Diastolic Blood Pressure Levels Research Articles

Relationship between Serum Zinc Level and Retinopathy in Type 2 Diabetic Patients

Abstract Background Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia caused by insulin resistance (IR) or impaired insulin production. Diabetic retinopathy (DR) is a common microvascular disorder which occurs in type 2 diabetes mellitus (T2DM) patients due to chronic hyperglycemia. Previous studies reported that serum zinc (Zn) was associated with certain diabetic microvascular complications. Objective To evaluate relation between serum zinc level and diabetic retinopathy in patients with type 2 diabetes mellitus. Subjects and Methods The current study included 60 subjects with their ages ranging from 18- 60, selected from diabetes and ophthalmology outpatient clinics of Ain Shams University Hospitals for 7 months in a period from July 2022 to January 2023 with matched age and sex . fasting and post prandial blood glucose, hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP),serum creatnine, LDL, HDL, TG,TC and serum zinc levels were measured among groups. Results The study shows statistically significant difference between DM type II subgroups regarding duration of disease (yrs) being higher in DM II with retinopathy 12.5 (10.5 – 16.5) than DM II without retinopathy 9 (6 – 12) with p < 0.001. serum Zn levels were significantly lower in the DR group than the controls and diabetic without retinopathy.in whole DM type II group, there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, LDL, TC, FBS, 2PP and serum creatinine level, while in DM II without retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, LDL, TC and FBS and also in DM type II retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, FBS, 2PP and serum cretainine level .There is no statistically significant difference found between control group and DM type II group regarding weight, height and BMI of the studied patients with p-value = 0.108, 0.198 and 0.343; respectively. There is no statistically significant difference found between control group and DM type II group regarding systolic and diastolic blood pressure of the studied patients with p- value = 0.554 and 0.405; respectively. Conclusion Our study suggested that lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications. Patients with lower serum zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function. Older age, higher HbA1c level, and the prevalence of DN were risk factors related to the lower serum zinc level.

Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents.

Adolescent sleep problems are prevalent, particularly among racial and ethnic minority groups, and can increase morbidity. Despite the numerous strengths of their racial and ethnic group, urban American Indian and Alaska Native adolescents face significant health disparities but are rarely included in health research. Understanding how sleep problems are associated with health outcomes among American Indian and Alaska Native adolescents may elucidate novel targets for interventions to promote health equity. To assess whether baseline sleep problems are associated with changes in behavioral and cardiometabolic health outcomes among urban American Indian and Alaska Native adolescents 2 years later. American Indian and Alaska Native adolescents were recruited via flyers and community events for an observational cohort study in California. Baseline assessments were conducted among 142 adolescents from March 1, 2018, to March 31, 2020, and follow-ups were conducted among 114 adolescents from December 1, 2020, to June 30, 2022. Baseline actigraphy-assessed sleep duration and efficiency and self-reported sleep disturbances and social jet lag (absolute value of the difference in sleep midpoint on weekends vs weekdays; indicator of circadian misalignment). Main outcome measures included self-reported depression (measured using the Patient Health Questionnaire), anxiety (measured using the Generalized Anxiety Disorder 7-item scale), past year alcohol and cannabis use, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), waist circumference, and glycosylated hemoglobin (HbA1c). Analyses examined whether baseline sleep was associated with health outcomes at follow-up, controlling for age, sex, and baseline outcome measures. The baseline sample included 142 urban American Indian and Alaska Native adolescents (mean [SD] age, 14.0 [1.4] years; 84 girls [59%]), 80% of whom (n = 114; mean [SD] age, 14.1 [1.3] years; 71 girls [62%]) completed follow-ups. Linear or logistic regressions showed significant negative associations between shorter sleep duration and depression (β = -1.21 [95% CI, -2.19 to -0.24]), anxiety (β = -0.89 [95% CI, -1.76 to -0.03]), DBP (β = -2.03 [95% CI, -3.79 to -0.28]), and HbA1c level (β = -0.15 [95% CI, -0.26 to -0.04]) and likelihood of alcohol (odds ratio [OR], 0.57 [95% CI, 0.36-0.91]) and cannabis use (full week: OR, 0.59 [95% CI, 0.35-0.99]) at follow-up. Greater social jet lag was associated with significantly higher SBP (β = 0.06 [95% CI, 0.01-0.11]) at follow-up. This cohort study found significant associations between poor sleep and adverse changes in health outcomes. Findings highlight the importance of developing culturally responsive interventions that target sleep as a key modifiable risk factor to improve the health of American Indian and Alaska Native adolescents.

