Female Hypertension Research Articles

Predicting sex differences in the effects of diuretics in renal epithelial transport during angiotensin II-induced hypertension.

Chronic angiotensin II (ANG II) infusion is an experimental model that induces hypertension in rodents. The natriuresis, diuresis, and blood pressure responses differ between males and females. This is perhaps not unexpected, given the rodent kidney, which plays a key role in blood pressure regulation, exhibits marked sex differences. Under normotensive conditions, compared with males, the female rat nephron exhibits lower Na+/H+ exchanger 3 (NHE3) activity along the proximal tubule but higher Na+ transporter activities along the distal segments. ANG II infusion-induced hypertension induces a pressure natriuretic response that reduces NHE3 activity and shifts Na+ transport capacity downstream. The goals of this study were to apply a computational model of epithelial transport along a rat nephron 1) to understand how a 14-day ANG II infusion impacts segmental electrolyte transport in male and female rat nephrons and 2) to identify and explain any sex differences in the effects of loop diuretics, thiazide diuretics, and K+-sparing diuretics. Model simulations suggest that the NHE3 downregulation in the proximal tubule is a major contributor to natriuresis and diuresis in hypertension, with the effects stronger in males. All three diuretics are predicted to induce stronger natriuretic and diuretic effects under hypertension compared with normotension, with relative increases in sodium excretion higher in hypertensive females than in males. The stronger natriuretic responses can be explained by the downstream shift of Na+ transport load in hypertension and by the larger distal transport load in females, both of which limit the ability of the distal segments to further elevate their Na+ transport.NEW & NOTEWORTHY Sex differences in the prevalence of hypertension are found in human and animal models. The kidney, which regulates blood pressure, exhibits sex differences in morphology, hemodynamics, and membrane transporter distributions. This computational modeling study provides insights into how the sexually dimorphic responses to a 14-day angiotensin II infusion differentially impact segmental electrolyte transport in rats. Simulations of diuretic administration explain how the natriuretic and diuretic effects differ between normotension and hypertension and between the sexes.

Kaposi sarcoma in an immunocompetent patient: a case report

Kaposi sarcoma (KS) is an uncommon vascular neoplasm associated with human herpes virus 8 (HHV8) infection. Lesions predominantly present at mucocutaneous sites, but may involve other organs. Epidemiological-clinical forms of KS include classic, endemic, AIDS associated and iatrogenic KS. KS is one of the most common AIDS defining malignancy. Lesions evolve from early (patch stage) macule into plaque stage and nodule stage. Diagnosis is made through clinical, histopathological findings and specific immunohistochemical markers for HHV8. Treatment is either by means of destructive procedures and systemic therapy in case of multiorgan involvement. This report is a case of classic KS in a 74-year nondiabetic, non hypertensive female, with no significant surgical, sexual or history of immunosuppression for the occurrence of KS. This case throws light on addressing KS in an immunocompetent patient or a newer variant of KS yet to be researched upon, which can go clinically misdiagnosed due to lack of significant history.

A Rare Clinical Scenario of Hypothyroid-induced Rhabdomyolysis

Abstract Muscle involvement is common in hypothyroidism and is seen in nearly 80% of the cases. However, rhabdomyolysis is a rare manifestation and is usually triggered by precipitating factors such as exercise, statins, and toxins. We describe the case of a 58-year-old woman with de novo hypothyroidism presenting with severe rhabdomyolysis requiring hemodialysis. A 58-year-old diabetic and hypertensive female was presented at our tertiary care center with symptoms of generalized weakness, difficulty in walking, and decreased urine output. Her blood investigations showed elevated creatine phosphokinase (CPK), renal parameters, and thyroid-stimulating hormone (TSH) levels suggestive of autoimmune thyroiditis with rhabdomyolysis. She was treated with thyroid hormone supplementation and hemodialysis. The patient recovered gradually with normalization of renal parameters. Although muscle involvement is common in hypothyroidism, rhabdomyolysis is a rare manifestation. Diagnosis is established by demonstrating elevated CPK and TSH levels. Management consists of hydration and thyroid hormone supplementation. Hemodialysis is required in severe cases with established acute kidney injury.

