Determinants Of Blood Pressure Research Articles

Birth Weight and Maternal Body Size as Determinants of Blood Pressure at Age 17: Results from the Jerusalem Perinatal Study Cohort.

To investigate the effect of birth weight (BW) and maternal pre-pregnancy BMI (mBMI) on blood pressure (BP) in adolescence. A Population-based cohort of 11,729 births in Jerusalem during 1974-1976, with archival data on maternal and birth characteristics was performed. Measurements at age 17 were assessed and linear regression models were used to evaluate the associations of birth characteristics with BP outcomes. BW was inversely associated with both systolic (SBP) and diastolic (DBP) BP at age 17 (SBP: B = - 0.829, p = 0.002; DBP: B = - 0.397, p = 0.033). The interaction term between BW and weight at age 17 was significant for DBP (p = 0.017) and pulse pressure (p = 0.005). mBMI yielded significant positive associations with BP, independent of BW. Our findings indicate that there are at least two distinct pathways linking early life characteristics with subsequent BP: Intrauterine growth, as reflected by BW and other genetic or environmental factors, reflected by mBMI and maternal education, contribute to offspring adolescent BP. These results warrant replication in other birth cohorts and underline the need to explore specific mechanisms that account for these associations.

Comparison of Heart Rate Variability among Young Malay Male Adult with Different BMI and Level of Adiposity

INTRODUCTION: Subclinical changes that occur in the heart at an early age may provide valuable information to outline prevention strategies for cardiovascular diseases. Heart rate variability (HRV) reflects regulation of autonomic balance, heart, and vascular tone, which are the determinants of blood pressure. Therefore, this study aimed to determine the difference in heart rate variability (HRV) of Malay male young adult with their BMI and adiposity level. MATERIALS AND METHODS: A total of 201 Malay male young adult aged between 19 to 24 years old were screened and their BMI and adiposity level were measured. Three non -invasive tests; Valsalva Manoeuvre, orthostatic response and 30/15 ratio of heart rate were performed. Short term HRV time and frequency domains were recorded. RESULTS: Despite few significant differences in HRV parameters of overweight/obese subjects, the result is inconclusive to conclude any reduced variability. However, those with high adiposity regardless of their BMI reported significantly lower mean of R -R SD in time domain and lower mean of LF/HF ratio in frequency domain. The orthostatic reflex results revealed that high adiposity subjects had significantly lower mean of LF and HF. A decrement of -0.28 ms2 HF/LF during Valsalva manoeuvre, -0.35 LF ms2 in orthostatic reflex and 0.33 ms2 in orthostatic reflex per 1% of body fat percentage were observed. CONCLUSION: HRV parameters were inversely proportional to the adiposity level which was suggestive of modulation of sympathetic function can occur at an early age.

Early Determinants of Childhood Blood Pressure at the Age of 6 Years: The GECKO Drenthe and ABCD Study Birth Cohorts.

BackgroundThere is still uncertainty about the nature and relative impact of early determinants on childhood blood pressure. This study explored determinants of blood pressure at the age of 6 years in 2 Dutch birth cohorts.Methods and ResultsResults of hierarchical multiple linear regression analyses in GECKO (Groningen Expert Center for Kids With Obesity) Drenthe study (n=1613) were replicated in ABCD (Amsterdam Born Children and Their Development) study (n=2052). All analyses were adjusted for child's age, sex, height, and body mass index (BMI), and maternal education and subsequently performed in the combined sample. No associations were found between maternal smoking during pregnancy and childhood blood pressure. In the total sample, maternal prepregnancy BMI was positively associated with systolic blood pressure (SBP) (β [95% CI], 0.09 [0.02–0.16] mm Hg) and diastolic blood pressure (β [95% CI], 0.11 [0.04–0.17] mm Hg). Children of women with hypertension had higher SBP (β [95% CI], 0.98 [0.17–1.79] mm Hg). Birth weight standardized for gestational age was inversely associated with SBP (β [95% CI], −6.93 [−9.25 to −4.61] mm Hg) and diastolic blood pressure (β [95% CI], −3.65 [−5.70 to −1.61] mm Hg). Longer gestational age was associated with lower SBP (β [95% CI] per week, −0.25 [−0.42 to −0.08] mm Hg). Breastfeeding for 1 to 3 months was associated with lower SBP (β [95% CI], −0.96 [−1.82 to −0.09] mm Hg) compared with no or <1 month of breastfeeding. Early BMI gain from the age of 2 to 6 years was positively associated with SBP (β [95% CI], 0.41 [0.08–0.74] mm Hg) and diastolic blood pressure (β [95% CI], 0.37 [0.07–0.66] mm Hg), but no effect modification by birth weight was found.ConclusionsHigher maternal prepregnancy BMI, maternal hypertension, a relatively lower birth weight for gestational age, shorter gestational age, limited duration of breastfeeding, and more rapid early BMI gain contribute to higher childhood blood pressure at the age of 6 years.

