding salt reduction remains concerning. This review will center on domestic and international salt reduction policies, as well as diverse strategies, given the detrimental effects of excessive dietary salt intake and the existing global salt intake scenario. Besides, we used visualization software to analyze the literature related to salt reduction research in the last five years to explore the research hotspots in this field. Our objective is to enhance public awareness regarding the imperative of reducing salt intake and promoting the active implementation of diverse salt reduction policies.
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Affiliation(s)
- Ting Nie
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Siqi Huang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Yuxin Yang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Anna Hu
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Jianing Wang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Zeneng Cheng
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Wenjie Liu
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
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Lei L, Hui S, Chen Y, Yan H, Yang J, Tong S. Effect of soy isoflavone supplementation on blood pressure: a meta-analysis of randomized controlled trials. Nutr J 2024; 23:32. [PMID: 38454401 PMCID: PMC10918941 DOI: 10.1186/s12937-024-00932-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 02/23/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Previous experimental studies have suggested that the consumption of soy isoflavones may have a potential impact on lowering blood pressure. Nevertheless, epidemiological studies have presented conflicting outcomes concerning the correlation between soy isoflavone consumption and blood pressure levels. Consequently, a comprehensive meta-analysis of all eligible randomized controlled trials (RCTs) was conducted to explore the influence of soy isoflavones on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults. METHODS A thorough search of PubMed, Embase, and the Cochrane Library for relevant literature up to April 30, 2023 was conducted. RCTs involving adults that compared soy isoflavone supplementation with a placebo (the same matrix devoid of soy isoflavone) were included. The combined effect size was presented as the weighted mean difference (WMD) along with 95% confidence interval (CI), employing a fixed-effects model. RESULTS Our meta-analysis included a total of 24 studies involving 1945 participants. The results revealed a significant reduction in both SBP and DBP with soy isoflavone supplementation. Subgroup analyses suggested more pronounced reductions in SBP and DBP for interventions lasting ≥6 months, in individuals receiving mixed-type soy isoflavone, and among patients with metabolic syndrome or prehypertension. However, we did not detect significant nonlinear associations between supplementation dosage and intervention duration concerning both SBP and DBP. The overall quality of evidence was deemed moderate. CONCLUSIONS The current meta-analysis revealed that supplementation with soy isoflavones alone effectively reduces blood pressure. Additional high-quality studies are required to investigate the efficacy of blood pressure reduction through supplementation with an optimal quantity and proportion of soy isoflavone.
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Affiliation(s)
- Lifu Lei
- Department of Clinical Nutrition, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Suocheng Hui
- Department of Clinical Nutrition, The People's Hospital of Chongqing Liang Jiang New Area, Chongqing, 401135, China
| | - Yushi Chen
- Department of Clinical Nutrition, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Hongjia Yan
- Department of Clinical Nutrition, The People's Hospital of Chongqing Liang Jiang New Area, Chongqing, 401135, China
| | - Jian Yang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 410020, China.
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 410020, China.
| | - Shiwen Tong
- Department of Clinical Nutrition, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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22
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Ma E, Wo D, Chen J, Yan H, Zhou X, He J, Wu C, Wang Q, Zuo C, Li X, Li L, Meng Q, Zheng L, Peng L, Chen L, Peng J, Ren DN, Zhu W. Inhibition of a novel Dickkopf-1-LDL receptor-related proteins 5 and 6 axis prevents diabetic cardiomyopathy in mice. Eur Heart J 2024; 45:688-703. [PMID: 38152853 PMCID: PMC10906985 DOI: 10.1093/eurheartj/ehad842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/12/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND AND AIMS Anti-hypertensive agents are one of the most frequently used drugs worldwide. However, no blood pressure-lowering strategy is superior to placebo with respect to survival in diabetic hypertensive patients. Previous findings show that Wnt co-receptors LDL receptor-related proteins 5 and 6 (LRP5/6) can directly bind to several G protein-coupled receptors (GPCRs). Because angiotensin II type 1 receptor (AT1R) is the most important GPCR in regulating hypertension, this study examines the possible mechanistic association between LRP5/6 and their binding protein Dickkopf-1 (DKK1) and activation of the AT1R and further hypothesizes that the LRP5/6-GPCR interaction may affect hypertension and potentiate cardiac impairment in the setting of diabetes. METHODS The roles of serum DKK1 and DKK1-LRP5/6 signalling in diabetic injuries were investigated in human and diabetic mice. RESULTS Blood pressure up-regulation positively correlated with serum DKK1 elevations in humans. Notably, LRP5/6 physically and functionally interacted with AT1R. The loss of membrane LRP5/6 caused by injection of a recombinant DKK1 protein or conditional LRP5/6 deletions resulted in AT1R activation and hypertension, as well as β-arrestin1 activation and cardiac impairment, possibly because of multiple GPCR alterations. Importantly, unlike commonly used anti-hypertensive agents, administration of the anti-DKK1 neutralizing antibody effectively prevented diabetic cardiac impairment in mice. CONCLUSIONS These findings establish a novel DKK1-LRP5/6-GPCR pathway in inducing diabetic injuries and may resolve the long-standing conundrum as to why elevated blood DKK1 has deleterious effects. Thus, monitoring and therapeutic elimination of blood DKK1 may be a promising strategy to attenuate diabetic injuries.
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Affiliation(s)
- En Ma
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
| | - Da Wo
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Jinxiao Chen
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Hongwei Yan
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
| | - Xiaohui Zhou
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
| | - Jia He
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Celiang Wu
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Qing Wang
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Changhai Hospital, Shanghai, China
| | - Xiao Li
- Department of Nuclear Medicine, Changhai Hospital, Shanghai, China
| | - Li Li
- Department of Health Management, Shengli Clinical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Qingshu Meng
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
| | - Liang Zheng
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
| | - Luying Peng
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
| | - Lidian Chen
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Jun Peng
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Dan-ni Ren
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
| | - Weidong Zhu
- Innovation and Transformation Center, Collaborative Innovation Center for Rehabilitation Technology, Fujian Key Laboratory of Integrative Medicine on Geriatrics, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, 1 Qiuyang Road, Minhou, Fuzhou 350122, China
- Clinical and Translational Research Center, Research Institute of Heart Failure Shanghai East Hospital, Key Laboratory of Arrhythmias of Ministry of Education, Tongji University School of Medicine, 1239 Siping Road, Yangpu, Shanghai, China
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Charles JA, Habibullah NK, Bautista S, Davis B, Joshi S, Hull SC. Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension. Curr Cardiol Rep 2024; 26:121-134. [PMID: 38526748 PMCID: PMC10990999 DOI: 10.1007/s11886-023-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients. RECENT FINDINGS DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.
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Affiliation(s)
- Justin A Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA, USA.
| | | | - Saul Bautista
- Ethos Farm to Health/Ethos Primary Care, Long Valley, NJ, USA
| | - Brenda Davis
- Brenda Davis, Nutrition Consultations, Calgary, AB, Canada
| | - Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Program for Biomedical Ethics, Yale School of Medicine, New Haven, CT, USA
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24
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Abstract
Excessive salt intake raises blood pressure, but the implications of this observation for human health have remained contentious. It has also been recognized for many years that potassium intake may mitigate the effects of salt intake on blood pressure and possibly on outcomes such as stroke. Recent large randomized intervention trials have provided strong support for the benefits of replacing salt (NaCl) with salt substitute (75% NaCl, 25% KCl) on hard outcomes, including stroke. During the same period of time, major advances have been made in understanding how the body senses and tastes salt, and how these sensations drive intake. Additionally, new insights into the complex interactions between systems that control sodium and potassium excretion by the kidneys, and the brain have highlighted the existence of a potassium switch in the kidney distal nephron. This switch seems to contribute importantly to the blood pressure-lowering effects of potassium intake. In recognition of these evolving data, the United States Food and Drug Administration is moving to permit potassium-containing salt substitutes in food manufacturing. Given that previous attempts to reduce salt consumption have not been successful, this new approach has a chance of improving health and ending the 'Salt Wars'.
