Diastolic Blood Pressure Levels Research Articles

FRI099 Advanced Lipoprotein Analysis In Patients With Cushing’s Syndrome

Abstract Disclosure: R.T. Varghese: None. R. McGlotten: None. M. Sampson: None. A. Prakash: None. R. Shamburek: None. A.T. Remaley: None. R. Muniyappa: None. L.K. Nieman: None. Introduction: Cushing syndrome (CS) patients have a higher mortality rate due to increased cardiovascular disease (CVD). Analysis of lipoprotein particles with nuclear magnetic resonance (NMR) spectroscopy provides additional insights into CVD risk beyond the standard lipid panel. The goal of the study was to better characterize the lipid abnormalities in patients with CS by using high-resolution separation of lipoprotein particles. Methods: We measured plasma lipids (Cholesterol, TC; calculated low density lipoprotein, LDL; triglycerides, TG; high density lipoprotein, HDL) by the traditional enzymatic assay and lipoprotein particles by NMR spectroscopy. Measures of inflammation and insulin resistance were also derived from NMR spectra. Values are shown as mean ± SEM or median [IQR]. Results: After initial evaluation, 42 subjects (mean age 47.4 ± 2.5 years; 28 females; weight 85.0 ± 3.1 kg) had Cushing's disease (n=23), ectopic ACTH secretion (n=17), or adrenal adenoma (n=2). Ten patients were on chronic statin therapy, and 14 subjects had type 2 diabetes mellitus (T2DM). The control group comprised 45 subjects without T2DM [mean age 45.4 ± 2.1 years and weight (83.5 ± 2.7) kg]. None in the control group were on statin therapy. Compared to controls, CS patients had significantly higher systolic (135 ±2 vs. 119 ±2 mm Hg, p<0.001) and diastolic blood pressure (79 ±2 vs. 71 ±1 mm Hg, p<0.001), HbA1c (6.1 [5.4-7.5] vs. 5.4 [5.0-5.7], p<0.001), plasma glucose (103 [90-137] vs 94 [89-100] mg/dL, p=0.003), and insulin (17[12-26] vs 11[7-15] uU/mL, p=0.01) levels. Compared to controls, patients with CS had significantly higher triglyceride concentration (116 [84 -146] vs 87 [62-120] mg/dL, p=0.02) and lower LDL concentration (90 [69 -113] vs 108 [90 -125] mg/dL, p=0.04). However, total cholesterol and HDL cholesterol concentrations were not different. LDL particle size in CS was smaller (20.5[20.0-21.0] vs 21.0 [20.7-21.2] nm, p=0.01) and VLDL particle size was larger (49.8 ± 0.9 vs 45.7 ± 1.0 nm, p=0.002) than in controls. No difference was noted between groups in HDL particle number or size or in LDL and VLDL particle number. In the group with CS, a marker of inflammation, GlycA (Glycan N-acetylglucosamine) (494.5 ± 18.2 vs. 382.5 ± 9.0 µmol/L, p<0.001) and Lipoprotein Insulin Resistance score (LPIR) (46.4 ± 3.1 vs. 36.2 ± 3.1, p=0.02) were significantly higher. There were no group differences in branch-chained amino acids (BCCA) levels. These differences remained even when patients with type 2 diabetes and those on statin therapy were excluded. Conclusions: These data suggest that the higher inflammatory and insulin resistance state, dysglycemia, hypertension, and altered lipoprotein profiles may contribute to the increased CV risk in patients with Cushing’s syndrome. Early detection and treatment for these abnormalities may attenuate CV risk. Presentation: Friday, June 16, 2023

Non-HDL cholesterol and long-term follow-up outcomes in patients with metabolic syndrome

BackgroundNon-high-density lipoprotein-cholesterol (non-HDL-C) has been identified as a potential biomarker for metabolic syndrome (MetS). However, its predictive capability for MetS varies among different ethnic groups, necessitating further investigation. This study aimed to assess the role of non-HDL-C in the early diagnosis of MetS in the Iranian population through a longitudinal study with a 10-year follow-up period.MethodsOur study enrolled 4684 individuals from the MASHAD (Mashhad Stroke and Heart Atherosclerotic Disorder) cohort who were followed for 10 years to examine the association between non-HDL-C and the incidence of MetS. Additionally, the contribution of individual MetS components to the overall burden was evaluated.ResultsA total of 1599 subjects developed MetS, while 3085 did not. Non-HDL-C levels ≥ 130 were associated with a 42% higher risk of developing MetS (relative risk (RR), 1.42; 95% confidence interval (CI), 1.25–1.62). Regarding MetS components, elevated waist circumference (WC) showed the strongest association with MetS incidence (RR, 2.32; 95% CI, 1.45–2.9), whereas triglyceride (TG) levels ≥ 150 mg/dL demonstrated the weakest association (RR, 1.23; 95% CI, 1.04–1.46). Additionally, higher HDL-C levels were reported to be 20% protective against the risk of MetS (RR, 0.8; 95% CI, 0.73–0.86). Moreover, fasting blood glucose (FBG) levels ≥ 100 mg/dL were not significantly linked to MetS burden, while systolic blood pressure (BP) levels ≥ 130 mmHg or diastolic BP levels ≥ 85 mmHg increased the risk of MetS incidence (RR, 1.25; 95% CI: 1.11–1.41).ConclusionsElevated non-HDL-C and increased WC serve as significant predictors of MetS in Iranians. Strategies targeting non-HDL-C levels and weight loss should be emphasized to mitigate the risk of MetS development.