Renal denervation ameliorated salt-induced hypertension by improving cardiac work, cardiac enzyme and oxidative balance in Sprague-Dawley rats

BackgroundHypertension is associated with cardiovascular dysfunction, dysregulation of the antioxidant system and alteration of the level of some enzymes in the metabolic pathway. The possible modulatory effect of acute renal denervation (ARD) on cardiovascular function and the antioxidant system is still a subject of intense debate. This study sought to ascertain the ameliorative effects of ARD on cardiovascular parameters, antioxidant system, creatine kinase and lactate dehydrogenase levels. MethodsThirty-six Sprague-Dawley rats (5–6 weeks old) were divided into 6 groups of 6 animals each consisting of Normal Salt, High Salt, Normal Salt + Sham Denervation, High Salt + Sham Denervation, Normal Salt + Renal Denervation and High Salt + Renal Denervation. Induction of hypertension with 8 % salt in the diet lasted for 8 weeks. Renal or Sham denervation was thereafter done on selected groups. At the end of the experimental period, cardiovascular parameters, plasma antioxidant status, plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels were assessed. Significance level was set at p < 0.05. ResultsSalt-loading significantly increased systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), rate pressure product (RPP) while reducing superoxide dismutase (SOD), reduced glutathione (GSH) and catalase (CAT). Acute renal denervation significantly (p < 0.0001) reduced SBP, DBP, MABP, RPP, LDH and norepinephrine level while increasing SOD, GSH and CAT. ARD did not significantly alter CK level. ConclusionAcute renal denervation, by reducing sympathetic activity, ameliorates cardiovascular and antioxidant functions as well as reduces LDH level without significantly altering CK level in salt-induced hypertension.

#205 Features of chronic kidney disease in patients with obesity and arterial hypertension

Abstract Background and Aims to assess the indicators of composite body composition in patients with obesity and chronic kidney disease with arterial hypertension. Method 59 patients with obesity and arterial hypertension were examined. When selecting patients, inclusion criteria were taken into account: men and women aged 25 to 55 years, obesity (BMI more than 30 kg/m²; waist circumference (WC) more than 80 cm in women and more than 94 cm in men), presence of hypertension I– Stage II, grade 1–2, absence of renal pathology (history of kidney disease, structural changes in the parenchyma and vessels of the kidneys during ultrasound examination, changes in urinary sediment and urine density, proteinuria, decreased GFR less than 60 ml/min/1.73 m² ), signed informed consent. Metabolically complicated obesity was defined as the presence of abdominal obesity, a BMI of more than 30 kg/m2 in combination with hypertension and ≥ 2 cardiometabolic abnormalities. A metabolically healthy obesity phenotype was considered to be the presence of obesity without hypertension, dyslipidemia, or hyperglycemia. The results obtained during the study were compared with the indicators of a control group formed from 30 practically healthy individuals aged 25–55 years without obesity or overweight. Differences in age, gender, duration of hypertension and obesity were not established. Metabolic activity of adipose tissue was assessed by the level of leptin, soluble leptin receptors (sLR), adiponectin, resistin, free leptin index (FLI), leptin/adiponectin index (L/A). Renal function: GFR (CKD EPI and Hoek), serum and urine cystatin C, albuminuria. The composite composition of the body was studied using bioimpedance analysis using an ABC-01 Medass analyzer of body composition and balance of water sectors of the body. Results In a comparative analysis of the parameters of the composite body composition in the obese groups, the highest values ​​of fat mass (42.8 ± 6.8 and 35 ± 4.2 kg) and total fluid (40.2 ± 5.0 and 36.0 ± 2.8 kg) with a reduced proportion of 17 active cell mass (ACM) (53.0 ± 3.2 and 56.1 ± 3.4%) were detected in patients with complicated obesity (p &amp;lt; 0.05). Regardless of the obesity phenotype, correlations were established: between the level of diastolic blood pressure (DBP) and the volume of total (r1 = 0.42; r2 = 0.52) and extracellular fluid (r1 = 0.50; r2 = 0.60); level of DBP and urinary excretion of cystatin C (r1 = 0.51; r2 = 0.61) (p &amp;lt; 0.01). A decrease in the proportion of ACM in obese groups was associated with an increase in resistin levels (r1 = −0.56; r2 = −0.31). In obese groups, regardless of phenotype, fat mass was associated with leptin levels (r1 = 0.52; r2 = 0.42) and free leptin index (FLI) (r1 = 0.75; r2 = 0.46 ) (p &amp;lt; 0.05). In group 1, a positive correlation was additionally established for the volume of fat mass with systolic blood pressure (SBP) (r1 = 0.70) and DBP (r1 = 0.65), with the level of uric acid (r1 = 0.57), cholesterol LDL (r1 = 0.52), cystatin C in urine (r1 = 0.75) and insulin resistance index (HOMA-IR) (r1 = 0.65) (p &amp;lt; 0.01). Conclusion Body mass index does not determine the obesity phenotype. In patients with complicated obesity, the proportion of fat mass is higher than in metabolically healthy obesity and is associated with increased levels of glucose and uric acid. All obese patients are characterized by an increase in the percentage of total and extracellular fluid, associated with the level of blood pressure and urinary excretion of markers of tubular dysfunction.