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Affiliation(s)
- Robert Little
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- LeDucq Transatlantic Network of Excellence
| | - David H. Ellison
- Division of Nephrology and Hypertension, Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, Oregon, USA
- LeDucq Transatlantic Network of Excellence
- VA Portland Health Care System, Portland, OR
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25
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Affiliation(s)
- William B Earle
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - George Ormseth
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | | | - Milan Kaushik
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Stephen P Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
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26
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Olowoyo P, Dzudie A, Okekunle AP, Obiako R, Mocumbi A, Beheiry H, Parati G, Lackland DT, Sarfo FS, Odili A, Adeoye AM, Wahab K, Agyemang C, Campbell N, Kengne AP, Whelton PK, Pellicori P, Ebenezer AA, Adebayo O, Olalusi O, Jegede A, Uvere E, Adebajo O, Awuah B, Moran A, Williams B, Guzik TJ, Kokuro C, Bukachi F, Ogah OS, Delles C, Maffia P, Akinyemi R, Barango P, Ojji D, Owolabi M. ACHIEVE conference proceedings: implementing action plans to reduce and control hypertension burden in Africa. J Hum Hypertens 2024; 38:193-199. [PMID: 38424209 DOI: 10.1038/s41371-024-00903-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/15/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
The prevalence of hypertension, the commonest risk factor for preventable disability and premature deaths, is rapidly increasing in Africa. The African Control of Hypertension through Innovative Epidemiology, and a Vibrant Ecosystem [ACHIEVE] conference was convened to discuss and initiate the co-implementation of the strategic solutions to tame this burden toward achieving a target of 80% for awareness, treatment, and control by the year 2030. Experts, including the academia, policymakers, patients, the WHO, and representatives of various hypertension and cardiology societies generated a 12-item communique for implementation by the stakeholders of the ACHIEVE ecosystem at the continental, national, sub-national, and local (primary) healthcare levels.
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Affiliation(s)
- Paul Olowoyo
- Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Anastase Dzudie
- Departments of Internal Medicine and Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Akinkunmi Paul Okekunle
- College of Medicine, University of Ibadan, 200284, Ibadan, Nigeria
- Seoul National University, 08826, Seoul, Republic of Korea
| | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University Teaching Hospital Zaria, Zaria, Nigeria
| | - Ana Mocumbi
- Departamento de Medicina, Universidade, Eduardo Mondlane, Maputo, Mozambique
| | - Hind Beheiry
- Physiology Department, Faculty of Medicine, International University of Africa (IUA), Khartoum, Sudan
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, Univeristy of Milano-Bicocca, Milan, Italy
| | - Daniel T Lackland
- Division of Translational Neurosciences and Population Studies, Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Fred S Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustine Odili
- Department of Medicine, University of Abuja, FCT, Abuja, Nigeria
| | | | - Kolawole Wahab
- Department of Medicine, University of Ilorin, Ilorin, Nigeria
| | - Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Norman Campbell
- Departments of Medicine, Physiology, and Pharmacology and Community Health Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Andre Pascal Kengne
- South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - Paul K Whelton
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Pierpaolo Pellicori
- School of Cardiovascular & Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Oladimeji Adebayo
- Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladotun Olalusi
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Ayodele Jegede
- Department of Sociology, University of Ibadan, Ibadan, Nigeria
| | - Ezinne Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | | | | | | | - Tomasz J Guzik
- Co-Lead, Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, Arua, Uganda
- Centre for Cardiovascular Sciences, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Department of Internal and Agricultural Medicine and Omicron Medical Genomics Laboratory, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Collins Kokuro
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Fred Bukachi
- Co-Lead, Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, Arua, Uganda
- Department of Medical Physiology, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Okechukwu S Ogah
- Cardiology Unit, Department of Medicine, University of Ibadan/ University College Hospital, Ibadan, Nigeria
| | - Christian Delles
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pasquale Maffia
- Co-Lead, Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, Arua, Uganda
- Centre for Cardiovascular Sciences, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Rufus Akinyemi
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, University College Hospital Ibadan, Ibadan, Nigeria
| | - Prebo Barango
- WHO African Regional Office, DRC, Brazzaville, Democratic Republic of the Congo
| | - Dike Ojji
- Department of Medicine, University of Abuja, FCT, Abuja, Nigeria
- Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Mayowa Owolabi
- Department of Medicine, University College Hospital, Ibadan, Nigeria.
- Co-Lead, Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, Arua, Uganda.
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, University College Hospital Ibadan, Ibadan, Nigeria.
- Lebanese American University of Beirut, Beirut, Lebanon.
- Blossom Specialist Medical Center, Ibadan, Nigeria.
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Wan S, Pan D, Su M, Wang S, Wang Y, Xu D, Sun J, Xie W, Wang X, Yan Q, Xia H, Yang C, Sun G. Association between socio-demographic factors, lifestyle, eating habits and hypertension risk among middle-aged and older rural Chinese adults. Nutr Metab Cardiovasc Dis 2024; 34:726-737. [PMID: 38161126 DOI: 10.1016/j.numecd.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS Hypertension is a global health issue with increasing prevalence. This study aimed to understand the epidemiological characteristics and influencing factors of hypertension in rural Chinese populations and help develop effective prevention and control strategies. METHODS AND RESULTS This cross-sectional study used database from the Early Diagnosis and Early Treatment Project of Esophageal Cancer conducted in a rural population from September 2012 to December 2017. A total of 10,111 subjects aged 35-75 years residing in Huai'an District, Huai'an City, Jiangsu Province for at least three years were included. Unconditional univariate and multivariate logistic regression models were performed to evaluate the association between socio-demographic information, lifestyle habits, dietary characteristics and the risk of hypertension. The prevalence of hypertension was 34.32 % in this rural population. Men and older individuals are more likely to have hypertension when compared with women and young individuals, respectively. Factors associated with an increased risk of hypertension included: fast eating speed, a high-salt diet (both currently and ten years ago), a high-spicy diet ten years ago, high BMI, poor educational attainment, preference for fatty meats, hot diet, green tea drinking, intake of pickled potherb mustard and corn flour, family smoking and alcohol consumption. Light smoking in males, consumption of fruits, adzuki bean, and pork liver were associated with reduced risk of hypertension. CONCLUSIONS The study identified some factors, including eat habits and lifestyle, associated with hypertension risk, and highlighted the need for targeted policies and interventions in rural China to address potential risk factors for hypertension.
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Affiliation(s)
- Shiyun Wan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China.
| | - Ming Su
- Huai'an District Center for Disease Control and Prevention, 223200, Huai'an, PR China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China; School of Medicine, Xizang Minzu University, 712082, Xianyang, PR China
| | - Yuanyuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China
| | - Jihan Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China
| | - Wei Xie
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, PR China
| | - Xin Wang
- Huai'an District Center for Disease Control and Prevention, 223200, Huai'an, PR China
| | - Qingyang Yan
- Huai'an District Center for Disease Control and Prevention, 223200, Huai'an, PR China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China
| | - Chao Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China; Wuxi School of Medicine, Jiangnan University, 214122, Wuxi, PR China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 210009, Nanjing, PR China.
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28
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McMaster MW, Sharma D, Kafle P, Frishman WH, Aronow WS. Use of the DASH Diet and Coronary Artery Disease. Cardiol Rev 2024; 32:153-156. [PMID: 36398335 DOI: 10.1097/crd.0000000000000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Initial dietary approach to stop hypertension (DASH) diet feeding trials showed blood pressure (BP)-lowering effects that corresponded to higher degrees of concordance with the diet. These results popularized the idea that adherence to a DASH diet could reduce coronary artery disease (CAD) risk for patients. Recent evidence shows that the impact of DASH on CAD incidence and risk is less clear. While many studies show that the DASH diet impacts CAD risk factors, others suggest that these effects do not remain when important confounders are controlled. Also, the evidence from meta-analyses that the DASH diet impacts incident CAD is still inconclusive. Reassessment of the DASH diet, and the search for an ideal diet to prevent CAD will require a better understanding of the mechanisms through which the DASH diet works. Proposed mechanisms for its benefit include preventing inflammation and atherosclerosis progression as well as providing a heathy balance of dietary sodium and potassium intake.