A case-control regression analysis of liver enzymes in obesity-induced metabolic disorders in South Asian females.

Excessive body weight may disrupt hepatic enzymes that may be aggravated by obesity-related comorbidities. The current case-control study was designed to evaluate the extent of liver enzyme alteration in obesity-related metabolic disorders. Obese females with BMI ≥ 30 suffering from metabolic disorders were grouped according to existing co-morbidity and their hepatic enzymes were compared with non-obese healthy females. The resultant data was subjected to analysis of variance and mean difference in liver enzymes were calculated at P = 0.05. Analysis of variance indicated that obese diabetic and obese hypertensive females had almost 96% and 67% increase in the concentration of gamma-glutamyl transferase than control, respectively (P<0.0001). The obese females suffering from diabetes and hypertension exhibited nearly 54% enhancement in alanine transaminase level (P<0.0001) and a 17% increase in aspartate aminotransferase concentration (P = 0.0028). Obesity along with infertility decline liver enzyme production and a 31% significant decline in aspartate aminotransferase was observed while other enzyme concentrations were not significantly altered. Regression analysis was performed on the resultant data to understand the association between liver enzyme alteration and the development of metabolic diseases. Regression analysis indicated that obese diabetic and obese diabetic hypertensive women had 20% production of normal liver enzymes and 80% enzymes produced abnormally. Obese hypertensive and obese infertile females had only 5% and 6% normal production of liver enzymes, respectively. This research leads to the conclusion that the ability of the liver to function normally is reduced in obesity-related diabetes and hypertension. This may be due to inflamed and injured liver and poses a serious threat to developing fatty liver disease and ultimately liver cirrhosis.

Association of Body Mass Index and Biochemical Parameters with Pregnancy-Induced Hypertension in Women of District Lahore, Punjab, Pakistan

Hypertension is highly widespread problem in many parts of the world. It is a significant determinant of risk which can lead to cardiovascular morbidity and mortality. Pregnancy induced- hypertension is the hypertension which occurs in a pregnant woman after 20 weeks of gestation, previously having normal blood pressure. Objective: To ascertain the risks and complications associated with pregnancy-induced hypertension in females between the ages of 21 and 35 years. Methods: This study was conducted on 250 female subjects, which included 50 non-pregnant females, 50 pregnant non hypertensive females, and 150 pregnant hypertensive females. Symptoms were studied with the help of a questionnaire. Blood pressure was measured with the use of a manual blood pressure apparatus. Body mass index (BMI) was determined with the help of weight and height. The biochemical tests were performed in laboratories by taking blood samples with the help of standard methods. Statistical analysis was done by applying the Analysis of Variance (ANOVA). Results: Liver Function Tests (LFTs), Renal Function Tests (RFTs), and level of proteinuria were elevated in pregnant hypertensive females. At the same time, the platelet count was low in pregnant hypertensive females as compared to the other two groups. Conclusions: The present study showed significant results related to the demographic, BMI, and biochemical parameters.

Differences of Gonial Index value in male and female hypertension patients using panoramic radiography

Objectives: This study is aimed to measure the Gonial index (GI) value in male and female hypertensive patients using panoramic radiography. Materials and Methods: This is a comparative analytical research. The sampling technique used was the purposive sampling technique. The sample of this study was primary data from panoramic radiographs of hypertensive patients who had been X-rayed at the Radiology Installation of Ulin General Hospital, Banjarmasin. Results: There was no significant difference in the gonial index (GI) values between men (17.83 mm) and women (19.17 mm), with the size of the right region of the female 20.33 mm and the left of the female 16.67 mm and the size of the right region of the male is 17.03 mm and the left male is 19.97 mm. Conclusion: There was no significant difference between the gonial index (GI) values ​​between women and men, although the decrease of bone density in women is higher than in men.

