Diastolic Blood Pressure Levels Research Articles

Racial and gender inequities in the control of arterial hypertension in ELSA-Brasil: An intersectional approach.

This study investigated the association of the intersectional categories of gender-race/color with inadequate blood pressure (BP) control in Brazilian adults using antihypertensive drugs to treat hypertension. This is a cross-sectional analysis conducted with 4448 participants living with hypertension from visit 2 (2012-2014) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) undergoing pharmacological treatment. The association of the intersectional categories - White woman, Brown woman, Black woman, White man, Brown man, Black man - with inadequate BP control (systolic BP levels ≥140mmHg and/or diastolic BP levels ≥90mmH) was estimated by the prevalence ratio (PR) and 95% confidence interval (95% CI) obtained by generalized linear models with Poisson distribution, adjusted covariates. The age-standardized prevalence of inadequate BP control ranged from 18.9% (White women) to 35.6% (Black men). After adjusting for sociodemographic characteristics, health-related behavior, health conditions, and the class number of antihypertensive medications, compared to White women, Black men (PR: 1.49 95% CI: 1.26-1.75), Brown men (PR: 1.42 95% CI: 1.18-1.72), Black women (PR: 1.36 95% CI: 1.12-1.65), and White men (PR: 1.32 95% CI: 1.09-1.60) showed poorer BP control. Results corroborate a higher prevalence of inadequate BP control in Black and Brown men. Furthermore, this intersectional approach evidenced that the prevalence of inadequate BP control in Black women is higher than that in White men, when compared to White women. Findings highlight that, for the development of more equitable BP control strategies, one must consider the specificities of socially marginalized intersectional groups, especially Black men and women.

Accuracy of a Novel High-Throughput "Car Blood Pressure" Measurement Protocol.

More than one in three adults with hypertension in the United States are unaware of their condition, highlighting the importance of large-scale screening campaigns. Currently, the identification of hypertension is largely limited to medical settings. To help overcome this barrier, we developed a novel high-throughput screening protocol that measures blood pressure (BP) while patients remain seated in an automobile ("car-BP"). The aim of this study was to provide an initial assessment of the accuracy of car-BP. Three BP readings were determined in a clinic exam room before and after three BP readings were taken while patients were seated in a parked car outside (n=100 participants). The same validated device model (Omron HEM-907XL) and BP measurement methods adhering to guidelines were used in both scenarios. The average of all 6 clinic readings was compared to the average of the 3 car-BP readings in each individual. Mean clinic and car-BP readings were 120.9 ± 16.2/78.0 ± 9.9 and 118.9 ± 15.2/76.0 ± 10.0mm Hg, respectively. The paired mean and absolute mean differences in systolic BP levels between methods were -1.92mm Hg (95% confidence interval (CI) -3.2 to -0.7mm Hg) and 4.8mm Hg (95%CI 3.8 to 5.6mm Hg), respectively. A total of 85% of participants had both systolic and diastolic BP levels ≤10mm Hg different between measurement scenarios (meeting the a priori determined study primary outcome). Car-BP represents an innovative and accessible approach for potential large-scale hypertension screening campaigns.

Interactions Between Toxic Metals and Serum Micronutrient Level in Auto-mechanics in Ibadan Metropolis, Nigeria: a Pilot study.

Auto-mechanics who often work without safety measures are vulnerable to the harmful effects of toxic metals like lead (Pb) and cadmium (Cd). These toxic metals exert their deleterious effect by interacting with the micronutrients at their primary site of action. This study aimed to investigate the effects of toxic metal exposure on serum micronutrient levels of auto-mechanics in Nigeria. This case-control study involves 60 participants aged 18 to 45years. The control group consists of 30 healthy male staff of University College Hospital Ibadan, Nigeria. The test group consists of 30 male auto-mechanics recruited from their workshops in the Bodija and Olodo areas of Ibadan, Nigeria. Blood lead (Pb), cadmium (Cd), plasma iron (Fe), zinc (Zn), selenium (Se), manganese (Mn), magnesium (Mg), and calcium (Ca) were quantified by inductively coupled plasma optical emission spectroscopy (ICP-OES) method. Results show that systolic and diastolic blood pressure (SBP and DBP) and plasma levels of Pb and Cd were significantly higher in the auto-mechanic group when compared with control, while there were significantly lower levels of micronutrients: Fe, Zn, Mn, and Se when compared with control (p < 0.05). The plasma levels of Ca and Mg were not statistically different in the two groups. Also, there was a significant negative relationship between Cd and Zn (r = - 0.38, p = 0.001), a weak positive relationship (r = 0.46, p = 0.001) between Pb and SBP, and a weak non-significant negative relationship between Pb and Se (r = 0.4, p = 0.11) in the auto-mechanics. The chronic exposure to Pb and Cd in auto-mechanics is associated with elevated blood pressure and reduced micronutrients levels which can impact negatively on their health.

