Hypertensive State Research Articles

Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19.

Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. Retrospective analysis of prospectively collected database. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0-11.9 g/dL for women, 10.0-13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). Patients older than 18 years with acute COVID-19 infection in the ICU. None. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05-1.67). In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.

Exploring the Renoprotective Potential of Bioactive Nutraceuticals in Chronic Kidney Disease Progression: A Narrative Review.

Chronic kidney disease (CKD) is a condition that is characterized by progressive loss of kidney function over time. A substantial increase in the burden of CKD is evident globally, attributed to multifactorial conditions like an expanding aging population, rising diabetes and hypertension rates, and more significant exposures to risk factors associated with the environment and lifestyle. Nutraceuticals are substances that are usually considered a food or an active part of a food that provides medical or health benefits, including the prevention and treatment of a disease. The aim is to review the positive role of nutraceuticals in managing CKD. A narrative review is generated, extracting the papers from databases like Web of Science, Scopus, ScienceDirect, ResearchGate, and PubMed. Animal and human trials focusing on the effect of different nutraceuticals on the initial stage of kidney disease, i.e., stages 1, 2, and 3 of CKD, were included. The review's outcome is understanding the effectiveness of nutraceuticals that have shown positive results in CKD conditions. Active compounds include ubiquinone, curcumin, nitrates, nitrites, lycopene, and resveratrol. These bioactive components are also beneficial for other comorbid conditions like diabetes, hypertension, and cardiovascular conditions that have an eminent adverse effect on CKD. Lycopene, coenzyme Q10 (CoQ10), resveratrol, curcumin, and flavonoids have positively impacted CKD complications. Nutraceuticals hold great promise for individuals with CKD in the coming years, offering diverse potential benefits. These include delivering vital antioxidant and anti-inflammatory support to alleviate oxidative stress and inflammation, helping to regulate blood pressure and lipid levels for improved cardiovascular health, promoting optimal renal function to sustain kidney health, assisting in maintaining electrolyte balance, warding off complications, influencing gut microbiota for enhanced digestive well-being, and ultimately elevating the overall quality of life, for those managing CKD.

Healthcare resource utilization and related cost among hospitalized patients with prurigo nodularis: a retrospective cohort study using Italian health claims data.

Prurigo nodularis (PN) is a chronic, inflammatory skin disease characterized by intense itch. Little evidence exists on the burden of PN in Italy. This real-world analysis aimed to investigate the healthcare resource consumption and related direct costs of patients hospitalized for PN. The analysis utilized the administrative databases of healthcare units that cover approximately 12 million inhabitants across Italy. Adult patients were included by ICD-9-CM=698.3 (lichen simplex chronicus; neurodermatitis circumscripta; PN) as proxy of PN diagnosis, from 01/2010 to 09/2021, and had 1 year of data availability before (baseline) and after (follow-up) hospitalization (index date). These patients were 1:2 matched by age, sex, and index date (year) to adults without such hospitalization in the baseline period (matched non-PN controls). The analysis comprised 295 PN-hospitalized patients, matched with 590 non-PN individuals (mean age 63.2 years, 43.7% female). At baseline, patients had a greater comorbidity burden than non-PN controls, including higher prevalence of hypertension (56.6% vs. 36.6%, respectively), dyslipidemia (26.4% vs. 18.0%), diabetes (24.4% vs. 12.5%) and mental health conditions (14.9% vs. 7.8%). During 1-year follow-up, PN-hospitalized patients had significantly higher resource consumption than matched controls, in terms of mean number of prescriptions most commonly prescribed in PN patients (5.1 vs. 1.9, P<0.001), other drugs (11.7 vs. 6.5, P<0.001), all-cause hospitalization (1.4 vs. 0.1, P<0.001) and outpatient services (5.4 vs. 2.5, P<0.001). Mean annual all-cause healthcare costs for patients over 1-year follow-up were € 3847 total (€ 875 drugs, € 2652 hospitalization, € 320 outpatient services), higher than those for the matched controls, of € 711 total (P<0.001) (€ 353 drugs, € 228 hospitalization, € 130 outpatient services). Patients hospitalized for PN had a higher comorbidity burden at baseline and greater healthcare resource consumption during 1-year follow-up compared to matched controls, with a 5.4-fold increase in all-cause healthcare costs, indicating substantial clinical burden and remaining unmet need in these patients.

