Higher Incidence Of Hypertension Research Articles

POS-358 SERUM NITRIC OXIDE AND NOT ASYMMETRIC DIMETHYL ARGININE OR MATRIX METALLOPROTEINASE 2 DETECTS ENDOTHELIAL DYSFUNCTION IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE PATIENTS WITH EARLY DISEASE

Cardiovascular complications are the leading cause of death in patients with autosomal dominant polycystic kidney disease (ADPKD) and there is a high incidence of hypertension in ADPKD patients with early disease. Endothelial dysfunction (ED) is an early marker of cardiovascular complications and this has also been reported in ADPKD. However, published studies have included a significant number of patients with later stage disease and other known comorbidities that are also associated with ED including hypertension.

Incident hypertension in relation to aircraft noise exposure: results of the DEBATS longitudinal study in France

BackgroundAlthough several cross-sectional studies have shown that aircraft noise exposure was associated with an increased risk of hypertension, a limited number of longitudinal studies have addressed this issue. This study...

Defining kidney outcomes in children with acute lymphoblastic leukemia in the modern era.

To define the incidence of acute kidney injury (AKI), chronic kidney disease (CKD), and hypertension (HTN) in pediatric patients diagnosed with acute lymphoblastic leukemia (ALL) over a recent 9-year period. This study is a retrospective cohort study of all pediatric patients diagnosed with ALL at Nationwide Children's Hospital from January 1, 2008, to December 31, 2016. Patient demographic and clinical data including serum creatinine and blood pressure were collected at diagnosis up to 9years post diagnosis. A total of 222 patients were identified for this study. The overall incidence of AKI in our cohort was high, with 101 subjects (45.5%, CI 38.8-52.3%) developing AKI at least once. CKD status could only be determined in 214 patients due to limited later GFR data. The incidence of CKD was low with only 5 of 214 patients developing CKD (2.3%, CI: 0.8-5.4%). The overall incidence of HTN at diagnosis was 45.6% (95% CI: 59.1-72%), and at 1month post diagnosis was 65.8% (95% CI: 59.1-72.0%). Chronic HTN could only be determined in 216 patients due to limited blood pressure data. Chronic HTN was noted in 34.3% of patients (74/216, 95% CI: 28-41%). Among children with ALL, the incidence of AKI is relatively high at the time of diagnosis. However, development of CKD is relatively rare, suggesting good mid-term kidney prognosis. There is a high incidence of HTN at the time of diagnosis, 1month post diagnosis, and chronic HTN that often goes untreated. A higher resolution version of the Graphical abstract is available as Supplementary information.

Swallowing Function in COVID-19 Patients After Invasive Mechanical Ventilation

ObjectiveTo explore swallowing function and risk factors associated with delayed recovery of swallowing in patients with COVID-19 post–invasive mechanical ventilation using the Functional Oral Intake Scale (FOIS). DesignLongitudinal cohort study. SettingThree secondary-level hospitals. ParticipantsInvasively ventilated patients (N=28) who were hospitalized with severe COVID-19 and referred to the hospitals’ speech and language pathology (SLP) departments after mechanical ventilation between March 5 and July 5, 2020 for an evaluation of swallowing function before commencing oral diet. InterventionsSLP assessment, advice, and therapy for dysphagia. Main Outcome MeasuresOral intake levels at baseline and hospital discharge according to the FOIS. Patients were stratified according to FOIS (1-5, dysphagia; 6-7, functional oral intake). Data regarding comorbidities, frailty, intubation and tracheostomy, proning, and SLP evaluation were collected. ResultsDysphagia was found in 71% of the patients at baseline (79% men; age, 61±12y; body mass index, 30±8 kg/m2). The median FOIS score at baseline was 2 (interquartile range [IQR], 1) vs 5 (IQR, 2.5) at hospital discharge. Patients with dysphagia were older (64±8.5y vs 53±16y; P=.019), had a higher incidence of hypertension (70% vs 12%; P=.006), and were ventilated invasively longer (16±7d vs 10±2d; P=.017) or had a tracheostomy (9±9d vs 1±2d; P=.03) longer. A negative association was found between swallowing dysfunction at bedside and days hospitalized (r=–0.471, P=.01), and number of days in the intensive care unit (ICU) (r=–0.48, P=.01). ConclusionDysphagia is prevalent in COVID-19 patients after invasive mechanical ventilation and is associated with number of days in hospital and number of days in the ICU. Swallowing function and tolerance of oral diet improved at discharge (P<.001).

Serum Uric Acid Might Be Positively Associated With Hypertension in Chinese Adults: An Analysis of the China Health and Nutrition Survey.