THE EFFICACY OF VERY LOW CALORIE KETOGENIC DIET (VLCKD) ON CARDIO–METABOLIC PROFILE IN PATIENTS WITH OBESITY

Abstract Background Obesity is associated with alterations in cardiac structure and haemodynamics leading to cardiovascular mortality and morbidity. Very low calorie ketogenic diet (VLCKD) has been proposed as an effective intervention to achieve a significant weight loss in obese patients in a short time period. Furthermore, hyperketonemia induced by VLCKD is associated with beneficial cardiovascular effects. In addition, ketogenic diet is able to prevent mitochondrial fission, improve mitochondrial function, suppress oxidative stress and attenuate cardiac myocytes apoptosis in the heart of mice. Aim To evaluate the role of VLCKD on cardio–metabolic risk factors, cardiac dysfunction and myocardial remodelling in obese patients. Materials and Methods Ten obese patients treated with VLCKD were enrolled. All patients were characterized from an anthropometric, cardio–metabolic and echocardiographic point of view at baseline and 8 weeks after VLCKD treatment. In addition, each patient underwent measurement of global myocardial work efficiency (GWE), a novel indicator that accounts for deformation and afterload, which may provide additional value for assessment of myocardial function. The insulin resistance (IR) was evaluated by HOMA–IR. Results As expected, all the patients showed a significant reduction in body weight and an overall improvement of body composition parameters after VLCKD. Weight (kg) (from 105.1 ± 18.2 to 83.7 ± 16.7, P &amp;lt;0.05), BMI (kg/m2) (from 40.1 ± 4.7 to 31.8 ± 4.8, P= 0.002) and waist circumference (cm) (from 115 ± 13.6 to 101.8 ± 12.4, p &amp;lt; 0.05) were significantly lower after VLCKD treatment. VLCKD treatment improved also significantly fasting glucose levels (P &amp;lt;0.05), fasting insulin levels (P =0.004), HOMA–IR values (P &amp;lt;0.001), lipid profile and systolic and diastolic blood pressure levels. In addition, the echocardiogram evaluation showed an improved in end–diastolic left ventricular volume, end–systolic left ventricular volume, left ventricular mass and left ventricular mass index. Interestingly, a significantly changes in GWE was observed (P&amp;lt;0.05). Conclusion Although preliminary, our data suggest that VLCKD treatment is able to reduce cardio–metabolic risk factors and to improve cardiac dysfunction and myocardial function.

Associations of TSH, free T3, free T4, and conversion ratio with incident hypertension: results from the prospective Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

To evaluate the association of TSH, free T3 (FT3), free T4 (FT4), and conversion (FT3:FT4) ratio values with incident hypertension. The study included data from participants of the ELSA-Brasil study without baseline hypertension. Serum TSH, FT4 and FT3 levels, and FT3:FT4 ratio values were assessed at baseline, and incident hypertension (defined by blood pressure levels ≥ 140/90 mmHg) was estimated over a median of 8.2 years of follow-up. The risk of incident hypertension was evaluated considering a 1-unit increase in TSH, FT4, FT3, and conversion ratio values and after dividing these variables into quintiles for further analysis using Poisson regression with robust variance. The results are presented as relative risks (RR) and 95% confidence intervals (CIs) before and after adjustment for multiple variables. The primary analysis incorporated data from 5,915 euthyroid individuals, and the secondary analysis combined data from all euthyroid individuals, 587 individuals with subclinical hypothyroidism, and 31 individuals with subclinical hyperthyroidism. The rate of incident hypertension was 28% (95% CI: 27%-29.3%). The FT4 levels in the first quintile (0.18-1.06 ng/dL) were significantly associated with incident hypertension (RR: 1.03, 95% CI: 1.01-1.06) at follow-up. The association between FT4 levels in the first quintile and incident hypertension was also observed in the analysis of combined data from euthyroid individuals and participants with subclinical thyroid dysfunction (RR: 1.04, 95% CI: 1.01-1.07). The associations were predominantly observed with systolic blood pressure levels in euthyroid individuals. However, in the combined analysis incorporating euthyroid participants and individuals with subclinical thyroid dysfunction, the associations were more pronounced with diastolic blood pressure levels. Low FT4 levels may be a mild risk factor for incident hypertension in euthyroid individuals and persons with subclinical thyroid dysfunction.

Effects of olive leaf extract and nifedipine, alone and in combination, on blood pressure, neutrophil gelatinase-associated lipocalin, malondialdehyde, and creatinine levels in an Nω-nitro-L-arginine methyl ester-induced rat model of preeclampsia

Preeclampsia (PE) is a significant health problem in pregnancy, affecting 6–7% of all gestations and leading to fetal growth retardation, infant morbidity and mortality, premature birth, and maternal death. Currently, effective treatment options for PE are limited. This study aimed to evaluate the therapeutic potential of olive leaf extract (OLE) and nifedipine, alone and in combination, in improving pregnancy outcomes in rats induced with Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME). Rats were treated with single and combination treatments of nifedipine and OLE for four weeks, after being induced with L-NAME for six weeks. Following gestational day assessment and systolic blood pressure testing, the rats were sacrificed, and blood samples were collected for Neutrophil Gelatinase-Associated Lipocalin (NGAL), Malondialdehyde (MDA), proteinuria and Creatinine (SCr) Levels examinations. The results revealed the combination of nifedipine and OLE significantly improved the results of several biomarker analyses associated with PE, including increased NGAL levels, a significant decrease in MDA levels, decrease in proteinuria and elevated creatinine levels. The combination nifedipine and OLE treatment also exhibited a significant antihypertensive effect compared to either nifedipine or OLE monotherapy, as evidenced by the reduction in systolic and diastolic blood pressure levels. This study provides novel evidence for the potential of olive leaf extract as a nutraceutical adjunct for the prevention and treatment of PE. The significant improvements observed in several pathological features associated with PE, including antihypertensive effects, warrant further investigation. Future research should focus on elucidating the underlying mechanisms of action and exploring the clinical applicability of olive leaf extract in human populations with PE.