The Evolving Landscape of Gout in the Female: A Narrative Review

Gout is at least three times more prevalent in males than in females. However, concurrent with rising total gout prevalence, complex factors, including comorbidities, diet, lifestyle, and aging, have promoted higher gout prevalence in females. This narrative review focuses on summarizing recent developments in the landscape of gout in females and the mechanisms involved. New knowledge on sex hormone effects on both urate-excreting and urate-reabsorbing transporters and higher hypertension and chronic kidney disease prevalence in females compared to males may help explain why gout incidence rises robustly after menopause in females, to approach that in males. Racial and ethnic factors, risk profiles based on heritable genetic polymorphisms of urate transporters, diet, body mass index, and lifestyle factors differ according to sex. In addition, sex differences in clinical phenotypes, outcomes of gout, and non-gout illnesses include more frequent comorbidities, more pain and disability during gout flares, different perceptions of disease burden, and more frequent severe cutaneous hypersensitivity reaction to allopurinol in females. Collectively, such findings support the potential clinical benefits of tailoring gout and hyperuricemia treatment according to sex.

Hypertension in periand postmenopausal women: mechanisms, management, observation

An important role in the development and evolution of hypertension in females is applied to sex hormones. Estrogen deficiency and hyperandrogenism, characteristic of periand postmenopause, are links in the pathogenesis of hypertension in this period of a woman's life and are accompanied by an increase in sympathetic nervous system activity, renin-angiotensin-aldosterone system activation, salt sensitivity, abdominal obesity and metabolic syndrome, left ventricle hypertrophy, left atrial dilatation with a high risk of atrial fibrillation, stroke and heart failure development. The paper discusses antihypertensive therapy during periand postmenopause, effectiveness and tolerability of different drug classes. Special attention is paid to the mechanism of action of selective I1-imidazoline receptor agonist moxonidine, which in women during this period both effectively reduces high blood pressure and has a beneficial metabolic effect, what is documents in studies of monotherapy, combined antihypertensive therapy with major classes and in combination with menopausal hormone therapy. The paper presents the joint expert opinion concerning above mentioned issues.

Sex differences in individuals with high normal blood pressure who developed hypertension in three-year follow-up

Abstract Background Recent data demonstrated that females are at risk for cardiovascular disease at a lower blood pressure (BP) level than males. Purpose Identify normotensive individuals with high normal BP who are going to develop hypertension in three-year follow-up and demonstrate differences according to their gender. Methods 100 individuals with high normal BP were followed-up for 3 consecutive years. During enrolment they underwent ambulatory BP monitor (ABPM), electrocardiogram (ECG), echocardiogram, carotid-femoral pulse wave velocity (PWV), sympathetic drive assessed by muscle sympathetic nerve activity (MSNA), a negative for ischemia treadmill exercise stress test (TST) (Bruce protocol) and blood sampling. Follow-up was scheduled every 6 months for 3 consecutive years, where BP measurements were assessed in office and with ABPM. All participants offered lifestyle advise to lower their BP. Endpoint was development of hypertension (HTN). Results 19 males and 21 females developed HTN. Office and ABPM measurements did not differ significantly but women who developed HTN demonstrate higher pulse pressure 50vs45 mmHg (p=0.03). In ABPM systolic blood pressure (SBP) differ (123 vs 119 mmHg, p=0.01) in future hypertensive females. Additionally night-time SBP differ in both genders who were going to develop HTN (women: 116vs111 mmHg, p=0.007 and men: 116vs111 mmHg, p=0.043). Both genders demonstrate significantly different PWV values among future hypertensives and those who remained normotensives (women: 8.2vs7.2 m/s, p&amp;lt;0.001, men: 8.3vs7.2 m/s, p&amp;lt;0.001). Males and females who developed hypertension had higher sympathetic activity as reflected from MSNA levels (men: 33vs27 bursts/minute, p&amp;lt;0.001, women: 36vs28 bursts/minute, p&amp;lt;0.001). Both genders who developed HTN had higher SBP at peak exercise (men: 208vs184 mmHg, p&amp;lt;0.0001, women: 197vs173 mmHg, p&amp;lt;0.0001) as also steeper SBP/MET slope (men: 6.7vs5.0, p=0.038, women: 7.1vs3.8, p&amp;lt;0.0001), while their maximal heart rate achieved differ (men: 158bpm vs 167bpm, p=0.014, women: 153bpm vs 162bpm, p&amp;lt;0.0001). Only in women's baseline ECG who developed HTN had wider p-wave duration (103vs94ms, p=0.032) and QRS length (88vs80ms, p=0.018). While echocardiographicly they displayed increased left ventricular mass index (LVMI) (81vs72 g/m²,p=0.006), atrial diameter (37vs34 mm,p&amp;lt;0.0001) and decrease E/A ratio of transmitral flow velocity (0.8vs1.0, p=0.005). Kidney function assessed by 2021 CKD-EPI eGFR reveals a deterioration in those women who are going to develop HTN (87 vs 97 mL/min/1.73 m², p=0.009). Conclusions Both men and women benefit from treadmill exercise stress test as a prognostic tool that can reveal the likelihood of development of hypertension in both sexes and arouse the need to research for target organ damage in women who are in prehypertensive state and may benefit from an early intervention until clarify sex-specific thresholds for diagnosis of hypertension.

