Blood Pressure Variability Research Articles

Abstract P187: Obesity predicts left ventricular mass in youth undergoing ambulatory blood pressure monitoring

Background: Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular disease in adults. In youth, elevated blood pressure (BP) is associated with LVH, but independent effects of adiposity and hypertension on LVH are not well defined. The purpose of our study was to investigate relationships among LVH, LV mass, BMI, and other clinical parameters in pediatric patients referred for elevated BP. We hypothesized both BP and BMI to be associated with LV mass. Methods: We conducted an IRB-approved retrospective chart review of all patients ages 6-18 years who underwent 24-hour ambulatory BP monitoring via the pediatric nephrology clinic at Kentucky Children’s Hospital from August 2012-December 2023 (excluding those with secondary HTN). Obesity was defined by BMI and weight-for-length percentiles according to CDC guidelines. LV mass was assessed by standard echocardiography. We compared LVMI and BP measures among groups stratified by obesity stage. Associations among BP, obesity, and LVMI were determined using descriptive statistics, correlational analyses, and multivariable logistic modeling using a backwards elimination variables selection criteria with α=0.05. Results: Of the 520 patients, 66% (n=342) were male, 76% (n=395) were obese, and 46% (n=238) had LVH. LVMI was strongly correlated with 24-hr systolic BP, however there was no difference in mean LVMI across BP severity category. In contrast, there was a near stepwise increase in LVMI across obesity stage with the strongest effect in girls – Normal: 29.7 ± 5.3 (girls) v. 34.8 ± 11.4 (boys) g/m 2.7 ; OB-1: 36.5 ± 6.6 (girls) v. 43.2 ± 10.3 (boys) g/m 2.7 ; OB-2: 41 ± 11.6 (girls) v. 44.2 ± 9.2 (boys) g/m 2.7 ; OB 3: 48 ± 11.6 (girls) v. 43.5 ± 9.4 (boys) g/m 2.7 . LVMI was positively correlated with TSH, creatinine, uric acid, cystatin, and inversely correlated with HDL. Multivariable logistic modeling revealed obesity stage and HDL cholesterol, but not BP or laboratory variables, as significant independent predictors of LVH. Conclusions: We report a high incidence of LVH in youth with obesity and demonstrate a strong association between obesity and LVMI. Our data, in agreement with previous studies, indicate that adiposity is a significant determinant of left ventricular mass, and suggest the need for cardiac screening of youth with obesity even in the absence of elevated blood pressure.

Xeroderris stuhlmannii (Taub.) Mendonça & E.P.Sousa (Fabaceae): Evidence of the antihypertensive and antioxidant activities of its leaf aqueous extract in cadmium chloride hypertensive rats

Xeroderris stuhlmannii (Fabaceae) is a medicinal reported in Cameroonian herbal medicine to treat hypertension. The aim of the study was to assess the antihypertensive and antioxidant activities of X. stuhlmannii aqueous leaf extract (AEXS) on cadmium chloride-induced hypertensive rats. The in vitro antioxidant activities of AEXS were investigated for their radical scavenging potency using 2,2-diphenyl-1-picrylhydrazyl (DPPH), Ferric reducing antioxidant power (FRAP), 2,2′-azino-bis-(3-ethylbenzothiazoline-6-sulfonic) acid (ABTS), Nitric oxide (NO) and OH- assays completed with oxidative stress markers analyses. Antihypertensive activity of AEXS (35, 100, and 300 mg/kg) was assessed in CdCl2 induced-hypertensive rats. Antihypertensive activities performed include systolic (SBP), diastolic blood pressure (DBP) and heart rate (HR) variation, followed by evaluation of selected biochemical parameters in urine, blood (Alanine aminotransferase (ALT), aspartate aminotransferase (AST)), creatinine, urea and total protein) and histological examination of tissue samples (aorta, heart, kidneys and liver). The amount of the phenols of the leaf extract was estimated in mg gallic acid equivalent and identification of some compounds was done by UPLC-UV-ESI-TOF-MS. Accordingly, the identified phenols were stuhlmannione A (1), formononetin (2), stuhlmarotenoid A (3), 9-methoxymaackiain (4), 4-hydroxymaackiain (5) and 7-hydroxy-3′,4′-methylenedioxy-isoflavone (6). The extract exhibited a significant (P < 0.05–0.001) decrease of SBP, DBP and HR when compare to control. AEXS also reduced (P < 0.05) serum rates of ALT, AST, and urea. The extract showed beneficial effects on alterations observed in the histological structures of the aorta, heart, kidneys and liver. AEXS highlighted high level of phenols (26.48 ± 2.89 mg GAE/g) and a strong antiradical activity on DPPH, ABTS+, OH− and NO with IC50 of 148.8 μg/mL, 27.83 μg/mL, 22.29 μg/mL, 29.84 μg/mL respectively. An optical density of 1.79 nm was obtained with FRAP test. Thus, X. stuhlmannii leaf extract has in vitro antioxidant and antihypertensive effects that may support its use against hypertension.