Hypovitaminosis D, Dyslipidaemia and Thyroid Dysfunction Among Adolescents and Their Associations With Raised Blood Pressure in a North Eastern City of India

Background: Raised blood pressure (BP) has been found to be associated with serum levels of vitamin D3, lipid profile and thyroid hormones among adults. But limited information is available regarding such associations in adolescents. Objectives To estimate the prevalence vitamin D3 deficiency, dyslipidaemia and thyroid dysfunction among secondary school students of Agartala municipal corporation area and to study their associations with raised BP. Methods: This school based cross-sectional study was conducted during April 2018 to December 2018 among 1000 students studying in different secondary level schools located in Agartala municipal corporation area chosen by multi stage sampling technique ensuring proportionate representation in the sample. Result: Prevalence of vitamin D3 deficiency, thyroid dysfunction and dyslipidaemia were found to be 79.4%, 62.8% and 37.5% respectively. Out of total, 58.1% of the study subjects had raised BP, 34.1% were fatty, 16.7% were overweight, 5.3% were obese and 48.3% had high waist hip ratio (WHR). Among all, 82.27% subjects with high BMI, 70.97% fatty subjects and 69.05% subjects with either low or normal WHR had significantly elevated BP (p 0.05). Binary logistic regression has identified higher BMI, higher body fat content, high WHR, habit of consuming extra salt and fast food on regular basis as the significant determinants of raised BP in this population (p<0.05). Conclusion: Though vitamin D deficiency, thyroid dysfunction and dyslipidaemia are prevalent among adolescents of Northeast India, they did not emerge as significant determinants of blood pressure in them. Funding Statement: Department of Health Research (DHR), Ministry of Health & Family Welfare, Govt. of India, New Delhi through Multidisciplinary Research Unit, AGMC. Declaration of Interests: There is no conflict of interest. Ethics Approval Statement: Informed written consent document for participation in this study was handed over to participating students for obtaining consent from their guardians. This study was approved by the institutional ethics committee of Agartala Government Medical College.

Effect of urinary angiotensinogen and high-salt diet on blood pressure in patients with chronic kidney disease: results from the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD).

Background/AimsThis study aimed to investigate whether urinary angiotensinogen (UAGT) excretion was associated with elevated blood pressure in patients with chronic kidney disease (CKD) and to evaluate the relationship among blood pressure, intra-renal renin-angiotensin system (RAS) activity, and dietary sodium in patients with CKD.MethodsParticipants from the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) were included. Of the total cohort of 2,238 individuals with CKD, we included 1,955 participants who underwent complete 24-hour urinary sodium (24-hour UNa) analysis. They were categorized into three groups according to three tertiles of their 24-hour UNa, reflecting daily salt intake. To measure intra-renal RAS activity, the UAGT excretion was assayed with an enzyme-linked immunosorbent assay.ResultsElevated 24-hour UNa levels, logarithm of UAGT-to-creatinine ratio (UAGT/Cr), increased waist-to-hip ratio, and decreased estimated glomerular filtration rate were the risk factors for increased systolic blood pressure. Systolic blood pressure showed a positive correlation with 24-hour UNa levels and logarithm of UAGT/Cr.ConclusionsUAGT and urinary sodium excretion are independent determinants of systolic blood pressure in patients with CKD. These findings suggest that increased systolic blood pressure in CKD patients is associated with both increased dietary sodium levels and intra-renal RAS activity. The risk of elevated systolic blood pressure in the 3rd tertile of both the UAGT/Cr and 24-hour UNa groups was about 2.3 times higher than that in the reference group.