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Affiliation(s)
- Matthew W McMaster
- From the Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
| | - Dikshya Sharma
- Department of Cardiology, Westchester Medical Center, Valhalla, NY
| | - Paritosh Kafle
- Department of Medicine, Maimonides Medical Center, Brooklyn, NY
| | - William H Frishman
- From the Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
| | - Wilbert S Aronow
- From the Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY
- Department of Cardiology, Westchester Medical Center, Valhalla, NY
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29
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Zhang X, Yuan Y, Li C, Feng X, Wang H, Qiao Q, Zhang R, Jin A, Li J, Li H, Wu Y. Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults. J Am Coll Cardiol 2024; 83:711-722. [PMID: 38355240 DOI: 10.1016/j.jacc.2023.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND Reports on the effects of salt substitution among individuals with normal blood pressure are scarce and controversial. OBJECTIVES This study sought to assess the effects of a salt substitute (62.5% NaCl, 25% KCl, and 12.5% flavorings) on incidence of hypertension and hypotension among older adults with normal blood pressure. METHOD A post hoc analysis was conducted among older adults with normal blood pressure participating in DECIDE-Salt, a large, multicenter, cluster-randomized trial in 48 elderly care facilities for 2 years. We used the frailty survival model to compare risk of incident hypertension and the generalized linear mixed model to compare risk of hypotension episodes. RESULTS Compared with usual salt group (n = 298), the salt substitute group (n = 313) had a lower hypertension incidence (11.7 vs 24.3 per 100 person-years; adjusted HR: 0.60; 95% CI: 0.39 to 0.92; P = 0.02) but did not increase incidence of hypotension episodes (9.0 vs 9.7 per 100 person-years; P = 0.76). Mean systolic/diastolic blood pressure did not increase from the baseline to the end of intervention in the salt substitute group (mean changes: -0.3 ± 11.9/0.2 ± 7.1 mm Hg) but increased in the usual salt group (7.0 ± 14.3/2.1 ± 7.5 mm Hg), resulting in a net reduction of -8.0 mm Hg (95% CI: -12.4 to -3.7 mm Hg) in systolic and -2.0 mm Hg (95% CI: -4.1 to 0.1 mm Hg) in diastolic blood pressure between intervention groups. CONCLUSIONS In Chinese older adults with normal blood pressure, replacing usual salt with a salt substitute may reduce the incidence of hypertension without increasing hypotension episodes. This suggests a desirable strategy for population-wide prevention and control of hypertension and cardiovascular disease, deserving further consideration in future studies. (Diet Exercise and Cardiovascular Health [DECIDE]-Salt Reduction Strategies for the Elderly in Nursing Homes in China [DECIDE-Salt]; NCT03290716).
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Affiliation(s)
- Xianghui Zhang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; Shihezi University School of Medicine, Shihezi, China
| | - Yifang Yuan
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | | | - Hongxia Wang
- Department of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Inner Mongolia, China
| | - Qianku Qiao
- Yangcheng Ophthalmic Hospital, Shanxi, China
| | - Ruijuan Zhang
- Department of Public Health, Xi'an Jiaotong University, Shaanxi, China
| | - Aoming Jin
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiayu Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Huijuan Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
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Fujii Y, Streeter TE, Schieb L, Casper M, Wall HK. Finding Optimal Locations for Implementing Innovative Hypertension Management Approaches Among African American Populations: Mapping Barbershops, Hair Salons, and Community Health Centers. Prev Chronic Dis 2024; 21:E10. [PMID: 38359159 PMCID: PMC10870996 DOI: 10.5888/pcd21.230329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Affiliation(s)
- Yui Fujii
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Centers for Disease Control and Prevention, 4770 Buford Hwy, Bldg 107, Mailstop S107-1, Atlanta, GA 30341
- Bizzell US, New Carrollton, Maryland
| | - Taylor E Streeter
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Linda Schieb
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michele Casper
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hilary K Wall
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Hanssen H, Pescatello LS. Is isometric exercise training the best FIT for exercise prescription in the prevention and treatment of arterial hypertension? Br J Sports Med 2024; 58:231-232. [PMID: 38123947 DOI: 10.1136/bjsports-2023-107743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Basel-Stadt, Switzerland
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
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Van Iterson EH, Laffin LJ. Exercise prescription for the prevention and treatment of arterial hypertension: targeting blood pressure is not necessarily the goal. Br J Sports Med 2024; 58:181-182. [PMID: 38212044 DOI: 10.1136/bjsports-2023-107566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Erik H Van Iterson
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Luke J Laffin
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
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Lai X, Yuan Y, Wang H, Zhang R, Qiao Q, Feng X, Jin A, Li H, Li J, Si L, Gao P, Jan S, Fang H, Wu Y. Cost-Effectiveness of Salt Substitute and Salt Supply Restriction in Eldercare Facilities: The DECIDE-Salt Cluster Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2355564. [PMID: 38345818 PMCID: PMC10862151 DOI: 10.1001/jamanetworkopen.2023.55564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/15/2023] [Indexed: 02/15/2024] Open
Abstract
Importance Salt substitution has been reported to be a cost-saving sodium reduction strategy that has not yet been replicated in different contexts. Objective To estimate the cost-effectiveness of sodium reduction strategies within the DECIDE-Salt trial. Design, Setting, and Participants The DECIDE-Salt trial cluster randomized in a 1:1:1:1 ratio 48 eldercare facilities in China into 4 groups for evaluation of 2 sodium reduction strategies for 2 years: 1 with both strategies, 2 with either strategy, and 1 with neither strategy. The trial was conducted from September 25, 2017, through October 24, 2020. Interventions The 2 intervention strategies were replacing regular salt with salt substitute and progressively restricting salt supply to kitchens. Main Outcomes and Measures The main outcomes included per-participant costs of intervention implementation and medical treatments for hypertension and major adverse cardiovascular events (MACEs) against mean reductions in systolic blood pressure, hypertension prevalence, MACE incidence, and mortality. The incremental cost-utility ratio was then assessed as the additional mean cost per quality-adjusted life-year gained. Analyses were conducted separately for each strategy, comparing groups assigned and not assigned the test strategy. Disease outcomes followed the intention-to-treat principle and adopted different models as appropriate. One-way and probabilistic sensitivity analyses were conducted to explore uncertainty, and data analyses were performed between August 13, 2022, and April 5, 2023. Results A total of 1612 participants (1230 males [76.3%]) with a mean (SD) age of 71.0 (9.5) years were enrolled. Replacing regular salt with salt substitute reduced mean systolic blood pressure by 7.14 (95% CI, 3.79-10.48) mm Hg, hypertension prevalence by 5.09 (95% CI, 0.37-9.80) percentage points, and cumulative MACEs by 2.27 (95% CI, 0.09-4.45) percentage points. At the end of the 2-year intervention, the mean cost was $25.95 less for the salt substitute group than the regular salt group due to substantial savings in health care costs for MACEs (mean [SD], $72.88 [$9.11] vs $111.18 [$13.90], respectively). Sensitivity analysis showed robust cost savings. By contrast, the salt restriction strategy did not show significant results. If the salt substitution strategy were rolled out to all eldercare facilities in China, 48 101 MACEs and 107 857 hypertension cases were estimated to be averted and $54 982 278 saved in the first 2 years. Conclusions and Relevance The findings of this cluster randomized clinical trial indicate that salt substitution may be a cost-saving strategy for hypertension control and cardiovascular disease prevention for residents of eldercare facilities in China. The substantial health benefit savings in preventing MACEs and moderate operating costs offer strong evidence to support the Chinese government and other countries in planning or implementing sodium intake reduction and salt substitute campaigns. Trial Registration ClinicalTrials.gov Identifier: NCT03290716.