P098 CARDIAC REMODELING IN MICE TREATED WITH SODIUM OXALATE AND AORTIC STENOSIS

Background: Cardiovascular Diseases are one of the main global public health problems, with increasing mortality due to population aging and Hypertension (HTN). HTN is a risk factor for other diseases, such as aortic stenosis, renal dysfunction, and cardiac hypertrophy (CH). The hemodynamic overload caused by HTN affects the heart and kidneys, but the exact mechanisms of these alterations are not fully understood. Experimental models help study these mechanisms; however, a well-established model of CH with cardiorenal dysfunction does not yet exist. Objective: to evaluate whether the combination of cardiac hypertrophy, induced by transverse aortic constriction (TAC), and renal injury, induced by soluble sodium oxalate (OXA), can be a new model of CH with cardiorenal dysfunction. Methods: Male C57BL mice were randomized as follows: SHAM, receiving saline or OXA solution, and TAC, receiving saline or OXA solution. Echocardiography, direct blood pressure (BP) recording, metabolic cage, histology were performed to evaluate cardiac and renal function, hemodynamics, autonomic modulation, and baroreflex. Results: The TAC+OXA group showed the highest systolic BP(SBP) (SBP: SHAM: 122±5.24 vs. TAC+OXA: 160±5.24 mmHg, p&lt;0.01), increased double product (DP) (DP: SHAM: 64.65±4.76 mmHg/bpm vs. TAC: 89.53±5.85 mmHg/bpm, p=0.02), significant reduction in autonomic modulation (RMSSD: OXA: 12.5±1.8 vs. TAC+OXA: 2.8±0.2 ms, p&lt;0.01) and reflex tachycardia, eccentric hypertrophy, and worse renal function. The TAC group showed eccentric hypertrophy, increased BP variability (SD-SBP: SHAM: 2.97±0.07 mmHg vs. TAC: 5.63±0.57 mmHg, p≤0.01), diastolic dysfunction, and dilated left ventricle in diastole. The OXA group showed increased autonomic modulation and heart rate variability, renal damage characterized by inflammation, proximal tubule damage, and interstitial fibrosis when associated with TAC. All treated groups showed a significant reduction in reflex tachycardia. Conclusion: Transverse aortic constriction combined with OXA gavage is a model of CH with renal dysfunction, as the combination caused more significant renal damage, systemic hypertension, decreased autonomic modulation and baroreflex sensitivity, and eccentric hypertrophy with subsequent LV diastolic dysfunction.

P089 RELATION BETWEEN ISOMETRIC STRESS-INDUCED PRESSURE RESPONSE AND P-WAVE OF THE ELECTROCARDIOGRAM

Background and objectives: The effects of isometric stress-induced vascular hyperreactivity on P wave duration have scarcely been studied. We set out to determine the relationship between isometric stress reactivity and the P wave in young hypertensives. Materials: A cross-sectional, prospective study was carried out on the relationship between the duration of the maximum P wave corrected for heart rate (Pmaxc) and the degree of blood pressure reactivity in two groups of 30 young men, who were divided into normotensive and hypertensive patients. The hypertensive patients were of recent clinical diagnosis. Vascular reactivity was measured by the sustained weight test (PPS). Results: Diastolic blood pressure variation (ΔPAD) was greater in hypertensives than in normotensives (15.83 mmHg ± 7.321 vs. 10.17 mmHg ± 5.331, p&lt;0.01) after application of the PPS. The ΔPAD correlated positively with Pmaxc in both groups studied, but was only significant in the hypertensive group (r=0.433; p&lt;0.05). Conclusions: Increasing levels of isometric stress induced by PPS correlate positively and significantly with Pmaxc. Figure 1: Correlation between diastolic blood pressure reactivity (ΔPAD) and heart rate correction for peak P wave (Pmaxc) in hypertensives and normotensives