The effect of propolis supplementation on blood pressure: a systematic review and meta-analysis of controlled trials.

The current meta-analysis aimed to determine the efficacy of propolis supplementation on hypertension. The systematic review and meta-analysis. were undertaken on five online databases to find clinical trials assessing the effects of propolis on systolic blood pressure (SBP) and diastolic blood pressure (DBP) markers up to October 2023. The pooled estimation of the weighted mean difference (WMD) and the corresponding 95% confidence intervals (CI) were calculated using a fixed-effect model. Egger's regression test was used to assess publication bias. A significant decrease was observed in SBP levels following propolis supplementation (WMD=-5.58 mmHg, 95% CI: -7.74, -3.42; I2=42.99%, P=0.08). However, no significant change was found in the levels of DBP (WMD=-1.34 mmHg, 95% CI: -6.10, 3.41; I2=75.94%, P<0.01). Moreover, studies with an experimental design (-5.53, 95% CI: -13.24, 2.18) and trials with <30 individuals (-3.96, 95% CI: -7.98, 0.06) did not demonstrate a significant impact of propolis on SBP levels. In trials with an experimental design, a substantial decrease in DBP levels was seen in subgroup analyses after propolis supplementation (-9.29, 95% CI: -12.50, -6.08). The results of the study revealed the positive effects of propolis supplementation in the context of hypertension, as evidenced by a reduction in SBP levels.

The influence of microplastics on hypertension-associated cardiovascular injury via the modulation of gut microbiota.

Microplastics (MPs) have been found to interfere with the gut microbiota and compromise the integrity of the gut barrier. Excessive exposure to MPs markedly elevates the risk of cardiovascular disease, yet their influence on hypertension remains elusive, calling for investigation into their potential impacts on blood pressure (BP) regulation. In the present study, an increase in the concentration of MPs was observed in the fecal samples of individuals suffering from hypertension, as compared to the controls. Oral administration of MPs led to obvious increases in systolic, diastolic and mean BP levels in mice. MPs were associated with promoting myocardial hypertrophy, fibrosis, and cardiac remodeling through alterations in gut microbial composition, such as Prevotella and Coprobacillus, or fecal metabolites Betaine and Glycyrrhetinic acid. The hypertensive damage mediated by MPs was significantly mitigated by the high-fiber diet or antibiotics that targeted the gut microbiota. Notablely, fecal microbiota transplantation from mice treated with MPs led to an increase in systolic BP levels and the development of cardiac dysfunction. Our findings offer valuable insights into the complex interplay between MPs and the gut microbiome in the context of hypertension, and suggest potential strategies for reducing the vascular and cardiac injury caused by MPs.

Effect of a health management model based on the three-tier prevention and control system for cardiovascular and cerebrovascular diseases: a prospective cohort study in rural Central China (CENTRAL-HMM)