Renal Interstitial Fibroblasts Coproduce Erythropoietin and Renin Under Anaemic Conditions

Erythrocyte mass contributes to maintaining systemic oxygen delivery and blood viscosity, with the latter being one of the determinants of blood pressure. However, the physiological response to blood pressure changes under anaemic conditions remain unknown. Here, we show that anaemia decreases blood pressure in human patients and mouse models. Analyses of pathways related to blood pressure regulation demonstrate that anaemia enhances the expression of the gene encoding the vasopressor substance renin in kidneys. Although kidney juxtaglomerular cells are known to continuously produce renin, renal interstitial fibroblasts are identified in the present study as a novel site of renin induction under anaemic hypotensive conditions in mice and rats. Notably, some renal interstitial fibroblasts are found to simultaneously express renin and the erythroid growth factor erythropoietin in the anaemic mouse kidney. Antihypertensive agents but not hypoxic stimuli induced interstitial renin expression, suggesting that blood pressure reduction triggers interstitial renin induction in anaemic mice. The interstitial renin expression was also detected in injured fibrotic kidneys of the mouse and human, and the renin-expressing interstitial cells in murine fibrotic kidneys were identified as myofibroblasts originating from renal interstitial fibroblasts. Since the elevated expression levels of renin in fibrotic kidneys along with progression of renal fibrosis were well correlated to the systemic blood pressure increase, the renal interstitial renin production seemed to affect systemic blood pressure. These results propose that renal interstitial fibroblasts function as central controllers of systemic oxygen delivery by producing both renin and erythropoietin.

Determinants of High Blood Pressure in Subjects Living with Type 2 Diabetes in Urban Areas in Togo

Determinants of High Blood Pressure in Subjects Living with Type 2 Diabetes in Urban Areas in Togo

Selective Phosphodiesterase 1 Inhibitor BTTQ Reduces Blood Pressure in Spontaneously Hypertensive and Dahl Salt Sensitive Rats: Role of Peripheral Vasodilation.

Regulation of the peripheral vascular resistance via modulating the vessel diameter has been considered as a main determinant of the arterial blood pressure. Phosphodiesterase enzymes (PDE1-11) hydrolyse cyclic nucleotides, which are key players controlling the vessel diameter and, thus, peripheral resistance. Here, we have tested and reported the effects of a novel selective PDE1 inhibitor (BTTQ) on the cardiovascular system. Normal Sprague Dawley, spontaneously hypertensive (SHR), and Dahl salt-sensitive rats were used to test in vivo the efficacy of the compound. Phosphodiesterase radiometric enzyme assay revealed that BTTQ inhibited all three isoforms of PDE1 in nanomolar concentration, while micromolar concentrations were needed to induce effective inhibition for other PDEs. The myography study conducted on mesenteric arteries revealed a potent vasodilatory effect of the drug, which was confirmed in vivo by an increase in the blood flow in the rat ear arteriols reflected by the rise in the temperature. Furthermore, BTTQ proved a high efficacy in lowering the blood pressure about 9, 36, and 24 mmHg in normal Sprague Dawley, SHR and, Dahl salt-sensitive rats, respectively, compared to the vehicle-treated group. Moreover, additional blood pressure lowering of about 22 mmHg could be achieved when BTTQ was administered on top of ACE inhibitor lisinopril, a current standard of care in the treatment of hypertension. Therefore, PDE1 inhibition induced efficient vasodilation that was accompanied by a significant reduction of blood pressure in different hypertensive rat models. Administration of BTTQ was also associated with increased heart rate in both models of hypertension as well as in the normotensive rats. Thus, PDE1 appears to be an attractive therapeutic target for the treatment of resistant hypertension, while tachycardia needs to be addressed by further compound structural optimization.

Prevalence and determinants of blood pressure variability in pygmies of Southern region Cameroon.