P138 CORRELATION OF THE NDUFV2 RS874250 LOCUS OF THE MITOCHONDRIAL RESPIRATORY COMPLEX I NUCLEAR GENE WITH SUSCEPTIBILITY TO ESSENTIAL HYPERTENSION IN YUNNAN REGION

Background and Objective: Essential hypertension is a multifactorial disease characterized by the interaction of genetic and environmental factors, with genetic factors accounting for 30-50%. Currently, the relevant SNPs identified through genome-wide screening analysis explain only 2-3% of the blood pressure variance. It is suggested that there is a large number of undiscovered genetic variants associated with essential hypertension. The NADH-ubiquinone oxidoreductase core subunit V2 (NDUFV2) is one of the key subunits of mitochondrial respiratory Complex I, which plays an important role in oxidative stress, inflammation, and cell death, and those are associated with endothelial cell damage, vascular remodeling, and hypertension. The study aims to investigate whether the NDUFV2 rs874250 is associated with essential hypertension. Methods: In total of 1437 subjects, were Chinese-Han from Yunnan province, including 824 patients with essential hypertension (378 males and 446 females) and 613 healthy controls (240 males and 373 females). NDUFV2 rs874250 was selected for genotyping and establishing 2 genetic models: a genotypic model (GG vs GA vs AA) and a super-dominant model [GA vs (GG+AA)] for all subjects. Results: In this study, the frequency distribution of genotypes conformed to the HWE test (p&gt;0.05). The super-dominant model was the best genetic model for the rs874250 locus of the NDUFV2 gene. Under the super-dominant model, we found that the distribution frequency of the GA genotype in the essential hypertension group was higher than that in the control group (P&lt;0.05), and the GA genotype was a risk factor for hypertension (OR=1.30, P&lt;0.05). Diastolic blood pressure (DBP) and mean arterial pressure were significantly higher in GA genotype carriers than in GG+GA genotype carriers after correction for sex, age, and BMI (P&lt;0.05). Conclusions: Our study indicated that the NDUFV2 rs874250 is likely to be involved in essential hypertension, especially in diastolic pressure. We postulate that GA genotype may be a risk factor for elevated DBP, which requires further validation.

Reliability of beat-to-beat blood pressure variability in older adults

Blood pressure variability (BPV) is emerging as an important risk factor across numerous disease states, including cerebrovascular and neurodegenerative disease in older adults. However, there is no current consensus regarding specific use cases for the numerous available BPV metrics. There is also little published data supporting the ability to reliably measure BPV across metrics in older adults. The present study derived BPV metrics from continuous beat-to-beat blood pressure monitoring data. Two sequential 7 min waveforms were analyzed. Absolute and relative reliability testing was performed. Differences between antihypertensive medication users and non-users on BPV metric reliability was also assessed. All sequence and dispersion based BPV metrics displayed good test–retest reliability. A measure of BP instability displayed only moderate reliability. Systolic and diastolic average real variability displayed the highest levels of reliability at ICC = 0.87 and 0.82 respectively. Additionally, systolic average real variability was the most reliable metric in both the antihypertensive use group, and the no antihypertensive use group. In conclusion, beat-to-beat dispersion and sequence-based metrics of BPV can be reliably obtained in older adults using noninvasive continuous blood pressure monitoring. Average real variability may be the most reliable and specific beat-to-beat blood pressure variability metric due to its decreased susceptibility to outliers and low frequency blood pressure oscillations.