BackgroundCardiovascular and cerebrovascular diseases (CVDs) present a significant challenge in the realm of chronic disease management in China. The objective of this study is to assess the efficacy of a health management model rooted in a three-tier prevention and control system for CVDs.MethodsFrom August 2020 to September 2020, this study enrolled 2033 CVDs patients from 105 villages across three townships in central China. All participants underwent a 12-month health management involving monitoring, risk assessment, health education, and interventions. The primary endpoint focused on recurrence and exacerbation, while secondary outcomes encompassed health economic indicators, awareness of prevention and control knowledge, risk factor, lifestyle behavior. Data analysis was conducted using generalized estimating equation models.ResultsAfter 1 year of follow-up, the odds of recurrence and exacerbation decreased significantly compared to the baseline [odds ratio (OR) 0.30, 95% confidence interval (CI): 0.26, 0.35], accompanied by reduced hospitalization frequency [mean difference (MD) -0.61, 95% CI: -0.66, -0.56] and a monthly average reduction in medication costs (MD, -69.80, 95% CI: -104.55, -35.05). Moreover, patients’ awareness of CVDs prevention and treatment knowledge markedly improved (P < 0.01). Diastolic blood pressure, blood lipid and plasma glucose levels, anxiety and depression, lifestyle behavior all demonstrated significant enhancements from baseline levels (P < 0.01). Crucially, health management did not result in an increased abnormality rate of safety indicators.ConclusionsThe health management model, grounded in a three-level prevention and control system, showed potential applicability in reducing recurrence and exacerbation, easing healthcare economic burden, boosting awareness of prevention and treatment, and positively influencing risk factors. Additional multicenter and long-term studies are necessary to validate these findings and support broader implementation of this model.Trial registrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2000032243 (24/04/2020) (https://www.chictr.org.cn/showproj.html?proj=52395).

Impact of Thrombomodulin Polymorphism -33G>A on Acute Myocardial Infarction Risk and Circulating Inflammatory Markers.

There is increasing evidence that thrombomodulin (THBD) polymorphisms, along with inflammatory markers [i.e., C-reactive protein (CRP), fibrinogen, albumin], may increase the risk of acute myocardial infarction (AMI). The aim of the study was to investigate the role of the THBD -33G>A polymorphism (rs1042579) as a marker of AMI risk and to correlate it with serum levels of inflammatory markers. Case-control study of 277 AMI patients and 329 healthy controls. A binary logistic regression analysis was performed to evaluate the association between the parameters studied and AMI risk. The frequencies of genotypes AA, GA, and GG of the THBD -33G>A polymorphism were 31.4%, 45.5%, and 23.1% in patients and 21.6%, 44.1%, and 34.3% in controls. A significant association was found between the AA genotype of the THBD -33G>A polymorphism (AA: OR = 2.011, 95% CI 1.561-3.074, P < .001) or A allele (A: OR = 1.725, 95% CI 1.493-2.510, P < .001) and AMI risk. A backward stepwise logistic regression method combining AMI status as the dependent variable and conventional risk factors (age, smoking, arterial hypertension (HTA), diabetes, dyslipidemia, CRP, albumin, fibrinogen, serum angiotensin converting enzyme (ACE) activity, serum malondialdehyde, conjugated dienes, glutathione peroxidase, cardiac troponin-I (cTnI) and THBD AA genotype) as independent variables showed that the most predictive risk factors for AMI were smoking, HTA, albumin, fibrinogen, CRP, ACE activity, cTnI, and the THBD AA-genotype with odds ratios of 2.942, 2.203, 2.352, 1.323, 1.652, 1.014, 2.105, and 3.781 respectively. The AA genotype was associated with increased diastolic blood pressure, CRP, ACE activity, and albumin levels. The study shows that the THBD -33G>A polymorphism should be included in the stratification of AMI risk.

Cinnamon (Cinnamomum zeylanicum) Aqueous Extract Regulates the Parameters of Metabolic Syndrome in a Model of Wistar Rats with a Diet High in Fat and Fructose.