The impact of urbanization and living conditions on the prevalence of hypertension in the Cameroonian population is poorly known. To evaluate the prevalence and determinants of blood pressure (BP) in adult Pygmies and Bantus living in urban and rural areas of Southern Cameroon. This was a cross-sectional comparative study of 406 adults (96 urban Bantus, 100 urban Pygmies, 111 rural Bantus and 99 tropical rainforest Pygmies with a traditional Pygmies way of life), recruited in Southern Cameroon (mean age 42 ± 17 years; 56.7% women). Sociodemographic, anthropometric and BP parameters were collected. Hypertension was defined as BP at least 140/90 mmHg and/or use of BP-lowering drug(s). The age-standardized prevalence of hypertension in urban Bantus, rural Bantus, urban Pygmies and traditional Pygmies was 18.0, 13.5, 9.3 and 4.1%, respectively. Mean SBP and DBP differed significantly according to Bantu vs. Pygmy ethnicity, and urban vs. rural residency. After multiple adjustments, mean arterial pressure was significantly associated with age, BMI, Bantu ancestry and urban residency. Bantu ethnicity and urban residency are significantly associated with high-BP among people from Southern Cameroon.

Prevalence and determinants of self-reported high blood pressure among women of reproductive age in Benin: a population-based study

BackgroundAddressing chronic diseases is a challenge for healthcare systems worldwide, which have largely developed to deal with acute episodic care, rather than to provide organized care for people with age-long conditions. Therefore, exploring the prevalence and identifying the risk factors is a major approach to prevention and control of chronic diseases. The aim of this study was to examine the prevalence and factors associated with self-reported high blood pressure among women of reproductive age in Benin.MethodsWe utilized population-based cross-sectional data from Benin Demographic and Health Survey (BDHS). BDHS 2017–18 is the round V of the survey. A total of 7712 women of reproductive age were included in this study. The outcome variable was self-reported high blood pressure. Percentages, chi-square test and multivariable logistic regression model were used to analyze the data. Results from the multivariable logistic model were presented as adjusted odds ratio (aOR) and confidence interval (95%CI). The significance level was set at p < 0.05.ResultsThe total prevalence of self-reported high blood pressure among women of reproductive age in The Gambia was about one-tenth (9.9%). Furthermore, geographical region was associated with high blood pressure. Women aged 45–49 years had increased odds of high blood pressure, when compared with women aged 15–19 years (aOR = 2.73; 95%CI: 1.10, 6.79). In addition, increased maternal enlightenment gave higher odds of high blood pressure, when compared to women with low maternal enlightenment (aOR = 1.41; 95%CI: 1.08, 1.84). Women with highest neighbourhood socioeconomic disadvantaged status (poor women) had 30% reduction in the odds of high blood pressure, when compared with women of low neighbourhood socioeconomic disadvantaged status (aOR = 0.70; 0.50, 0.99). Women having increased lifetime number of sex partners (total of 3 lifetime number of sex partners: aOR = 1.40; 95%CI: 1.01, 1.94; more than 3 total lifetime number of sex partners: aOR = 1.53; 95%CI: 1.01, 2.32) were more likely to have high blood pressure, when compared to women with only one lifetime number of sex partner.ConclusionsEmphasis on high blood pressure prevention methods and involvement of multiple sectors could help to disseminate health care interventions widely. Also, a concerted effort from the stakeholders in health care system and decision-makers is needed to address the drivers of high blood pressure while maintaining health system improvement strategies. The findings could prompt appropriate policy responses towards improving the knowledge and control of high blood pressure in Benin.

Blood Pressure Profiles And Determinants Of Hypertension Among Public Secondary School Students In Nnewi, Southeast Nigeria