Background: Previous studies have clarified the relationship between serum uric acid (SUA) and hypertension; most of previous studies suggest that elevated uric acid levels are associated with an increased risk of hypertension, while in China, there are relatively few studies to explore above association. The objective of this longitudinal study is to investigate the correlation of SUA and hypertension in Chinese adults with a nationwide large-scale sample.Methods: Data from the China Health and Nutrition Survey 2009, 2011, and 2016 were used; a total of 8,469 participants (3,973 men and 4,496 women) were involved. This study was conducted separately by gender. Clinical characteristics of the participants among different uric acid groups are compared. The binary logistic regression analysis was conducted to examine the association between SUA and hypertension. Restricted cubic spline analysis with three knots of the SUA concentration were used to characterize the dose-response relationship. Additionally, we compared the incidence of hypertension in the different baseline uric acid groups during follow-up in 2011 and 2015.Results: After the covariates were fully adjusted, we found that elevated uric acid levels were correlated with increased risk of hypertension in both males (p < 0.01) and females (p < 0.01). With 2-year or 6-year of follow-up, we found participants with higher baseline uric acid levels had a higher incidence of hypertension (p < 0.01). In stratified analysis by obesity, above relationship remained significant in nonobesity population (males: p < 0.05, females: p < 0.01) and became nonsignificant in obesity people. In stratified analysis by age, above positively correlation remained significant in middle-aged men (p < 0.05) and elderly women (p < 0.01). Restricted cubic spline revealed the dose-response relationship between SUA and hypertension; we also found that above relationship was much stronger in females.Conclusion: This study suggests that elevated SUA levels might be positively associated with an increased risk of hypertension in general Chinese adults.

Clinical and Endoscopic Outcomes in Coronavirus Disease-2019 Patients With Gastrointestinal Bleeding.

Background and AimsOver 404 million people worldwide have been infected with coronavirus disease–2019 (COVID-19), 145 million in the United States (77 million) and Europe (151 million) alone (as of February 10, 2022). This paper aims to analyze data from studies reporting gastrointestinal bleeding (GIB) and/or endoscopic findings in COVID-19 patients in Western countries.MethodsWe conducted a systematic review of articles on confirmed COVID-19 cases with GIB in Western countries published in PubMed and Google Scholar databases from June 20, 2020, to July 10, 2021.ResultsA total of 12 studies reporting GIB and/or endoscopic findings in 808 COVID-19 patients in Western countries were collected and analyzed. Outcomes and comorbidities were compared with 18,179 non-GIB COVID-19 patients from Italy and the United States. As per our study findings, the overall incidence of GIB in COVID-19 patients was found to be 0.06%. When compared to the non-GIB cohort, the death rate was significantly high in COVID-19 patients with GIB (16.4% vs 25.4%, P < .001, respectively). Endoscopic treatment was rarely necessary, and blood transfusion was the most common GIB treatment. The most common presentation in GIB patients is melena (n = 117, 47.5%). Peptic, esophageal, and rectal ulcers were the most common endoscopic findings in upper (48.4%) and lower (36.4%) endoscopies. The GIB cohort had worse outcomes and higher incidence of hypertension (61.1%), liver disease (11.2%), and cancer (13.6%) than the non-GIB cohort. Death was strongly associated with hypertension (P < .001, r = 0.814), hematochezia (P < .001, r = 0.646), and esophagogastroduodenoscopy (P < .001, r = 0.591) in COVID-19 patients with GIB.ConclusionOverall, the incidence of GIB in COVID-19 patients is similar to that estimated in the overall population, with melena being the most common presentation. The common endoscopic findings in GIB COVID-19 patients were ulcers, esophagitis, gastritis, and colitis. Patients with GIB were more prone to death than non-GIB COVID-19 patients.

Comparison of Long-Term Oncologic Outcomes Depending on SLC-6A14 Expression in Pancreatic Ductal Adenocarcinoma

Introduction Tumors alter their metabolism to meet the increasing demand for nutrients of their proliferating cancer cells. SLC6A14 is an amino acid transporter that is highly up-regulated in pancreatic cancer. This study was designed to identify correlation between SLC6A14 expression and long-term oncologic outcomes of patients with pancreatic ductal adenocarcinoma(PDAC). Method Patients who underwent pancreatic resection with PDAC at Gangnam Severance Hospital between 1997–2014 were enrolled. We evaluated immunohistochemically the expression of SLC6A14. SLC6A14 grade 0 and 1 were classified as SLC low, and grade 3 as SLC high. Patients demographics, pathologic findings, recurrence pattern and long-term outcomes were compared between two groups. Result Among 112 patients, 29(25.9%) and 83(74.1%) patients were classified as SLC low and SLC high group, respectively. Patients in SLC low group had a higher body mass index(23.5 vs 21.6, p=0.024) and a higher incidence of hypertension(62.1% vs 32.5%, p=0.005) than SLC high group. Pathologic findings and recurrence patterns were comparable between two groups. There were significant differences in long-term oncologic outcomes.The 1-year and 3-year overall survival were 79.3% and 50.5%, and 85.5% and 31.8% for patients in SLC low and high group, respectively(p=0.268). The 1-year and 3-year disease-free survival were 55.2% and 30.1%, and 50.6% and 20.8% for patients in SLC low and high group, respectively(p=0.518). Conclusion The higher expression of SLC6A14 in associated with worse outcome of overall survival and disease-free survival in patients with PDAC. These results showed that SLC6A14 is a novel therapeutic target for pancreatic cancer.

