Elevated Diastolic Blood Pressure Research Articles

Alcohol and Binge Drinking Frequency and Hypertension: a national cross-sectional study in the U.S.

The relationship between alcohol consumption and hypertension is multifaceted and a major public health concern. The association becomes even more complicated when hypertension is undiagnosed. This study investigates how alcohol consumption patterns are linked to measured, diagnosed, undiagnosed, and composite hypertension (any indications of hypertension from blood pressure readings, professional diagnosis, or reported medication use) in the United States. Data from the National Health and Nutrition Examination Survey (NHANES) 2015-2020, a nationally representative cross-sectional study, were analyzed in 2023-24. The final analytic sample was 12,950 participants. Complex-survey weighted multivariable linear and logistic regression models estimated the effect of different alcohol consumption levels on hypertension. Descriptive findings show that those who consumed alcohol more than three times weekly exhibited the highest prevalence of measured (52.5%), undiagnosed (27.0%), and composite hypertension (69.4%) compared to other levels of alcohol drinking. Multivariable linear regression analysis indicated a notable elevation in systolic (4.8 unit) and diastolic (2.46 unit) blood pressure among individuals with frequent binge drinking episodes compared to individuals with infrequent drinking. Logistic regression models estimated that drinking over three times weekly increases the odds of measured, undiagnosed, and composite hypertension by 64%, 70%, and 54%, respectively, while frequent binge drinking episodes raise these odds by 82%, 65%, and 47%. Contrary to some studies suggesting moderate alcohol intake has protective cardiovascular effects, the findings did not corroborate a "J-shaped" curve. This underscores the importance of regular blood pressure monitoring among individuals with binge drinking episodes and emphasizes the need for public health interventions to mitigate alcohol consumption and its associated hypertension risks.

The Relationship of Hot Work Climate on Physiological Response in Traditional Clover Leaf Oil Refining Workers

In the clove leaf oil refining process which uses steam, it produces a hot temperature residue which affects clove leaf oil refinery workers. Exposure to a hot working climate can have an impact on human physiological responses such as an increase in body temperature, pulse rate, blood pressure and weight loss. as a result of producing quite a lot of sweat fluid. This research aims to investigate the physiological responses of clove leaf oil refinery workers to exposure to a hot working climate. In the clove leaf oil refining process, which utilizes steam, the production of hot temperature residue affects the workers. Exposure to such conditions can lead to various physiological responses, including increased body temperature, pulse rate, blood pressure, and weight loss due to significant sweating. Employing a quantitative research design with a cross-sectional analytical approach, data were collected from all 22 workers using a total sampling technique. The primary data collected were subjected to analysis using paired simple t-tests and the Pearson correlation test to explore relationships between variables. The findings reveal significant increases in physiological responses post-work, including elevated body temperature, pulse rate, systolic and diastolic blood pressure, and a reduction in body weight. The obtained p-values for all variables were <0.05, indicating statistically significant differences between pre-work and post-work conditions. Furthermore, the Pearson correlation test analysis between heat stress data and post-work physiological responses, including body temperature, pulse rate, systolic and diastolic blood pressure, as well as body weight, revealed moderate to strong correlations (r). These results underscore the detrimental impact of hot working climates on the physiological well-being of clove leaf oil refinery workers. Such findings highlight the urgent need for implementing appropriate measures to mitigate heat-related health risks in occupational settings, safeguarding the health and safety of workers.

Effect of the early diastolic blood pressure response to the head-up tilt test on the recurrence of benign paroxysmal positional vertigo.