Cross-sectional and longitudinal associations of Iron biomarkers and cardiovascular risk factors in pre- and postmenopausal women: leveraging repeated measurements to address natural variability

BackgroundThe association between iron biomarkers and cardiovascular disease risk factors (CVD-RFs) remains unclear. We aimed to (1) evaluate the cross-sectional and longitudinal associations between iron biomarkers (serum ferritin, transferrin saturation (TSAT), transferrin) and CVD-RFs among women, and (2) explore if these associations were modified by menopausal status.MethodCross-sectional and longitudinal analyses including 2542 and 1482 women from CoLaus cohort, respectively. Multiple linear regression and multilevel mixed models were used to analyse the associations between Iron biomarkers and CVD-RFs. Variability of outcomes and iron markers between surveys was accessed using intraclass correlation (ICC).ResultsAfter multivariable adjustment, elevated serum ferritin levels were associated with increased insulin and glucose levels, while higher transferrin levels were linked to elevated glucose, insulin and total cholesterol, and systolic and diastolic blood pressure (p < 0.05). No association was observed between CVD-RFs and TSAT (p > 0.05). Iron biomarkers demonstrated low reliability across reproductive stages but exhibited stronger associations in the perimenopausal group. In longitudinal analysis, we found association only for transferrin with lower glucose levels [β = − 0.59, 95% CI (− 1.10, − 0.08), p = 0.02] and lower diastolic blood pressure [β = − 7.81, 95% CI (− 15.9, − 0.56), p = 0.04].ConclusionIn cross-sectional analysis, transferrin was associated with several CVD-RFs, and the associations did not change according to menopausal status. Conversely, in the longitudinal analyses, changes in transferrin were associated only with lower glucose and diastolic blood pressure levels. These differences might stem from the substantial longitudinal variation of iron biomarkers, underscoring the need for multiple iron measurements in longitudinal analyses.

Troponin I, Hyperlipidemia and Obesity as Predictor of Cardiovascular Complications: A Cross Sectional Study

High levels of Troponin I, cholesterol, triglycerides, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and Body Mass Index (BMI) are predictor of cardiac complications. Objective: To investigate the predictive efficacy of Troponin I, BMI, and lipid profiles in detecting cardiovascular problems. Methods: 300 male and female individuals were selected for current study. 100 normal individuals were in Control Group A, while 100 participants were placed in Group B all the individuals of Group B have the indications of different cardiac medical complications. BMI, systolic, diastolic blood pressure, Troponin I, cholesterol, triglycerides, LDL, HDL levels were measured respectively. Results: In present study BMI, systolic blood pressure, diastolic blood pressure, Troponin I, cholesterol, triglycerides, LDL, HDL blood serum levels of male and female in Group A and Group B were measured, the comparative analysis of above biomarkers showed a significant p-Value ≤ 0.05 change (0.02 ± 0.01, 183.01 ± 0.02, 120.01 ± 0.02, 87.01 ± 0.03, 44.01 ± 0.01), (0.02 ± 0.01, 172.01 ± 0.02, 130.01 ± 0.01, 88.01 ± 0.03, 42.01 ± 0.04), (0.39 ± 0.04, 272.01 ± 0.02, 180.01 ± 0.01, 138.01 ± 0.03, 37.01 ± 0.01) and ( 0.37 ± 0.04, 282.01 ± 0.02, 184.01 ± 0.01, 141.01 ± 0.03, 36.01 ± 0.01) were measured respectively. Conclusions: The present study found that there were notable significant p-value &lt;0.05 differences in the blood serum levels of BMI, systolic and diastolic blood pressure, Troponin I, cholesterol, triglycerides, LDL, and HDL in both the male and female groups in Groups A and B

Burden of hypertension and associated risk factors among the Nicobarese tribe of Car Nicobar Island, India

Background: Hypertension, a significant risk factor for various non-communicable diseases, poses a preventable threat to mortality and disease burden. However, there remains a lack of data on hypertension within Indian tribes, particularly those residing in impoverished areas. Determining the prevalence of hypertension and identifying associated risk factors among the Nicobarese tribes. A cross-sectional survey was conducted, involving 2600 tribal individuals aged 18 years and above from ten randomly selected villages on Car Nicobar Island. Methods: A structured questionnaire was utilized to gather data on blood pressure (BP), anthropometric measurements, and detailed participant characteristics. Prevalence of hypertension was determined and analyzed in relation to various identified risk factors using chi-square, Karl Pearson coefficient of correlation, and generalized linear models. Prevalence ratio and adjusted risk ratio calculated, along with their corresponding confidence intervals. Results: Prevalence of hypertension was 57.9%. Several factors, including age, male gender, illiteracy, diabetes, smoking, alcohol consumption, and higher body mass index (BMI), were significantly associated with hypertension. Systolic and diastolic BP levels increased significantly with age, socio-economic scores, BMI, and weight. Conclusions: The prevalence of hypertension among the Nicobarese tribes is significantly higher compared to the general population. Adapting preventive strategies based on an understanding of the tribe's specific culture and lifestyle is important for controlling hypertension. However, it is also crucial to consider genetic and environmental influences that may contribute to the high prevalence of hypertension in this tribe.