Gene[sbnd]environment interaction between phthalate exposure and pubertal genetic polymorphisms on blood pressure variability in children: Exploring the moderating effects of lifestyle behaviours

Phthalates (PAEs) are synthetic compounds extensively employed in consumer products. Blood pressure (BP) in children can vary, the degree of visit-to-visit BP variability (VVV) is at least partially independent of BP. The interactions between PAEs exposure, pubertal-related genetic susceptibility and lifestyles on childhood VVV are not investigated. This study utilized data from a cohort collected from Oct 2017–2020 in Xiamen, China. Seven urine PAE metabolites were measured. The long-term VVV was characterized employing the standard deviation (SD) and average real variability. We constructed a genetic risk score (GRS) of pubertal-related genes and healthy lifestyle scores. Exposed to high levels of mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) (OR=1.43, 95 %CI=1.07, 1.92) and mono-2-ethyl-5-oxohexyl phthalate (OR=1.36, 95 % CI=1.01, 1.83) was related to increased SBP-SD, and the OR for high SBP-SD related to high GRS was 1.38 (95 % CI=1.02, 1.85). Compared to participants who had low GRS and low MEHHP exposure, participants exhibiting high GRS and MEHHP levels were more likely to experience high SBP-SD (OR=2.00, P<0.05). Individuals exhibiting low GRS, low MEHHP levels, and adhering to healthy lifestyles were associated with the least probability of experiencing high SBP-SD (OR=0.31, P<0.05). Increased PAEs exposure could elevate childhood systolic VVV, and exacerbated the adverse impact of pubertal-related genetic susceptibility on the high VVV of SBP; however, healthy lifestyles might alleviate these adverse effects. Promoting healthy lifestyles and reducing PAEs exposure for preventing elevated BP variability among children is important, especially for individuals with greater genetic susceptibility to early pubertal onset. Environmental implicationBlood pressure (BP) in children can vary, as a noninvasive, inexpensive and applicable method, the extent of visit-to-visit variability (VVV) is at least partially independent of BP. The interactions between phthalates (PAEs) exposure, variants of puberty-related genes and lifestyles on VVV are not investigated. Increased childhood systolic VVV might be associated with PAEs exposure, with the associations more pronounced combined with pubertal genetic susceptibility. Yet, healthy habits could partly eliminate such adverse effects. Our study underscores the importance of advocating for healthy lifestyles and reducing exposure to PAEs, especially among individuals with high genetic susceptibility to early puberty onset.

Circadian blood pressure variability and associated factors among chronic kidney disease patients at Nekemte Town public Hospitals, West Oromia, Ethiopia: a comparative cross-sectional study

ObjectiveThis study aimed to assess the pattern of circadian blood pressure variability (CBPV) and associated factors among chronic kidney disease (CKD) patients admitted to Nekemte Town public Hospitals.DesignA hospital-based comparative...

Effects of arginine intake during weight training on blood variables.

This experiment studied the effect of arginine intake on blood pressure and blood variables during weight training in 20 men in their 20s. The resistance exercise program was performed 3 times a week at 60% of one repetition maximum for 8 weeks. The arginine intake group consumed 1,000 mg of arginine 2 tablets per day before weight training for 8 weeks. The placebo group was instructed to consume two of placebo with water, the same as the arginine intake group. After 8 weeks, the day after the end of the resistance exercise program, systolic pressure, diastolic pressure, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, muscle mass, and maximum muscle strength were measured. In changes in systolic blood pressure, the arginine intake group was 118.20±2.40 mmHg, showed a statistically significant decrease compared to the placebo group. Triglyceride in the arginine intake group was 112.62±2.40 mg/dL, showing a statistically significant decrease compared to the placebo group. Based on these results, arginine intake during resistance exercise is judged to have a positive effect on lowering blood pressure, and is also believed to reduce triglycerides, a blood lipid variable, so it is thought to function as a supplement during exercise.

Dialysate sodium and short-term blood pressure variability in patients with intradialytic hypertension: a randomized crossover study.