Abstract P167: Sex Dependent Associations of the Gut Microbiota with Hypertension – A Prospective Cohort

Background: Whilst there is emerging evidence that the associations of the gut microbiota (GM) with hypertension differ between sexes, it remains uncertain whether the GM 1) is altered with antihypertensive-use, 2) can predict blood pressure (BP) trajectories, and 3) whether these associations are also sex-dependent. We therefore aimed to determine the sex-dependent associations of the GM with baseline hypertensive state in untreated versus treated participants and BP changes over time. Methods: A total of 451 community-dwelling middle-aged Hong Kong Chinese without symptomatic cardiovascular diseases were recruited (50% men, 14% on antihypertensive agents, mean age, 54.6±6.5 years). Shotgun metagenomic sequencing of stool samples and 24-hour ambulatory blood pressure monitoring (ABPM) were performed. The 24hr-ABPM was repeated on 139 returned subjects after 4 years. Statistical analysis was conducted with 4 covariate models that include age, sex, menopause status, body mass index (BMI), smoking, fasting glucose, triglyceride, cholesterol, sodium intake, and fatty liver status. Results: Amongst the 389/451 subjects not on antihypertensive agents, 167/389 (42.9%) had newly diagnosed hypertension at baseline. Females drove the significantly different b-diversity of the GM composition ( p &lt;0.01) between the normotensives and hypertensives in the baseline study. Multiple GM species were significantly associated with hypertension. In sex stratified analysis, Faecalimonas umbilicate was significantly enriched in hypertensive females while Roseburia sp Am16-25 and Eubacterium ramulus were enriched in hypertensive males (all p &lt;0.05-0.01). When comparing the 62 treated and 167 nontreated hypertensive subjects, the GM abundance, a-, and b-diversity were not significantly different. However, there were significant GM species associated with the use of antihypertensive medication. Notably, Lachnospiraceae bacterium and Flavonifractor plautii were significantly enriched in treated and untreated individuals, respectively (all p &lt;0.05-0.001). During a mean follow up of 51.2±4.5 months, 73.2% of the 71 untreated subjects remained normotensive and were associated with enriched Bacteroides uniformis in their baseline metagenomic data under models adjusted for age, sex, and BMI. Conclusion: The GM displayed sex-dependent associations with hypertension within untreated and treated individuals and can potentially predict BP trajectory changes within a Chinese population.

Abstract 36: Ablation of T-Lymphocyte β-Arrestins Reduces Inflammation and Increases Salt Retention in the Absence of Blood Pressure Changes Following Angiotensin II Infusion