To identify the effect of Cinnamomum zeylanicum (CZ) aqueous extract on glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, and blood pressure in male Wistar rats, fed with a high-fat and high-fructose diet (HFFD). Twenty-four male Wistar rats were randomized into four groups: Healthy (fed with standard diet), Healthy + CZ (fed with standard diet + CZ extract), HFFD (fed with HFFD), HFFD+CZ, (fed with HFFD + CZ extract). The CZ aqueous extract was administered 100 mg/kg/day by oral gavage to each rat for 8 weeks. Blood samples, blood pressure, and weight were taken at the beginning and end of the experiment. The rats were euthanized after the experiment, according to the Mexican Official Standard NOM-062-ZOOO-1999. The administration of CZ aqueous extract significantly decreased glucose levels (F[1,18]=46.458, P < .001). The interaction between the type of diet and the extract had an effect on triglycerides (F[1,18]=14.93, P = .001), and systolic (F[1,18]=127, P < .001) and diastolic blood pressure levels (F[1,18]=146.13, P < .001) in male Wistar rats. HFFD, plus the administration of CZ aqueous extract over 8 weeks, significantly improved glucose, triglyceride, and systolic and diastolic blood pressure levels, regulating metabolic parameters in male Wistar rats.

Effects of pre-pregnancy body mass index on cardiometabolic biomarkers in pregnant emirati women

BackgroundTo study effect of pregnancy on obese women’s maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications.MethodsThis cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured.ResultsWe enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration.ConclusionThis study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program.

Comparison between femalekidney donors with prediabetes and withoutdiabetes in blood pressure measurements, kidney and diabetes biomarkers: a prospective cohort study.

A comprehensive evaluation of potential living kidney donors is crucial to ensure their shortandlong-term safety. We explored differences in kidney biochemical indicators, blood pressure measurements, and glucose control pre- and post-kidney donation between women with pre-diabetes and those with normal glucose levels. We performed a prospective cohort study at West Bank and Gaza University hospitals between 2016 and 2022. Differences in sociodemographic and clinical factors that were collected from the participants' medical records between women with pre-diabetes and without diabetes, pre- and post-donation, were assessed using the chi-square test for categorical variables and the Mann-Whitney U test for variables with skewed distribution. Trained nurses performed anthropometric measurements and drew fasting blood samples at various time points from one year before donation to five years after donation. Altogether, 114 female kidney donors (57 with pre-diabetes) aged 27-45years (median = 35.7, IQR = 5.6) were included in the study. The post-donation median Body Mass Index (BMI) remained higher in women with pre-diabetes (35.02) than in those without diabetes (29.34) five years after donation, (P < 0.001). The 24h protein, diastolic, and systolic blood pressure levels were significantly higher among women with pre-diabetes than among those without diabetes five years after donation, (P < 0.001). The median estimated glomerular filtration rate (eGFR) was significantly lower in pre-diabetic women (78.2ml/min/1.73m2) compared with the non-diabetic participants (87.9ml/min/1.73m2) five years after donation, (P < 0.001). Pre-diabetic donors showed an increased risk of adverse outcomes, including hypertension, impairedoral glucose tolerance test, worsening kidney function, and proteinuria. Our findings underscore the importance of maintaining regular check-ups and follow-ups in particular inpre-diabetic kidney donors.

Utilizing deep learning-based causal inference to explore vancomycin's impact on continuous kidney replacement therapy necessity in blood culture-positive intensive care unit patients.

Patients with positive blood cultures in the intensive care unit (ICU) are at high risk for septic acute kidney injury requiring continuous kidney replacement therapy (CKRT), especially when treated with vancomycin. This study developed a machine learning model to predict CKRT and examined vancomycin's impact using deep learning-based causal inference. We analyzed ICU patients with positive blood cultures, utilizing the Medical Information Mart for Intensive Care III data set. The primary outcome was defined as the initiation of CKRT during the ICU stay. The machine learning models were developed to predict the outcome. The deep learning-based causal inference model was utilized to quantitatively demonstrate the impact of vancomycin on the probability of CKRT initiation. Logistic regression was performed to analyze the relationship between the variables and the susceptibility of vancomycin. A total of 1,318 patients were included in the analysis, with 41 requiring CKRT. The Random Forest and Light Gradient Boosting Machine exhibited the best performance, with Area Under Curve of Receiver Operating Characteristic Curve values of 0.905 and 0.886, respectively. The deep learning-based causal inference model demonstrated an average 7.7% increase in the probability of CKRT occurrence when administrating vancomycin in total data set. Additionally, that younger age, lower diastolic blood pressure, higher heart rate, higher baseline creatinine, and lower bicarbonate levels sensitized the probability of CKRT application in response to vancomycin treatment. Deep learning-based causal inference models showed that vancomycin administration increases CKRT risk, identifying specific patient characteristics associated with higher susceptibility.IMPORTANCEThis study assesses the impact of vancomycin on the risk of continuous kidney replacement therapy (CKRT) in intensive care unit (ICU) patients with blood culture-positive infections. Utilizing deep learning-based causal inference and machine learning models, the research quantifies how vancomycin administration increases CKRT risk by an average of 7.7%. Key variables influencing susceptibility include baseline creatinine, diastolic blood pressure, heart rate, and bicarbonate levels. These findings offer insights into managing vancomycin-induced kidney risk and may inform patient-specific treatment strategies in ICU settings.