Increased blood pressure (BP) variability (BPV) is associated with high cardiovascular risk in hemodialysis. Patients with intradialytic hypertension (IDH) also exhibit an increased cardiovascular risk compared to hemodialysis patients without this condition. The impact of non-pharmacological BP-lowering interventions on BPV in this population remains unknown. This analysis evaluated the effect of low (137mEq/L) compared to standard (140mEq/L) dialysate sodium concentration on short-term BPV in patients with IDH. In a randomized cross-over manner, 29 IDH patients underwent 4 hemodialysis sessions with low (137mEq/L) followed by 4 sessions with standard (140mEq/L) dialysate sodium or vice versa. 48h ambulatory BP measurement was performed from the start of the 4th session on each dialysate sodium. BPV indices during the 48 h, 24 h, day-time and night-time periods were calculated. Mean 48h BP was 5.3/2.6 mmHg lower with low compared to standard dialysate sodium concentration, (p = 0.005/p = 0.007 respectively). All 48 h systolic BPV indices examined showed non-significant differences between low and standard dialysate sodium (SBP-SD: 16.99 ± 5.39 vs. 16.98 ± 4.33 mmHg, p = 0.982; SBP-wSD: 15.93 ± 5.02 vs. 16.12 ± 4.16 mmHg, p = 0.769; SBP-ARV: 11.99 ± 3.67 vs. 11.45 ± 3.35 mmHg, p = 0.392; SBP-CV: 12.36 ± 3.65 vs. 11.92 ± 3.18%, p = 0.302, with low vs. standard dialysate sodium, respectively). Diastolic BPV indices were numerically, but not statistically, lower with low dialysate sodium. Overall, significant differences were observed in some comparisons with a trend for lower BPV during day-time 2 and higher BVP during night-time 2 with low dialysate sodium. In conclusion, low dialysate sodium concentration does not affect BPV levels in patients with IDH. Future research should explore alternative interventions to reduce BP and BPV in this high-risk population.

Approaches for Evaluating Visit-to-Visit Blood Pressure Variability as a Cardiovascular Disease Risk Factor: A Scoping Review.

Visit-to-visit blood pressure variability (BPV) is associated with cardiovascular disease (CVD) and its mortality, independent of mean blood pressure (BP). However, in real world clinical practice this phenomenon is under-appreciated by clinicians. Serial BPV measured at clinical visits are frequently considered random fluctuations. This scoping review aims to review methodologies for estimating BPV, including metrics, frequency of BP measurements, BPV observation and follow-up durations. The review also compares studies that used electronic health record (EHR) data and those that used non-EHR data to assess BPV. We found little or no consensus on metrics used for BPV estimation in either study using EHR or non-EHR data. The non-EHR studies followed a stricter protocol for BP measurement than the EHR-based studies. Both groups of studies used comparable methodologies to estimate BPV.

Association between blood pressure variability and clinical outcomes after successful thrombectomy in acute basilar artery occlusion stroke patients: A multicenter cohort study

BackgroundLimited data are available on the appropriate choice of blood pressure management strategy for patients with acute basilar artery occlusion (BAO) treated with mechanical thrombectomy (MT). We evaluated the impact of blood pressure variability on clinical outcomes after MT in patients with acute BAO. MethodsThis multicenter cohort study included 108 patients with acute BAO who underwent successful emergency thrombectomy at two comprehensive stroke centers from 2016 to 2021. Blood pressure was measured hourly during the first 24 h after successful reperfusion. Blood pressure variability was calculated as mean arterial pressure (MAP) assessed by the standard deviation (SD). Multivariate logistic models were used to investigate the association between BPV, the primary outcome (futile recanalization, 90‐day modified Rankin Scale score 3–6), and the secondary outcome (30-day mortality). Subgroup analysis was performed as a sensitivity test. ResultsFutile recanalization occurred in 60 (56 %) patients, while 26 (24 %) patients died within 30 days. In the fully adjusted model, MAP SD was associated with a higher risk of futile recanalization (OR adj=1.36, per 1 mmHg increase, 95 % CI: 1.09–1.69, P=0.006) and 30-day mortality (OR adj=1.56, per 1 mmHg increase, 95 % CI: 1.20–2.04, P=0.001). A significant interaction between MAP SD and the lack of hypertension history on futile recanalization (P<0.05) was observed. ConclusionsAmong recanalized acute BAO ischemic patients, higher blood pressure variability during the first 24 h after MT was associated with worse outcomes. This association was stronger in patients without a history of hypertension.