Abstract 13852: Sex Differences in Blood Pressure Reduction and Cardiovascular Outcomes in Patients With Resistant Hypertension Undergoing Radiofrequency Renal Denervation: Global SYMPLICITY Registry DEFINE

Introduction: Hypertension (HTN) prevalence and outcomes differ by sex. Radiofrequency renal denervation (RF RDN) safely reduces blood pressure (BP) in patients with resistant HTN. Hypothesis: After RF RDN, there are no sex-based differences in BP changes and cardiovascular (CV) outcomes. Methods: The Global SYMPLICITY Registry (GSR) DEFINE is an all-comer registry of patients with uncontrolled BP undergoing RF RDN. BP changes (analysis of covariance [ANCOVA] adjusted for baseline BP and age), CV death, stroke, myocardial infarction (MI) rates at 3yrs were compared between sexes with office systolic BP (OSBP) ≥140mmHg, prescribed ≥3 anti-HTN drugs. Results: Patients enrolled up to March 2023 were included (N=2502, female=1062). Females were older (62 vs 59 y; p&lt;0.0001), less likely to have a history of sleep apnea (12.5 vs 25.0% p&lt;0.0001), cardiac disease (45.2 vs 50.3%; p&lt;0.0012) and smoking (19.1 vs 41.3%; p&lt;0.0001). Body mass index, rates of diabetes and chronic kidney disease, number of anti-HTN drugs (5.1±1.5 in both sexes; p=0.88) and 24-hr SBP were similar by sex. Baseline OSBP was higher in females (174±23 vs 169±19mmHg; p&lt;0.0001). After 3yrs, OSBP significantly decreased in both sexes from baseline (female: -21.5mmHg vs male: -20.4mmHg; ANCOVA adjusted difference: 3.2mmHg [95% CI: 0.5 to 6.0; p=0.021]). There was no difference in 24-hr SBP change (Figure 1A) or number of anti-HTN drugs by sex. CV death rate was significantly higher in females (4.1% vs 2.1% vs p=0.024), but MI rate was significantly lower in females (1.3% vs 3.5%; p=0.007). Stroke rate was similar by sex (Figure 1). Conclusion: Females with resistant hypertension referred for RF RDN were older, had higher OSBP with fewer comorbidities compared to males. Despite similar BP reductions up to 3yrs after RF RDN, CV death rate in females was greater than males. These results suggest the need for sex specific analyses and control of HTN in females.

Effect of SGLT2 inhibition on salt-induced hypertension in female Dahl SS rats

Sodium-glucose co-transporters (SGLTs) in the kidneys play a pivotal role in glucose reabsorption. Several clinical and population-based studies revealed the beneficial effects of SGLT2 inhibition on hypertension. Recent work from our lab provided significant new insight into the role of SGLT2 inhibition in a non-diabetic model of salt-sensitive hypertension, Dahl salt-sensitive (SS) rats. Dapagliflozin (Dapa) blunted the development of salt-induced hypertension by causing glucosuria and natriuresis without changes in the Renin–Angiotensin–Aldosterone System. However, our initial study used male SS rats only, and the effect of SGLT2 inhibitors on hypertension in females has not been studied. Therefore, the goal of this study was to determine whether SGLT2 inhibition alters blood pressure and kidney function in female Dahl SS rats. The result showed that administration of Dapa for 3 weeks prevented the progression of salt-induced hypertension in female rats, similar to its effects in male SS rats. Diuresis and glucose excretion were significantly increased in Dapa-treated rats. SGLT2 inhibition also significantly attenuated kidney but not heart fibrosis. Despite significant effects on blood pressure, Dapa treatment caused minor changes to electrolyte balance and no effects on kidney and heart weights were observed. Our data suggest that SGLT2 inhibition in a non-diabetic model of salt-sensitive hypertension blunts the development of salt-induced hypertension independent of sex.