Glycemic Profile and Lipid Profile in Chronic Obstructive Pulmonary Disease (COPD) Patients With and Without Metabolic Syndrome.

There is a lack of Indian data regarding the frequency of metabolic syndrome (MetS) or its components in chronic obstructive pulmonary disease (COPD). As a result, the present study aimed to determine the prevalence of MetS in COPDcases and investigate its association with COPD severity. After receiving ethical approval fromIndex Medical College and Hospital, we conducted this cross-sectional study in Indore. We recruited 100 participants with a history of COPD and divided them into two groups: those with MetS and those without. Researchers examined the subjects' fasting blood glucose, serum high-density lipoprotein, triglyceride(TG), systolic and diastolic blood pressure (SBP/DBP), waist circumference, and fasting blood glucose levels. We discovered that 59% of patients with COPD and 52% of individuals with impaired fasting glucose (IFG) had MetS (mean ± SD = 110.8 ± 32.8). In comparison, 48% (mean ± SD = 98.2 ± 24.8) of individuals with normal fasting glucose do not experience this. The incidence of MetS was higher in both groups, those with IFG and those without, but the difference was not statistically significant (t = 1.7088, df = 98; p = 0.0907). We observed X2 = 1.336, df = 1, and p = 0.2476 when we tested the association between IFGand COPD with the Chi-square test. Individuals with MetS were more likely to have high BP, raised TG levels, low HDL cholesterol, abdominal obesity, and other risk factors.

The effects of Mediterranean diet on cardiovascular risk factors, glycemic control and weight loss in patients with type 2 diabetes: a meta-analysis

To explore the impact of the Mediterranean diet on cardiovascular risk factors, glycemic control and weight loss in patients with type 2 diabetes(T2D) by a meta-analysis of randomized controlled trials (RCTs). We systematically searched PubMed, Cochrance Library, EMBASE and four Chinese databases to identify RCTs that compared the Mediterranean diet with control diets in patients with T2D up to December 2021. The Risk of Bias of the included studies was assessed using the version 2 of the Cochrane risk-of-bias tools for randomized trials (ROB 2). Seven RCTs with 1371 patients met the eligibility criteria and entered into the meta-analysis. Compared to control diets, the beneficial effects of Mediterranean diet were not statistically significant in high-density lipoprotein (MD = 2.33; 95% CI: -0.27 to 4.92), low-density lipoprotein (MD = -2.34; 95% CI -5.67 to 0.99) and total cholesterol (MD = 2.60; 95% CI: -0.95 to 6.15). But Mediterranean diet led to reduce the level of diastolic blood pressure (MD = -1.20; 95% CI: -2.21 to -0.19) and systolic blood pressure (MD = -4.17; 95% CI: -7.12 to -1.22). Meanwhile, Mediterranean diet showed beneficial effects in glycemic control (HbA1[%]: MD = -0.39, 95% CI: -0.58 to -0.20; fasting plasma glucose: MD = -15.12, 95% CI: -24.69 to -5.55) and weight loss (BMI: MD = -0.71, 95% CI: -1.30 to -0.78; WC: MD = -1.69; 95% CI: -3.35 to -0.02) compared to the control diets. The meta-analysis presented evidence supporting the beneficial effects of the Mediterranean diet on blood pressure, glycemic control, and weight loss. However, the impact of the Mediterranean diet on the lipid profile was not found to be significant, warranting further verification. This Meta-analysis was registered on the INPLASY website (Registration number: INPLASY 202160096).

ARTERIAL HYPERTENSION AS A COMPONENT OF METABOLIC SYNDROME IN MEN IN AN OPEN URBAN POPULATION

Purpose. To determine blood pressure (BP) levels and the prevalence of arterial hypertension (AH), as a component of metabolic syndrome, in men of an open urban population aged 25–64 years. Materials and methods. A one-time epidemiological study was conducted on a representative sample of men 25–64 years old, formed from the electoral lists of citizens of the city of Tyumen in the amount of 1000 people, the response was 85.0%. To analyze the prevalence of AH as a component of the metabolic syndrome, the NCEP ATP III (2004), IDF (2005), All-Russian Scientific Society of Cardiology (2009) assessment criteria were used. Results. The levels of systolic BP in men of the Tyumen population were high due to the average age groups of 35–44 and 45–54 years; in the same groups there was a significant increase in the average values and percentile distribution of the trait. According to the levels of diastolic BP in men of the Tyumen population, a directional age trend of the indicator was formed with a significant increase in its levels in each subsequent age group. In terms of the prevalence of AH, the standardized indicator in the male population of Tyumen 25–64 years old was 59.8%; a positive relationship was established with age in the younger and older age categories. Conclusion. Thus, the study results obtained in an open urban population, which identified the most vulnerable age categories of men with regard to the development of metabolic syndrome, represent a scientific basis for the formation of a preventive program in the region.