Assessment of blood pressure variability: characteristics and comparison of blood pressure measurement methods.

Previous studies have reported that blood pressure variability (BPV) is associated with the risk of cardiovascular events independent of blood pressure (BP) levels. While there is little evidence from intervention trials examining whether suppressing BPV is useful in preventing cardiovascular disease, it is suggested that detection of abnormally elevated BPV may be useful in reducing cardiovascular events adding by complementing management of appropriate BP levels. Cuffless BP devices can assess beat-to-beat BPV. Although cuffless BP monitoring devices have measurement accuracy issues that need to be resolved, this is an area of research where the evidence is accumulating rapidly, with many publications on beat-to-beat BPV over several decades. Ambulatory BP monitoring (ABPM) can assess 24-hour BPV and nocturnal dipping patterns. Day-to-day BPV and visit-to-visit BPV are assessed by self-measured BP monitoring at home and office BP measurement, respectively. 24 h, day-to-day, and visit-to-visit BPV have been reported to be associated with cardiovascular prognosis. Although there have been several studies comparing whether ABPM and self-measured BP monitoring at home is the superior measurement method of BPV, no strong evidence has been accumulated that indicates whether ABPM or self-measured home BP is superior. ABPM and self-measured BP monitoring have their own advantages and complement each other in the assessment of BPV.

Sleep and hypertension - up to date 2024.

People spend one-third of their lives sleeping, and adequate, restful sleep is an essential component of a healthy life. Conversely, disruption of sleep has been found to cause various physical and mental health problems. Emerging research has shown that blood pressure (BP) during sleep is a stronger predictor of cardiovascular events than conventional office BP or daytime BP. Thus, management of both sleep health and nighttime BP during sleep is important for preventing cardiovascular events. However, recent studies demonstrated that nighttime BP is poorly controlled compared with office BP and daytime BP. This finding is understandable, given the challenges in monitoring BP during sleep and the multiplicity of factors related to nocturnal hypertension and BP variability. This review summarizes recent evidence and considers future perspectives for the management of sleep and hypertension.

The effects of combining visual-auditory stimuli with exercise on short-term affect improvement: a randomized controlled trial

Abstrac tPrior research has explored the effects of engaging with real or virtual natural landscapes and listening to music during aerobic exercise on short-term affect, however, the specific differences in the improvement of short-term affect by different combinations of Virtual Reality (VR) and music rhythm require further investigation. The objective of this study is to investigate the effects of various combinations of VR and music on short-term mood, thereby providing a reference for future research on public fitness. This study recruited 132 valid participants (mean age 24.0 ± 0.9 years), with a gender distribution of 68 males and 64 females. Participants were randomly assigned to one of four groups: Visual-Music (V-M), Music-Visual (M-V), Visual-only (V), and Music-only (M). The exercise mode was 15 min of aerobic power cycling with 2 min of low-intensity power cycling intervals in the middle. After the exercise, the participants were asked to sit and then performed either a VR intervention or a music intervention for 15 min. The collected indicators included blood pressure, positive/negative affect, and heart rate variability indicators (RMSSD, SDNN, LF/HF). Data analysis included descriptive statistics, repeated measures ANOVA, and multifactor ANOVA. The effect of different VR and Music combined with exercise interventions on the improvement of short-term affect was analyzed based on the effect size (ɳp2) and combined with the significance p-value. Intra-group results showed that DBP, positive and negative affect, SDNN, RMSSD indicators in V-M group were significant differences (p < 0.05), while SBP, positive affect, negative affect, SDNN, RMSSD, LF/HF indicators in M-V group were significant differences (p < 0.05). Only SDNN and RMSSD indicators in M group had significant differences (p < 0.05), and only SBP and RMSSD indicators in V group had significant differences (p < 0.05). The results between groups showed that only SDNN and LH/HF groups had a significant difference (p < 0.05), other indicators had a trend of improvement or positive promotion to a certain extent, but the statistical difference was not significant (p > 0.05). Aerobic exercise with consistent intensity and the combined visual-auditory interventions (M-V and V-M) significantly improved blood pressure, and the short-term affect of physiological responses (LF/HF, SDNN, RMSSD), along with subjective affect measures, compared to other groups. These findings suggest that incorporating VR and music with exercise can effectively enhance short-term affect, recommending an integrated approach to aerobic exercise and relaxation through music and visual exposure to natural environments.