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Affiliation(s)
- Xiaozhen Lai
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yifang Yuan
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Hongxia Wang
- Department of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Inner Mongolia, China
| | - Ruijuan Zhang
- Department of Public Health, Xi’an Jiaotong University, Shaanxi, China
| | - Qianku Qiao
- Yangcheng Ophthalmic Hospital, Shanxi, China
| | | | - Aoming Jin
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
- Now with China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huijuan Li
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
| | - Jiayu Li
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
| | - Lei Si
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Stephen Jan
- George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yangfeng Wu
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
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Olowoyo P, Barango P, Moran A, Williams B, Whelton PK, Owolabi M. Priorities to reduce the burden of hypertension in Africa through ACHIEVE. Lancet Glob Health 2024; 12:e192-e193. [PMID: 38245107 DOI: 10.1016/s2214-109x(23)00540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Paul Olowoyo
- Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria; Department of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Prebo Barango
- WHO African Regional Office, Brazzaville, Democratic Republic of the Congo
| | | | - Bryan Williams
- Department of Medicine, University College London, London, UK; International Society of Hypertension, Eastbourne, UK
| | - Paul K Whelton
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; World Hypertension League, Hong Kong Special Administrative Region, China
| | - Mayowa Owolabi
- World Hypertension League, Hong Kong Special Administrative Region, China; Centre for Genomics and Precision Medicine, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria; Lebanese American University of Beirut, Beirut, Lebanon; Department of Medicine, University College Hospital, Ibadan, Nigeria; Blossom Specialist Medical Center, Ibadan, Nigeria.
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35
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Johnson C, Gerbers A, Staudt A, Cohrs J, Tutu P. Heart on hypertension: Improving hypertension control in the FQHC setting through a group visit program. J Natl Med Assoc 2024; 116:70-74. [PMID: 38199903 DOI: 10.1016/j.jnma.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Many solutions for increasing hypertension control rates have been proposed yet the social determinants of health create health disparities within the populations served by Federally Qualified Health Centers (FQHC) that can complicate reaching these goals. This study observes impact of a group visit program on hypertension control within the patient population served by an FQHC. METHODS Retrospective review and analysis of blood pressure data was performed for patients enrolled in the first 4 cohorts of the Heart on Hypertension Group Visit Program at the end of the program as well as 3 months, 6 months, and 12 months after the program ended. RESULTS AND DISCUSSION Twenty-two patients participated in the program. Seventeen patients achieved the goal with a statistically significant mean change in blood pressure at p > 0.001. Patients who completed the program had a statistically significant mean change in blood pressure at p > 0.001 and those who discontinued prior to completing the program had a statistically significant mean change in blood pressure at p = 0.001 systolic and p = 0.002 diastolic. Changes in patient blood pressure were sustained for 3-months (78%), 6-months (83%), and 12-months (83%). IMPLICATIONS Patients in the Heart on Hypertension program were successful in making significant changes in hypertension control in the FQHC setting. This method was useful in improving hypertension control metrics for patients facing increased influences by the Social Determinants of Health.
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Affiliation(s)
- Christen Johnson
- Director of Medical Education and Research and Family Physician, Heart of Ohio Family Health Centers, 5000 E. Main Street, Columbus, OH, 43213, United States.
| | - Abigail Gerbers
- Lead Clinical Dietitian, Heart of Ohio Family Health Centers, United States
| | - Anna Staudt
- Allied Health Manager and Lead Clinical Pharmacist, Heart of Ohio Family Health Centers, United States
| | - Janessa Cohrs
- RN Care Coordinator Supervisor and Clinical Pharmacist, Heart of Ohio Family Health Centers, United States
| | - Priscilla Tutu
- HIV Case Manager, Heart of Ohio Family Health Centers, United States
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Santana-Garrido Á, Reyes-Goya C, André H, Vázquez CM, Mate A. Exploring the Potential of Wild Olive (Acebuche) Oil as a Pharm-Food to Prevent Ocular Hypertension and Fibrotic Events in the Retina of Hypertensive Mice. Mol Nutr Food Res 2024; 68:e2200623. [PMID: 38044285 DOI: 10.1002/mnfr.202200623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 08/25/2023] [Indexed: 12/05/2023]
Abstract
SCOPE Our laboratory has previously described the antioxidant and anti-inflammatory potential of a wild olive (acebuche, ACE) oil against hypertension-associated vascular retinopathies. The current study aims to analyze the antifibrotic effect of ACE oil on the retina of hypertensive mice. METHODS AND RESULTS Mice are rendered hypertensive by administration of NG-nitro-L-arginine-methyl-ester (L-NAME) and simultaneously subjected to dietary supplementation with ACE oil or a reference extra virgin olive oil (EVOO). Intraocular pressure (IOP) is measured by rebound tonometry, and retinal vasculature/layers are analyzed by fundus fluorescein angiography and optical coherence tomography. Different fibrosis-related parameters are analyzed in the retina and choroid of normotensive and hypertensive mice with or without oil supplementation. Besides preventing the alterations found in hypertensive animals, including increased IOP, reduced fluorescein signal, and altered retinal layer thickness, the ACE oil-enriched diet improves collagen metabolism by regulating the expression of major fibrotic process modulators (matrix metalloproteinases, tissue inhibitors of metalloproteinases, connective tissue growth factor, and transforming growth factor beta family). CONCLUSION Regular consumption of EVOO and ACE oil (with better outcomes in the latter) might help reduce abnormally high IOP values in the context of hypertension-related retinal damage, with significant reduction in the surrounding fibrotic process.
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Affiliation(s)
- Álvaro Santana-Garrido
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Claudia Reyes-Goya
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
| | - Helder André
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Carmen M Vázquez
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Alfonso Mate
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
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Zhang W, Neupane D, Zhao Z, Jiang B, Zhang M, Zhang X, Huang Z, Li C, Sharman JE, Hu C, Ye P, Wang L. Knowledge and practices related to salt consumption in China: findings from a national representative cross-sectional survey. J Hum Hypertens 2024; 38:155-167. [PMID: 37857758 PMCID: PMC10844095 DOI: 10.1038/s41371-023-00861-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/31/2023] [Indexed: 10/21/2023]
Abstract
There is limited information on the knowledge and practice of salt-reduction in China. The purpose of this study was to describe the status of the knowledge and practice of salt-reduction among the Chinese population from a nationally representative survey stratified according to hypertension status. The association between hypertensive status and salt-reduction knowledge and practice was calculated using multivariate hierarchical logistic regression adjusting for related confounders. The study included 179,834 participants; 51.7% were women, and the mean age was 44 years. The levels of overall salt-reduction knowledge (7.9%) and practice (37.1%) were low. The percentage of the use of salt-control spoons and low-sodium salt was 10.7% and 12.2%. The aging population (≥60 years) had the lowest levels of salt-reduction knowledge (5.7%) than other age groups (P < 0.0001). People living in rural areas (OR = 0.64; 95% CI: 0.51, 0.81) had lower odds of using salt-control spoons. Females (OR = 1.23; 95% CI: 1.10, 1.36) had higher odds of using salt-control spoons. People living in rural areas (OR = 0.48; 95% CI: 0.36, 0.63) had lower odds of using low-sodium salt. Females (OR = 1.26; 95% CI: 1.13, 1.41) and people living in the southern region (OR = 1.43; 95% CI: 1.11, 1.83) had higher odds of using low-sodium salt. Our work highlights the need to promote education related to hypertension, salt-reduction knowledge and methods among the public and the need to strengthen strategies for the popularization of salt-reduction knowledge and practices among males, people living in rural areas, people living in the northern region and the aging population in China.
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Affiliation(s)
- Wenrong Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Zhenping Zhao
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bo Jiang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhengjing Huang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chun Li
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Caihong Hu
- Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Pengpeng Ye
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Limin Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Rigatto K. Cardiovascular health: balancing salt and water consumption. Eur J Nutr 2024; 63:93-94. [PMID: 37730792 DOI: 10.1007/s00394-023-03248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Katya Rigatto
- Laboratório de Fisiologia Translacional, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil.
- Programa de Pós-graduação em Ciências da Saúde, UFCSPA, Porto Alegre, Brazil.