An integrated machine learning predictive scheme for longitudinal laboratory data to evaluate the factors determining renal function changes in patients with different chronic kidney disease stages.

Chronic kidney disease (CKD) is a global health concern. This study aims to identify key factors associated with renal function changes using the proposed machine learning and important variable selection (ML&IVS) scheme on longitudinal laboratory data. The goal is to predict changes in the estimated glomerular filtration rate (eGFR) in a cohort of patients with CKD stages 3-5. A retrospective cohort study. A total of 710 outpatients who presented with stable nondialysis-dependent CKD stages 3-5 at the Shin-Kong Wu Ho-Su Memorial Hospital Medical Center from 2016 to 2021. This study analyzed trimonthly laboratory data including 47 indicators. The proposed scheme used stochastic gradient boosting, multivariate adaptive regression splines, random forest, eXtreme gradient boosting, and light gradient boosting machine algorithms to evaluate the important factors for predicting the results of the fourth eGFR examination, especially in patients with CKD stage 3 and those with CKD stages 4-5, with or without diabetes mellitus (DM). Subsequent eGFR level after three consecutive laboratory data assessments. Our ML&IVS scheme demonstrated superior predictive capabilities and identified significant factors contributing to renal function changes in various CKD groups. The latest levels of eGFR, blood urea nitrogen (BUN), proteinuria, sodium, and systolic blood pressure as well as mean levels of eGFR, BUN, proteinuria, and triglyceride were the top 10 significantly important factors for predicting the subsequent eGFR level in patients with CKD stages 3-5. In individuals with DM, the latest levels of BUN and proteinuria, mean levels of phosphate and proteinuria, and variations in diastolic blood pressure levels emerged as important factors for predicting the decline of renal function. In individuals without DM, all phosphate patterns and latest albumin levels were found to be key factors in the advanced CKD group. Moreover, proteinuria was identified as an important factor in the CKD stage 3 group without DM and CKD stages 4-5 group with DM. The proposed scheme highlighted factors associated with renal function changes in different CKD conditions, offering valuable insights to physicians for raising awareness about renal function changes.

Frequency of physical activity and blood pressure levels among persons with type 2 diabetes at a public health center in Southwest Trinidad

Aim: To determine the association between the frequency of physical activity and blood pressure (BP) levels among persons with type 2 diabetes at a public health center in Southwest Trinidad. Settings and Design: In 2011, the Penal Health Center, Diabetes Patient Self-Care Study enrolled 523 persons with type 2 diabetes in routine care in Southwest Trinidad aiming to obtain information on health status including diabetes and cardiovascular disease. The study was cross-sectional and included both males and females aged 25–87 years, having the exposure – physical activity and the outcome – BP levels. Subjects and Methods: Adults with type 2 diabetes aged 25–87 years with available information on physical activity and BP (n = 469). The main outcomes measures were systolic and diastolic BP (DBP) levels. Linear regression models examined the association between the frequency of physical activity (infrequent: <3x/week or frequent: ≥3x/week) and systolic BP (SBP)/DBP adjusting for potential confounders. Episodes of physical activity were defined as continuous physical activity, averaging ≥ 20 min/episode/week. Results: BP among hypertensive participants who exercise ≥ 3x/week was 5.3 mmHg lower than those who exercise <3x/week (Unadjusted β = −5.3, [95% confidence interval (CI) −10.0, −0.6], P = 0.026). DBP among hypertensive participants who exercise ≥3x/week was 0.4 mmHg lower than those who exercise <3x/week (Model 2: Adjusted β = −0.4, [95% CI – −3.5, 2.8], P = 0.818). Conclusion: Our findings may suggest an association between the frequency of physical inactivity and SBP levels in persons with type 2 diabetes.