Introduction: T-cells contribute to hypertension (HT) development. Among several G-protein coupled receptors regulating T-cell function, it has been hypothesized that some subpopulations use the angiotensin II (ANG II) type 1 receptor (AT 1 R) to modulate immune responses in HT. Selective ablation of AT 1 Rs in T-cells paradoxically increases hypertensive end-organ damage (EOD). While AT 1 Rs typically induces classical G-protein signaling, recent studies have uncovered a protective signaling cascade via β-arrestin ( ARRB ) proteins. We hypothesize that T-cell ARRB s mediate an anti-hypertensive and anti-inflammatory role in response to ANG II, decreasing EOD in HT. Methods: Breeding CD4-Cre mice with Arrb1 -Flox or Arrb2 -Flox mice generated lines with T-cell-specific deficiency of Arrb1 or Arrb2 genes. Hypertensive conditions modeling kidney damage consisted of unilateral nephrectomy, 4% salt diet, and continuous infusion of 1 mg/kg/min ANG II (UNX/HSD/ANG). Age/sex-matched Cre - littermates were used as controls (WT). Blood pressure (BP) was measured at baseline and for the following three weeks using radiotelemetry. Results: At baseline, there were no significant differences in systolic BP between groups (WT:124.1±8.0 mmHg; CD4 Arrb1-null :125.4±8.1; CD4 Arrb2-null :128.7±3.1; p =0.37; n=12/10/8). Three weeks of UNX/HSD/ANG equally increased systolic BP in all groups (WT:178.0±14.0 mmHg; CD4 Arrb1-null :174.8±26.3; CD4 Arrb2-null :179.9±11.1; p =0.86; n=7/9/7). Despite similar BPs, CD4 Arrb2-null mice demonstrated less renal inflammation than WT after four weeks of UNX/HSD/ANG, with a reduction in interleukin-1α protein (3.8±3.2 vs. 8.3±2.8 p &lt;0.05; n=4/6) and a trend towards decreased tumor necrosis factor-α transcript (0.63-fold change vs. 1.9, p =0.051; n=10/8). Furthermore, CD4 Arrb1-null mice increased 24-hour voluntary water intake compared to WT (15.7±3.4 mL vs. 12.2±1.6; p &lt;0.05; n=12/7), and 24-hour urine output (10.0±3.7 mL/d vs. 6.8±1.5; p &lt;0.05; n=11/8). However, there was no difference in sodium excretion during this period (1.9±0.5 eq/d vs. 1.7±0.1; p =0.14; n=11/7). Interestingly, 4 hours after intraperitoneal saline injection, CD4 Arrb1-null mice excreted significantly less sodium compared to WT (5.6±3.5% vs . 31.4±10.6%; p &lt;0.05; n=4/5). Conclusion: Contrary to our hypothesis, these data suggest that T-cell Arrb s do not protect against the hypertensive response to ANG II, but instead play a complicated role in the modulation of hydromineral balance and inflammation.

Twenty-eight days of repeated dose sub-acute toxicological evaluation of polyherbal Ayurvedic medicine BPGrit in Sprague-Dawley rats.

A pre-clinical toxicological evaluation of herbal medicines is necessary to identify any underlying health-associated side effects, if any. BPGrit is an Ayurveda-based medicine prescribed for treating hypertensive conditions. High-performance liquid chromatography-based analysis revealed the presence of gallic acid, ellagic acid, coumarin, cinnamic acid, guggulsterone E, and guggulsterone Z in BPGrit. For sub-acute toxicity analysis of BPGrit, male and female Sprague-Dawley rats were given repeated oral gavage at 100, 300, and 1000 mg/kg body weight/day dosages for 28 days, followed by a 14-day recovery phase. No incidences of mortality, morbidity, or abnormal clinical signs were observed in BPGrit-treated rats throughout the study period. Also, the body weight and food consumption habits of the experimental animals did not change during the study duration. Hematological, biochemical, and histopathological analysis did not indicate any abnormal changes occurring in the BPGrit-treated rats up to the highest tested dose of 1000 mg/kg body weight/day. Finally, the study established the "no-observed-adverse-effect level" for BPGrit at >1000 mg/kg body weight/day in Sprague-Dawley rats.

Search for metabolomic markers of hypertensive conditions of different genesis: Experimental study

Search for metabolomic markers of hypertensive conditions of different genesis: Experimental study

Identification and Analysis of Differentially Expressed Genes Associated with Ferroptosis an d HIV in PASMCs Based on Bioinformatics.