Background: Hypertension and associated factors among adolescents have not been given the deserved attention in health care, more so as hypertensive children end up as hypertensive adults with serious co-morbidities. This is even more expedient among public school students, who in our environment are generally of lower socioeconomic status than those in private schools.&#x0D; Objective: To determine the BP profiles and association of obesity indicators, socioeconomic level and physical activity with hypertension among public secondary school students.&#x0D; Methodology: A cross-sectional school-based assessment of blood pressure (BP), body mass index (BMI), weight to height ratio (WHR), waist circumference (WC), physical activity and socioeconomic level among 593 students aged 10 – 17 years in public schools in Nnewi, Southeast Nigeria was carried out.&#x0D; Results: The mean systolic BP increased with age and was higher for girls than for boys. The prevalence of systolic hypertension and prehypertension were 8.4% and 6.6% respectively, while that of diastolic hypertension and prehypertension were 5.7% and 11.8% respectively. Both systolic and diastolic hypertension occurred in 2.4% of students. Girls had a higher prevalence of hypertension – both systolic and diastolic. There was no significant gender difference in the prevalence of systolic hypertension and prehypertension between early and late adolescents. Early adolescent males were more likely to have diastolic hypertension and prehypertension compared to late adolescent males, while no difference in prevalence was noted among the females. Systolic hypertension was more evident in the lower socioeconomic level, those with minimal physical activity, and those in the obese/overweight categories of BMI, WC, and WHR.&#x0D; Conclusion: There is a noteworthy prevalence of hypertension among adolescent public secondary school students in Nnewi. This was significantly higher among the female gender, lower socioeconomic level and students with minimal physical activity. Waist circumference in the obese/overweight category very likely predicts hypertension.

Obesity, metabolic syndrome, and primary hypertension

Primary hypertension is the dominant form of arterial hypertension in adolescents. Disturbed body composition with, among other things, increased visceral fat deposition, accelerated biological maturation, metabolic abnormalities typical for metabolic syndrome, and increased adrenergic drive constitutes the intermediary phenotype of primary hypertension. Metabolic syndrome is observed in 15–20% of adolescents with primary hypertension. These features are also typical of obesity-related hypertension. Metabolic abnormalities and metabolic syndrome are closely associated with both the severity of hypertension and the risk of target organ damage. However, even though increased body mass index is the main determinant of blood pressure in the general population, not every hypertensive adolescent is obese and not every obese patient suffers from hypertension or metabolic abnormalities typical for metabolic syndrome. Thus, the concepts of metabolically healthy obesity, normal weight metabolically unhealthy, and metabolically unhealthy obese phenotypes have been developed. The risk of hypertension and hypertensive target organ damage increases with exposure to metabolic risk factors which are determined by disturbed body composition and visceral obesity. Due to the fact that both primary hypertension and obesity-related hypertension present similar pathogenesis, the principles of treatment are the same and are focused not only on lowering blood pressure, but also on normalizing body composition and metabolic abnormalities.

Genetic aetiology of blood pressure relates to aortic stiffness with bi-directional causality: evidence from heritability, blood pressure polymorphisms, and Mendelian randomization.

Haemodynamic determinants of blood pressure (BP) include cardiac output (CO), systemic vascular resistance (SVR), and arterial stiffness. We investigated the heritability of these phenotypes, their association with BP-related single-nucleotide polymorphisms (SNPs), and the causal association between BP and arterial stiffness. We assessed BP, central BP components, and haemodynamic properties (during a single visit) including CO, SVR, and pulse wave velocity (PWV, measure of arterial stiffness) in 3531 (1934 monozygotic, 1586 dizygotic) female TwinsUK participants. Heritability was estimated using structural equation modelling. Association with 984 BP-associated SNP was examined using least absolute shrinkage and selection operator (LASSO) and generalized estimating equation regression. One and two-sample Mendelian randomization (MR) was used to estimate the causal direction between BP and arterial stiffness including data on 436419 UK Biobank participants. We found high heritability for systolic and pulsatile components of BP (>50%) and PWV (65%) with overlapping genes accounting for >50% of their observed correlation. Environmental factors explained most of the variability of CO and SVR (>80%). Regression identified SNPs (n = 5) known to be associated with BP to also be associated with PWV. One-sample MR showed evidence of bi-directional causal association between BP and PWV in TwinsUK participants. Two-sample MR, confirmed a bi-directional causal effect of PWV on BP (inverse variance weighted (IVW) beta = 0.11, P < 0.02) and BP on arterial stiffness (IVW beta = 0.004, P < 0.0001). The genetic basis of BP is mediated not only by genes regulating BP but also by genes that influence arterial stiffness. Mendelian randomization indicates a bi-directional causal association between BP and arterial stiffness.

Childhood OSA is an independent determinant of blood pressure in adulthood: longitudinal follow-up study

BackgroundCurrent literature supports cross-sectional association between childhood obstructive sleep apnoea (OSA) and elevated blood pressure (BP). However, long-term cardiovascular outcomes in children with OSA remain unexplored.ObjectiveTo evaluate the associations of...

Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia.

BackgroundHypertension is the leading cause of morbidity and mortality among non-communicable diseases. The rate of blood pressure (BP) control among hypertensive patients is poor and the reasons for poor control of BP remain poorly understood globally. Therefore, this study aimed to assess the magnitude and determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at Nekemte referral hospital (NRH).MethodsA hospital-based cross-sectional study was conducted from February to April 2018 at NRH. BP control status was determined by the average consecutive BP recordings across the 3 months. The data was entered and analyzed using SPSS version 20.0 and p-value <0.05 was considered statistically significant.ResultsOut of 297 study participants included, the majority were females, 181 (60.9%), and the mean age of the patients was 59.4 ±10.4 years. About half, 137 (46.12%), of the patients had at least one comorbidity and the most common class of anti-hypertensive medication was angiotensin-converting enzyme inhibitors (88.2%). The mean of systolic blood pressure was 132.41± 15.61mmHg, while the mean of diastolic blood pressure was 84.37± 9.32 mmHg. The proportion of participants with optimally controlled BP was 63.6% and 36% were adherent to their medications. Male sex (Adjusted Odd Ratio [AOR]: 1.89, 95% CI: 1.09–4.84), illiteracy (AOR= 1.56, 95% CI: 1.22–6.78), duration of hypertension diagnosis > 10 years (AOR= 2.01, 95% CI: 1.04–16.11), non-adherence (AOR= 3.14, 95% CI: 1.35–10.76) and lack of physical exercise (AOR= 2.8, 95% CI: 1.16–6.74) were positively associated with uncontrolled BP status. Whereas age older than 55 years (AOR= 0.38, 95% CI: 0.11–0.92) was negatively associated with uncontrolled BP.ConclusionBP control was relatively achieved in about two-third of pharmacologically treated patients. We recommend better health education and care of patients to improve the rate of BP control status.

Selective Phosphodiesterase 1 Inhibitor LY1 Reduces Blood Pressure in Spontaneously Hypertensive and Dahl Salt Sensitive Rats

Regulation of the peripheral vascular resistance via modulating the vessel diameter has been considered as a main determinant of the arterial blood pressure. Phosphodiesterase enzymes (PDE1‐11) hydrolyse cyclic nucleotides, which are key players controlling the vessel diameter and thus peripheral resistance, aiming at achieving and maintaining a homeostatic balance between their production and destruction. On the contrary, pathological shift in the balance to words the destruction leads to depletion of the cyclic nucleotides and dysregulation of the blood pressure. Here, we have tested and reported the effects of a novel selective PDE1 inhibitor (LY1) on the cardiovascular system. In vitro experiments have been conducted to determine the IC50 of LY1 using phosphodiesterase radiometric enzyme assay. We used rat mesenteric artery to conduct myogrphy study to determine the effect of the drug on the vessel diameter. Also, short as well as long term telemetric studies were done on normal Sprague Dawley (SD), spontaneously hypertensive (SHR), and Dahl salt sensitive (SS) rats to document the in vivo efficacy of the compound. LY1 inhibited all three isoforms of PDE1 in nanomolar concentration (1.74 nM, 2.44 nM and 1.20 nM for PDE1A, PDE1B and PDE1C, respectively), while micromolar concentrations were needed to induce effective inhibition for other PDEs. The myography study revealed a potent vasodilatory effect of the drug, which was confirmed in vivo by an increase in the blood flow in the rat ear arteriole reflected by the rise in the temperature. LY1 proved a high efficacy in lowering the blood pressure in two animal models for hypertension i.e. SHR and SS rats. 3 mg/kg of LY1 twice daily through oral gavage could efficiently reduce the blood pressure in both SHR and SS rats approximately 40 mmHg compared to the untreated control group. Therefore, LY1 induced an efficient vasodilation that was accompanied by a significant reduction of blood pressure in different hypertensive rat models. Thus, PDE1 appears to be a tempting therapeutic target for treatment of resistant hypertension.