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Mkhize X, Oldewage-Theron W, Napier C, Duffy KJ. Associations between Cardiometabolic Risk Factors and Increased Consumption of Diverse Legumes: A South African Food and Nutrition Security Programme Case Study. Nutrients 2024; 16:354. [PMID: 38337639 PMCID: PMC10856818 DOI: 10.3390/nu16030354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
The programme aimed to improve selected cardiometabolic risk (CMR) variables using a nutritional intervention among farmers who reported hypertensive disorders as hindrances during agricultural activities. The intervention had two case controls (n = 103) [experimental group-EG (n = 53) and control group-CG (n = 50)] which were tracked and whose blood pressure measurements, dietary intake, blood indices for cholesterol concentration and glucose levels from pre- and post-intervention surveys after the baseline survey (n = 112) were analysed. The interval for data collection was 12 weeks (±120 days) after five legume varieties were consumed between 3 and 5 times a day, and servings were not <125 g per at least three times per week. Sixty-five per cent of farmers were above 60 years old, with mean age ranges of 63.3 (SD ± 6.3) years for women and 67.2 (SD ± 6.7) for men. The post-intervention survey revealed that EG blood results indicated nutrient improvement with p <= 0.05 for blood glucose (p = 0.003) and cholesterol (p = 0.001) as opposed to the CG. A trend analysis revealed that cholesterol (p = 0.033) and systolic blood pressure (SBP); (p = 0.013) were statistically significant when comparing genders for all study phases. Interventions focusing on legumes can improve hypertension and cardiovascular disease and fast-track the achievement of SGDs 3 and 12 through community-based programmes.
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Affiliation(s)
- Xolile Mkhize
- Department of Community Extension, Mangosuthu University of Technology, Durban 4031, South Africa
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Department of Sustainable Food Systems and Development, University of Free State, Bloemfontein 9301, South Africa
| | - Carin Napier
- Department of Food and Nutrition, Durban University of Technology, Durban 4001, South Africa;
- School of Population Health, University of Auckland, Auckland 1023, New Zealand
| | - Kevin Jan Duffy
- Institute of Systems Science, Durban University of Technology, Durban 4001, South Africa;
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Liberona J, Araos P, Rodríguez M, León P, Stutzin A, Alzamora R, Michea L. Low-Chloride Diet Prevents the Development of Arterial Hypertension and Protects Kidney Function in Angiotensin II-Infused Mice. Kidney Blood Press Res 2024; 49:114-123. [PMID: 38246148 DOI: 10.1159/000535728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION A comprehensive pathophysiological mechanism to explain the relationship between high-salt intake and hypertension remains undefined. Evidence suggests that chloride, as the accompanying anion of sodium in dietary salt, is necessary to develop hypertension. We evaluated whether reducing dietary Cl- while keeping a standard Na+ intake modified blood pressure, cardiac hypertrophy, renal function, and vascular contractility after angiotensin II (AngII) infusion. METHODS C56BL/6J mice fed with standard Cl- diet or a low-Cl- diet (equimolar substitution of Cl- by a mixture of Na+ salts, both diets with standard Na+ content) received AngII (infusion of 1.5 mg/kg/day) or vehicle for 14 days. We measured systolic blood pressure (SBP), glomerular filtration rate (GFR), natriuretic response to acute saline load, and contractility of aortic rings from mice infused with vehicle and AngII, in standard and low-Cl- diet. RESULTS The mice fed the standard diet presented increased SBP and cardiac hypertrophy after AngII infusion. In contrast, low-Cl- diet prevented the increase of SBP and cardiac hypertrophy. AngII-infused mice fed a standard diet presented hampered natriuretic response to saline load, meanwhile the low-Cl- diet preserved natriuretic response in AngII-infused mice, without change in GFR. Aortic rings from mice fed with standard diet or low-Cl- diet and infused with AngII presented a similar contractile response. CONCLUSION We conclude that the reduction in dietary Cl- as the accompanying anion of sodium in salt is protective from AngII pro-hypertensive actions due to a beneficial effect on kidney function and preserved natriuresis.
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Affiliation(s)
- Jessica Liberona
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile,
| | - Patricio Araos
- Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Marcelo Rodríguez
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Pablo León
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andrés Stutzin
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Millennium Nucleus of Ion Channel-Associated Diseases (MiNICAD), Universidad de Chile, Santiago, Chile
| | - Rodrigo Alzamora
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Anestesiología y Medicina Perioperatoria, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Luis Michea
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Medicina Interna Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Martínez-Casales M, Hernanz R, González-Carnicero Z, Barrús MT, Martín A, Briones AM, Michalska P, León R, Pinilla E, Simonsen U, Alonso MJ. The Melatonin Derivative ITH13001 Prevents Hypertension and Cardiovascular Alterations in Angiotensin II-Infused Mice. J Pharmacol Exp Ther 2024; 388:670-687. [PMID: 38129126 DOI: 10.1124/jpet.123.001586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Inflammatory mechanisms and oxidative stress seem to contribute to the pathogenesis of hypertension. ITH13001 is a melatonin-phenyl-acrylate hybrid that moderately induces the antioxidant transcription factor Nrf2 (nuclear factor erythroid 2-related factor 2) and has a potent oxidant scavenging effect compared with other derivatives of its family. Here we investigated the effect of ITH13001 on hypertension and the associated cardiovascular alterations. Angiotensin II (AngII)-infused mice were treated with ITH13001 (1 mg/kg per day, i.p.) for 2 weeks. The ITH13001 treatment prevented: 1) the development of hypertension, cardiac hypertrophy, and increased collagen and B-type natriuretic peptide (Bnp) expression in the heart; 2) the reduction of elasticity, incremental distensibility, fenestrae area, intraluminal diameter, and endothelial cell number in mesenteric resistance arteries (MRA); 3) the endothelial dysfunction in aorta and MRA; 4) the plasma and cardiovascular oxidative stress and the reduced aortic nitric oxide (NO) bioavailability; 5) the increased cardiac levels of the cytokines interleukin (IL)-1β, IL-6, and C-C motif chemokine ligand 2 (Ccl2), the T cell marker cluster of differentiation 3 (Cd3), the inflammasome NLRP3 (NOD-, LRR-, and pyrin domain-containing protein 3), the proinflammatory enzymes inducible nitric oxide synthase (iNOS) and COX-2, the toll-like receptor 4 (TLR4) adapter protein myeloid differentiation primary response 88 (MyD88), and the nuclear factor kappa B (NF-κB) subunit p65; 6) the greater aortic expression of the cytokines tumor necrosis factor alpha (Tnf-α), Ccl2 and IL-6, Cd3, iNOS, MyD88, and NLRP3. Although ITH13001 increased nuclear Nrf2 levels and heme oxygenase 1 (HO-1) expression in vascular smooth muscle cells, both cardiac and vascular Nrf2, Ho-1, and NADPH quinone dehydrogenase 1 (Nqo1) levels remained unmodified irrespective of AngII infusion. Summarizing, ITH13001 improved hypertension-associated cardiovascular alterations independently of Nrf2 pathway activation, likely due to its direct antioxidant and anti-inflammatory properties. Therefore, ITH13001 could be a useful therapeutic strategy in patients with resistant hypertension. SIGNIFICANCE STATEMENT: Despite the existing therapeutic arsenal, only half of the patients treated for hypertension have adequately controlled blood pressure; therefore, the search for new compounds to control this pathology and the associated damage to end-target organs (cerebral, cardiac, vascular, renal) is of particular interest. The present study demonstrates that a new melatonin derivative, ITH13001, prevents hypertension development and the associated cardiovascular alterations due to its antioxidant and anti-inflammatory properties, making this compound a potential candidate for treatment of resistant hypertensive patients.
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Affiliation(s)
- Marta Martínez-Casales
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Raquel Hernanz
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Zoe González-Carnicero
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - María T Barrús
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Angela Martín
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Ana M Briones
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Patrycja Michalska
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Rafael León
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Estefano Pinilla
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - Ulf Simonsen
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
| | - María J Alonso
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain (M.M.-C., R.H., Z.G.-C, M.T.B., A.M., M.J.A.); Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.H., A.M., A.M.B., M.J.A.); Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain (A.M.B.); Department of Chemistry, Molecular Sciences Research Hub, Imperial College London, London, UK (P.M.); Instituto de Química Médica (IQM-CSIC), Madrid, Spain (R.L.); and Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Faculty of Health, Aarhus University, Aarhus, Denmark (E.P., U.S.)