Otolith organ acts complementarily with the autonomic nervous system to maintain blood pressure. However, the effect of blood pressure variability in the autonomic nervous system on otolith organ has not yet been determined. This study aimed to verify the hypothesis that blood pressure variability in the autonomic nervous system affects the recurrence of benign paroxysmal positional vertigo (BPPV), which is the most common disease of the vestibular organs, by using the head-up tilt test (HUTT). This study included 432 patients diagnosed with idiopathic BPPV. The follow-up period for all patients was 12 months. Age, sex, hypertension, diabetes and recurrence were analyzed. The HUTT parameters were divided into a group of patients whose average diastolic blood pressure increased in the upright position compared to supine position during the HUTT (DBP1) and a group of patients whose average diastolic blood pressure decreased in the upright position compared to supine position during the HUTT (DBP2). Model selection, general loglinear analysis, and logit loglinear analysis were performed using a hierarchically progressing loglinear analysis. In summary, the group with increased average diastolic blood pressure (DBP1) showed a higher tendency for BPPV recurrence compared to the group with decreased diastolic blood pressure (DBP2) in the upright position during the HUTT, although the difference was not statistically significant (p = 0.080). However, in males, the DBP1 group demonstrated a significantly higher recurrence rate of BPPV than the DBP2 group during the HUTT (95% CI, -20.021 to -16.200; p < 0.001). It is presumed that poor autonomic nervous system response through vestibulosympathetic reflex maintains elevated diastolic blood pressure in the upright position during the HUTT. This variability is assumed to affect the recurrence of BPPV.

Early vascular aging in acute ischemic stroke: A systematic review and meta-analysis

BackgroundWhile arterial stiffening is a known risk factor for cardiovascular diseases, it remains unclear whether there is an early vascular aging (EVA) in patients who have experienced acute ischemic stroke (AIS). This systematic review and meta-analysis aims to investigate whether patients with AIS exhibit EVA through pulse wave velocity (PWV) measurements shortly after the stroke onset, shedding light on the relationship between arterial stiffness, hypertension, and stroke. MethodsThirteen case-control studies were included, comparing PWV measurements between AIS patients and non-AIS individuals. A meta-analysis was performed to compare PWV levels, age, blood pressure, and the prevalence of different cardiovascular risk factors among 1711 AIS patients and 1551 controls. ResultsDespite AIS patients showing higher PWV compared to controls (mean difference: 1.72 m/s, 95 % CI: 1.05–2.38, p < 0.001; I2 = 88.3 %), their age did not significantly differ (95 % CI: −0.47–0.94, p = 0.519; I2 = 0 %), suggesting EVA in AIS patients. Moreover, AIS patients exhibited elevated systolic and diastolic blood pressure and had higher odds of smoking, hypertension, diabetes, and male gender compared to controls. ConclusionsThis study's findings underscore the presence of EVA in AIS patients, evident through increased PWV measurements shortly after stroke onset. Notably, smoking, hypertension, and diabetes mellitus emerge as substantial factors contributing to accelerated arterial stiffness within this population.

Relationship Between Dietary Intakes and Elevated Diastolic Blood Pressure Among Children: A Cross-Sectional Study Using Wearable Devices.

Elevating systolic blood pressure (SBP) and diastolic blood pressure (DBP) independently influences clinical outcomes and adverse cardiovascular events. Blood pressure can be affected by modifiable (such as diets and physical activities) and non-modifiable factors (such as age and gender). Elevated blood pressure (EBP or formerly prehypertension) during childhood is associated with hypertension incidence in later adulthood. This cross- sectional study investigated modifiable risk factors for blood pressure among children (aged 3-12). We employed wearable devices to monitor the blood pressure of 45 preschool and primary school children and analyze this data with secondary blood pressure data of their parents from electronic medical records. EBP phenotypes in children (offspring) were not related to their parent's blood pressure phenotypes (P = 0.15 and 0.19 for SBP). Consumption of high saturated fat (P = 0.032), copper (P = 0.026), and vitamin B12 (P = 0.032) was associated with a significant increase in DBP. Daily sodium intakes between normal and DBP hypertensive groups were not significantly different (P = 0.75). This study indicates that dietary intakes of high saturated fat, copper, and vitamin B12, but not parental blood pressure statuses, determine high diastolic blood pressure among children regardless of daily sodium intake. Early dietary consumption behavioral adaptation should be considered to prevent further hypertension in adulthood.