The Use of Chlorisondamine to Assess the Vasomotor Sympathetic Tonus in Normotensive Mice

Chlorisondamine (CSD), a long‐lasting nicotinic receptor antagonist and ganglionic blocker, has been commonly used to assess the sympathetic vasomotor tone in mice. Both cardiac output and peripheral resistance are blood pressure (BP) determinants; however, it is not defined whether the BP reduction observed after the administration of this agent is caused by a decrease in the sympathetic activity solely to the blood vessels (vasomotor tone) or if there is a contribution from the reduction in cardiac output. The aim of this study was to examine the effects of CSD in cardiac output and BP, and to identify an appropriate dose of CSD for the assessment of the sympathetic vasomotor tone in normotensive mice. We used echocardiography to examine the cardiac output (CO) and function, and telemetry system to record BP and heart rate (HR) in response to intraperitoneal (i.p.) injection of CSD.C57Bl/6J mice (12–14 weeks old) were i.p. injected with series doses of CSD (1, 2, 3, or 6 mg/Kg) and the cardiac function was assessed by Echocardiography (VEVO® 2100, Fujifilm Visualsonics) after 30 minutes of injection. Two‐dimensional M‐mode images of the parasternal long‐axis and the short‐axis of the heart were used to calculate CO, stroke volume (SV), ejection fraction (EF) and fractional shortening (FS). We found that CSD in 1 mg/kg (16.1±1.0 ml/min, n=7, p=0.70) and 2 mg/kg (14.89±0.7 ml/min, n=7, p=0.22) did not affect the CO; while, the doses of 3 mg/Kg (CO: 13.3±0.4 ml/min, n=7, p&lt;0.05) and 6 mg/Kg (CO: 14.3±1.1 ml/min, n=14, p&lt;0.05) of CSD significantly reduced CO when compared to baseline (CO: 18.0±0.8 ml/min, n=21). There was no impact of CSD on stroke volume (SV), ejection fraction (EF) and fractional shortening (FS). The data indicate that a higher dose of CSD reduced CO in mice.A second set of C57Bl/6J (n=5–7/group) mice were instrumented with radio telemetry transmitters (PA‐C10; Data Science International). After 14 days of recovery, baseline BP and HR were recorded and the mice were i.p. injected with series doses of CSD (1, 2, 3, or 6 mg/Kg) every 48 hours while BP and HR were simultaneously recorded. The trough in mean arterial pressure (MAP) and HR tracings were used to calculate the maximum response to CSD. We found that 1 mg/Kg of CSD did not significantly reduce BP or HR when compared to the i.p. injection of 0.9% saline; whereas, all other doses of CSD significantly reduced BP (ΔMAP) (2 mg/Kg: −25.5±3.3 mmHg; 3 mg/Kg: −31.1±3.4 mmHg, 6 mg/Kg: −31.0±7.0 mmHg, p&lt;0.01), an indicative of sympathetic contribution to the BP. Interestingly, there is no significant difference in reduction in BP among mice that received 2, 3, or 6 mg/kg of CSD. In summary, our data suggest that 2 mg/Kg of CSD is an appropriate dose that can be used to assess the sympathetic vasomotor tone in normotensive mice as the BP reduction observed after the injection of this dose of CSD are not accompanied by changes in cardiac output.Support or Funding InformationNIH/NHLBI (R01HL122770), American Heart Association ( 17IRG33370128), NIH/NIGMS (1P20GM130459‐5451)

Identification of High-Risk Pregnancies in a Remote Setting Using Ambulatory Blood Pressure: The MINDI Cohort.