HIV-associated pulmonary arterial hypertension (HIV-PAH), a rare and fatal condition within the pulmonary arterial hypertension spectrum, is linked to HIV infection. While ferroptosis, an iron-dependent cell death form, is implicated in various lung diseases, its role in HIVPAH development remains unclear. Leveraging Gene Expression Omnibus data, we identified differentially expressed genes (DEGs) in pulmonary arterial smooth muscle cells, including HIV-related DEGs (HIV-DEGs) and ferroptosis-related HIV-DEGs (FR-HIV-DEGs). PPI network analysis of FR-HIV-DEGs using CytoHubba in Cytoscape identified hub genes. We conducted functional and pathway enrichment analyses for FR-HIV-DEGs, HIV-DEGs, and hub genes. Diagnostic value assessment of hub genes utilized ROC curve analysis. Key genes were further screened, and external validation was performed. Additionally, we predicted a potential ceRNA regulatory network for key genes. 1372 DEGs were found, of which 228 were HIV-DEGs, and 20 were FR-HIV-DEGs. TP53, IL6, PTGS2, IL1B (downregulated), and PPARG (upregulated) were the five hub genes that were screened. TP53, IL6, and IL1B act as ferroptosis drivers, PTGS2 as a ferroptosis marker, and PPARG as a ferroptosis inhibitor. Enrichment analysis indicated biological processes enriched in "response to oxidative stress" and pathways enriched in "human cytomegalovirus infection." Key genes IL6 and PTGS2 exhibited strong predictive value via ROC curve analysis and external validation. The predicted ceRNA regulatory network identified miRNAs (has-mir-335-5p, has-mir-124-3p) targeting key genes and lncRNAs (XIST, NEAT1) targeting these miRNAs. This study advances our understanding of potential mechanisms in HIV-PAH pathogenesis, emphasizing the involvement of ferroptosis. The findings offer valuable insights for future research in HIV-PAH.

A Cross-Sectional Study on the Prevalence of Subclinical Hypothyroidism in Metabolic Syndrome Patients at a Tertiary Care Hospital.

Metabolic syndrome (MetS) is defined as a "constellation" of cardiometabolic risk factors, characterized by hypertension, atherogenic dyslipidemia, hyperglycemia, prothrombotic and proinflammatory conditions which, jointly, increase the risk of suffering cardiovascular diseases (CVD) and type 2 diabetes mellitus.Thyroid dysfunction is also believed to affect parameters such as high-density lipoprotein (HDL) cholesterol, triglycerides, plasma glucose, and blood pressure, in turn increasing the risk of CVD. Subclinical hypothyroidism (SCH), which independently raises the risk of CVDs and their associated complications, is more frequently detected in patients with MetS compared to the general population. When both conditions coexist, the risk of CVD and its complications is significantly heightened. The objective of the study was to find out the prevalence of SCH in patients with MetS. A prospective cross-sectional study was conducted in the Department of General Medicine, New Civil Hospital, Surat, Gujarat, India. Eighty patients who fulfilled the criteria for MetS by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), were taken into the study. A detailed history, anthropometric measurements, blood pressure, fasting blood glucose, lipid profile, and thyroid profile (Free T3, Free T4, and serum thyroid-stimulating hormone (TSH)) were undertaken. The thyroid profile was done by chemiluminescence immunoassay (CLIA) method. Out of 80 patients with MetS, 48 were female and 32 were male, with the overall mean age of the study population being 46.5±9.5 years. Among them, 23.7% of the population was found to be having thyroid dysfunction. Among the thyroid dysfunction, SCH was highly prevalent (18.8%), 3.8% patients had overt hypothyroidism and 1.3% patients had subclinical hyperthyroidism. There were no overt hyperthyroid patients in our study.HDL (mg/dl) and TSH (mIU/L) were significantly higher in the SCH group as compared to other types of hypothyroidism group (p-value < 0.05). There is a statistically significant prevalence of SCH (18.8%) in MetS patients. It is clear from the study that one-fifth of MetS patients or every fifth patient with MetS had SCH. Thus, looking proactively for SCH in MetS and treating it would prevent conversion to overt hypothyroidism and complications of MetS.

The Relationship Between Pre-Pandemic Comorbidities With SARS-CoV-2 Infections and Hospitalizations in Black Versus White Military Service Members: A Retrospective Study.