Microbiota-associated mechanisms underlying sexual dimorphism in hypertension.

Consistent research over the last 20 years has shown that there are clear sex differences in the pathogenesis of hypertension, the leading risk factor for the development of cardiovascular diseases. More recently, there is evidence in both humans and experimental animal models that causally implicates the gut microbiota in hypertension. It therefore follows that sex differences in the gut microbiota may mediate the extent of disease between sexes. This new field is rapidly changing and advancing, and the purpose of this review is to cover the most up-to-date evidence regarding the sexual dimorphism of the gut microbiota and its potential influence on the differential manifestation of hypertension in males versus females. Emphasis will be placed on the mechanisms thought to contribute to these sex differences in both the gut microbiota and hypertension, including sex steroid hormones, gut-derived metabolites, the immune system, and pregnancy.

Identification of Subjective Fatigue accompanied by Hypertension in Female Workers Making Tiles in Indonesia: A Cross-Sectional Survey

Introduction: The home industry has production process activities that are carried out manually. The release of the hormone adrenaline increases blood pressure through an increase in heart rate and arterial contractions, thereby accelerating the feeling of tiredness. As a result, female workers risk getting tired faster than men. Fatigue can lead to a decrease in productivity, poor quality of work, negatively affect the safety of workers, and increase the risk of work accidents. It aims to analyze the risk factors for subjective fatigue in female workers who have hypertension. Methods: This type of quantitative research with a cross-sectional design. Respondents were 278 female hypertension workers at the Karangasem Village Tile Making Home Industry Center, Wirosari District, Grobogan, Indonesia. Data analysis using Chi-square with the SPSS 21. Results: Of a total of 278 female workers, most were married (85.3%), did not smoke (98.9%), did not consume alcohol (96%), worked longer than 8 hours (93.5%), worked more than five years (80.9%), heavy workload (80.6%). Subjective fatigue factors related such as alcohol consumption habits (0.019), exercise habits (0.000), body mass index (0.000), working period (0.000), and workload (0.000). Meanwhile, other risk factors were not related, age (0.315), marital status (0.744), education level (0.811), smoking habits (0.236), disease history (0.762), length of work (0.530), type of work (0.393) and work stress (0.451). Conclusion: Risk factors that have a relationship with subjective fatigue are workload, BMI, alcohol consumption habits, exercise habits, and length of service

A glimpse into the future: modelling global prevalence of hypertension

BackgroundHypertension is a major risk factor for cardiovascular diseases. Insights and foresights on trends of hypertension prevalence are crucial to informing health policymaking. We examined and projected the patterns of hypertension prevalence among sexes.MethodsUsing annual hypertension prevalence (18 + years) data sourced from WHO Global Health Observatory data repository from 1975 to 2015, Prophet models were developed to forecast the 2040 prevalence of hypertension in males, females, and both sexes. We used k-means clustering and self-organising maps to determine the clusters of hypertension prevalence concerning both sexes among 176 countries.ResultsWorldwide, Croatia is estimated to have the highest prevalence of hypertension in males by 2040, while that of females is in Niger. Among the world’s most populated countries, Pakistan and India are likely to increase by 7.7% and 4.0% respectively in both sexes. South-East Asia is projected to experience the largest hypertension prevalence in males, whereas Africa is estimated to have the highest prevalence of hypertension in females. Low-income countries are projected to have the highest prevalence of hypertension in both sexes. By 2040, the prevalence of hypertension worldwide is expected to be higher in the male population than in female. Globally, the prevalence of hypertension is projected to decrease from 22.1% in 2015 to 20.3% (20.2 – 20.4%) in 2040. We also identified three patterns of hypertension prevalence in 2040, cluster one countries are estimated to have the highest prevalence of hypertension in males (29.6%, 22.2 – 41.1%) and females (29.6%, 19.4 – 38.7%).ConclusionThese findings emphasise the need for new and effective approaches toward the prevention and control of hypertension in Africa, South-East Asia, and Low-income countries.