The impact of visit-to-visit blood pressure variability on renal functional status in rural dwellers with arterial hypertension

The impact of visit-to-visit blood pressure variability on renal functional status in rural dwellers with arterial hypertension

Nutrigenetics and Nutritional Strategies in Systemic Arterial Hypertension: Evidence From a Scoping Review.

Nutrition and genetics have individual roles in systemic arterial hypertension (SAH); however, they can interact, influencing the regulation of blood pressure (BP) levels. The aim of this study was to evaluate the available evidence regarding gene-nutrient interactions in modulating BP levels in adults with SAH. The review followed the recommendations of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Twelve studies met the inclusion criteria for this review, reporting on 20 genes and 31 single nucleotide polymorphisms (SNPs), with 19 of them associated with BP variations. The most frequently evaluated SNPs were ACE rs4646994 and AT1R rs5186. Among the nutritional interventions, dietary sodium content was the focus of most studies (n = 11). Interactions with sodium consumption were observed for the following SNPs: KDM1A rs587168, EDNRB rs5351, LSS rs2254524, IRS1 rs1801278, KCNK9 rs6997709, ACE rs4646994, GNB3 rs5443, PPARG rs4684847, EDN1 rs5370, BCAT1 rs7961152, IL18 rs5744292, NOS3 rs2070744, and AT1R rs5186. In the presence of a diet rich in fruits and vegetables, moderate alcohol consumption, and reduced sodium intake, the SNP AT2R rs11091046 was associated with a decrease in BP levels. Furthermore, the SNP MTHFR rs1801133 exhibited an interaction with riboflavin supplementation in affecting BP levels. The evidence regarding the interaction between genetics and diet on BP levels remains limited. Among the existing findings, an interaction was observed between sodium, calcium, riboflavin, and specific polymorphisms; however, the underlying mechanisms for these interactions have yet to be identified. Note: This paper is part of the Nutrition Reviews Special Collection on Precision Nutrition.

Arterial blood pressure monitoring in stroke cohorts: the impact of reduced sampling rates to optimise remote patient monitoring.

Remote patient monitoring (RPM) beat-to-beat blood pressure (BP) provides an opportunity to measure poststroke BP variability (BPV), which is associated with clinical stroke outcomes. BP sampling interval (SI) influences ambulatory BPV, but RPM BP SI optimisation research is limited. SI and RPM device capabilities require compromises, meaning SI impact requires investigation. Therefore, this study assessed healthy and stroke subtype BPV via optimised BP sampling, aiding sudden BP change identification and potentially assisting cardiovascular event (recurrent stroke) prediction. Leicester Cerebral Haemodynamic Database ischaemic [acute ischaemic stroke (AIS), n = 68] and haemorrhagic stroke (intracerebral haemorrhage, n = 12) patient and healthy control (HC, n = 40) baseline BP data were analysed. Intrasubject and interpatient SD (SDi/SDp) represented individual/population variability with synthetically altered SIs. Matched-filter approaches using cross-correlation function detected sudden BP changes. At SIs between 1 and 180 s, SBP and DBP SDi staticised while SDp increased at SI < 30 s. Mean BP and HR SDi and SDp increased at SI < 60s. AIS BPV, normalised to SI1s, increased at SI30s (26%-131%) and SI120s (1%-274%). BPV increased concomitantly with SI. Cross-correlation analysis showed HC and AIS BP sudden change detection accuracy reductions with increasing SI. Positive BP deviation detection fell 48.48% (SI10s) to 78.79% (SI75s) in HC and 67.5% (SI10s) to 100% (SI75s) in AIS. Negative BP deviation detection fell 50% (SI10s) to 82.35% (SI75s) in HC and 52.27% (SI10s) to 95.45% (SI75s) in AIS. Sudden BP change detection and BPV are relatively robust to SI increases within certain limits, but accuracy reductions generate unacceptable estimates, considerable within RPM device design. This research warrants further SI optimisation.