Comorbidities such as hypertension, diabetes mellitus, asthma, and cardiovascular conditions have been reported to worsen the clinical progression of coronavirus disease 2019 (COVID-19) and related hospitalizations. Furthermore, the COVID-19 pandemic has disproportionately affected the historically marginalized groups, i.e., Black, Hispanic, and Asian individuals have substantially higher rates of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection, COVID-19 hospitalization, and death compared to White individuals. Despite these findings in civilian populations, the impact of comorbidities and race in SARS-CoV-2 infection and COVID-19 hospitalizations in military populations is unknown. We evaluated the relationship of pre-selected pre-pandemic comorbidities and race with SARS-CoV-2 infections and COVID-19 hospitalizations in U.S. military service members (SMs). We conducted a systematic review of Military Health System beneficiaries' records by accessing the Defense Medical Epidemiological Database. Our inclusion criteria were being an active duty SM and having at least one pre-COVID-19 pandemic comorbidity. Retired as well as uninfected healthy active duty SMs and beneficiaries were excluded from the study. A total population of 1.334 million active duty SM records was drawn from Defense Medical Epidemiological Database. The data were stratified, by race (primary outcome), as well as gender, age, and military service branches (secondary outcomes). We found higher trends in SARS-CoV-2 infection and COVID-19 hospitalization rates in Black compared to White SMs. This seamless inequality was also seen in other viral infections affecting SMs including human immunodeficiency virus and viral hepatitis. We hypothesized this disparity to some extent be associated with the presence of pre-pandemic comorbidities that is affecting this military subpopulation. Supporting our hypothesis, we found trends toward the higher pre-pandemic prevalence of diabetes mellitus, asthma, hypertension, and ischemic heart disease, in Black compared to White military SMs, especially in Black older male adults. Our results highlight the role of pre-pandemic comorbidities and race likely enhancing the frequency of SARS-CoV-2 infections and COVID-19 hospitalizations in military SMs. These preliminary findings underscore the need for future retrospective studies using additional Military Health System data bases reporting data on this military subpopulation, especially in the setting of future pathogens outbreaks or pandemics affecting military populations.

Kir6.1, a component of an ATP-sensitive potassium channel, regulates natural killer cell development.

Involved in immunity and reproduction, natural killer (NK) cells offer opportunities to develop new immunotherapies to treat infections and cancer or to alleviate pregnancy complications. Most current strategies use cytokines or antibodies to enhance NK-cell function, but none use ion channel modulators, which are widely used in clinical practice to treat hypertension, diabetes, epilepsy, and other conditions. Little is known about ion channels in NK cells. We show that Kcnj8, which codes for the Kir6.1 subunit of a certain type of ATP-sensitive potassium (K ATP ) channel, is highly expressed in murine splenic and uterine NK cells compared to other K + channels previously identified in NK cells. Kcnj8 expression is highest in the most mature subset of splenic NK cells (CD27 - CD11b + ) and in NKG2A + or Ly49C/I + educated uterine NK cells. Using patch clamping, we show that a subset of NK cells expresses a current sensitive to the Kir6.1 blocker PNU-37883A. Kcnj8 does not participate in NK cell degranulation in response to tumor cells in vitro or rejection of tumor cells in vivo . Transcriptomics show that genes previously implicated in NK cell development are amongst those differentially expressed in CD27 - CD11b + NK cells deficient of Kcnj8 . Indeed, we found that mice with NK-cell specific Kcnj8 gene ablation have fewer CD11b + CD27 - and KLRG-1 + NK cells in the bone barrow and spleen. These results show that the K ATP subunit Kir6.1 has a key role in NK-cell development.

Association between acetaminophen administration and outcomes in critically ill patients with gout and hypertension.