Triglyceride-glucose index is associated with hypertension incidence up to 13 years of follow-up in mexican adults

The triglyceride-glucose index (TyG index) is an indicator of insulin resistance that has been studied recently. The relationship between insulin resistance and the risk of hypertension has been documented previously. However, there is limited knowledge regarding the association of the TyG index with hypertension incidence. This study aimed to evaluate the association of the TyG index with changes in blood pressure (BP) and hypertension incidence in Mexican adults. This analysis was performed using the Health Workers Cohort Study data. The TyG index was estimated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2] and divided into categories defined by tertiles. The analysis was conducted using fixed-effects linear regression models (n = 1,545) and Cox proportional hazards regression models (n = 1,113), adjusting for potential confounding variables. The incidence rates (95% CI) for the low, medium, and high categories of the TyG index were 22.1 (17.8, 27.5), 35.8 (30.1, 42.7), and 49.4 (42.1, 57.9), respectively. An increase in the levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed when changing from a low to a medium (DBP: β 2.55 mmHg, 95% CI 0.81, 4.29) and from a low to a high category of the TyG index (SBP: β 3.10 mmHg, 95% CI 1.16, 5.04; DBP: β 4.91 mmHg, 95% CI 2.88, 6.94). Furthermore, participants within the top category of the TyG index had a 56% higher risk of hypertension than those in the bottom category (HR = 1.56; 95% CI 1.18, 2.08). These results support the hypothesis that the TyG index is associated with high blood pressure in Mexican adults.

Mitochondrial transfer restores impaired liver functions by AMPK/ mTOR/PI3K-AKT pathways in metabolic syndrome

AimWe investigated the effect of mitochondria transfer in high fat diet and streptozotocin (HFD + STZ) induced metabolic syndrome (MeS) in rats. The effect of mitochondria transfer in MeS with co-existing hypertension, hyperlipidaemia, diabetes and fatty liver together, has not been reported. Materials and methodsHeathy mitochondria was transferred intravenously and the effect on several physiological parameters and biochemical parameters were examined in HFD + STZ rats. In addition, RNA-sequencing of healthy liver tissues was performed to elucidate the molecular pathways affected by mitochondria transfer in restoring metabolic health. Key findingsWe observed reduction in both systolic and diastolic blood pressure levels, reduced blood glucose levels, and a marked reduction in serum lipid profiles. The levels of alanine transaminase (ALT) and aspartate transaminase (AST) also improved along with evident restoration of liver morphology demonstrated by histopathological analysis. Enhanced mitochondrial biogenetics and reduction in oxidative stress and inflammatory markers was also observed. The pathway enrichment analysis revealed reduction in insulin resistance, inflammatory markers, regulation of mitochondrial bioenergetics, calcium ion homeostasis, fatty-acid β-oxidation, cytokine immune regulators, and enhanced lipid solubilisation. The significant effect of healthy mitochondria transfer in restoration of metabolic functions was observed by the activation of PI3K-AKT, AMPK/mTOR pathways and cytokine immune regulators, suggesting that inflammatory mediators were also significantly affected after mitochondria transfer. SignificanceThis study, provides insights on molecular processes triggered by mitochondria transfer in fatty liver regeneration and improvement of overall metabolic health.

Efficacy of metformin targets on cardiometabolic health in the general population and non-diabetic individuals: a Mendelian randomization study

Metformin shows beneficial effects on cardiometabolic health in diabetic individuals. However, the beneficial effects in the general population, especially in non-diabetic individuals are unclear. We aim to estimate the effects of perturbation of seven metformin targets on cardiometabolic health using Mendelian randomization (MR). Genetic variants close to metformin-targeted genes associated with expression of the corresponding genes and glycated haemoglobin (HbA1c) level were used to proxy therapeutic effects of seven metformin-related drug targets. Eight cardiometabolic phenotypes under metformin trials were selected as outcomes (average N=466,947). MR estimates representing the weighted average effects of the seven effects of metformin targets on the eight outcomes were generated. One-sample MR was applied to estimate the averaged and target-specific effects in 338,425 non-diabetic individuals in UK Biobank. Genetically proxied averaged effects of five metformin targets, equivalent to a 0.62% reduction of HbA1c level, was associated with 37.8% lower risk of coronary artery disease (CAD) (odds ratio [OR]=0.62, 95% confidence interval [CI]=0.46-0.84), lower levels of body mass index (BMI) (β=-0.22, 95% CI=-0.35 to-0.09), systolic blood pressure (SBP) (β=-0.19, 95% CI=-0.28 to-0.09) and diastolic blood pressure (DBP) levels (β=-0.29, 95% CI=-0.39 to-0.19). One-sample MR suggested that the seven metformin targets showed averaged and target-specific beneficial effects on BMI, SBP and DBP in non-diabetic individuals. This study showed that perturbation of seven metformin targets has beneficial effects on BMI and blood pressure in non-diabetic individuals. Clinical trials are needed to investigate whether similar effects can be achieved with metformin medications. Funding information is provided in the Acknowledgements.