Effect of breathing exercises with biofeedback on blood pressure in pre-hypertensive women: a randomised controlled trial

IntroductionPre-hypertensive women are significantly more likely to develop hypertension or serious cardiovascular disease (CV). Autonomic nervous system abnormalities, such as sympathetic overactivity and parasympathetic withdrawal, are most likely the earliest functional changes in hypertension. The objective of this study was to determine the effect of breathing exercises with biofeedback on blood pressure (BP), heart rate variability (HRV), respiratory rate (RR), and skin galvanic response (SGR).MethodsThirty middle-aged women with pre-hypertension (120/80–139/89 mm Hg) were recruited from Ain Shams University. They were divided randomly into two equal groups, with ages ranging from 30 to 40: study group (group A) who performed slow abdominal breathing (six cycles/minute) combined with frontal electromyography (EMG) biofeedback training (3 days per week for 10 sessions) and a control group (group B) who performed slow abdominal breathing (six cycles/minute, 3 days per week for 10 sessions). All subjects were assessed by measuring systolic blood pressure (SBP), diastolic blood pressure (DBP), HRV, RR, and SGR levels before and after the intervention.ResultsSBP, DBP, RR, and SGR mean values showed a statistically significant decline; however, Group A’s HRV post-treatment increased significantly compared to pre-treatment (&lt;i&gt;p&lt;/i&gt; = 0.001). In Group B, there was no significant difference in DBP or SGR; however, there was a substantial drop in SBP and HRV (&lt;i&gt;p&lt;/i&gt; = 0.001) and a significant rise in RR (&lt;i&gt;p&lt;/i&gt; = 0.001). Following therapy, there was a significant difference between the two groups in terms of DBP, HRV, RR, and SGR (&lt;i&gt;p&lt;/i&gt; = 0.001), favouring group A.ConclusionsAs a result, it is possible to infer that breathing exercises combined with biofeedback were beneficial in lowering BP in middle-aged pre-hypertensive women.

A clinical audit on longer-term stroke management as a specific service in a primary care setting: Assessing adherence of service and clinical parameters.

Primary-care long-term stroke care service offers comprehensive management at the community level. A clinical audit was carried out to assess the services of this clinic as compared to the established standardized criteria for longer-term stroke care.A retrospective audit was performed to evaluate the adherence to service parameters based on eleven criteria adapted from the Canadian Post-Stroke Checklist. The following clinical parameters were audited using the Malaysian CPG on Cardiovascular Disease 2017 and Malaysian CPG on Ischemic Stroke 2020: systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), HbA1c, and weight, and smoking status. 113 registered patients from the 2022 clinic census were audited using paired Student's t-test and McNemar's test.Overall, only 2 out of 11 criteria for service parameters did not meet the standard: inquiring about patient fatigue (43.4%) and access to community resources (26.5%). The attainment of the target for BP and HbA1c meets the standards set for this audit. Patients experienced reduced SBP, DBP, LDL-C, and HbA1c levels, and a statistically significant reduction was observed in DBP (4.15 mmHg, p<0.05) and LDL-C (0.30 mmol/L, p<0.05). A notable reduction in the percentage of smokers (p<0.05) was also seen.Post-stroke patients at a specific-service clinic within the primary care setting benefited from clinicians' high adherence to clinical guidelines, observed from improved clinical parameters. These may serve as an impetus for clinicians to include long-term stroke service as a specialized service within primary care specialties.