Acetaminophen is a commonly used medication, yet its recommendation for patients with comorbid conditions of gout and hypertension is contradictory, and the impact of its usage on clinical outcomes in real-world practical settings remains uncertain. The aim of this study was to investigate the association between acetaminophen administration and clinical outcomes in critically ill patients with gout and hypertension, utilizing real-world data. A retrospective cohort study was conducted based on the MIMIC-IV (Medical Information Mart in Intensive Care-IV) database. Adult critically ill patients with gout and hypertension were included in the analysis. The exposure was acetaminophen use during ICU stay. The primary outcome was in-hospital mortality. The secondary endpoints were frequent hospitalization, 30-day, and 60-day all-cause mortality, and incidence of hypertensive emergencies. Propensity score matching (PSM) was conducted at a 1:1 ratio. Multivariable analyses were used to adjust for confounders. The pre-matched and propensity score-matched cohorts included 2448 and 1012 patients, respectively. In the PSM analysis, in-hospital mortality was 9.7% (49/506) in the acetaminophen use group and 12.1% (61/506) in the no use group. Acetaminophen use was associated with a decrease in-hospital mortality (hazard ratio [HR], 0.62; 95% CI, 0.41-0.92; P = 0.018). In terms of secondary endpoints, after PSM, there was no statistically significant difference for both 30-day and 60-day all-cause mortality reductions in the acetaminophen use group, and HRs were 0.78 (95% CI 0.55-1.11; P = 0.175), and 0.75 (95% CI 0.55-1.02; P = 0.069), respectively. According to the analysis of dosage and treatment group, the use of APAP within the dosage range of 2-4g and within 3-5days of treatment significantly reduced the mortality rate of the entire cohort and PSM cohort, with statistical differences. Subgroup analysis demonstrated that lower in-hospital mortality was consistent across different baselines (age, gender, BMI, liver disease, and renal disease), with no interactions in all subgroups (interaction p-values >0.05), thereby affirming the robustness and reliability of the findings. Acetaminophen use was associated with lower in-hospital mortality in critically ill patients with gout and hypertension. Prospective studies are needed to verify this finding.

Alterations in maternal cardiovascular parameters and their impact on uterine and fetal circulation in hypertensive pregnancies and fetal growth restriction

ObjectiveTo examine potential alterations in maternal cardiovascular parameters in hypertensive pregnancies with or without fetal growth restriction (FGR) in comparison to uncomplicated normotensive pregnancies, and to determine the correlation between maternal cardiovascular parameters and changes in umbilical and uterine artery circulation. Materials and methodsThis study enrolled 73 pregnant women starting from the 20th week of gestation, categorized into three groups: hypertensive conditions (pregnancy-induced hypertension, preeclampsia or eclampsia, n = 30), hypertensive conditions with FGR (n = 8) and a control group of healthy normotensive pregnant women (n = 35). All participants underwent echocardiography to assess cardiac output and calculate peripheral vascular resistance. Additionally, fetal biometric measurements and Doppler ultrasound examinations of the uterine and umbilical artery were performed. The results were standardized into gestational age-adjusted z-scores. ResultsThe mean pulsatility index (PI) of the uterine artery (1.36, p < 0.001) and umbilical artery PI z-scores (1.32, p < 0.001) showed significant increases in the hypertensive conditions + FGR group. Maternal cardiac output z-scores were notably lower in both the hypertensive + FGR group (−2.62, p = 0.001) and the hypertensive group (−2.49, p < 0.001). Peripheral vascular resistance was significantly elevated in the hypertensive + FGR group (7.43, p < 0.001) and the hypertensive group (6.06, p < 0.001). There was a positive correlation between maternal peripheral vascular resistance and uterine artery PI (R2 = 0.172; p = 0.0004), and a negative correlation between cardiac output and uterine artery PI (R2 = 0.067; p = 0.031). However, significant correlation between maternal cardiovascular parameters and umbilical artery PI was not identified. ConclusionsMaternal cardiac output exhibits a significant decrease whereas peripheral vascular resistance increases in hypertensive pregnancies, irrespective of the presence of FGR. Both uterine and umbilical artery PI notably increase when hypertensive pregnancies are accompanied by FGR. A positive correlation exists between maternal peripheral vascular resistance and uterine artery PI, as well as a negative correlation between maternal cardiac output and uterine artery PI. However, changes in maternal cardiovascular parameters do not exhibit significant correlations with umbilical artery PI.

Physiological rationale for an effective method of deprogramming the masticatory muscles for persons engaged in strength training

The study is devoted to the topical issue of physiological justification for the use of various methods for relaxation of masticatory muscles in a state of hypertension in individuals engaged in strength training. Data are presented on a comparative analysis of the effectiveness of the effects of the following deprogramming devices on the masticatory muscles: “Aquasplint”, muscle relaxation mouthguard and transcutaneous electrical neurostimulation, according to electromyography of the masticatory muscles and Dopplerography of the superficial temporal arteries. The predominant physiological effectiveness of using a stabilizing mouthguard and transcutaneous electrical neurostimulation as a method of targeted impact on the tone of the masticatory muscles has been established.