Redefining Hypotension in Older Adults: Implications for the Prevention of Age Related Cognitive Decline

Chronically low blood pressure in older adults is associated with significantly increased long-term risks of dementia and all-cause mortality risk. Yet low blood pressure is generally not treated until an individual begins to experience the acute symptoms arising from very low cerebral perfusion. However, these acute symptoms, such as dizziness, balance difficulty, syncope, increased fall occurrence, vision impairment, and nausea, begin to occur only at very low blood pressure levels, such that mean arterial pressure levels as low as 65mmHg are often considered to be of limited concern. If the long-term consequences of chronic low blood pressure are to be prevented, an alternative approach to defining what constitutes too low a blood pressure for older adults, i.e. hypotension, will be required. Cognitive aging is a significant health concern for many older adults as it has significant impact on quality of life, and is widely considered a precursor to dementia. Here, we utilize an FDA cleared computer aided cognitive assessment tool to identify the relationship between resting brachial blood pressure in the upright seated position, and cognitive function in a convenience sample of independently living older adult men and women. We observed that resting diastolic blood pressure is significantly and positively correlated with cognitive function in adults over the age of 60 years. Specifically, cognitive performance was found to be significantly impaired for diastolic blood pressure levels below approximately 80 mmHg. Diastolic blood pressures (DBP) below 80 mmHg in older adults have consistently been shown to increase the risk of dementia as well as all-cause mortality, but the influence of below normal DBP on quality of life (QoL) in older adults has not been extensively addressed. The present work shows that adults over age 60, with a DBP below 80 mmHg, are significantly more likely to demonstrate mild to moderate cognitive impairment, and correspondingly, the associated impacts on QoL. These results lead to the suggestion that maintenance of diastolic blood in older adults in the 80-90 mmHg range will not only improve quality of life in this population, but may also provide substantial clinical benefit in terms of preventing, or reversing, age-related cognitive decline.

Resistin: A Potential Indicator of Aortic Stiffness in Non-Dialysis Chronic Kidney Disease Patients.

Background and Objectives: In the progression and development of atherosclerosis, resistin plays a significant role. Chronic kidney disease (CKD), frequently associated with atherosclerosis, exhibits a marked increase in morbidity and mortality rates. This study set out to explore the association between aortic stiffness and serum levels of resistin in non-dialysis-dependent CKD patients ranging from stages 3 to 5. Materials and Methods: We collected fasting blood samples from 240 CKD patients across stages 3 to 5. The concentration of resistin in serum was determined using a commercially available enzyme immunoassay kit. Those patients who exhibited a carotid-femoral pulse wave velocity (cfPWV) greater than 10 m/s were identified as the aortic stiffness group. Results: Out of the 240 CKD patients, 88 (36.7%) were classified within the aortic stiffness group. This group demonstrated higher incidences of diabetes, advanced age, increased body weight, body mass index, body fat mass, systolic and diastolic blood pressure, fasting glucose, and serum resistin levels. Multivariate logistic regression analysis highlighted resistin, diabetes, and body weight as independent predictors of aortic stiffness. Additionally, body fat mass, logarithmically transformed cfPWV (log-cfPWV) values and log-triglyceride levels were independent predictors of log-resistin levels by multivariate stepwise linear regression analysis. Conclusions: In CKD patients from stages 3 to 5, a positive correlation exists between elevated serum resistin levels and cfPWV values, identifying resistin as a potential predictor of aortic stiffness.

Effect of tirzepatide on blood pressure and lipids: A meta-analysis of randomized controlled trials.

To perform a meta-analysis to quantify the effect of tirzepatide on blood pressure and lipids. PubMed, Ovid/Medline, Web of Science, Scopus, Cochrane Library and CINAHL databases were screened and the randomized controlled trials evaluating the effects of tirzepatide on either blood pressure or lipid profiles were included. Seven randomized controlled trials have investigated the effects of tirzepatide on blood pressure and lipid profiles. Regardless of the dose administered, tirzepatide resulted in significant decreases in systolic blood pressure of median -4.20 (95% confidence interval [CI] -5.17 to -3.23) mmHg for 5 mg, -5.34 (-6.31 to -4.37) mmHg for 10 mg, and -5.77 (-6.73 to -4.81) mmHg for 15 mg. At all three once-weekly doses, tirzepatide treatment resulted in significant decreases in total cholesterol levels: median -3.76% (95% CI -5.20% to -2.31%) for 5 mg; -4.63% (-6.07% to -3.19%) for 10 mg; and -5.93% (-7.36% to -4.49%) for 15 mg. Additionally, tirzepatide treatment led to increased high-density lipoprotein (HDL) cholesterol levels and decreased low-density lipoprotein (LDL) cholesterol and triglyceride levels. Tirzepatide induced clinically meaningful reductions in the levels of systolic and diastolic blood pressure, total cholesterol, LDL cholesterol and triglycerides, along with increases in the level of HDL cholesterol.