Association of indoor solid fuel pollution with risk factors for cardiovascular disease among Chinese adults: A nationally multi-center study

Few studies have comprehensively assessed the associations of household air pollution (HAP) from solid fuel burning with cardiovascular risk factors (eg, hypertension, diabetes, dyslipidemia, and obesity). Moreover, whether these associations with cardiovascular disease (CVD) risk factors varied by residential environment characteristics remains unclear. Using two waves data (2011 and 2015) of 13,953 participants aged at least 45 years from 125 cities in the China Health and Retirement Longitudinal Study, we explored how solid fuel exposure is associated with CVD risk factors among Chinese adults. Blood pressure (BP), fasting blood glucose (FBG), lipid profiles, C-reactive protein, and body mass index (BMI) were measured using standard methods. Multivariate logistic regression and generalized linear models explored the associations of solid fuel use for heating and cooking with CVD risk factors. Stratified analyses examined whether the associations varied by sociodemographics and living environmental characteristics. Compared with clean fuels, solid fuel used for heating and cooking was associated with a higher risk of hypertension, diabetes, and dyslipidemia, respectively. Solid fuel was related to elevated systolic BP (adjusted β 1.369 mmHg, 0.481–2.258), diastolic BP (0.704 mmHg, 0.183–1.225), FBG (0.309 mmol/l, 0.218–0.399), total cholesterol (0.055 mmol/l, 0.012–0.099), and low-density lipoprotein (0.100 mmol/l, 0.061–0.139), while inversely with BMI (−0.437 kg/m2, -0.599-–0.275). Women, who live in a house with poor cleanliness (according to the overall tidiness and whether have tap water in the house) had a stronger association for hypertension or dyslipidemia. Our findings provide implications for policymakers to implement interventions to improve cardiovascular health by reducing HAP.

SYSTEMATIC REVIEW: COMPARISON OF CUCUMBER JUICE WITH TOMATO JUICE IN THE EFFECTIVENESS OF BLOOD PRESSURE REDUCTION IN PATIENTS WITH HYPERTENSION

Hypertension is a disease characterized by elevated systolic and diastolic blood pressure, or the use of antihypertensive drugs. Hypertension has complications in the form of diseases that target organs including the brain, kidneys, peripheral blood vessels, and heart. This requires effective management by considering effective management in the long term. Pharmacological management of hypertension has side effects of drug-related problems (DRPs) that have an undesirable impact. This makes non-pharmacological interventions recommended for effectiveness. The utilization of fruits is part of non-pharmacological interventions, one of them is with cucumber and tomato which are processed into juice. This research aims to identify further studies through systematic review research on the comparison of the effectiveness of cucumber juice with tomato juice on blood pressure in patients with hypertension. The method used was a systematic review by identification and evaluation of literature with a quasi-experiment research design in according to predetermined eligibility criteria. Databases used included Cochrane Library, DOAJ, Google Scholar, PubMed, Science Direct, and Semantic Scholar. All relevant articles were quality assessed using JBI Critical appraisal. The results of the study resulted in 11 articles that were relevant to the criteria that had been set. The articles retrieved had a low risk of bias after quality assessment. 11 articles resulted in the finding that cucumber juice and tomato juice have ingredients that have an impact on blood pressure in hypertensive patients. Both therapies have effectiveness as hypertension management

The association between PM2.5 components and blood pressure changes in late pregnancy: A combined analysis of traditional and machine learning models

BackgroundPM2.5 is a harmful mixture of various chemical components that pose a challenge in determining their individual and combined health effects due to multicollinearity issues with traditional linear regression models. This study aimed to develop an analytical methodology combining traditional and novel machine learning models to evaluate PM2.5's combined effects on blood pressure (BP) and identify the most toxic components. MethodsWe measured late-pregnancy BP of 1138 women from the Heshan cohort while simultaneously analyzing 31 p.m.2.5 components. We utilized multiple linear regression modeling to establish the relationship between PM2.5 components and late-pregnancy BP and applied Random Forest (RF) and generalized Weighted Quantile Sum (gWQS) regression to identify the most toxic components contributing to elevated BP and to quantitatively evaluate the total effect of the PM2.5 component mixtures. ResultsThe results revealed that 16 p.m.2.5 components, such as EC, OC, Ti, Fe, Mn, Cu, Cd, Mg, K, Pb, Se, Na+, K+, Cl−, NO3−, and F−, contributed to elevated systolic blood pressure (SBP), while 26 components, including two carbon components (EC, OC), fifteen metallics (Ti, Fe, Mn, Cr, Mo, Co, Cu, Zn, Cd, Na, Mg, Al, K, Pb), one metalloid (Se), and nine water-soluble ions (Na+, K+, Mg2+, Ca2+, NH4+, Cl−, NO3−, SO42−, F−), contributed to elevated diastolic blood pressure (DBP). Mn and Cr were the most toxic components for elevated SBP and DBP, respectively, as analyzed by RF and gWQS models and verified against each other. Exposure to PM2.5 component mixtures increased SBP by 1.04 mmHg (95% CI: 0.33–1.76) and DBP by 1.13 mmHg (95% CI: 0.47–1.78). ConclusionsOur study highlights the effectiveness of combining traditional and novel models as an analytical strategy to quantify the health effects of PM2.5 constituent mixtures.