Pro-atherogenic medical conditions are associated with widespread regional brain metabolite abnormalities in those with alcohol use disorder.

Widespread brain metabolite abnormalities in those with alcohol use disorder (AUD) were reported in numerous studies, but the effects of the pro-atherogenic conditions of hypertension, type 2 diabetes mellitus, hepatitis C seropositivity, and hyperlipidemia on metabolite levels were not considered. These conditions were associated with brain metabolite abnormalities in those without AUD. We predicted treatment-seeking individuals with AUD and pro-atherogenic conditions (Atherogenic+) demonstrate lower regional metabolite markers of neuronal viability [N-acetylaspartate (NAA)] and cell membrane turnover/synthesis [choline-containing compounds (Cho)], compared with those with AUD without pro-atherogenic conditions (Atherogenic-) and healthy controls (CON). Atherogenic+ (n = 59) and Atherogenic- (n = 51) and CON (n = 49) completed a 1.5T proton magnetic resonance spectroscopic imaging study. Groups were compared on NAA, Cho, total creatine, and myoinositol in cortical gray matter (GM), white matter (WM), and select subcortical regions. Atherogenic+ had lower frontal GM and temporal WM NAA than CON. Atherogenic+ showed lower parietal GM, frontal, parietal and occipital WM and lenticular nuclei NAA level than Atherogenic- and CON. Atherogenic- showed lower frontal GM and WM NAA than CON. Atherogenic+ had lower Cho level than CON in the frontal GM, parietal WM, and thalamus. Atherogenic+ showed lower frontal WM and cerebellar vermis Cho than Atherogenic- and CON. Findings suggest proatherogenic conditions in those with AUD were associated with increased compromise of neuronal integrity and cell membrane turnover/synthesis. The greater metabolite abnormalities observed in Atherogenic+ may relate to increased oxidative stress-related compromise of neuronal and glial cell structure and/or impaired arterial vasoreactivity/lumen viability.

Relationship of anthropometrics and blood pressure to identify people at risk of hypertension and obesity-related conditions in Nigerian rural areas.

The prevalence of obesity and hypertension is increasing, particularly in the urban areas. However, there is limited research on the relationship between obesity and hypertension in the rural areas of southeastern Nigeria. The present study aimed to investigate the association between anthropometric parameters and adiposity indicators and the risk of hypertension with obesity-related conditions, based on a descriptive study of people living in the southeastern rural areas of Nigeria. The cluster sampling procedure randomly recruited study participants. Finally, 200 participants (100 male and 100 female) aged 18 to 25 years were included in the study. A simplified correlation analysis was used to derive the adjusted indicators in relation to age and sex. This study found that females generally had a higher body mass index (BMI), waist circumference (WC), and Z-score, whereas systolic blood pressure (SBP) was higher in men. A high correlation was found between the body shape index (ABSI) and BMI (r = -.529, P < .001), WC (r = .399, P < .001) and Z-score (r = .982, P < .001) in male participants. In females, there was a high correlation between ABSI and BMI, blood pressure (BP), and Z score in female participants (r = -.481, P < .000; r = -.267, P = .007; r = .941, P < .000). In male participants, BMI was correlated with diastolic blood pressure (DBP; r = .236, P = .018), SBP (r = .282, P = .005), Z score (r = -.539, P < .000), and WC (r = .541, P < .001). This study highlights the importance of considering a range of anthropometric measurements and health parameters when assessing health risks and identifying potential interventions. In addition, the body shape index may be a particularly useful tool for predicting health risks in both men and women. In contrast, correlations between various health parameters can provide insights into the underlying mechanisms and risk factors.