Role of beta 2 microglobulin in chronic kidney disease

The aim: to study the relationship of beta-2-microglobulin (beta-2 MG) with clinical and laboratory manifestations of chronic kidney disease (CKD).Patients and Methods. The results of a comprehensive examination of 284 people (118 males and 166 females) aged 18 to 86 years with various types of socially significant diseases were studied. All patients underwent thorough collection of clinical and anamnestic data, laboratory monitoring with the determination of the level of systolic and diastolic blood pressure (BP), body mass index, red blood, beta-2-microglobulin (B2M), lipid profile and proteinuria. Kidney function was assessed according to the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula using serum creatinine. The main group included 113 patients (55 men and 58 women, mean age 50.9±15.8 years), diagnosed with chronic kidney disease (CKD). The control group consisted of 171 people (63 men and 108 women) with various forms of socially significant diseases, but without signs of CKD. Statistical analysis was carried out using the programs Statistica 10.0 (StatSoft Inc., USA) and Microsoft Office Excel 2010 (Microsoft Corp., USA).Results. In the subgroup of patients with CKD, signs of renal failure were observed in 46 people in 40.7 % of cases. As CKD progressed, the signs of impaired metabolism of B2M were more severe: its serum level was 8.646 (7.892; 12.231) mg/l at C4 and 18.444 (11.225; 23.717) mg/l at C5 stages of CKD, and urinary excretion was 2.502 (0.305; 6.313) mg/l at C4 and 2.614 (1.535; 25.812) mg/l at C5 stages of CKD. Regardless of renal dysfunction, the median serum B2M level was clinically significantly higher in females (p>0.05). Single-factor one-way correlation analysis showed statistically highly significant relationship was between serum B2M and creatinine levels both in the subgroup of patients with CKD (r = 0.905; p = 0.001) and in the total sample (r = 0.749; p = 0.001). There was a strong negative relationship between serum B2M levels and estimated glomerular filtration rate (GFR) (r = -0.717; p = 0.001). In individuals without CKD, an increase in serum creatinine was closely associated with an increase in urinary excretion of B2M (r=0.252; p=0.005). Simultaneously, in this category of patients, there was a close correlation between estimated GFR with serum B2M level (r= -0.433; p=0.002) and its urinary excretion (r= -0.247; p=0.005). A direct relationship between an increase in serum B2M and an increase in diastolic blood pressure (r=0.274; p=0.034) among CKD patients was established. In the total sample, a direct relationship between the value of systolic BP and serum B2M level (r= 0.223; p=0.01) was registered, as well as between diastolic BP (r= 0.268; p=0.01) and urinary excretion of B2M.Conclusion. As a result of the study, metabolism of B2M and its relationship with the clinical and laboratory manifestations of CKD were evaluated. The data obtained show high prognostic potential of changes in metabolism of B2M in the population of patients with various forms of socially significant diseases, as well as CKD, which allows to identify among them groups of patients with high and/or very high renal and cardiovascular risk, in order to take timely targeted therapy.

«СОСУДИСТЫЙ ВОЗРАСТ» И ЕГО ЗНАЧЕНИЕ В КЛИНИЧЕСКОЙ ПРАКТИКЕ

Introduction: The term "vascular age" (VA) was developed to motivate and increase patients' commitment to a healthy lifestyle. This assessment can significantly help in communication between the doctor and the patient. CO is the age of a person who has the same probability of death from cardiovascular diseases as the patient, only without modifiable risk factors. CV can be determined using instrumental methods or risk can be calculated using the modified SCORE scale, the latter method is currently limited due to the modification of the SCORE2 and SCORE-OP scales. The aim of our study was to assess the vascular age in patients with arterial hypertension (AH) using the method of volumetric sphygmography and the relationship of vascular aging with the main clinical and laboratory parameters. Materials and methods: 48 patients with AH were examined, including 21 men (44%) and 27 women (56%), the mean age was 66.9 years and 67.3 years, respectively. The duration of the disease was about 10 years. All patients were receiving antihypertensive therapy at the time of the examination. Vascular age was assessed using the volumetric sphygmography method using the BPLab-Vasotens apparatus (LLC Petr Telegin, Russia). This technique is quite simple, non-invasive, does not require the use of expensive equipment and additional specialists. Statistical processing was carried out using the Microsoft Excel package (Microsoft Office 2011) and Statistica 10.0. Results. Our assessment showed that CO in patients with AH was 69.0 years and did not differ statistically from the passport (67.0 years, р˃0.05). The groups of men and women did not differ from each other in terms of the passport age of the patients (р˃0.05). Correlation analysis showed a positive relationship between passport and vascular age (r=0.88, p<0.001). When analyzing hemodynamic parameters, the patients were divided into 2 groups: group 1 included patients with CO less than or equal to the passport one (n=22), and group 2 included patients with CO greater than the passport one (n=26). In the first group there were more men (14 - 63.6%), and in the second group there were more women (19 - 73.1%), р=0.1. It was found that the indicators of systolic, mean and pulse BP in group 2 were higher: 117.0 [109.0;133.0] and 137.0 [122.0;146.0] mm Hg (p=0.005), 86.5 [84.0;94.0] and 100.5 [92.0;108.0] mm Hg (p=0.006), 44.5 [38.0;64.0] and 70.5 [48.0;74.0] mm Hg (p=0.01), respectively. The groups did not differ from each other in terms of passport age, body mass index, diastolic BP level, length of service, stage of hypertension, lipid profile, creatinine, glomerular filtration rate, incidence of coronary artery disease, history of stroke (р˃0.05). Conclusion. The assessment of vascular age using volumetric sphygmography is simple and improves communication between the doctor and the patient. Vascular age directly correlates with passport age. In the group of patients whose vascular age was higher than the passport one, an increase in systolic, mean and pulse BP was revealed, compared with the group of patients in whom the CO was less than or equal to the passport one. The absence of statistically significant correlations between CO and other generally recognized risk factors indicates the need for an individualized comprehensive assessment of cardiovascular risk using clinical, laboratory and instrumental data.