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Stewart CM, Bassiri-Tehrani B, Jones HE, Nahai F. Evidence of Hematoma Prevention After Facelift. Aesthet Surg J 2024; 44:134-143. [PMID: 37540899 DOI: 10.1093/asj/sjad247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/06/2023] Open
Abstract
Hematoma is a common complication after facelift procedures. Multiple factors have been shown to increase the risk of hematoma formation, such as male gender, anticoagulant medication use, perioperative hypertension, increased intrathoracic pressure, and operative technique. The purpose of this manuscript is to provide an overview of existing literature to provide surgeons with evidence-based recommendations on how to minimize hematoma risk during facelift surgery. A literature search for hematoma and facelift surgery was performed that identified 478 unique manuscripts. Abstracts were reviewed, excluding articles not describing facelift surgery, those written before 1970, studies with a sample size of fewer than 5 patients, non-English studies, and those that did not provide postoperative hematoma rates. Forty-five articles were included in this text, with their recommendations. Measures such as the prophylactic management of pain, nausea, and hypertension, the use of fibrin glue tissue sealants, the use of local anesthesia rather than general anesthesia, and strict blood pressure control of at least <140 mmHg were found to significantly reduce hematoma formation. Quilting sutures has shown benefit in some high-risk patients. Measures such as drains, compression dressings, perioperative use of selective serotonin reuptake inhibitors, and perioperative steroids had no significant effect on hematoma formation. In addition to appropriate patient selection and careful intraoperative hemostasis, many adjunct measures have been shown to reduce postoperative hematoma formation in facelift procedures. LEVEL OF EVIDENCE: 3
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Rada I, Cabieses B. Challenges for the prevention of hypertension among international migrants in Latin America: prioritizing the health of migrants in healthcare systems. Front Public Health 2024; 11:1125090. [PMID: 38274523 PMCID: PMC10809178 DOI: 10.3389/fpubh.2023.1125090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Among the health priorities of international migrants, non-communicable diseases such as hypertension are of major interest due to their increasing prevalence, mainly in low- and middle-income countries. Previous evidence has reported a significant risk of hypertension in international migrants derived from multiple exposures during the migration process and at the destination, such as living conditions, health literacy and access to preventive services. Also, poorer disease control has been found compared to the local population. Considering existing deficiencies in access and use of healthcare services related to hypertension prevention and continuity of care of migrants globally, we aimed to offer a Latin American perspective of the challenges faced by international migrants residing in Latin America in accessing hypertension preventive care from a human rights, equity, and universal primary healthcare approaches. From a health systems perspective, we conducted a scoping review of scientific literature on hypertension prevention and control among international migrants in Latin America and the Caribbean. Based on the findings, we discuss the potential influence of migration and health policies on healthcare systems and individual and structural barriers to healthcare access, including lack of insurance, linguistic barriers, limited intercultural competence, and geographical and financial barriers. From existing evidence related to hypertension, we highlight the particular healthcare needs of migrants and their implications for regional public health goals. This aligns with promoting culturally tailored interventions considering the migration process, lifestyle patterns, structural vulnerabilities, and gender particularities in hypertension prevention, diagnosis, and treatment. We advocate for developing universal, voluntary, and systemic regional screening and disease control initiatives in Latin America for hypertension and other chronic conditions.
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Affiliation(s)
- Isabel Rada
- Centro de Salud Global Intercultural (CeSGI), Facultad de Medicina Clínica Alemana, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
- Programa de Doctorado en Ciencias e Innovación en Medicina, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Baltica Cabieses
- Centro de Salud Global Intercultural (CeSGI), Facultad de Medicina Clínica Alemana, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
- Department of Health Sciences, University of York, York, United Kingdom
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Ibsen DB, Chiu YH, Gémes K, Wolk A. Hypothetical 22-Year Intervention With the Dietary Approaches to Stop Hypertension and Risk of Heart Failure in a General Population. Am J Epidemiol 2024; 193:96-106. [PMID: 37656615 PMCID: PMC10773477 DOI: 10.1093/aje/kwad181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 05/18/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023] Open
Abstract
We used design principles of target trial methodology to emulate the effect of sustained adherence to the Dietary Approaches to Stop Hypertension (DASH) diet on the 22-year risk of heart failure. Women and men aged 45-83 years without previous heart failure, who answered questionnaires in 1997 from the Swedish Mammography Cohort and the Cohort of Swedish Men, were eligible. Follow-up questionnaires were sent in 2008-2009. Incidence of heart failure was ascertained using the Swedish Patient Register, updated until December 31, 2019. The parametric g-formula was used to estimate the 22-year risk of heart failure under sustained adherence to a population-adapted DASH diet compared with no intervention. Intakes before 1997 for before-baseline adjustment was available only for women. In total, 31,238 women and 34,939 men were eligible. The 22-year risk of heart failure was 14.5% with long-term adherence to the DASH diet compared with 15.2% with no intervention (risk difference = -0.7%, 95% confidence interval: 1.6, 0.0%) in women and correspondingly in men 15.3% vs. 16.2% (risk difference = -0.9%, 95% confidence interval: -1.6, -0.2%). Our hypothetical intervention suggests that sustained adherence to the population-adapted DASH diet may reduce risk of heart failure in middle-aged and elderly Swedish women and men.
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Affiliation(s)
- Daniel B Ibsen
- Correspondence to Dr. Daniel B. Ibsen, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177 Stockholm, Sweden (e-mail: )
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Piao W, Li S, Guo Q, Cheng X, Xu X, Zhao L, Yu D. Bean and Nut Intake Were Protective Factors for Comorbid Hypertension and Hyperuricemia in Chinese Adults: Results from China Nutrition and Health Surveillance (2015-2017). Nutrients 2024; 16:192. [PMID: 38257085 PMCID: PMC10820914 DOI: 10.3390/nu16020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
This study aimed to describe the prevalence of comorbid hypertension and hyperuricemia (HH) and detected the dietary factors for HH in Chinese adults aged 18 to 64 years. All of the data were collected from the China Nutrition and Health Surveillance 2015-2017, with a stratified, multistage, random sampling method on a national scale. A total of 52,627 adult participants aged 18~64 years from the CNHS 2015-2017 were included in this study. HH was identified as SUA level cut-offs for males and females of 420 μmol/L and 360 μmol/L, respectively, with mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥ 90 mmHg and/or received antihypertensive treatment within two weeks. The differences in HH prevalence between or among the subgroups were compared by the Rao-Scott chi-square test. The correlations between HH and covariates or metabolic factors were detected by a weighted two-level multivariate survey logistic regression. The total weighted sufficient intake ratios of beans and nuts, vegetables, and red meat were 59.1%, 46.6%, and 64.8%, respectively. The weighted prevalence of HH in the total participants was 4.7% (95% CI: 4.3-5.0%). The positive effects of bean and nut on HH were observed. The participants who had sufficient bean and nut intake showed lower risk for HH (for the total participants: OR = 0.734, 95% CI = 0.611-0.881). The prevalence of HH might have been a public health problem, and bean and nut intake might be a protective factor for HH in the Chinese population.