The impact of folic acid/VB12 deficiency on essential hypertension in children and adolescents: from a nested case-control and a cohort study.

To explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated BP in children and adolescents. Both a nested case control and a cohort study were designed to explore the relationship between serum folic acid (FA) or Vitamin B12 (VB12) and elevated blood pressure (BP). All the included participants were from primary school. A total of 326 subjects (116:210) in nested case control were from an established cohort. And 270 participants without hypertension at baseline and followed in 2019 in cohort. FA and VB12 levels were lower in the elevated BP group than in the control group, and homocysteine level was higher than that in the control group. In the elevated BP group, overweight/obese children had lower FA than overweight/obese children in the normal BP group. FA was positively correlated with high-density lipoprotein (HDL) and Apo lipoprotein A (APOA), but negatively correlated with triglyceride (TG). FA was significantly correlated with elevated BP in children and adolescents (β = -0.353, P = 0.032), after adjusting VB12, and homocysteine (HCY), and the interaction effect of FA*HCY was significant. Both systolic and diastolic BP levels were statistically lower in the FA high exposure group than in the FA low exposure group in the cohort study. This study found that FA and vitamin B12 deficiency in childhood was correlated with elevated BP levels, which may affect BP by regulating lipid levels, and confirmed the importance of maintaining high levels of FA and vitamin B12 in childhood either by diet or supplementation.

High-Risk Influential Factors for Cardiovascular Diseases among Young Adults.

The aim of this study was to compare high-risk influential factors for cardiovascular diseases among different young adults. It was a retrospective study carried out from January 2020 to 2022. A total of 700 young adults who underwent a physical examination or were hospitalised at the Baoding No.1 Central Hospital, Baoding, Hebei, P. R. China. The participants were divided into three groups: Young social health examinees (n = 300), who underwent physical examinations in January 2020; young medical workers (n = 300), young hospital employees who underwent physical examinations in January 2020; and young myocardial infarction patients (n = 100), who were hospitalised with myocardial infarction from January 2019 to 2021. Analysis was performed on the cardiovascular high-risk influential factors of different young adults. The proportions of males, smoking history, drinking history, hypertension history, lack of exercise, high stress, obesity, fatty liver levels of serum uric acid (UA), body mass index (BMI), diastolic blood pressure (DBP), systolic blood pressure (SBP), and weight in the young myocardial infarction patient group were higher than the other two groups while the HDL levels were lower than those of the latter two groups (p <0.05). The proportions of drinking history, hypertension history, lack of exercise, and high stress levels of UA, DBP, and SBP in the young medical worker group were higher than those in the young social health examinee group (p <0.05). Multivariate analysis revealed that males, high stress, obesity, high DBP and SBP levels were independent risk factors for cardiovascular diseases in young adults (p <0.05). High-risk influential factors of cardiovascular diseases in young adults include males, high stress, obesity, high blood pressure, etc. Key Words: Young people, Cardiovascular system, Medical workers, High-risk influential factors.

Very low-calorie ketogenic diet reduces central blood pressure and cardiometabolic risk in post-menopausal women with essential hypertension and obesity: a single-center, prospective, open-label, clinical study.

Obesity represents a crucial modifiable risk factor for cardiovascular complications. Two dietary approaches, Very Low-Calorie Ketogenic (VLCKD) and Intermittent Fasting (IFD) diets, have demonstrated to reduce blood pressure (BP) and produce cardiovascular and metabolic advantages. We aimed to evaluate the effects of VLCKD or IFD compared to Free Diet (FD) on office brachial and central systolic BP levels. Secondary outcomes included changes from baseline of diastolic BP and several weight-related indexes. In this single-center, open-label, prospective clinical study, post-menopausal women with treated uncomplicated hypertension and obesity were assigned to 3 dietary programs: VLCKD, IF, and FD. All patients underwent BP measurements, dietary consultation with personalized dietary program, and blood tests for metabolic parameters. All outcome variables were measured at baseline (T0), two (T1) and six months (T2). We included 18 patients in the VLCKD, 16 in the IFD and 9 in the FD groups, respectively. At T2 VLCKD patients showed significantly lower brachial systolic (p=0.005) and diastolic (p=0.038), central systolic (p=0.02) and diastolic (p=0.03) BP levels than those in other groups. VLCKD also induced reductions in weight (p=0.03), WC (p<0.01), WHR (p<0.01), BFP (p<0.01); TOT-C (p=0.01), LDL-C (p<0.01), and triglycerides (p=0.02). No relevant changes were observed in IF and FD groups. KD emerged as the clear front-runner in reducing brachial and central office systolic/diastolic BP levels and weight-related parameters in post-menopausal women with treated hypertension and obesity.