Analysis of clinical efficacy of comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia.

To evaluate the clinical efficacy of the comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia. This was a retrospective study. One hundred elderly patients with hypertension combined with hyperuricemia admitted to the Baoding No.1 Central Hospital from May 2019 to May 2020 were included and randomly divided into two groups. Patients in the control group were treated with conventional nursing intervention, while those in the experimental group were treated with comprehensive nursing intervention based on the therapy in the control group. The improvement of compliance behavior, clinical efficacy, quality of life and satisfaction with hypertension combined with hyperuricemia before and after treatment were compared and analyzed between the two groups. The proportion of patients in both groups who developed gout or renal insufficiency was recorded, and their long-term treatment outcomes were compared and analyzed. After the comprehensive nursing intervention, the number of cases of compliance behaviors in the experimental group was significantly higher than that in the control group(p<0.05). The systolic and diastolic blood pressure and uric acid levels were significantly lower in the experimental group compared to the control group after the intervention(p=0.00). The scores of physical function, psychological function, social function and material life status improved significantly in the experimental group compared to the control group after the intervention(p=0.00). The satisfaction rate of the experimental group was significantly higher than the control group(p=0.02). The proportion of patients in the experimental group who developed gout was significantly lower than that in the control group(p=0.03). Comprehensive nursing intervention plays a vital role in the treatment and prognosis of hypertension combined with hyperuricemia.

Minor stroke patients with mild-moderate diastolic blood pressure derive greater benefit from dual antiplatelet therapy

Not only systolic blood pressure (SBP) but also diastolic blood pressure (DBP) increases the risk of recurrence in the short- or long-term outcomes of stroke. The interaction between DBP and antiplatelet treatment for China stroke patients is unclear. This multicenter, observational cohort study included 2976 minor ischemic stroke patients. Patients accepted single antiplatelet therapy (SAPT) or dual antiplatelet therapy (DAPT) after arrival, and baseline DBP levels were trichotomized into <90 mmHg, 90–110 mmHg and ≥110 mmHg. We explore the interaction effect between antiplatelet therapy and DBP on 90-days composite vascular events. A total of 257 (8.6%) patients reached a composite vascular event during follow-up. The interaction term between DBP levels and treatment group (SAPT vs. DAPT) was significant (P for interaction = 0.013). DAPT’s adjusted HR for composite events in patients with DBP between 90 and 110 mmHg was 0.56 (95% confidence interval, 0.36 0.88; P = 0.011) and DBP ≥ 110 mmHg was 4.35 (95% confidence interval, 1.11–19.94; P = 0.046). The association between treatment and DBP was still consistent after propensity score matching of the baseline characteristics. The interaction term of DBP × treatment was not significant for the safety outcomes of severe bleeding (P for interaction = 0.301) or hemorrhage stroke (P for interaction = 0.831). In this cohort study based on the real world, patients with a DBP between 90 and 110 mmHg received a greater benefit from 90 days of DAPT than those with lower and higher baseline DBP. REGISTRATION: (https://www.chictr.org.cn; Unique identifier: ChiCTR1900025214)

The association between lipid profile, oxidized LDL and the components of metabolic syndrome with serum mineral status and kidney function in individuals with obesity

BackgroundMetabolic syndrome (MetS) is presented with a cluster of cardio-metabolic risk factors with widespread prevalence. In the present case-control study, we aimed to examine the relationship between several minerals and renal function tests with the components of MetS in individuals with obesity.MethodsThis study included 127 individuals with obesity of both gender with or without MetS as the case and control, respectively. MetS was characterized based on the Adult Treatment Panel III (ATP III) criteria. Anthropometric variables and blood pressure were recorded. Mineral status including serum magnesium, copper, calcium, phosphorous, and iron were measured using standard colorimetric methods. Also, the serum lipid levels, concentrations of oxidized low-density lipoprotein (Ox-LDL), and renal function tests, including total protein, albumin, urea, creatinine, and uric acid were evaluated using commercial enzyme-linked immunosorbent assay (ELISA) kits.ResultsAccording to our results, individuals with obesity and MetS had higher levels of waist circumference (WC) and diastolic blood pressure (P < 0.05) compared to individuals with obesity and without MetS. Moreover, individuals with obesity and MetS had higher levels of serum total cholesterol (TC), triglyceride (TG), insulin, and iron (P < 0.05). In individuals with obesity and MetS, iron and albumin showed a positive relationship with LDL cholesterol and TG concentrations, respectively (P < 0.05 for all of them). Also, there was a positive association between serum magnesium and Ox- LDL in individuals with obesity with MetS. While, in individuals with obesity and without MetS, only a positive association between urea and uric acid with WC was observed (P < 0.05).ConclusionOur results suggest that disturbed serum lipids in obesity-metabolic syndrome is associated with homeostatic changes in the level of minerals or proteins that are involved in their metabolism. Although, further studies are needed to better explain and clarify the underlying mechanism of observed relationships.