Background: Ambulatory blood pressure is a potential tool for early detection of complications during pregnancy, but its utility in impoverished settings has not been assessed. This cross-sectional study aimed to determine whether maternal infections, nutrient deficiencies and inflammation (MINDI) were associated with four measures of maternal blood pressure (BP) and to determine their association with symphysis-fundal-height (SFH).Methods: Environmental and dietary factors, intake of iron and a multiple-nutrient supplement (MNS), markers of inflammation, protein, anemia, folate, vitamins B12, A and D status, and urogenital, skin, oral and intestinal nematode infections were measured in indigenous pregnant Panamanian women. Stepwise multiple linear and logistic regression models explored determinants of systolic and diastolic blood pressure (SBP, DBP), hypotension (SBP < 100 and DBP < 60), mean arterial pressure (MAP), elevated MAP (eMAP), and pulse pressure (PP). Associations of BP with intestinal nematodes and with SFH Z scores (≥16 wk) were also explored.Results: Despite absence of high SBP or DBP, 11.2% of women had eMAP. Furthermore, 24.1% had hypotension. Linear regression showed that hookworm infection was associated with higher SBP (P = 0.049), DBP (P = 0.046), and MAP (P = 0.016), whereas Ascaris was associated with lower DBP (P = 0.018) and MAP (P = 0.028). Trichomonas was also associated with lower SBP (P < 0.0001) and MAP (P = 0.009). The presence of Trichuris (OR: 6.7, 95% CI 1.0–44.5) and folic acid deficiency (OR: 6.9, 95% CI 1.4–33.8) were associated with increased odds of eMAP. The odds of low BP was higher in the presence of Ascaris (OR: 3.63 ± 2.28, P = 0.040), but odds were lowered by MNS (OR: 0.35 ± 0.11, P = 0.001), more intake of animal-source foods/wk (OR: 0.7, 95% CI 0.5–0.9) and by higher concentrations of IL-17 (OR: 0.87 ± 0.05, P = 0.016).Conclusion: MINDI were bi-directionally associated with blood pressure indicators. In this MINDI cohort, infections, nutrients and cytokines both raised, and lowered BP indices. The presence of eMAP identified pregnant women at risk of hypertension whereas low PP was associated with lower SFH. Therefore, MAP and PP may help in detecting women at risk of adverse pregnancy outcomes in settings with limited access to technology.

Gender-specific associations of anthropometric measures of adiposity with blood pressure and hypertension in young Chinese Medical College Students

Purpose: There are uncertainties about whether general or central obesity is the more important determinant for blood pressure and hypertension in young Chinese. We aim to investigate the association between adiposity measures and blood pressure and hypertension in young medical students.

The Association Between Selected Molecular Biomarkers and Ambulatory Blood Pressure Patterns in African Chronic Kidney Disease and Hypertensive Patients Compared With Normotensive Controls: Protocol for a Longitudinal Study.

BackgroundChronic kidney disease (CKD) is a burgeoning epidemic in sub-Saharan Africa. Abnormal blood pressure variations are prevalent in CKD and potentiate the risk of cardiovascular morbidity and mortality. Certain genetic variants (angiotensin II receptor type 1 1166 A>C and angiotensin-converting enzyme insertion and deletion polymorphisms) and biomarkers such as interleukin–6, tumor necrosis factor, soluble (s) E-selectin, homocysteine, and highly sensitive C-reactive protein have been shown to affect blood pressure variability among non-African CKD, hypertensive. and nonhypertensive CKD population. However, the contributions of the pattern, genetic, and environmental determinants of ambulatory blood pressure in African CKD have not been characterized. Understanding these interactions may help to develop interventions to prevent major cardiovascular events among people with CKD.ObjectiveThe overarching objective of this study is to identify, document, and develop approaches to address related phenomic, genetic, and environmental determinants of ambulatory blood pressure patterns in African CKD and non-CKD hypertensive patients compared with normotensive controls.MethodsThis is a longitudinal short-term follow-up study of 200 adult subjects with CKD and 200 each of age-matched hypertensives without CKD and apparently healthy controls. Demographic information, detailed clinical profile, electrocardiography, echocardiography, and 24-hr ambulatory blood pressure measurements will be obtained. Blood samples will be collected to determine albumin-creatinine ratio, fasting plasma glucose, lipid profile, electrolytes, urea and creatinine, C-reactive protein, serum homocysteine, fibroblast growth factor–23, and complete blood count, while 2 mL blood aliquot will be collected in EDTA (ethylenediaminetetraacetic acid) tubes and mixed using an electronic rolling system to prevent blood clots and subsequently used for DNA extraction and genetic analysis.ResultsA total of 239 participants have been recruited so far, and it is expected that the recruitment phase will be complete in June 2020. The follow-up phase will continue with data analysis and publications of results.ConclusionsThis study will help stratify Nigerian CKD patients phenotypically and genotypically in terms of their blood pressure variations with implications for targeted interventions and timing of medications to improve prognosis.International Registered Report Identifier (IRRID)DERR1-10.2196/14820