Giving Boiled Celery Leaves to Reduce Blood Pressure in Elderly People with Hypertension

The high incidence of hypertension in the elderly and uncontrolled triggers degenerative diseases such as congestive heart failure, kidney failure, and vascular disease such as stroke and peripheral arterial disease. The high incidence of hypertension is directly proportional to the high complications that occur, so adequate nonpharmacologic treatment is needed. Celery (Apium graveolens L.) is one of the types of herbal therapy used to treat hypertension. Traditional Chinese society has long used celery to lower blood pressure. The purpose of this study was to determine the effect of celery leaf decoction on elderly blood pressure in patients with hypertension in the Mambi Health Center, Mamasa District. His research method is a quasi-experimental method, using a time-series research design. This study took a sample of 20 people. The sampling techniques were consecutive sampling, and the measuring instruments used were observation sheets and spigmanometers. Analyzed by the Friedman test with a significance level of alpha = 0.05. The results of the study obtained statistical tests showing that there were significant differences by comparing systolic blood pressure before, 3 days of administration and 7 days of administration of celery leaves, obtaining a mean value which decreased from the first day, the third day and the days of 2.75, 2.23 and 1.03 with a value of 0.000 &lt;0.05, as well as Diastolic blood pressure, respectively, 2.75, 1.98 and 1.30 with p value of 0.000 &lt;0.05, which means there is an effect of giving celery leaf decoction to reduce systolic and diastolic blood pressure

Impact of a Pharmacist-Led Hypertension Management Program for Oral Chemotherapy in a Specialty Pharmacy Setting.

Oral chemotherapy agents are a growing area of oncology treatment, but some are associated with a high incidence of hypertension. Management of hypertension in oncology patients may be insufficient due to a variety of reasons. A pharmacist-led hypertension management service within the specialty pharmacy setting has the potential to help patients on oral chemotherapy achieve and maintain adequate blood pressure control. The objective of this study was to assess the impact of a pharmacist-led hypertension management program on the blood pressure control of patients on oral chemotherapy. This retrospective, single-center study compared data from two groups of patients receiving oral chemotherapy agents from a health systems specialty pharmacy within an academic medical center, before and after the establishment of a pharmacist-led hypertension management program. Twenty-one of 50 (0.42) patients in the control group had blood pressure overall at goal, compared to 19 of 29 (0.66) patients in the intervention group who had blood pressures at goal at the end of the specified 3-month time period (p = 0.04). In cases where a pharmacist intervention was necessary per the hypertension management program's protocol, the rate of provider acceptance of recommendations regarding modifying or initiating antihypertensive therapy was high. When followed with a pharmacist-led hypertension management program, patients on oral chemotherapy showed improved blood pressure control and reduced mean blood pressure readings over time.

Next-Generation Sequencing Mutational Landscape and Clinical Features of Chinese Adults with Myeloproliferative Neoplasms