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Affiliation(s)
| | | | | | | | | | | | - Dongmei Yu
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention, Beijing 100050, China
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He Y, Zou P, Lu J, Lu Y, Yuan S, Zheng X, Liu J, Zeng C, Liu L, Tang L, Fang Z, Hu X, Liu Q, Zhou S. CD4+ T-Cell Legumain Deficiency Attenuates Hypertensive Damage via Preservation of TRAF6. Circ Res 2024; 134:9-29. [PMID: 38047378 DOI: 10.1161/circresaha.123.322835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND T cells are central to the immune responses contributing to hypertension. LGMN (legumain) is highly expressed in T cells; however, its role in the pathogenesis of hypertension remains unclear. METHODS Peripheral blood samples were collected from patients with hypertension, and cluster of differentiation (CD)4+ T cells were sorted for gene expression and Western blotting analysis. TLGMNKO (T cell-specific LGMN-knockout) mice (Lgmnf/f/CD4Cre), regulatory T cell (Treg)-specific LGMN-knockout mice (Lgmnf/f/Foxp3YFP Cre), and RR-11a (LGMN inhibitor)-treated C57BL/6 mice were infused with Ang II (angiotensin II) or deoxycorticosterone acetate/salt to establish hypertensive animal models. Flow cytometry, 4-dimensional label-free proteomics, coimmunoprecipitation, Treg suppression, and in vivo Treg depletion or adoptive transfer were used to delineate the functional importance of T-cell LGMN in hypertension development. RESULTS LGMN mRNA expression was increased in CD4+ T cells isolated from hypertensive patients and mice, was positively correlated with both systolic and diastolic blood pressure, and was negatively correlated with serum IL (interleukin)-10 levels. TLGMNKO mice exhibited reduced Ang II-induced or deoxycorticosterone acetate/salt-induced hypertension and target organ damage relative to wild-type (WT) mice. Genetic and pharmacological inhibition of LGMN blocked Ang II-induced or deoxycorticosterone acetate/salt-induced immunoinhibitory Treg reduction in the kidneys and blood. Anti-CD25 antibody depletion of Tregs abolished the protective effects against Ang II-induced hypertension in TLGMNKO mice, and LGMN deletion in Tregs prevented Ang II-induced hypertension in mice. Mechanistically, endogenous LGMN impaired Treg differentiation and function by directly interacting with and facilitating the degradation of TRAF6 (tumor necrosis factor receptor-associated factor 6) via chaperone-mediated autophagy, thereby inhibiting NF-κB (nuclear factor kappa B) activation. Adoptive transfer of LGMN-deficient Tregs reversed Ang II-induced hypertension, whereas depletion of TRAF6 in LGMN-deficient Tregs blocked the protective effects. CONCLUSIONS LGMN deficiency in T cells prevents hypertension and its complications by promoting Treg differentiation and function. Specifically targeting LGMN in Tregs may be an innovative approach for hypertension treatment.
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Affiliation(s)
- Yuhu He
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Pu Zou
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Junmi Lu
- Pathology (J. Lu), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yufei Lu
- Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha (Y.L.)
| | - Shuguang Yuan
- Nephrology (S.Y.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xialei Zheng
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jing Liu
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Cheng Zeng
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ling Liu
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Liang Tang
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhenfei Fang
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xinqun Hu
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiming Liu
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shenghua Zhou
- Departments of Cardiology (Y.H., P.Z., X.Z., J. Liu, C.Z., L.L., L.T., Z.F., X.H., Q.L., S.Z.), The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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47
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Shaver N, Beck A, Bennett A, Wilson BJ, Garritty C, Subnath M, Grad R, Persaud N, Thériault G, Flemming J, Thombs BD, LeBlanc J, Kaczorowski J, Liu P, Clark CE, Traversy G, Graham E, Feber J, Leenen FHH, Premji K, Pap R, Skidmore B, Brouwers M, Moher D, Little J. Screening for hypertension in adults: protocol for evidence reviews to inform a Canadian Task Force on Preventive Health Care guideline update. Syst Rev 2024; 13:17. [PMID: 38183086 PMCID: PMC10768239 DOI: 10.1186/s13643-023-02392-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/16/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening in a primary care setting for hypertension in adults aged 18 years and older. This protocol outlines the scope and methods for a series of systematic reviews and one overview of reviews. METHODS To evaluate the benefits and harms of screening for hypertension, the Task Force will rely on the relevant key questions from the 2021 United States Preventive Services Task Force systematic review. In addition, a series of reviews will be conducted to identify, appraise, and synthesize the evidence on (1) the association of blood pressure measurement methods and future cardiovascular (CVD)-related outcomes, (2) thresholds for discussions of treatment initiation, and (3) patient acceptability of hypertension screening methods. For the review of blood pressure measurement methods and future CVD-related outcomes, we will perform a de novo review and search MEDLINE, Embase, CENTRAL, and APA PsycInfo for randomized controlled trials, prospective or retrospective cohort studies, nested case-control studies, and within-arm analyses of intervention studies. For the thresholds for discussions of treatment initiation review, we will perform an overview of reviews and update results from a relevant 2019 UK NICE review. We will search MEDLINE, Embase, APA PsycInfo, and Epistemonikos for systematic reviews. For the acceptability review, we will perform a de novo systematic review and search MEDLINE, Embase, and APA PsycInfo for randomized controlled trials, controlled clinical trials, and observational studies with comparison groups. Websites of relevant organizations, gray literature sources, and the reference lists of included studies and reviews will be hand-searched. Title and abstract screening will be completed by two independent reviewers. Full-text screening, data extraction, risk-of-bias assessment, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers. Results from included studies will be synthesized narratively and pooled via meta-analysis when appropriate. The GRADE approach will be used to assess the certainty of evidence for outcomes. DISCUSSION The results of the evidence reviews will be used to inform Canadian recommendations on screening for hypertension in adults aged 18 years and older. SYSTEMATIC REVIEW REGISTRATION This protocol is registered on PROSPERO and is available on the Open Science Framework (osf.io/8w4tz).
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Affiliation(s)
- Nicole Shaver
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Andrew Beck
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alexandria Bennett
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Brenda J Wilson
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Chantelle Garritty
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Melissa Subnath
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Navindra Persaud
- Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Guylène Thériault
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Jennifer Flemming
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Kingston Health Sciences Centre, Kingston, Canada
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
- Faculty of Medicine, McGill University, Montreal, Canada
| | - John LeBlanc
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Janusz Kaczorowski
- Department of Family and Emergency Medicine, University of Montreal, Montreal, QC, Canada
| | - Peter Liu
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada
| | - Christopher E Clark
- Primary Care Research Group, University of Exeter Medical School, Exeter, Devon, England
| | - Gregory Traversy
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Eva Graham
- Substance-Related Harms Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Janusz Feber
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Frans H H Leenen
- Department of Medicine and Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Kamila Premji
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Robert Pap
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Melissa Brouwers
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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48
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van Dorst DCH, Mirabito Colafella KM, van Veghel R, Garrelds IM, de Vries R, Mathijssen RHJ, Danser AHJ, Versmissen J. Cyclooxygenase-2 inhibition prevents renal toxicity but not hypertension during sunitinib treatment. Eur J Pharmacol 2024; 962:176199. [PMID: 38029870 DOI: 10.1016/j.ejphar.2023.176199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Anticancer angiogenesis inhibitors cause hypertension and renal injury. Previously we observed in rats that high-dose aspirin (capable of blocking cyclooxygenase (COX)-1 and-2) was superior to low-dose aspirin (blocking COX-1 only) to prevent these side-effects during treatment with the angiogenesis inhibitor sunitinib, suggesting a role for COX-2. High-dose aspirin additionally prevented the rise in COX-derived prostacyclin (PGI2). Therefore, we studied the preventive effects of selective COX-2 inhibition and the hypothesized contributing role of PGI2 during angiogenesis inhibition. METHODS Male WKY rats received vehicle, sunitinib ((SU), 14 mg/kg/day) alone or combined with COX-2 inhibition (celecoxib, 10 mg/kg/day) or a PGI2 analogue (iloprost, 100 μg/kg/day) for 8 days (n = 8-9 per group). Mean arterial pressure (MAP) was measured via radiotelemetry, biochemical measurements were performed via ELISA and vascular function was assessed via wire myography. RESULTS SU increased MAP (17±1mmHg versus 3±1mmHg after vehicle on day 4, P < 0.002), which could not be significantly blunted by celecoxib (+12±3mmHg on day 4, P = 0.247), but was temporarily attenuated by iloprost (treatment days 1 + 2 only). Urinary PGI2 (996 ± 112 versus 51 ± 11ng/24h after vehicle, P < 0.001), but not circulating PGI2 increased during SU, which remained unaffected by celecoxib and iloprost. Celecoxib reduced sunitinib-induced albuminuria (0.36 ± 0.05 versus 0.58 ± 0.05mg/24h after SU, P = 0.005). Wire myography demonstrated increased vasoconstriction to endothelin-1 after SU (Emax P = 0.005 versus vehicle), which remained unaffected by celecoxib or iloprost. CONCLUSION Selective COX-2 inhibition ameliorates albuminuria during angiogenesis inhibition with sunitinib, which most likely acts independently of PGI2. To combat angiogenesis inhibitor-induced hypertension, dual rather than selective COX-1/2 blockade seems preferential.