Abstract P202: Changes In Cerebral Mitochondrial Function In Intrauterine Growth-Restricted Offspring Before The Development Of Hypertension And Cerebrovascular Dysfunction

Background: Preeclampsia (PE), new-onset gestational hypertension (HTN) affects 3-8% of all births in the USA. PE is the leading cause for intrauterine growth restriction (IUGR). IUGR children have increased risks of HTN and cerebrovascular disease (CVD) later in life. Prior studies in our lab show adult male IUGR rat offspring (OS) to develop HTN, CVD, and cerebral mitochondrial dysfunction (mtDys) at 17 weeks while female IUGR OS exhibit CVD. The role of mtDys in HTN is unknown and is the focus of our study. We hypothesize that IUGR OS will have mtDys prior to HTN. Methods: Our surgical PE animal model utilized the reduced-uterine-perfusion pressure (RUPP) surgery at GD 14. OS from NP served as controls (CON) while OS from RUPP mothers were IUGR. At 12 weeks, OS BP was measured alongside cerebral mtDys through mitochondrial fusion and fission, electron-transport chain (ETC) proteins, and respiration. Results: BP did not change between sexes or among IUGR and CON offspring. Male IUGR OS showed elevated mtRes (State 2: 199 ± 1.08 v. 76 ± 1.13 pmol/mg, p &lt; .05; State 3: 555 ± 3.02 v. 245 ± 1.77 pmol/mg, p &lt; .05; State 4: 346 ± 1.66 v. 85 ± 1.12 pmol/mg, p &lt; .05). Female IUGR and CON OS had no changes in BP or mtRes. Male IUGR OS had increased mito-fusion proteins MFN-1 (176 ± 1.68 v. 100 ± .57 IU/protein/CON %, p &lt; .05), MFN-2 (155 ± 1.36 v. 100 ± .74 IU/protein/CON %, p &lt; .05) and OPA-1 (166 ± 1.99 v. 100 ± .73 IU/protein/CON %, p &lt; .05). DRP-1 had no changes in males; females had no changes in fusion or fission. Male IUGR OS had changes in ETC proteins (CI: 8 ± 9.34 v. 100 ± .82 IU/protein/CON %, p &lt; .05; CII: 23 ± .53 v. 100 ± .52 IU/protein/CON %, p &lt; .05; CIII: 26 ± .23 v. 100 ± .41 IU/protein/CON %, p &lt; .05), as did female IUGR OS (CI: 12 ± .24 v. 100 ± .86 IU/protein/CON %, p &lt; .05; CII: 29 ± .39 v. 100 ± .61 IU/protein/CON %, p &lt; .05; CIII: 39 ± .56 v. 100 ± .62 IU/protein/CON %, p &lt; .05; CIV: 76 ± .74 v. 100 ± .73 IU/protein/CON %, p &lt; .05) vs. CON OS. Summary: Male IUGR OS have elevated mtRes, changed ETC proteins, and fusion proteins that may lead to mtDys and HTN development. This study is clinically relevant because specific cerebral therapy for mtDys for IUGR OS may prevent HTN and CVD development. Future studies will examine changes in mtDys causing male HTN and protection from HTN in females.

Abstract 063: Pregnancy Protects Aged G Protein-coupled Estrogen Receptor 1 Knock-out Mice Against Hypertension