▪Myeloproliferative neoplasms (MPNs) include three classical subtypes: polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Since prefibrotic primary myelofibrosis (pre-PMF) was recognized as a separate entity in the 2016 revised classification of MPN, it has been a subject of debate among experts due to its indefinite diagnosis. However, pre-PMF usually has a distinct outcome compared with either ET or overt PMF. We conducted a retrospective study of MPN patients from October 2014 to June 2020 in the Fourth Affiliated Hospital of Zhejiang University. Patients who were diagnosed with ET, pre-PMF or overt-MF according to the 2016 WHO Classification were included. We reviewed the clinical parameters, haematologic information, and genetic mutations of patients using next-generation sequencing (NGS).Mutation screening was performed in 44 patients by next‐generation sequencing techniques, 84 genes and 258 mutations were detected. JAK2 was the most frequently mutated gene (25/44, 56.82%), followed by TET2 (14/44, 31.82%), KMT2C (13/44, 29.55%), and ASXL1 (10/44, 23.73%) in MPN (Figure 1-A). The VAFs of all studied genes with mutation frequencies >10% are shown in Figure 1-B. Of the 20 patients with ET, 9 (45%) were positive for the JAK2 mutation, 5 (25%) carried FAT1, 5 (25%) carried KMT2C, and 4 (20%) carried CALR. Of the 5 patients with pre-PMF, 4 (80%) carried JAK2, 3 (60%) carried EP300, and 2 (40%) carried TET2. Of the 19 patients with overt PMF, 12 (63%) carried JAK2, 10 (53%) carried TET2, 7 (37%) carried ASXL1, and 6 (32%) carried KMT2C, as reported in Figure 2. The median follow-up was 36 months for ET, 42 months for pre-PMF, and 53 months for overt PMF. Overall survival between pre-PMF, overt PMF, and ET was significantly different (P<0.001), as shown in Figure 3. During the follow-up time, only one death of ET was registered, so we analysed the impact of clinical parameters and mutational status at diagnosis on outcome in PMF, including pre-PMF and overt PMF. We performed Kaplan-Meier curves to examine the relationships between the clinical parameters and patient survival. We found that male sex (P=0.0107), MPN10 symptoms (P=0.0354), anaemia (haemoglobin<120g/L, P=0.0239), and thrombocytopenia (platelet count <100 ×10 9/L, P=0.0002) were significantly related to inferior OS (Figure 4). Pre-PMF patients exhibited higher leukocyte counts, higher LDH values, a higher frequency of splenomegaly, and a higher incidence of hypertension than ET patients. On the other hand, pre-PMF patients had higher platelet counts and haemoglobin levels than overt PMF patients. Molecular analysis revealed that the frequency of EP300 mutations was significantly increased in pre-PMF patients compared with ET and overt PMF patients. In terms of outcome, male sex, along with symptoms including MPN10, anaemia, thrombocytopenia, and KMT2A and CUX1 mutations, indicated a poor prognosis for PMF patients.In conclusion, we identified differences in the clinical, haematologic, and molecular presentations of ET, pre-PMF, and overt PMF patients, indicating that comprehensive evaluation of not only BM features but also clinical, haematologic, and molecular profiles is needed for accurate diagnosis and treatment of these three disease entities. The molecular analysis revealed that pre-PMF might be relevant to EP300 mutation, demonstrating the value of molecular examination. The results of this study indicated that comprehensive evaluation of BM features, clinical phenotypes, haematologic parameters, and molecular profiles is needed for the accurate diagnosis and treatment of ET, pre-PMF, and overt PMF patients.Acknowledgment:The research was supported by the Public Technology Application Research Program of Zhejiang, China (LGF21H080003), the Key Project of Jinhua Science and Technology Plan, China (2020XG-29 and 2020-3-011), the Academician Workstation of the Fourth Affiliated Hospital of the Zhejiang University School of Medicine (2019-2024), the Key Medical Discipline of Yiwu, China (Hematology, 2018-2020) and the Key Medical Discipline of Jinhua, China (Hematology, 2019-2021). [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Characteristic People With Hypertension in Yogyakarta Special Region During The First Year of Covid-19 Pandemics

Since 2017, hypertension was the top first disease in the Yogyakarta Special Region (DIY). It cannot be ignored because hypertension is an entrance for other degenerative diseases. Along with the COVID-19 pandemic at the beginning of 2020 raising our curiosity whether there has been a change in the incidence of hypertension in DIY during this year, then what are its characteristics. This study explores the characteristics of people with hypertension by age group and gender in the first year of the COVID-19 pandemic in the Yogyakarta Special Region. A descriptive study was employed in this study, with the main source was the secondary data from the Yogyakarta Special Region health office, the year 2020. Analysis was conducted by univariate tabulation. Data from the Yogyakarta provincial health office shows that in 2020 there will be an increase of more than eight thousand cases of hypertension. In general, this increase was lower than the increase in the previous two years. In 2020, the highest incidence of hypertension was found in women in the age range of 60-69. Meanwhile, in the (15–19) age group, the majority of cases happened in men. This study shows that during 2020, which was the COVID-19 pandemic, the incidence of hypertension increased but not as high as the previous two years. The majority of hypertension occurred in the 60-69 age group, with the majority in men.