Age-specific in the relationship between diastolic blood pressure and the risk of cardiovascular disease: A cohort study of the UK Biobank.

To investigate the effect of optimal diastolic blood pressure (DBP) level on cardiovascular disease (CVD) events, considering different age groups. And the nonlinear relationship between DBP and CVD events by age were evaluated. 358,734 participants of the UK biobank were included. Multivariable Cox regressions were performed to evaluate the relation between DBP and cardiovascular risk, and the natural cubic spline was applied to estimate the nonlinear relationship between the DBP measures and the hazard. In the UK Biobank, a total of 358,734 participants (mean [SD] age, 55.3 [8.1] years; 205,215 [57.2%] female) were included in this analysis. The rate of CVD cases was 6.05 per 1000 person-years. For each SD increase, DBP was associated with elevated CVD events for both <50year (HR, 1.19; 95% CI, 1.12 to 1.26) and 50-59year-old group (HR, 1.04; 95% CI, 1.01 to 1.08). However, for every SD increment, a marginal protective effect against CVD events was observed between DBP and the CVD events in elder people (≥60years old) and lower DBP (<70mmHg) may confer an increased CVD risks (HR, 1.10; 95% CI, 1.03 to 1.17). For adults younger than 60years old, the study seems to support the ACC/AHA blood pressure guidelines lowering the DBP threshold to 80mmHg. Conversely, it may be reasonable to rule out large effects of high DBP on CVD events and DBP <70mmHg may be cause for caution in older people aged 60-69.

Higher Dietary Inflammatory Index Score Is Associated With a Greater Risk of High Allostatic Load in US Adults: National Health and Nutrition Examination Survey, 2017-2020.

Allostatic load (AL) is a comprehensive indicator of chronic stress. Foods with pro-inflammatory properties can increase the risk of elevated AL levels. However, no studies have explored the association between AL and dietary inflammation. The aim of this study was to investigate the relationship between Dietary Inflammatory Index (DII) scores and AL. This cross-sectional study examined dietary data from 24-hour dietary recalls and biomarkers associated with AL in adult participants 18 years and older from the National Health and Nutrition Examination Survey (2017-2020). The National Health and Nutrition Examination Survey examines a nationally representative sample of approximately 5000 individuals each year. A total of 15 560 participants were surveyed during the 2017-2020 period, and 1577 participants were ultimately included in this study. Twenty-six dietary components were selected to calculate the DII, and 10 biomarkers representing the cardiovascular, metabolic, and immune systems were chosen to calculate the AL. Logistic regression and linear regression analyses were used to investigate the relationship between DII and AL and between each biomarker. Subgroup analyses were conducted based on sociodemographic variables, including age, sex, race and ethnicity, and BMI. The risk of high AL was 1.53 times higher in those with DII scores in the highest quartile than in those with DII scores in the lowest quartile (odds ratio [OR] 1.53; 95% CI 1.00 to 2.36; Ptrend= .04). For each unit increase in DII, the probability of having high AL increased by 11% (OR 1.11; 95% CI 1.01 to 1.21; Ptrend= .03). Higher DII scores were significantly associated with higher systolic blood pressure, diastolic blood pressure, pulse, waist-to-hip ratio, and high-sensitivity C-reactive protein levels. Higher DII scores were also significantly associated with lower total cholesterol and high-density lipoprotein cholesterol levels (P < .05). The association between DII score and AL was more pronounced in women (ORQuartile3vs1 2.04; 95% CI 1.15 to 3.61; ORQuartile4vs1 2.07; 95% CI 1.18 to 3.62; Ptrend= .01) and in those with a BMI < 24.9 (ORQuartile3vs1 4.74; 95% CI 1.21 to 18.05; Ptrend= .03). This study found that higher DII scores were associated with greater risk of high AL. Further research with more rigorous study designs is needed to build on these results and evaluate the effect of diets with low inflammatory potential (low DII scores) on AL.