Systemic Arterial Hypertension and Ophthalmohypertension as Independent Risk Factors for Poor Response to Antiangiogenic Therapy with Line 1 Drugs in Neovascular Age-related Macular Degeneration

Purpose: to assess hypertension as a risk factor for a poor response to antiangiogenic therapy.Patients and methods. Systemic blood pressure was studied in 84 patients (92 eyes) with age-related macular degeneration who were treated with intravitreal injections of Eilea in a fixed mode.Results. It was found that significantly more often a poor response to treatment in the form of partial non-resposing or progression of the disease, despite treatment, is associated with elevated diastolic blood pressure (DBP, p = 0.01). An increase in systolic (SBP) blood pressure in patients with arterial hypertension and AMD is accompanied by an increase in eye perfusion pressure (p &lt; 0.01), which apparently worsens the absorption of angiostatics and causes a poor response to treatment. According to the results of the study, the most favorable corridor of SBP values associated with ideal response is in the range of values of 104–140 mm Hg, and DBP is in the range of 68–80 mm Hg st., which should be taken as the recommended parameters of blood pressure in patients with nVMD receiving a course of treatment for Eylea. Intraocular pressure (IOP) has demonstrated itself as a second modifiable independent and independent risk factor for poor response to treatment with nVMD with line 1 anti-VEGF therapy drugs. Intraocular pressure (IOP) has demonstrated itself as a second modifiable independent and independent risk factor for poor response to nVMD treatment with line 1 anti-VEGF therapy drugs. The biomarker associated with the ideal response was — 12.6 mm Hg, and the corridor of recommended values — 11–21 mm Hg. An increase in ophthalmotonus with the output of personalized values beyond this corridor seems to worsen the outcome of treatment.Conclusion. The identification of modifiable risk factors is extremely important in practical ophthalmology, as it opens up the possibility of increasing the patient’s chances of a better treatment outcome. Modifiable risk factors are valuable and powerful tools that replenish our arsenal. Information about them is important not only in the treatment of AMD, but can also be the patient’s motivation for switching to a healthy lifestyle and reducing the risk of developing the disease.

Intensive Blood Pressure Lowering in Individuals With Low Diastolic Blood Pressure and Elevated Troponin Levels in SPRINT.

Among individuals with hypertension and low diastolic blood pressure (DBP), the optimal BP target remains controversial due to concerns that BP lowering may reduce coronary perfusion. We determined the impact of intensive BP control among individuals with elevated systolic BP who have low DBP and elevated hs-cTnT (high-sensitivity cardiac troponin T) levels. A total of 8828 participants in SPRINT (Systolic Blood Pressure Intervention Trial) were stratified by baseline DBP. Those with low DBP (<70 mm Hg) were further stratified by elevated hs-cTnT (≥14 ng/L) at baseline. The effects of intensive versus standard BP lowering on a cardiovascular disease composite end point, all-cause death, and 1-year change in hs-cTnT were determined. The combination of low DBP/high hs-cTnT was independently associated with a higher risk for cardiovascular disease and all-cause death, as well as greater 1-year increases in hs-cTnT, compared with DBP ≥70 mm Hg. However, randomization to intensive versus standard BP lowering led to similar reductions in cardiovascular disease risk among individuals with low DBP/high hs-cTnT (hazard ratio [HR], 0.82 [95% CI, 0.57-1.19]), low DBP/low hs-cTnT (HR, 0.48 [95% CI, 0.29-0.79]), and DBP ≥70 mm Hg (HR, 0.73 [95% CI, 0.60-0.89]; P for interaction=0.20). Intensive BP lowering also led to a reduction in all-cause death that was similar across groups (P for interaction=0.57). In this nonprespecified subgroup analysis of SPRINT, individuals with low DBP and elevated hs-cTnT, low DBP and nonelevated hs-cTnT, and DBP ≥70 mm Hg derived similar cardiovascular disease and mortality benefits from intensive BP lowering. These findings warrant confirmation in other studies.