Exploring phenotypes in hypertrophic cardiomyopathy with machine learning data integration. A multicentric, multimodality pilot study

Abstract Background Interpreting patient phenotypes is a challenge when screening for hypertrophic cardiomyopathy (HCM). Machine learning (ML) can potentially help with advanced data integration - combining information contained in whole-cardiac cycle echo deformation and velocity profiles with standard clinical variables. The aim is to apply an ML approach to integrate whole cardiac cycle echo data with clinical variables to explore HCM phenotypes. Methods The cohort consisted of 138 participants from two centres: HCM patients (n=91) and relatives (n=47). Echocardiography was performed, whereas magnetic resonance and genetic testing in 48% and 82%, respectively. Whole cardiac cycle echo data (mitral and aortic velocity profiles, and six regional left ventricular (LV) deformation curves) were combined with clinical variables (age, sex, heart rate, e' medial and e' lateral) and used as the ML input. An unsupervised ML algorithm created a representative space where participants were positioned based on integrated data, blinded to disease status. Clustering was used to determine phenogroups and estimate the average characteristics. Data on family history (FHx), genotype, arrhythmias or syncope, implantable cardioverter-defibrillators (ICD), and late gadolinium enhancement (LGE) were used to interpret the phenogroups. As the LA diameter was not available in the dataset, the HCM risk for sudden cardiac death (SCD) was not calculated, however, the Table shows relevant variables to infer clinical risk. Results Clustering divided the participants into 6 phenogroups (P1–6) (Figure). Average echo profiles are shown in the Figure, while the clinical data in the Table. P1/2 was defined by symptomatic patients with a high prevalence of positive genotypes, a positive FHx of SCD, and a burden of comorbidities. Echo findings showed pronounced structural/functional remodeling, and P1 was associated with severe septal hypertrophy and outflow tract obstruction. The high prevalence of ICD devices defined P1/2 as high risk groups. In comparison, patients in P3/4 were younger, with milder LV hypertrophy, but still considerable functional impairment. P3 had a higher burden of FHX and a higher prevalence of pathogenic mutations, whereas P4 a higher incidence of hypertension, high heart rate, mitral inflow fusion and findings of LGE. Finally, P5/6 consisted of younger individuals, predominantly HCM relatives, with a mild phenotype and, thus, low inferred risk. As expected, the majority of patients with the genetic variants of undetermined significance were located in P5. Conclusion ML can help derive clinically interpretable phenotypes in HCM based on the automated integration of whole cardiac cycle deformation and velocity data with conventional clinical parameters. The derived phenogroups correspond with established risk profiles in HCM. An expanded dataset is needed to enable further exploration of the phenotype-genotype relations and to define prognostic value. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This work was supported by the Horizon 2020 European Commission Project H2020-MSCA-ITN

The Effect of Alcohol on Blood Pressure and Hypertension.

To examine the acute and chronic effects of alcohol on blood pressure (BP) and the incidence of hypertension. We discuss the most current understanding of the mechanisms underlining these effects and their associations with the putative cardioprotective effects of consumption of low-to-moderate amounts of alcoholic beverages. A recent meta-analysis confirmed findings of experimental studies, demonstrating an acute biphasic effect of ethanol on BP, decreasing up to 12h of ingestion and increasing after that. This effect is mediated by vagal inhibition and sympathetic activation. A meta-analysis found that chronic consumption of alcoholic beverages was associated with a high incidence of hypertension in men and women; it also found that, in women, the risk begins at moderate alcohol consumption. The risks of alcohol consumption are higher in Blacks than in Asians or Caucasians. The mechanism underlying the chronic effects of alcohol on BP, and particularly the differential effect on Blacks, is still unknown. Short-term trials showed that alcohol withdrawal promotes BP reduction; however, the long-term effectiveness of interventions that aim to lower BP through the restriction of alcohol consumption has not been demonstrated. The harmful effects of alcohol on BP do not support the putative cardioprotective effect of low-to-moderate consumption of alcoholic beverages. The absence of a tangible mechanism of protection, and the possibility that this beneficial effect is biased by socioeconomic and other characteristics of drinkers and abstainers, calls into question the hypothesis that consuming low amounts of alcoholic beverages improves cardiovascular health. The evidence from investigations with various designs converge regarding the acute biphasic effect of ethanol on BP and the risk of chronic consumption on the incidence of hypertension, particularly for Blacks. These effects do not support the putative cardioprotective effect of consumption of low-to-moderate amounts of alcoholic beverages. Mechanisms of chronic BP increase and the demonstration of long-term benefits of reducing alcohol intake as a means to treat hypertension remain open questions.