Muscleness and fatness phenotypes for diabetes and hypertension prediction from the Chilean National Health Survey 2016-17

Introduction: Diabetes and arterial hypertension are increasing in adults, where calf circumference and waist circumference are two clinical epidemiological markers poorly studied for predicting cardiometabolic risk. Objective: To characterize four phenotypical models in the Chilean adult population based on muscleness and fatness using both calf circumference and waist circumference outcomes. Methodology: An epidemiological observational cross-sectional representative study based on the Chilean National Health Survey 2016-17, where four phenotypes groups were analyzed; Low skeletal muscle mass and high-waist circumference (Lsmm-Hwc, n=140), low skeletal muscle mass and low waist circumference (Lsmm-Lwc, n=242), high skeletal muscle mass and high waist circumference (Hsmm-Hwc, n=1076), and high skeletal muscle mass and low waist circumference (Hsmm-Lwc, n=1358). These groups described information about diabetes, hypertension prevalence, including other risk factors. Results: The reference group Hsmm-Lwc group showed lower fasting plasma glucose (FPG) vs. Hsmm-Hwc (90.4 [95%CI] [89.0; 91.8] vs. 111.7 [109.1; 114.3]), and vs. Lsmm-Hwc (90.4 [89.0; 91.8] vs. 118.3 [107.2; 129.4] mg/dL, both P&lt;0.0001). Lower levels (i.e., appropriate) of FPG (R2 4.8%), glycated hemoglobin (R2 2.6%), systolic BP (R2 19.0%), and diastolic BP (R2 2.5%) were significantly associated (all, P&lt;0.0001) with the Reference group Hsmm-Lwc. Conclusion: A high muscleness and low fatness phenotype is present in those who are younger adults, is associated with better glucose/blood pressure control, and reports low cardiovascular risk factors for diabetes and hypertension in Chilean adults.

The effect of ascending- descending ultrafiltration and sodium profiles on blood pressure in hemodialysis patients: a randomized cross-over study

BackgroundConsidering no previous research into the utilization of ascending/descending ultrafiltration and linear sodium profiles in improving blood pressure among hemodialysis patients, the present study aimed to explore the effect of the A/D-UF along with linear sodium profiles on HD patients with hypotension.MethodsApplying a crossover design, this clinical trial was fulfilled between December 2022 and June 2023 on 20 patients undergoing HD, randomized into two groups, each one receiving two intervention protocols, viz., (a) an intervention protocol in which the liquid sodium in the dialysis solution was linear and the UF profiling was A/D, and (b) a routine protocol or HD, wherein both liquid sodium and UF in the dialysis solution remained constant. The HD patients’ BP was then checked and recorded at six intervals, namely, before HD, one, two, three, and four hours after it, and following its completion, within each session. The data were further statistically analyzed using the IBM SPSS Statistics 20 and the related tests.ResultsIn total, 20 patients, including 12 men (60%) and 8 women (40%), with the mean age of 58.00 ± 14.54 on HD for an average of 54 months, were recruited in this study. No statistically significant difference was observed in the mean systolic and diastolic BP levels in the group receiving the A/D-UF profile all through the desired hours (p > 0.05), indicating that the patients did not face many changes in these two numbers during HD. Our cross-over clinical trial demonstrated a statistically significant reduction in symptomatic IDH episodes from 55 to 15% with the application of the A/D-UF profile (p < 0.05).ConclusionThe study demonstrated that the A/D-UF profile could contribute to the stability of blood pressure levels among HD patients, with no significant fluctuations observed during treatment sessions.Trial RegistrationThis study was registered in the Iranian Registry of Clinical Trials (no. IRCT20180429039463N5) on 07/01/2023.

Theory of the Leaky Intestine: Sex Differences in Intestinal Parasitic Infections, Cytoskeletal Wall Dysfunctions, and Hypertension

BACKGROUND: Intestinal parasitic infections (IPIs) impact approximately 3.5 billion individuals globally. Protozoan IPIs may influence the intestinal microbiome. This research investigates IPI effects on intestinal wall thickness and their potential links to sex-specific hypertension. It also explores the impact of alterations in intestinal wall permeability on sodium and blood glucose levels. METHODS: The study enrolled 108 subjects, including 83 consecutive patients with confirmed symptomatic IPIs (48 males, 35 females) and 25 healthy volunteers used as controls (9 males, 16 females). B-mode ultrasound grayscale images of the duodenum and colon were taken with and without water contrast. RESULTS: Patients with parasites exhibited a higher BMI (mean = 28.9 ± 7.4) compared to controls (mean = 24.68 ± 7.2), F (1, 96) = 5.78, _p _&lt; 0.05. IPI patients showed a tendency towards increased duodenal wall thickness (DUOTHICK = 0.88 ± 0.7 cm) versus controls (0.6 ± 0.1 cm), _p = _0.05. Additionally, IPI patients had significantly greater thickness in the ascending colon (ASCTHICK = 1.1 ± 0.3 cm) and descending colon (DSCTHICK = 1.2 ± 0.4 cm) compared to controls (ASCTHICK = 0.6 ± 0.2 cm, DSCTHICK = 0.6 ± 0.1 cm), _p _&lt; 0.05. Men over 50 years exhibited greater DSCTHICK (1.25 ± 0.434 cm) than postmenopausal women (0.986 ± 0.389 cm), _p _&lt; 0.05. DSCTHICK significantly predicted diastolic blood pressure (β = −0.295, _p _&lt; 0.05) and blood sodium level (β = −0.300, _p _&lt; 0.05). DUOTHICK in diabetic IPI patients exceeded that in nondiabetic patients. Effective antiparasitic and antidiabetic treatments induced changes in the echoanatomy of the intestinal wall, suggesting the sealing of ‘the leak’. CONCLUSIONS: IPIs disrupted the intestinal cytoskeleton, leading to “leaky gut syndrome” development.