Identification of Circulating Plasma Proteins as a Mediator of Hypertension-Driven Cardiac Remodeling: A Mediation Mendelian Randomization Study.

This study focused on circulating plasma protein profiles to identify mediators of hypertension-driven myocardial remodeling and heart failure. A Mendelian randomization design was used to investigate the causal impact of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure on 82 cardiac magnetic resonance traits and heart failure risk. Mediation analyses were also conducted to identify potential plasma proteins mediating these effects. Genetically proxied higher SBP, DBP, and pulse pressure were causally associated with increased left ventricular myocardial mass and alterations in global myocardial wall thickness at end diastole. Elevated SBP and DBP were linked to increased regional myocardial radial strain of the left ventricle (basal anterior, mid, and apical walls), while higher SBP was associated with reduced circumferential strain in specific left ventricular segments (apical, mid-anteroseptal, mid-inferoseptal, and mid-inferolateral walls). Specific plasma proteins mediated the impact of blood pressure on cardiac remodeling, with FGF5 (fibroblast growth factor 5) contributing 2.96% (P=0.024) and 4.15% (P=0.046) to the total effect of SBP and DBP on myocardial wall thickness at end diastole in the apical anterior segment and leptin explaining 15.21% (P=0.042) and 23.24% (P=0.022) of the total effect of SBP and DBP on radial strain in the mid-anteroseptal segment. Additionally, FGF5 was the only mediator, explaining 4.19% (P=0.013) and 4.54% (P=0.032) of the total effect of SBP and DBP on heart failure susceptibility. This mediation Mendelian randomization study provides evidence supporting specific circulating plasma proteins as mediators of hypertension-driven cardiac remodeling and heart failure.

Vitamin D deficiency and the vitamin D receptor (VDR) gene polymorphism rs2228570 (FokI) are associated with an increased susceptibility to hypertension among the Bangladeshi population.

Vitamin D receptor (VDR) gene is implicated in hypertension vulnerability due to its role in regulating the renin-angiotensin system (RAS) and blood pressure. In this case-control study, a carefully selected cohort of 111 hypertensive individuals and 100 healthy controls underwent serum analysis using HPLC to measure 25-hydroxy vitamin D levels. Polymorphic variations in the VDR gene were detected and characterized using the PCR-RFLP method. At first, lower 25-hydroxy vitamin D levels were observed in hypertensive individuals compared to controls (p<0.001). The genotype frequency of the VDR gene TaqI showed no significant difference between cases and controls (p>0.05). Similarly, no significant difference was found in the VDR gene BsmI genotype frequency between hypertensive patients and controls (p>0.05). However, a statistically significant distinction was observed in the VDR gene FokI genotype frequency between cases and controls (p<0.01). The odds ratios for FokI genotypes (CC, CT, TT, and CT+TT) were 1.0, 0.590, 1.566, and 0.963, respectively. Furthermore, serum 25-hydroxy vitamin D levels were significantly higher in control subjects compared to hypertensive patients across all genotypes of VDR (p<0.001). Hypertensive patients, excluding those with the FokI VDR gene CC genotype, exhibited significantly higher systolic blood pressure levels compared to the control group (p<0.05). Similarly, hypertensive subjects displayed elevated diastolic blood pressure levels compared to the control group (p<0.001). Overall, the results suggest the presence of a potential inverse correlation between serum 25-hydroxy vitamin D levels and hypertension. The association analysis conducted indicated that there is no significant association between TaqI and bsmI genotypic variants and the risk of developing hypertension. However, it was observed that VDR gene polymorphisms do have a clear association with hypertension susceptibility, as evidenced by the significantly higher occurrence of FokI genotypic variants in hypertensive patients. Our study therefore introduces the possibility of utilizing 25-hydroxy vitamin D deficiency and VDR gene polymorphisms as a biomarker for hypertension.