Impact of Physical Exercise to Reduce the Risk of Gestational Hypertension, A Role of Leptin and Adiponectin

Objective: To investigate the effect of exercise on the blood pressure of new-onset hypertension and non-hypertensive pregnant women and to determine the serum leptin and adiponectin levels and their response to exercise. Methodology: This quasi-experimental cross-over study was conducted at the Department of Gynaecology and Obstetrics, Hayatabad Medical Complex Peshawar. Samples were processed and analyzed at Khyber Girls Medical College Peshawar from January 2022 to April 2022. A total of 140 pregnant females were recruited for this study through convenience sampling. Out of this total, 70 were normotensive for the control group and 70 were hypertensive (gestational hypertensive). All participants were included after taking an informed consent. Results: In normotensive pregnant women, mean systolic and diastolic blood pressure remained normal, and no hypertension developed. In gestational hypertensive women, 70% responded significantly to physical exercise. Post-exercise, Group A saw decreases in systolic BP , diastolic BP , and leptin levels, with an increase in adiponectin. Group B exhibited more pronounced changes by decreased systolic BP, diastolic BP, leptin, and increased adiponectin. Conclusions: We observed that recommended physical exercise during pregnancy is safe and beneficial for maternal health in pregnancy. Physical exercise significantly reduced the progression of GH and brought the serum leptin and adiponectin levels toward normal range. Therefore, physical activity should be encouraged in every healthy woman after addressing potential barriers to exercise during pregnancy.

Association of Serum Albumin and C-Reactive Protein with Outcomes in ESRD Patients Undergoing Hemodialysis at a Tertiary Care Center in Salem, Tamil Nadu

ABSTRACT Background: Chronic kidney disease (CKD) is a chronic condition characterized by irreversible renal dysfunction, leading to excretory and metabolic failure. Patients with end-stage renal disease (ESRD) often have elevated CRP and reduced albumin levels, causing inflammation. This study compares serum CRP, albumin, urea, creatinine, eGFR, blood pressure, and weight in patients on MHD with ESRD. Methodology: The study measured weight, eGFR, systolic and diastolic blood pressure, serum CRP, albumin, urea, and creatinine in 90 MHD patients and 90 controls using various methods, including GLDH, Jaffe’s, BCG, and Nephelometry. Results: The CRP levels in pre hemodialysis were 4.74 ± 2.25 mg/dl and the control group had 0.6 ± 0.2 mg/dl. So comparison of both CRP and albumin in cases and control were highly significant. The pre hemodialysis albumin was 2.74 ± 0.7 mg/dl and control were measured as 4.2 ± 0.5 mg/dl which is statistically significant. The Urea levels in pre hemodialysis were 112.2 ± 23.7 mg/dl and the control group had 24.9 ± 6.2 mg/dl. The Creatinine levels in pre hemodialysis were 8.5 ± 2.7 mg/dl and the control group had 0.8 ± 0.1 mg/dl. The Systolic Blood Pressure (SBP) in pre hemodialysis were 167.0 ± 21.4 mm of Hg and the control group had 121.9 ± 6.9 mm of Hg. The Diastolic Blood Pressure (DBP) in pre hemodialysis were 88.8 ± 10.7 mm of Hg and the control group had 76.8 ± 4.6 mm of Hg. The eGFR in pre hemodialysis was 7.3 ± 4.1 mL/min/1.73 m2 and the control group had 98.7 ± 17.7 mL/min/1.73 m. Conclusion: The study found that patients with MHD had significantly higher CRP, albumin, Urea, Creatinine, SBP, and DBP levels compared to controls, with decreased albumin levels and increased CRP in ESRD patients.