Blood pressure and the hypertension care cascade in The Gambia: Findings from a nationwide survey.

Community treatment of hypertension in sub-Saharan Africa is hampered by gaps at several stages of the care cascade. We compared blood pressure (BP) levels (systolic, diastolic and pulse pressures) in four groups of participants by hypertension and treatment status. We conducted a nationally representative survey of adults 35 years and older using a multistage sampling strategy based on the 2013 Gambia Population and Housing Census. The BP measurements were taken in triplicate 5min apart, and the average of the last two measurements was used for analysis. Systolic and diastolic BP levels and pulse pressure were compared by hypertension status using mean and 95% confidence intervals (CI). 53.1% of the sample were normotensive with mean systolic BP (SBP) of 119.2mmHg (95% CI, 118.7-119.6) and diastolic BP (DBP) of 78.1mmHg (77.8-78.3). Among individuals with hypertension, mean SBP was 148.7mmHg (147.7-149.7) among those unaware of their hypertension, 152.2mmHg (151.0-153.5) among treated individuals and was highest in untreated individuals at 159.3mmHg (157.3-161.2). The findings were similar for DBP levels, being 93.9mmHg (93.4-94.4) among the unaware, 95.1mmHg (94.4-95.8) among the treated and highest at 99.1mmHg (98.1-100.2) in untreated participants. SBP and DBP were higher in men, and SBP was as expected higher in those aged≥55 years. BP level was similar in urban and rural areas. Our data shows high BP levels among participants with hypertension including those receiving treatment. Efforts to reduce the health burden of hypertension will require inputs at all levels of the care cascade.

Differences in aging rates based on different methods of calculation in patients with arterial hypertension and subclinical hypothyroidism

Objective — to evaluate two distinct methods for determining biological age (BA) and aging rates among patients with arterial hypertension (AH) in combination with subclinical hypothyroidism (SH) that can be applicable to practical medical settings.&#x0D; Materials and methods. The study involved 150 patients (women 54.7%, n=82) with an average age of 47.1 [39.7;54.0] years, who were divided into three groups reciprocal by age and sex: the main group included 70 patients with AH in combined with SH, the comparison group consisted of 50 subjects with isolated AH, and control group of 30 healthy volunteers. All subjects were assessed for objective data, anthropometric status, standard clinical‑biochemical indicators, insulin, HOMA IR, C‑reactive protein (CRP), tumor necrosis factor‑alpha (TNF‑α), thyroid‑stimulating hormone (TSH), free thyroxine (T4), and sirtuin 1 (SIRT1). Additionally, the pro‑oxidant‑antioxidant balance was evaluated by assessing total hydroperoxides (THP) levels and total antioxidant activity (TAA). The assessment of BA and aging rates (ΔBA) were chosen as the main markers of premature aging and were performed with two different methods: by M. Levin et al. (ΔBA1), by authors’ own method (ΔBA2). Depending on ΔBA, patients from all three groups were divided into subgroups with normal/slowed aging rates (ΔBA ≤0) and accelerated aging rates (ΔBA &gt;0).&#x0D; Results. According to ΔBA1 (p=0.004), 4 subjects with accelerated aging rates reveled in the controls, while in the main group the rate was 2.2 times higher than in the comparison group (40.0% versus 18%). According to ΔBA2 (p=0.0001), more people had an increased aging rates both in the main group and in the comparison group (57.1% versus 38.0%). Patients with AH and accelerated aging rates according to ΔBA1 had significant differences in the levels of SIRT1 (p=0.012), aspartate aminotransferase (AST) (p=0.012), alanine aminotransferase (ALT) (p=0.005), uric acid (p=0.011), and diastolic blood pressure (DBP) (p=0.001), and according to ΔBA2, higher levels of insulin (p=0.019), HOMA IR (p=0.013), triglycerides (TG) (p=0.011), very low‑density lipoprotein cholesterol (VLDL‑C) (p=0.020), DBP (p=0.032), and lower levels of total protein (p=0.048), compared to patients with AH and normal/slower aging rates. In the group of patients with AH combined with SH, differences in the levels of THP (p=0.023), uric acid (p=0.044), and body mass index (BMI) (p=0.046) were found among patients with different aging rates according to ΔBA1, and according to the results of the ΔBA2 assessment — in the levels of glucose (p=0.045) and uric acid (p=0.026). Among the studied patients in the AH group and in the group with a combined course of AH and SH, there were 52 patients whose aging rates (accelerated and normal/slowed) did not coincide in the assessment according to ΔBA1 and ΔBA2 : 11 patients had accelerated aging rates only according to ΔBA1, and 23 patients — only according to ΔBA2. Among the aforementioned 52 patients, 50% had elevated levels of ALT, 32.7% — AST, 3.8 — alkaline phosphatase (ALP), 90.2% — HOMA IR, 80.8% — total cholesterol (TC), 28.8% — triglycerides (TG), 26.9% had decreased levels of high‑density lipoprotein cholesterol (HDL‑C), 82.7% had elevated levels of LDL‑C, 15.4% — creatinine, 46.2% had decreased eGFR, 15.4% had elevated levels of CRP, 3.8% — TNF‑α, and 50.0% had uncontrolled levels of systolic and diastolic BP.&#x0D; Conclusions. Assessment of BA should be mandatory for patients with AH and SH to enable early detection and prevention of premature aging. As an indicator of accelerated aging rates, the combined use of ΔBA assessment based on clinical and biochemical indicators according to the method of M. Levin et al. (2018), as well on our own developed method based on the assessment of anthropometric indicators, TSH levels and the content of THP can be effective. Primary determination of BA can be conducted during regular (e.g., annual) preventive screening of patients. In case of detection of cardiometabolic disorders, repeat determination of BA can be performed after some time following their correction.&#x0D;