Hypertension, a major cause of premature death worldwide, is more prevalent in postmenopausal women compared to premenopausal women. Data implicate a protective effect of G protein-coupled estrogen receptor 1 (GPER1) in cardiovascular diseases. A recent study showed that previous pregnancy lowers blood pressure in hyperandrogenemic rats. We hypothesized that pregnancy protects against hypertension elicited in aged female mice lacking GPER1. 16-20 month-old GPER1 wild-type (WT) and knock-out (KO) mice with or without a history of former pregnancies were implanted with telemeters for blood pressure recording and placed in metabolic cages for 24h urine collection. Plasma, adrenal glands and kidneys were collected. GPER1 deletion increased mean arterial pressure in virgin mice (125±3 vs. 109±2 mmHg; n=3,7; p=0.0005), and previous pregnancies (PP) eliminated this genotypic effect (106±1 mmHg; n=6; p≤0.0001). Aldosterone plays a critical role in blood pressure regulation, we measured its urinary excretion and revealed lower levels in PP KO mice compared to virgin KO mice (4.8±0.8 vs. 13.0±3.0 pg/day; n=6; p=0.0099). PP KO mice elicited greater levels of circulating estradiol levels compared to virgin KO mice (42.8±5.2 vs. 29.5±3.4 pg/mL; n=8,6; p=0.0451). To explore the role of adrenal estrogen receptors (ER) in regulating aldosterone production, we assessed the adrenal expression of ER and CYP112B, the gene coding for aldosterone synthase. No difference was observed in ERα, however ERβ expression was higher in PP KO mice compared to virgin KO mice (2.4±0.3 vs. 1.1±0.1 fold change; n=6,5; p=0.0359). GPER1 deletion increased CYP112B expression in virgin mice (2.0±0.4 vs. 1.0±0.2 fold change; n=7,5; p=0.0265), and this was eliminated with PP (0.9±0.2 fold change; n=5; p=0.0260). Aldosterone regulates renal epithelial sodium channel (ENaC), so we assessed its subunits’ expression. Renal ENaCα and ENaCβ increases with the deletion of GPER1 in the virgin group, and this effect was lost with PP. ENaCγ withheld the same trend, but it did not reach significance. Overal, our data suggest that GPER1 and former pregnancy protect from hypertension in aged females at least partially via regulating aldosterone and ENaC signaling.

Abstract 011: Cluster Of Differentiation 14 (CD14) Inhibits NADPH Oxidase 2 (NOX2)-Derived Oxidative Stress In Hematopoietic Cells And Modulates Dahl Salt-Sensitive Hypertension And Renal Damage

We recently discovered that genetic deletion of CD14 in Dahl SS rats (CD14-/-) amplifies the development of salt-sensitive hypertension and renal damage in females. Interestingly, the expression of CD14 in leukocytes and the level of plasma CD14 protein are increased in cardiovascular disease and hypertension in humans. An examination of macrophages from CD14-/- females revealed enhanced production of superoxide from NOX2 compared to Dahl SS. Furthermore, a double knockout Dahl SS strain lacking both CD14 and functional NOX2 (DKO) exhibits significantly reduced salt-induced hypertension and associated renal damage, indicating that free radical production from NOX2 is likely mediating the amplification of disease following CD14 deletion. The present study examined the specific effects of CD14 and NOX2 deletion in hematopoietic cells via a total body irradiation/bone marrow transfer (TBI/BMT) approach. Female Dahl SS recipients were irradiated (11Gy) then received either CD14 or DKO bone marrow transplantation via tail vein injection. Rats that received DKO hematopoietic cells had blunted mean arterial pressure (147±4 mmHg, n=3, p=0.052) versus those that received CD14-/- (179±19mmHg, n=3) in response to a 3-week high salt challenge (HS, 4.0% NaCl, AIN-76A). As an index of renal damage, albuminuria was significantly reduced in the DKO (110.3±7 mg/day, n=3, p&lt;0.01) compared to the CD14-/- (280.9±42 mg/day, n=3) at HS day 21. Flow cytometric analysis of isolated renal immune cells indicated a reduction in renal inflammation in the DKO compared to the CD14-/-. There were fewer CD45+ total leukocytes (2.8x10 6 vs 3.8x10 6 cells/kidney, p&lt;0.05) and CD11b/c+ monocytes/macrophages (2.4x10 6 vs 3.3x10 6 cells/kidney, n=3, p&lt;0.05) in DKO versus CD14-/- kidneys. Finally, to document the TBI/BMT, macrophages from CD14-/- rats produced 7-fold greater superoxide from NOX2 when stimulated with 12-phorbol myristate 13-acetate compared to DKO macrophages. Together, these data suggest a regulatory role of CD14 in hematopoietic cells to reduce oxidative stress from NOX2 in the kidney of female Dahl SS rats during salt-sensitive hypertension and associated renal disease.