Prospective Association of Occupational and Leisure-Time Physical Activity With Cardiovascular Risk Factors in Early Adulthood: Findings From Pelotas (Brazil) 1982 Birth Cohort.

The benefits of physical activity in health outcomes are well established. However, recent evidence suggests that benefits may differ by domain and population. Thus, we aimed to investigate the prospective association of occupational (OPA) and leisure-time physical activity (LTPA) with cardiovascular risk factors. In 1982, the maternity hospitals of Pelotas were visited daily; those live births whose families lived in urban areas were evaluated, and their mothers were later interviewed (n = 5914). In the 2004/5 follow-up (23y old), both OPA and LTPA were measured in 4295 participants using their respective sections of the International Physical Activity Questionnaire. In the 2012 follow-up (30y old), the following cardiovascular risk factors were collected: high-density lipoprotein (in milligrams per deciliter), low-density lipoprotein (in milligrams per deciliter), triglycerides (in milligrams per deciliter), glucose (in milligrams per deciliter), and blood pressure (in millimeters of mercury). Multivariable linear regressions were performed to evaluate associations between OPA and LTPA with these specific cardiovascular risk factors. In total, 3241 participants were analyzed. Our main findings suggest that there was no association between OPA and LTPA with high- and low-density lipoprotein. There were inverse associations between OPA and lower levels of triglycerides among males (β = -0.002; 95% confidence interval, -0.003 to -0.000) and positive associations between LTPA and higher levels of diastolic blood pressure among females (β = 0.111; 95% confidence interval, 0.005-0.216). In conclusion, our findings suggest that there was no association, or association with limited clinical relevance, of OPA and LTPA with cardiovascular risk factors in early adulthood.

Abstract P341: Age Differences In The Impact Of Dietary Salt On Blood Pressure In Male Rats

Background: The role of dietary salt intake in the modulation of blood pressure (BP) levels is crucial, yet difficult to regulate experimentally in humans due to ethical considerations. Previous research has primarily focused on the impact of exceptionally high salt diets on BP, which lacks clinical relevance due to the extreme nature of such diets. Therefore, this study investigates the influence of moderate-high salt diets on BP levels and BP variability, and whether there are age differences. Methods: Male Sprague-Dawley rats (young adult, 3 months; and aged 22-24 months old) were subjected to either a control diet containing 0.4% NaCl (sodium chloride) or moderate-high salt diets containing 1% NaCl for 12 weeks. BP levels and BP variability (BPV) were measured repeatedly at baseline, 2, 4, 8, and 12 weeks after the onset of the diet. Blood sodium (Na+) was measured at the endpoint. Results: Our preliminary results indicated that aged rats demonstrated an increase in blood sodium levels when subjected to the moderate-high salt diet, a change that was not observed in the young adult rats. Both the young adult and aged rats displayed an increase in systolic BP levels in response to the moderate-high salt diet. However, there were no significant alterations noted in systolic BPV across both age groups. Neither diastolic BP levels nor diastolic BPV showed any significant variation in response to the moderate-high salt diet in both the young adult and aged rat groups. Conclusions: This study suggested age differences in the effects of a moderate-high salt diet on BP levels but not BP variability in male rats. Funding Sources: This research was funded by the START-UP FUNDING OF HANGZHOU NORMAL UNIVERSITY, grant number 4255C50221204123 (Dr. Fen Sun).

Abstract P414: Cytomegalovirus, Hypertension, And Oxidative Stress: Is There A Connection?

Cytomegalovirus (CMV) infection is associated with various chronic inflammatory conditions, including cardiovascular disease. Hypertension is characterized by increased levels of reactive oxygen species in various tissues and blood, and oxidative stress is thought to contribute to organ damage in this disease. In view of this, the aim of this study was to assess the association between CMV infection, blood pressure, and oxidative stress in hypertensive patients. A total of 89 patients with normal or high blood pressure participated in the study. Patients with systolic blood pressure &gt; 130 mmHg or diastolic blood pressure &gt; 90 mmHg or using anti-hypertensive drugs were included in hypertensive group. Blood samples were collected to measure IgG CMV and indirect markers of oxidative stress. In the hypertensive group, 61 patients were included, 45 women and 16 men, with a mean age of 60.8 years. In normotensive group, 228 patients were included, 20 women and 8 men, with a mean age of 47.4 years. The normotensive group showed higher levels of IgG CMV (180.5 ± 20.7 RU/mL) and catalase (1.34 ± 1 μmol/min/mg) compared with the hypertensive group (155.4 ± 57 RU/mL and 1.01 ± 0.74 μmol/min/mg, respectively). In addition, serum carbonylated proteins (13.16 ± 2.6) were higher in the hypertensive than the normotensive group (11.24 ± 2.4). No differences were observed in glutathione S-transferase between groups. A Pearson correlation analysis revealed a positive correlation between IgG CMV concentration (0.236, p=0.026) and catalase (0.217, p=0.041) in the normotensive group. However, IgG CMV was not associate with the levels of systolic (-0.108) or diastolic (-0.052) blood pressure. Based on these data, we suggest that CMV may play a role in the oxidative process.