Prevalence of Metabolic Syndrome Among Emerging Adult Cannabis Users by Race/Ethnicity: Analysis of the 2009-2018 National Health and Nutrition Examination Surveys

BackgroundAssociation between cannabis use and metabolic syndrome (MetS) has been documented; yet variation by race/ethnicity is understudied. We examined cannabis use and MetS by race/ethnicity among emerging adults (18-25 years old), the age group with the highest prevalence of cannabis use. MethodsData from 18- to 25-year-olds who completed the National Health and Nutrition Examination Survey (2009-2018) were analyzed. Current cannabis use was defined as ≥1 day of use in the last 30 days. MetS was defined using standardized guidelines as ≥3 of the following: elevated fasting glucose, triglycerides, systolic (SBP) and/or diastolic blood pressure (DPB), waist circumference, and/or low high-density lipoprotein (HDL) cholesterol. Logistic regression was used to examine the association between current cannabis use (CCU) and MetS, adjusting for covariates. ResultsOf 3974 respondents, 48.8% were female, mean age 21.1 years (SD = 2.4), 56.7% non-Hispanic white, 20.4% Hispanic, and 14.0% non-Hispanic black (NHB). Hispanics had the highest MetS prevalence (7.9%) and lowest CCU prevalence (23.5%). NHB had highest CCU prevalence (33.4%, P < .0001) and lowest MetS prevalence (4.8%, P = .2543). CCUs had a higher mean SBP (P = .020) and Hispanics (P = .002) than never users. Conversely, NHB CCUs exhibited lower mean SBP than NHB never users (P = .008). CCUs had 42% reduced odds of MetS than never users (AOR: 0.58, 95% CI: 0.35-0.95). Among NHB, CCUs had 78% lower likelihood of having MetS than never users (AOR: 0.22, 95% CI: 0.06-0.81). ConclusionsCannabis use impacts MetS and blood pressure differently by race/ethnicity. Current cannabis use was associated with lower odds of MetS overall and among NHB. Further research is warranted to investigate how administration routes, dosages, and usage duration affect MetS.

CHRONIC USE OF NON-STEROID ANTI-INFLAMMATORY DRUGS AND ITS RELATIONSHIP WITH THE DEVELOPMENT OF HYPERTENSIVE CRISIS: A NARRATIVE REVIEW

INTRODUCTION: Arterial hypertension is defined as high blood pressure, generally speaking of a systolic that reaches at least 140 mmHg and/or an elevation of diastolic blood pressure of at least 90 mmHg. For its part, hypertensive crisis does not have a standardized definition, but it is known as a sudden or acute increase in blood pressure with compromise of the target organ.&#x0D; OBJECTIVES: The main objective of this study was to describe the chronic consumption of non-steroidal anti-inflammatory drugs and its relationship with the development of hypertensive crises.&#x0D; DISCUSSION: Around 10 studies were found that report increased systolic and diastolic pressure after the consumption of certain NSAIDs such as naproxen, ibuprofen and indomethacin. The increase in pressure for this group of drugs ranges from 14 to 20%.&#x0D; CONCLUSION: NSAIDs do not reach the necessary levels for the induction of a hypertensive crisis, however, there is limited literature that reports possible cases of hypertensive crisis secondary to the use of these, for this reason, it is relevant to expand the study of the possibility of crises. hypertensive. for this pharmacological group.

Effect of Accessory Renal Arteries on Essential Hypertension and Related Mechanisms.

This case-control study aimed to determine whether there were differences between patients with essential hypertension with accessory renal arteries (ARAs) and those without ARAs. The enrolled patients with essential hypertension were divided into the ARA group (n=200) and control group without ARAs (n=238). After propensity matching, 394 patients (197 in each of the 2 groups), were included. The 24-hour BP (4.33/2.43 mm Hg) and daytime BP (4.48/2.61 mm Hg) of patients in the ARA group were significantly higher than those of the control group (P<0.05). The flow-mediated dilation was lower in the ARA group (5.98±2.70 versus 5.18±2.66; P<0.05). In correlation analysis, the horizontal plasma aldosterone concentration had the highest correlation with 24-hour, daytime, and nighttime systolic BP (r=0.263, 0.247, and 0.243, respectively; P<0.05) and diastolic BP (r=0.325, 0.298, and 0.317, respectively; P<0.05). As for multivariate regression analysis, plasma aldosterone concentration was a significant risk factor for elevated 24-hour, daytime, and nighttime systolic BP (β=0.249 [95% CI, 0.150-0.349], 0.228 [95% CI, 0.128-0.329], and 0.282 [95% CI, 0.187-0.377], respectively; P<0.05) and elevated diastolic BP (β=0.289 [95% CI, 0.192-0.385], 0.256 [95% CI, 0.158-0.353], and 0.335 [95% CI, 0.243-0.427], respectively; P<0.05). Direct renin concentration was also a risk factor for 24-hour and daytime BPs, whereas heart rate was a risk factor correlated with 24-hour, daytime, and nighttime diastolic BP (all P<0.05). For the mixed-effects model for repeated measures, the results were similar to results of the multivariate regression analysis (all P<0.05). ARAs could contribute a higher BP of patients with essential hypertension and might promote the development of essential hypertension. The mechanism might be related to overactivation of the renin-angiotensin-aldosterone system and sympathetic nervous system.