Kidney complications in 107 Fanconi anemia patients submitted to hematopoietic cell transplantation

Fanconi anemia (FA) is a rare disease characterized by progressive bone marrow failure, cancer predisposition, and multiple systemic malformations, including congenital abnormalities of the kidney and urinary tract (CAKUT). Hematopoietic cell transplantation (HCT), the only potentially curative treatment for the hematological complications of FA, may precipitate acute kidney injury (AKI) and hypertension. We retrospectively investigated 107 FA patients who underwent HCT between 2009 and 2017. We investigated the incidence and risk factors of AKI within 100 days after HCT in a cohort of FA patients, and kidney function and hypertension over 2-year follow-up.The incidence of AKI (mainly stage I) was 18.7%. Patients aged ≥ 11 years at transplantation showed a higher risk of AKI (OR 3.53). The eGFR was 60-90 mL/min/1.73 m2 in 53 (49.5%), 55 (51.4%), 50 (50.5%), 50 (51%), and 46 (59.7%) patients before HCT, at 100 days, 6 months, 1 year, and 2 years. Within the first 100 days after HCT, hypertension was observed in 72% of the patients and was associated with cyclosporine therapy. Most (62.3%) patients had stage 2 hypertension. CAKUT was observed in 33.7% of the patients and was associated with both hypertension (86%) and diminished kidney function but not with AKI.Conlusion: Although AKI, a commonly known HCT complication, was mild in this study, the prevalence of chronic kidney disease (CKD), as well as the high incidence of hypertension, specially associated with CAKUT point out the importance of kidney care in short and long-term follow up of FA patients. What is Known: • Fanconi anemia (FA) is the most frequent inherited bone marrow failure in children, and 30% of cases have congenital anomalies of kidney (CAKUT). • Acute kidney injury and hypertension after hematopoietic cell transplantation (HCT) may impact the outcomes.. What is New: • Despite the presence of CAKUT and stage 2 CKD in 33.7% and 50% of the patients, respectively, AKI was mild and transitory after HCT in FA patients. • CAKUT in FA patients was associated with lower kidney function and hypertension after HCT.

Correlation of periodontal diseases with intracranial aneurysm formation: novel predictive indicators

BackgroundWe investigated whether periodontal diseases, specifically, periodontitis and gingivitis, could be risk factors of the incidence of intracranial aneurysms (IAs).MethodsWe performed a case–control study to compare the differences in the periodontal disease parameters of 281 cases that were divided into the IAs group and non-IAs group. All cases underwent complete radiographic examination for IAs and examination for periodontal health.ResultsComparing with those in the non-IAs group, the cases in the IAs group were older (53.95 ± 8.56 vs 47.79 ± 12.33, p < 0.001) and had a higher incidence of hypertension (76 vs 34, p = 0.006). Univariate logistic regression analysis revealed that age (> 50 years) and hypertension were predictive risk factors of aneurysm formation (odds ratio [OR] 1.047, 95% confidence interval [95% CI] 1.022–1.073, p < 0.001 and OR 2.047, 95% CI 1.232–3.401, p = 0.006). In addition, univariate and multivariate logistic regression analyses showed that the parameters of periodontal diseases, including gingival index, plaque index, clinical attachment loss, and alveolar bone loss, were significantly associated with the occurrence of IAs (all p < 0.05). For further statistical investigation, the parameters of periodontal diseases were divided into four layers based on the quartered data. Poorer periodontal health condition (especially gingival index > 1.1 and plaque index > 1.5) had the correlation with IAs formation (p = 0.007 and p < 0.001).ConclusionSevere gingivitis or periodontitis, combining with hypertension, is significantly associated with the incidence of IAs.

The relationship between rotating shift work and blood pressure among nurses working in hospitals of Abadan, Iran

ABSTRACT Hypertension is a major risk factor for developing cardiovascular disease. Various factors such as occupational and environmental risk factors affect blood pressure. Shift work is considered to be an occupational stressor. The aim of this study was to determine the relationship between rotating shift work and blood pressure among nurses working in hospitals associated with faculty of medical science. This cross‐sectional and descriptive-analytic study was conducted on nurses who worked in three hospitals associated with faculty of medical science, located in Abadan, southwest of Iran from September until December 2019. The sample size was 120 participants and divided into 60 rotating shift workers and 60 day workers (non-shift workers). The nurses were selected through the stratified random sampling technique. Demographic data, smoking status, and medical and occupational history were collected through a check list and interviews. Blood pressure was measured using a digital sphygmomanometer. Data were analyzed by the Mann–Whitney U, chi-square, Pearson’s correlation coefficient and logistic regression by using SPSS software version 22. There was statistically significant difference in blood pressure between day workers and rotating shift workers (p ≤ 0.001). By logistic regression analyses, and even after adjusting for confounding variables, rotating shift work was associated with a higher prevalence of hypertension (OR: 1.76 [95%CI: 1.11–2.80]). The findings of this study showed that rotating shift workers have a higher incidence of hypertension than day workers. Therefore, a particular follow-up of rotating shift workers should be recommended to screen workers for hypertension.