Differences in Panoramic Mandibular Index value between male and female hypertension patients using panoramic radiography

Objectives: This study is aimed to analyze the panoramic mandibular index value in male and female hypertensive patients using panoramic radiography.&#x0D; Materials and Methods: This research is a comparative analytic research with a purposive sampling technique. The study sample was hypertensive patients at Ulin Hospital, Banjarmasin from March to May 2023.&#x0D; Results: The results showed that there was no statistically significant difference through statistical data on the panoramic mandibular index value between men (0.27 ± 0.07) and women (0.26 ± 0.09), The age group that experienced a decrease in mandibular cortical thickness was most in the age group ≥ 65 years (0.22 ± 0.06).&#x0D; Conclusion: It is known that there is no significant difference in the panoramic mandibular index value between women and men.

Sonographic assessment of the common carotid artery luminal diameter in adults with co-existing diabetes mellitus and hypertension

Background: Diabetes mellitus (DM) and hypertension (HTN) are known to cause major in changes in arterial morphology and function, (remodelling) including alterations in carotid intima media thickness (CIMT), carotid artery luminal diameter (CALD), and arterial compliance and blood flow velocity. However, there is a paucity of data evaluating common carotid luminal diameter (CCALD) in an adult with both DM and HTN (DM+HTN) in the study locality. Objective: This study is therefore aimed at evaluating the CCALD in adults with DM+HTN. Methodology: One hundred and fifteen (115) adult subjects with co-existing DM+HTN and one hundred and fourty four (144) healthy controls participated in the study. Their ages ranged from 18 to 80 years. The common carotid artery luminal diameter (CCALD) at the diastolic phase of the cardiac cycles was scanned and measured using a venue 50 ultrasound scanners with electronic calipers and high frequency linear array transducer. Result: The overall mean CCALD was 6.43±0.87 mm and 5.88±0.77 mm for subjects with DM+HTN and healthy controls, respectively. The mean CCALD value was significantly higher in subjects DM+HTN compared to the healthy controls (0.000). The mean CCALD correlated positively with age in males with DM+HTN hypertensive females, while no significant correlations were observed among healthy controls. Males had significantly higher mean CCALD value when compared to their female counterparts in both subjects with DM+HTN and healthy controls. Conclusion: In this study, the mean CCALD value in subjects with DM+HTN is significantly higher compared to those of healthy controls.

Hyperandrogenism Protects Against High Blood Pressure by Nongenomic Mechanisms and Obesity Causes Hypertension in Females with Polycystic Ovary Syndrome

ABSTRACT Background Androgens induce vasorelaxation and reduce blood pressure in different mammals, including humans. Most women with polycystic ovary syndrome (PCOS), with hyperandrogenism, are obese and exhibit hypertension; thus, the fact that androgens increase blood pressure (BP) is controversial. Our aim was to determine whether hypertension is produced by androgen excess and/or obesity. Methods Experiments were performed in dehydroepiandrosterone; (DHEA, s.c)-induced PCOS model. BP from nonobese and obese rats with PCOS (fed a normal or high-fat diet, respectively) was evaluated weekly for 10 weeks by plethysmography and compared between them. We determined whether androgen receptors are responsible for androgen action on BP in rats with PCOS; a group of DHEA-treated rats was implanted with pellets of an antiandrogen and was compared with nonobese rats with PCOS. Isometric tension from aortas of nonobese and obese rats was recorded and compared to explore the integrity of the vascular endothelium when acetylcholine-induced endothelium-dependent vascular relaxation on phenylephrine contraction. Additionally, BP was obtained from 30 women diagnosed with PCOS: nonobese (BMI ≤25) and obese women (BMI ≥35) and compared with healthy counterparts; 15 obese and 15 nonobese women. Results Nonobese rats and women with PCOS showed hypotension, while obese rats and women with PCOS displayed hypertension. Healthy obese women were hypertensive and nonobese women remained normotensive. Antiandrogen did not modify the BP values in nonobese rats with PCOS, and obese rats with PCOS revealed marked endothelial dysfunction. Conclusions Our findings show that obesity is responsible for hypertension in PCOS and partial endothelial damage was observed, which may contribute to elevated BP. Remarkably, hyperandrogenism is capable of regulating BP to low values that are androgen receptor-independent.