Association of whole blood copper, zinc, calcium, magnesium, and iron with non-alcoholic fatty liver disease in overweight and obese children.

Non-alcoholic fatty liver disease (NAFLD) is a common metabolic disorder in overweight and obese children, and its etiology and pathogenesis remain unclear, lacking effective preventive and therapeutic measures. This study aims to explore the association between whole blood copper, zinc, calcium, magnesium and iron levels and NAFLD in overweight and obese children aged 6 to 17 years, providing a scientific basis for the prevention and intervention of early NAFLD in overweight and obese children. A cross-sectional study design was used to collect relevant data from overweight and obese children who visited the Hunan Children's Hospital from January 2019 to December 2021 through questionnaire surveys. Fasting blood samples were collected from the subjects, and various indicators such as blood glucose, blood lipid, and mineral elements were detected. All children were divided into an overweight group (n=400) and a NAFLD group (n=202). The NAFLD group was divided into 2 subgroups according to the ALT level: A non-alcoholic fatty liver (NAFL) group and a non-alcoholic steatohepatitis (NASH) group. Logistic regression analysis was used to analyze the association between minerals (copper, zinc, calcium, magnesium, and iron) and NAFLD, NAFL and NASH. A total of 602 subjects were included, of whom 73.6% were male, with a median age of 10 (9, 11) years, and a body mass index (BMI) of 24.9 (22.7, 27.4) kg/m2. The intergroup comparison results showed that compared with the overweight group, the NAFLD group had higher levels of age, BMI, diastolic blood pressure (DBP), systolic blood pressure (SBP), triglyceride (TG), low density lipoprotein (LDL), alanine transaminase (ALT) and aspartate aminotransferase (AST), and lower level of high density lipoprotein (HDL). The NAFL group had higher levels of age, BMI, DBP, SBP, ALT, and AST, and lower levels of HDL compared with the overweight group. The levels of age, BMI, DBP, SBP, TG, LDL, ALT, and AST of NASH were higher than those in the overweight group, while the level of HDL was lower than that in overweight group (all P<0.017). After adjusting for a variety of confounders, the OR of NAFLD for the highest quantile of iron was 1.79 (95% CI 1.07 to 3.00) compared to the lowest quantile, and no significant association was observed between copper, zinc, calcium, and magnesium, and NAFLD. The subgroup analysis of NAFLD showed that the OR for the highest quantile of iron in children with NAFL was 2.21 (95% CI 1.26 to 3.88), while no significant association was observed between iron level and NASH. In addition, no significant associations were observed between copper, zinc, calcium, and magnesium levels and NAFL or NASH. High iron level increases the risk of NAFLD (more likely NAFL) in overweight and obese children, while copper, zinc, calcium, magnesium, and other elements are not associated with the risk of NAFLD in overweight and obese children.

Bye-Bye Dementia: Prevent dementia in the elderly with brain gym

Elderly individuals often encounter various health issues, including mental and psychological decline such as dementia. One solution to address this is through brain gym therapy. The aim of this community service is to enhance the knowledge of the elderly regarding dementia, improve their ability to perform brain gym exercises, and observe the effects on their blood pressure levels. Counseling and interventions were conducted with 25 participants aged over 45 years residing in RT 03/RW 05, Limo Village, Depok. Educational methods included lectures, distribution of educational leaflets, and demonstrations of brain gym. This service successfully increased the elderly's knowledge about dementia, with the majority scoring between 51-100, comprising 14 individuals (56%). Additionally, there was a decrease in the average systolic and diastolic blood pressure levels.