191-LB: Impact of Subsistence and Genetics on Lipid Profiles in Ethnically Diverse Africans

African Americans are at higher risk for cardiometabolic disease relative to individuals with European ancestry. Yet, populations with African ancestry are greatly under-represented in human genomics studies. To alleviate this bias and better distinguish the roles of genetics and environment on cardiometabolic traits, we conducted targeted metabolomics to measure levels of &amp;gt;700 lipids in 718 Africans and integrated with genomic data from &amp;gt;7M single nucleotide polymorphisms genotyped in the same individuals. These individuals are from 14 ethnic groups from diverse regions of Africa (Botswana, Cameroon, Ethiopia, Tanzania) and with diverse subsistence patterns (agriculturalists, pastoralists, hunter-gatherers). In contrast to US populations, most individuals were sampled from rural areas with relatively homogenous diets and, thus, we could better quantify lipids typically found at low levels in US individuals. Furthermore, several groups have similar genetic ancestry but distinct diets, and vice versa, enabling us to distinguish the role of genetic ancestry and environment on lipid variation. We identified 305 independent genetic variants associated with 103 lipid species, &amp;gt;50 of which have not previously been reported in similar studies of European/US populations (e.g. at ROCK2, ARHGEF28, DHODH, ALDH1A2). We observe correlations between subsistence and lipid profiles but show that genetic ancestry also plays an important role in variation within and between populations. For example, Eastern African pastoralists with a diet rich in milk and blood have relatively high levels of di-and tri-glycerides, but within each lipid class, levels are influenced by genotype. The Fulani pastoralists from Cameroon, with a high incidence of hypertension and diabetes but low BMI, also have relatively high levels of triglycerides, suggesting diet is predominantly influencing lipid levels and that genetic factors unrelated to lipid metabolism are influencing risk for disease in that population. Disclosure R. Ma: None. H. Li: Consultant; Self; Eli Lilly and Company. C. Burant: None. S. A. Tishkoff: None. M. Hansen: None. A. Ranciaro: None. S. R. Thompson: None. W. Beggs: None. S. W. Mpoloka: None. G. G. Mokone: None. T. B. Nyambo: None. G. Michailidis: None. Funding American Diabetes Association (1-19-VSN-02 to S.A.T.); National Institutes of Health (GM134957-01)

Clinical outcomes in HER2-positive and triple-negative breast cancer: Assessing racial disparities.

e18624 Background: Triple negative breast cancer (TNBC) &amp; HER2 positive breast cancer (Her2BC), are aggressive breast cancer subtypes. Both are associated with higher mortality in Non-Hispanic Black (NHB) compared to Non-Hispanic White women (NHW). Factors attributed to this racial disparity include socioeconomic status, insurance status, diagnosis(dx)/ treatment delays &amp; comorbidities. We examined the association between race &amp; clinical outcomes (pathological complete response, pCR; recurrence free survival, RFS &amp; overall survival, OS) in patients (pts) dxed with TNBC/Her2BC treated with neoadjuvant chemotherapy (NAC) at Roswell Park Comprehensive Cancer Center. Methods: Pts dxed with Stage I-III TNBC/Her2BC who received NAC from 2000-2018 were included. pCR was defined as absence of residual invasive cancer in the breast &amp; lymph nodes after NAC. Association of race with pCR &amp; survival outcomes was evaluated using logistic &amp; Cox regression models, respectively. Multivariate (MV) models were used to evaluate the association between race &amp; pCR or survival while controlling for relevant confounders including age, BMI, insurance, comorbidities, clinical stage, grade &amp; time from dx to chemotherapy(chemo)/surgery. Analysis was conducted using SAS v9.4 at a significance level of 0.05. Results: 174 TNBC (49 NHB, 125 NHW) &amp; 80 Her2BC (13 NHB, 67 NHW) pts were analyzed. Among TNBC pts, NHB pts had higher baseline BMI(34.3 vs 28.6 kg/m2; p&lt;0.001), higher incidence of hypertension (HTN) (45% vs. 24%; p&lt;0.01), diabetes mellitus (20% vs 8%; p&lt;0.05) &amp; higher Medicare/Medicaid use (M/M) (55% vs. 28%; p&lt;0.01). Among Her2BC pts, NHB pts had higher incidence of HTN (54% vs 25%; p&lt;0.05). There was no statistically significant difference in mean chemo relative dose intensity by race. Among TNBC pts, those with pCR were younger (47 vs 53 yrs; p=0.002) &amp; had more grade 3 tumors (96% vs 80.5%; p&lt;0.05) at dx compared to pts without pCR. Similarly, among Her2BC pts, those with pCR had more grade 3 tumors (64% vs 36%; p&lt;0.05) at dx compared to pts without pCR. Among TNBC pts, advanced age, higher clinical stage &amp; longer time from dx to surgery were associated with worse RFS &amp; OS (p&lt;0.05). Among Her2BC pts, M/M use &amp; advanced clinical stage were associated with worse RFS &amp; OS (p&lt;0.05). There were no significant associations between race &amp; pCR/RFS/OS on MV analysis (table below). Conclusions: Similar outcomes were noted between races for TNBC/Her2BC pts treated at a single academic center in Buffalo, NY. Given the known genetic diversity of African American ancestry in the US, further studies investigating the interplay between race, geography &amp; clinical outcomes are warranted.[Table: see text]