Prediction Score for Clinical Outcome of Chinese Patients with Cerebral Venous Thrombosis.

Although numerous prognostic markers for cerebral venous thrombosis (CVT) have been reported, inconsistencies exist in their predictive values, leading to contradictory forecasts. This study was designed to develop a comprehensive clinical outcome prediction score for Chinese patients with CVT, integrating key prognostic markers to furnish an overall prognosis. Participants were selected from the CCC cohort, a multicenter study encompassing 26 tertiary hospitals across mainland China. Between January 2021 and May 2022, 170 patients with CVT were prospectively recruited. Potential prognostic markers were extracted from the CCC database and subsequently analyzed. Age, diastolic blood pressure (DBP), neutrophil-to-lymphocyte ratio (NLR), and neuron-specific enolase (NSE) emerged as significant prognostic markers for CVT after a multivariate logistic analysis. Specific cut-off values were identified: Age > 27.5 years, DBP > 79.5 mmHg, NLR > 6.6, and NSE >16.5 ng/mL. The points assigned were: one each for age and NSE level, two for DBP, and three for NLR, based on the adjusted odds ratio. A positive correlation was found between the baseline CVT outcome score and the mRS at six months' follow-up. A CVT outcome score of 3.5 served as an effective cut-off value for predicting CVT clinical outcomes. Further analysis revealed that patients with CVT outcome scores > 3 exhibited significantly higher mRS scores than those with scores ≤ 3. This study led to the development of the CVT outcome score, consisting of age, DBP, NLR, and NSE level, specifically for Chinese patients with CVT. The baseline CVT outcome score positively correlated with the mRS score at the six-month follow-up. A CVT outcome score of > 3 serves as a reliable indicator to identify patients at a higher risk of unfavorable clinical outcomes. These patients may benefit from additional care and early interventions to avert potential deterioration.

Abstract P150: Dynamic Alu Cpg Methylation Change In Elevated Diastolic Blood Pressure

Hypertension is recognized as age-related disease. However, its interaction with aging at the epigenetic level is still not fully understood. Hypomethylation of Alu elements, the most abundant class of interspersed repetitive sequence in the genome, is associated with global hypomethylation, an important epigenetic event of aging. Dermal fibroblasts have been observed to be affected by hypertension. In vitro study has shown that hypertension accelerated expression of age-related phenotypes. Therefore, in our study, we aimed to examine the relationship between blood pressure, age and Alu methylation status using dermal fibroblasts as a model. Biopsies of dermal fibroblasts were performed on 39 patients with various ages and blood pressure statuses. The patients were grouped into three categories based on their systolic blood pressure (SBP) and diastolic blood pressure (DBP): Normal (SBP = 130 mmHg; DBP = 85 mmHg), High Normal (SBP = 130-139 mmHg; DBP = 85-89 mmHg) and Hypertensive (SBP ≥ 140 mmHg; DBP ≥ 90 mmHg). Combined Bisulfite Restriction Analysis was performed to determine the Alu methylation level and pattern. The data was analyzed using Two Way ANOVA factoring in age groups. The Alu methylation level in the normal, high normal and hypertensive groups according to SBP is 30.3 ± 2.15%, 30.2 ± 2.15%, and 30.1 ± 2.06% and 29.6 ± 1.85%, 31.1 ± 1.78%, and 30.2 ± 2.48% according to DBP (data displaying in mean ± SD). The percentages of u C u C methylation pattern were 42.8 ± 5.57%, 42.7 ± 3.84%, 41.9 ± 4.84%, 44.2 ± 5.19%, 40.4 ± 2.95%, and 42.3 ± 4.79% for normal, high normal and hypertensive group, by SBP and DBP respectively. There were statistically significant differences between groups of DBP status with methylation level lowest in the high normal group. u C u C methylation pattern was the highest in high normal DBP group (p-value &lt; 0.05). There was also a statistically significant interaction between age and DBP level to Alu methylation. However, there was no statistically significant difference between SBP groups. We conclude that there is a dynamic Alu methylation change in the elevation of DBP with overarching trend of Alu hypomethylation. This phenomenon suggests that Alu methylation may have a role in how hypertension accelerate cellular aging in different tissues.