Identification of a gene network driving the attenuated response to lipopolysaccharide of monocytes from hypertensive coronary artery disease patients.

The impact of cardiovascular disease (CVD) risk factors, encompassing various biological determinants and unhealthy lifestyles, on the functional dynamics of circulating monocytes-a pivotal cell type in CVD pathophysiology remains elusive. In this study, we aimed to elucidate the influence of CVD risk factors on monocyte transcriptional responses to an infectious stimulus. We conducted a comparative analysis of monocyte gene expression profiles from the CTMM - CIRCULATING CELLS Cohort of coronary artery disease (CAD) patients, at baseline and after lipopolysaccharide (LPS) stimulation. Gene co-expression analysis was used to identify gene modules and their correlations with CVD risk factors, while pivotal transcription factors controlling the hub genes in these modules were identified by regulatory network analyses. The identified gene module was subjected to a drug repurposing screen, utilizing the LINCS L1000 database. Monocyte responsiveness to LPS showed a highly significant, negative correlation with blood pressure levels (ρ< -0.4; P<10-80). We identified a ZNF12/ZBTB43-driven gene module closely linked to diastolic blood pressure, suggesting that monocyte responses to infectious stimuli, such as LPS, are attenuated in CAD patients with elevated diastolic blood pressure. This attenuation appears associated with a dampening of the LPS-induced suppression of oxidative phosphorylation. Finally, we identified the serine-threonine inhibitor MW-STK33-97 as a drug candidate capable of reversing this aberrant LPS response. Monocyte responses to infectious stimuli may be hampered in CAD patients with high diastolic blood pressure and this attenuated inflammatory response may be reversed by the serine-threonine inhibitor MW-STK33-97. Whether the identified gene module is a mere indicator of, or causal factor in diastolic blood pressure and the associated dampened LPS responses remains to be determined.

Incidence and prevalence of hypertension among HIV-TB co-infected participants accessing treatment: A five-year prospective cohort analysis.

Hypertension is a leading risk factor for cardiovascular disease among people living with human immunodeficiency virus (PLWH). This study determined incidence and prevalence of hypertension among PLWH receiving antiretroviral therapy (ART). We prospectively followed-up 642 HIV and tuberculosis (TB) co-infected study participants from 2005-2013. We defined hypertension as two consecutive elevated systolic and/or diastolic blood pressure measurements above 139/89 mmHg or current use of antihypertensive therapy. Of 507 participants analyzed, 53% were women. Median [interquartile range (IQR)] age, body mass index (BMI), and CD4 count was 34 (28.0-40.0) years, 22.7 (20.5-25.4) kg/m2, and 145 (69.0-252.0) cells/mm3, respectively. Incidence [95% confidence interval (CI)] of both systolic and diastolic hypertension overall, in men, and in women over 40 years was 1.9 (1.4-2.6), 5.9 (3.6-9.6), and 5.0 (2.7-9.3) per 100 person-years (PY), respectively. Risk of developing hypertension was higher in men [(adjusted hazard ratio (aHR) 12.04, 95% CI: 4.35-33.32)] and women over 40 years (aHR 8.19, 95% CI 2.96-22.64), and in men below 40 years (aHR 2.79, 95% CI 0.95-8.23). Higher incidence rates of hypertension among older men and women accessing ART highlight opportunities to expand current integrated HIV-TB care models, to include cardiovascular disease risk screening and care to prevent premature death.