Zinc Deficiency‐Induced NFκB Activation Promotes Hypertension by Driving Renal Na + Reabsorption

Background : Zinc deficiency (ZnD) is a common comorbidity with chronic disorders including diabetes and kidney disease. Patients with these diseases also have a higher incidence of hypertension. Recently, we reported that a zinc deficient diet is sufficient to induce hypertension in mice. Changes in blood pressure were accompanied by increased Na+ reabsorption via the renal sodium chloride cotransporter (NCC). Although our novel results indicate that zinc plays a critical role in NCC regulation and its downstream effects on blood pressure, the specific mechanisms involved are unknown. Hypothesis : Since nuclear factor-κB (NFκB) is a key transcription factor implicated in ZnD-mediated effects, we tested the hypothesis that ZnD stimulates renal NFκB activation which drives NCC upregulation and thereby promotes hypertension. Experimental Design : Adult, male C57BL/6 mice were fed a zinc adequate (ZnA; 50ppm) or a ZnD (1ppm) diet for 6 weeks. To examine the role of NFκB in ZnD-induced hypertension, mice were switched from a ZnA-diet to a ZnD-diet for 5 weeks. After, ZnD mice were administered caffeic acid phenethyl ester (CAPE), an NFκB inhibitor, for 1 week. In mice, NCC expression (qRT-PCR) and blood pressure (tail-cuff) were measured. To further investigate the role of NFκB in NCC expression (qRT-PCR and Western blot), mouse distal convoluted tubule (mDCT) cells were treated with TPEN (a zinc chelator) or vehicle (DMSO) ± CAPE. Results : Compared to ZnA mice, NCC mRNA abundance was increased in ZnD mice (7.625 ± 1.747 vs 1.0 ± 0.127) and was accompanied by enhanced renal NFκB nuclear localization. In mDCT cells, TPEN-induced ZnD stimulated NCC mRNA expression (3.152 ± 0.966 vs 1.0 ± 0.174) and NFκB upregulation (1.573 ± 0.117 vs 1.0 ± 0). However, NFκB inhibition by CAPE prevented TPEN-induced NCC mRNA (0.636 ± 0.178 vs 3.152 ± 0.966) and protein (1.039 ± 0.018 vs 2.335 ± 0.062) expression in mDCT cells. Finally, CAPE administration lowered blood pressure (154.5 ± 5.42 vs 138.1 ± 1.97 mm Hg) in ZnD mice. Summary : These results demonstrate that 1) renal NFκB is a Zn2+-regulated transcription factor, 2) NFκB is involved in NCC regulation and 3) NFκB mediates ZnD-induced blood pressure increases. Significance : Taken together, these data indicate that ZnD stimulates NFκB activation thereby driving NCC upregulation and hypertension.

Association of the Geriatric Nutritional Risk Index with incident hypertension in the older Chinese population: a 6-year cohort study.

BackgroundWe examined the association of the Geriatric Nutritional Risk Index (GNRI) with the incidence of hypertension.MethodsWe used data of the China Health and Nutrition Survey in this study. Participants aged ≥60 years were eligible. The GNRI was defined as follows: GNRI = [1.489 × albumin (ALB; g/L)] + [41.7 × (actual weight/ideal weight)]. Participants with systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of antihypertensive medication were defined as having hypertension.ResultsThis study included 4853 participants, comprising 3612 control participants and 1241 participants with hypertension. The GNRI, ALB, and body mass index (BMI) were significantly associated with higher incidence of hypertension (HR: 1.030, 1.026, and 1.088; 95% CI: 1.020–1.041, 1.008–1.044, and 1.069–1.107, respectively). The GNRI, ALB, and BMI were associated with an earlier age of hypertension onset (β = −0.403, −0.613, and −0.321; 95% CI: −0.493 to −0.314, −0.767 to −0.459, and −0.484 to −0.159, respectively).ConclusionsA higher GNRI was associated with increased incidence of hypertension. An elevated GNRI was associated with earlier age of hypertension onset.