Higher intraindividual variability of body mass index is associated with elevated risk of COVID-19 related hospitalization and post-COVID conditions.

Cardiometabolic diseases are risk factors for COVID-19 severity. The extent that cardiometabolic health represents a modifiable factor to mitigate the short- and long-term consequences from SARS-CoV-2 remains unclear. Our objective was to evaluate the associations between intraindividual variability of cardiometabolic health indicators and COVID-19 related hospitalizations and post-COVID conditions (PCC) among a relatively healthy population. This retrospective, multi-site cohort study was a post-hoc analysis among individuals with cardiometabolic health data collected during routine blood donation visits in 24 US states (2009-2018) and who responded to COVID-19 questionnaires (2021-2023). Intraindividual variability of blood pressure (systolic, diastolic), total circulating cholesterol, and body mass index (BMI) were defined as the coefficient of variation (CV) across all available donation timepoints (ranging from 3 to 74); participants were categorized into CV quartiles. Associations were evaluated by multivariable binomial regressions. Overall, 3344 participants provided 42,090 donations (median 9 [IQR 5, 17]). The median age was 48 years (38, 56) at the first study donation. 1.2% (N = 40) were hospitalized due to COVID-19 and 15.5% (N = 519) had PCC. Higher BMI variability was associated with greater risk of COVID-19 hospitalization (4th quartile aRR 4.15 [95% CI 1.31, 13.11], p = 0.02; 3rd quartile aRR 3.41 [95% CI 1.09, 10.69], p = 0.04). Participants with higher variability of BMI had greater risk of PCC (4th quartile aRR 1.29 [95% CI 1.02, 1.64]; p = 0.04). Intraindividual variability of blood pressure (systolic, diastolic) and total circulating cholesterol were not associated with COVID-19 hospitalization or PCC risk (all p > 0.05). From causal mediation analysis, the association between the highest quartiles of BMI variability and PCC was not mediated by hospitalization (p > 0.05). Higher intraindividual variability of BMI was associated with COVID-19 hospitalization and PCC risk. Our findings underscore the need for further elucidating mechanisms that explain these associations and importance for consistent maintenance of body weight.

Association between 24-hour blood pressure parameters and 90-day functional outcome in acute ischemic stroke patients with early anticoagulation.

This study aimed to examine the relationship between blood pressure (BP) and blood pressure variability (BPV) during the first 24 hours from admission with 90-day functional outcomes in acute ischemic stroke (AIS) patients whose onset within 24 hours and receiving early argatroban treatment. The study recruited 214 AIS patients. BP was monitored using a cuff at 1-hour fixed intervals, and BP/BPV parameters [standard deviation (SD), coefficient of variation (CV), successive variation (SV), and average real variability (ARV)] were collected. Age, the National Institutes of Health Stroke Scale (NIHSS) score at admission, previous history of diabetes mellitus (DM), and infarction site (located in anterior circulation) were identified as independent factors affecting 90-day outcomes in multiple logistic regression. After adjusting for confounding variables, association between BP/BPV and 90-day modified Rankin Scale (mRS) was assessed using logistic regression models. In model 1 (adjusted for age and NIHSS score at admission), mean-systolic blood pressure (SBP) showed association with 90-day outcomes [1.068 (1.008, 1.131), P = .025]. In model 2 (adjusted for age, NIHSS score at admission, previous history of DM), mean-SBP [1.061 (1.001, 1.123), P = .045] and max-SBP [0.951 (0.906, 0.998), P = .040] showed relatively weak association with outcomes. In model 3 [adjusted for age, NIHSS score at admission, previous history of DM, infarct site (located in anterior circulation)], all BP values were not related with outcomes, meanwhile, none of the BPV parameters calculated from SBP, diastolic blood pressure and mean arterial pressure showed association with 90-day outcomes. Future prospective studies are required to assess the relationship between early BP/BPV parameters with 90-day outcomes and further clarify the reference values for BP parameters. This is important for effective BP/BPV management and improved patient prognosis.