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Affiliation(s)
- Daan C H van Dorst
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
| | - Katrina M Mirabito Colafella
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia
| | - Richard van Veghel
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Ingrid M Garrelds
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - René de Vries
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - A H Jan Danser
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jorie Versmissen
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Hospital Pharmacy, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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49
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Saric J, Aerts A, Anne M, Barboza J, Boch J, Dashdorj N, McGhie DV, Santana A, Shellaby JT, Rollemberg SMS, Silveira M, Steinmann P, Cobos D. Assessing the contributions of an urban population health initiative to shift political priority towards cardiovascular health: three case studies from Brazil, Mongolia and Senegal. BMC Health Serv Res 2024; 24:16. [PMID: 38178108 PMCID: PMC10768224 DOI: 10.1186/s12913-023-10432-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The urban population health initiative was designed as a multidisciplinary, multisector programme to address cardiovascular (CV) disease, specifically hypertension and its underlying causes in the cities of Ulaanbaatar, Mongolia; Dakar, Senegal; and São Paulo, Brazil. This article aims to provide an overview of the history and dynamics of CV disease policy making in the three countries, to present the policy reform contributions of the initiative and its role in the policy agenda-setting framework/process in each country and to identify the enablers and challenges to the initiative for doing so. METHODS A qualitative case study was conducted for each setting from November 2020 to January 2021, comprised of a document review, semi-structured in-depth interviews and unstructured interviews with stakeholders involved in the initiative. The literature review included documents from the initiative and the peer-reviewed and grey literature with a total of 188 documents screened. Interviews were conducted with 21 stakeholders. Data collection and thematic analysis was guided by (i) the Kingdon multiple streams conceptual framework with the main themes being CV disease problems, policy, politics and the role of policy entrepreneurs; and (ii) the study question inquiring on the role of the urban population health initiative at the CV disease policy level and enabling and challenging factors to advancing CV disease policy. Data were thematically analysed using the Framework Method. RESULTS Each setting was characterized by a high hypertension and CV disease burden combined with an aware and proactive political environment. Policy outcomes attributed to the initiative were updating the guidelines and/or algorithms of care for hypertension and including revised physical and nutritional education in school curricula, in each city. Overall, the urban health initiative's effects in the policy arena, were most prominent in Mongolia and Senegal, where the team effectively acted as policy entrepreneur, promoting the solutions/policies in alignment with the most pressing local problems and in strong involvement with the political actors. The initiative was also involved in improving access to CV disease drugs at primary health levels. Its success was influenced by the local governance structures, the proximity of the initiative to the policy makers and the local needs. In Brazil, needs were expressed predominantly in the clinical practice. CONCLUSIONS This multi-country experience shows that, although the policy and political environment plays its role in shaping initiatives, often the local priority needs are the driving force behind wider change.
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Affiliation(s)
- Jasmina Saric
- Swiss Tropical and Public Health Institute, 4123, Allschwil, Switzerland.
- University of Basel, 4003, Basel, Switzerland.
| | - Ann Aerts
- Novartis Foundation, Basel, Switzerland
| | - Malick Anne
- Division de la Lutte contre les Maladies non transmissible Ministère de la Santé et de l'Action Sociale, Dakar, Sénégal
| | | | | | | | | | | | | | | | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, 4123, Allschwil, Switzerland
- University of Basel, 4003, Basel, Switzerland
| | - Daniel Cobos
- Swiss Tropical and Public Health Institute, 4123, Allschwil, Switzerland
- University of Basel, 4003, Basel, Switzerland
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50
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Conti G, Smith J, Anson E, Groth S, Knudtson M, Salvati A, Olds D. Early Home Visits and Health Outcomes in Low-Income Mothers and Offspring: 18-Year Follow-Up of a Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2351752. [PMID: 38236602 PMCID: PMC10797459 DOI: 10.1001/jamanetworkopen.2023.51752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/27/2023] [Indexed: 01/19/2024] Open
Abstract
Importance Individuals with low income may have heightened rates of obesity and hypertension. Objective To determine whether prenatal and infancy home visitation by nurses reduces maternal and offspring obesity and hypertension. Design, Setting, and Participants This randomized clinical trial of prenatal and infancy nurse home visitation in a public health care system in Memphis, Tennessee, enrolled 742 women with no previous live births and at least 2 sociodemographic risk factors (unmarried, <12 years of education, unemployed) from June 1, 1990, through August 31, 1991. At registration during pregnancy, 727 mothers (98%) were unmarried, and 631 (85%) lived below the federal poverty level. At offspring ages 12 and 18 years, maternal and offspring obesity and hypertension were assessed by staff masked to treatment. The data analysis was performed from July 1, 2021, to October 31, 2023. Interventions Women assigned to the control group received free transportation for prenatal care and child developmental screening and referral at child ages 6, 12, and 24 months. Women assigned to nurse visitation received transportation and screening plus prenatal and infant and toddler nurse home visits. Main Outcomes and Measures Obesity and hypertension among mothers and their offspring at child ages 12 and 18 years, although not hypothesized in the original trial design, were analyzed using post-double selection lasso method. Results Of the 742 participants randomized (mean [SD] age, 18.1 [3.2] years), interviews were completed with 594 mothers and 578 offspring at child age 12 years and 618 mothers and 629 offspring at child age 18 years. Obesity was assessed for 576 offspring at age 12 years and 605 at age 18 years and for 563 and 598 mothers at child ages 12 and 18 years, respectively. Blood pressure was assessed for 568 offspring aged 12 years and 596 aged 18 years and 507 and 592 mothers at child ages 12 and 18 years, respectively. There were no overall treatment-control differences in offspring obesity or hypertension at ages 12 and 18 years combined, although nurse-visited female offspring, compared with controls, had a lower prevalence of obesity (adjusted relative risk [ARR], 0.449; 95% CI, 0.234-0.858; P = .003) and severe obesity (ARR, 0.185; 95% CI, 0.046-0.748; P < .001). There were reductions at ages 12 and 18 years combined for stage 1 and stage 2 hypertension for nurse-visited vs control group mothers, with differences limited to mothers of females (stage 1: ARR, 0.613 [95% CI, 0.440-0.855; P = .001]; stage 2: ARR, 0.217 [95% CI, 0.081-0.582; P < .001]). For both obesity and hypertension outcomes, there was no intervention effect among male offspring or the mothers of males. Self-reported maternal health aligned with program effects on hypertension. Conclusions and Relevance In this clinical trial follow-up at offspring ages 12 and 18, nurse-visited female offspring had lower rates of obesity and mothers of females had lower rates of hypertension than control-group counterparts. These findings suggest that risks for chronic disease among mothers of females and their female offspring who live in extreme poverty may be prevented with prenatal and infant and toddler home visitations by nurses. Trial Registration ClinicalTrials.gov Identifier: NCT00708695.
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Affiliation(s)
| | - Joyce Smith
- University of Rochester School of Nursing, Rochester, New York
| | - Elizabeth Anson
- University of Rochester School of Nursing, Rochester, New York
| | - Susan Groth
- University of Rochester School of Nursing, Rochester, New York
| | - Michael Knudtson
- University of Colorado Denver–Anschutz Medical Campus, Aurora, Colorado
| | | | - David Olds
- University of Colorado Denver–Anschutz Medical Campus, Aurora, Colorado
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