Metabolic syndrome in children with overweight and obesity: a hospital based cross sectional study

Background: Objective of the research was to study metabolic syndrome (MS) in children with overweight and obesity. Methods: A cross sectional descriptive study was carried out on 264 children aged 3-16 years with overweight and obesity attending the endocrinology clinic of a tertiary care hospital in South India from January 2016 to March 2018. Children with and without MS were compared. Results: Out of 264 children with overweight or obesity, 80 had MS (30.3%). Among children with obesity, proportion of patients with MS (40.5% versus 24.2%, p=0.012), hypertriglyceridemia (54.8% versus 37.5%, p=0.013), low high density lipoprotein cholesterol (HDL-C) (42.9% versus 28.1%, p=0.027) and dyslipidemia (78.6% versus 59.4%, p=0.004) were higher among girls versus boys. Proportion of patients with elevated systolic blood pressure (BP) (18.8% versus 4.3%, p&lt;0.0001), elevated diastolic BP (34.5% versus 5.4%, p&lt;0.0001), impaired fasting glucose (16.2% versus 7.6%, p=0.033), hypertriglyceridemia (85% versus 26.6%, p&lt;0.0001), low HDL-C (75% versus 15.2%, p&lt;0.0001) and dyslipidemia (97.5% versus 57.1%, p&lt;0.0001) were higher in those with MS versus those without. Conclusions: MS noted in younger children with overweight and obesity in the current study is concerning as these children are at increased risk for hypertension, type 2 diabetes and cardiovascular disease in early adulthood leading to huge economic burden on the country. It is therefore of utmost importance to take necessary steps to identify these children, manage obesity effectively before MS sets in and initiate preventive measures thereby ensuring a healthy young generation in the coming years.

What Laboratory Examinations for Open-angle Glaucoma Risk Stratification

Purpose: We analyzed the laboratory examinations associated with open-angle glaucoma (OAG) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) to enhance our understanding of OAG risk factors.Methods: We categorized participants in KNHANES between 2008 and 2012 into OAG and non-glaucomatous groups. Next, we conducted a multivariate analysis, adjusting for age, sex, education level, and survey year.Results: Significant differences were observed in age, sex, and educational levels between the two groups. After propensity score matching, the OAG group demonstrated a significantly elevated intraocular pressure (IOP), myopia prevalence, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In addition, that group exhibited a significantly increased prevalence of hypertension and melancholic mood disorders and aspartate transaminase/alanine transaminase (AST/ALT) ratio. Multiple logistic regression revealed elevated IOP, SBP, DBP, AST/ALT ratio, and prevalence of hypertension, melancholic mood, and myopia as OAG risk factors.Conclusions: Our study revealed several risk factors for OAG, including elevated IOP, SBP, DBP, AST/ALT ratio, and prevalence of hypertension, melancholic mood, and myopia. However, the mechanism underlying OAG remains uncertain. Notably, a positive correlation was observed between the AST/ALT ratio and OAG risk. Further studies are needed to evaluate this association.

Association of consumption of sugar-sweetened beverages with elevated blood pressure among college students in Yunnan Province, China.

Although some studies have examined the association between eating behaviour and elevated blood pressure (EBP) in adolescents, current data on the association between sugar-sweetened beverages (SSB) and EBP in adolescents in Yunnan Province, China, are lacking. Cluster sampling was used to survey freshmen at a college in Kunming, Yunnan Province, from November to December. Data on SSB consumption were collected using an FFQ measuring height, weight and blood pressure. A logistic regression model was used to analyse the association between SSB consumption and EBP, encompassing prehypertension and hypertension with sex-specific analyses. The analysis included 4781 college students. Elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP) were detected in 35·10 % (1678/4781) and 39·34 % (1881/4781) of patients, respectively. After adjusting for confounding variables, tea beverage consumption was associated with elevated SBP (OR = 1·24, 95 % CI: 1·03, 1·49, P = 0·024), and carbonated beverage (OR = 1·23, 95 % CI: 1·04, 1·45, P = 0·019) and milk beverage (OR = 0·81, 95 % CI: 0·69, 0·95, P = 0·010) consumption was associated with elevated DBP in college students. Moreover, fruit beverage (OR = 1·32, 95 % CI: 1·00, 1·75, P = 0·048) and milk beverage consumption (OR = 0·69, 95 % CI: 0·52, 0·93, P = 0·014) was associated with elevated DBP in males. Our findings indicated that fruit and milk beverage consumption was associated with elevated DBP in males, and no association was observed with EBP in females.