Cost-effectiveness of group medical visits and microfinance interventions versus usual care to manage hypertension in Kenya: a secondary modelling analysis of data from the Bridging Income Generation with Group Integrated Care (BIGPIC) trial

The Bridging Income Generation with Group Integrated Care (BIGPIC) trial in rural Kenya showed that integrating usual care with group medical visits or microfinance interventions reduced systolic blood pressure and cardiovascular risk in participants. We aimed to estimate the incremental cost-effectiveness of three BIGPIC interventions for a modelled cohort and by sex, as well as the cost of implementing these interventions. For this analysis, we used data collected during the BIGPIC trial, a four-group, cluster-randomised trial conducted in the western Kenyan catchment area of the Academic Model Providing Access to Healthcare. BIGPIC enrolled participants from 24 rural health facilities in rural western Kenya aged 35 years or older with either increased blood pressure or diabetes. Participants were assigned to receive either usual care, group medical visits, microfinance, or a combination of group medical visits and microfinance (GMV-MF). Our model estimated the incremental cost-effectiveness of the three BIGPIC interventions via seven health states (ie, a hypertensive state, five chronic cardiovascular-disease states, and a death state) by simulating transitions between health states for a hypothetical cohort of individuals with hypertension on the basis of QRISK3 scores. In every cycle, participants accrued costs and disability-adjusted life-years (DALYs) associated with their health state. Incremental cost-effectiveness ratios (ICERs) were calculated for the entire modelled cohort and by sex by dividing the incremental cost by the incremental effectiveness of the next most expensive intervention. The main outcome of this analysis was ICERs for each intervention evaluated. This analysis is registered at ClinicalTrials.gov (NCT02501746). Between Feb 6, 2017, and Dec 29, 2019, 2890 people were recruited to the BIGPIC trial. 2020 (69·9%) of 2890 participants were female and 870 (30·1%) were male. At baseline, mean QRISK3 score was 11·5 (95% CI 11·1-11·9) for the trial population, 11·9 (11·5-12·2) for male participants, and 11·3 (11·0-11·6) for female participants. For the population of Kenya, group medical visits were estimated to cost US$7 more per individual than usual care and result in 0·005 more DALYs averted (ICER $1455 per DALY averted). Microfinance was estimated to cost $19 more than group medical visits but was only estimated to avert 0·001 more DALYs. Relative to group medical visits, GMV-MF was estimated to cost $29 more and avert 0·009 more DALYs ($3235 per DALY averted). Relative to usual care, GMV-MF was estimated to cost $37 more and avert 0·014 more DALYs ($2601 per DALY averted). In the first year of the intervention, usual care was estimated to be the least expensive intervention to implement ($87 per participant; $10 238 per health-facility catchment area [HFCA]), then group medical visits ($99 per participant; $12 268 per HFCA), then microfinance ($120 per participant; $14 172 per HFCA), with GMV-MF estimated to be the most expensive intervention to implement ($139 per participant; $16 913 per HFCA). Group medical visits and GMV-MF were estimated to be cost-effective strategies to improve blood-pressure control in rural Kenya. However, which intervention to pursue depends on resource availability. Policy makers should consider these factors, in addition to sex differences in programme effectiveness, when selecting optimal implementation strategies. US National Institutes of Health.

Caffeic acid and its derivative caffeic acid phenethyl ester as potential therapeutic compounds for cardiovascular diseases: A systematic review.

Cardiovascular diseases (CVDs) contribute to major public health issues. Some studies have found that caffeic acid (CA) and caffeic acid phenethyl ester (CAPE) may effectively prevent or treat CVDs. However, there is a major need to sum up our current understanding of the possible beneficial or detrimental effects of CA and CAPE on CVDs and related mechanisms. Therefore, this study aimed to summarize the data on this topic. A methodical search was carried out on key databases, including Pubmed, Google Scholar, Scopus, and Web of Science, from the beginning to June 2024. Studies were then assessed for eligibility based on inclusion and exclusion criteria. Treatment with CA and CAPE significantly and positively affected cardiovascular health in various aspects, including atherosclerotic diseases, myocardial infarction, hypertension, cardiac arrhythmias, and hypercoagulation state. Several mechanisms were proposed to mediate these effects, including transcription factors and signaling pathways associated with antioxidant, cytostatic, and anti-inflammatory processes. CA and CAPE were found to have several beneficial effects via multiple mechanisms during the prevention and treatment of various CVDs. However, these promising effects were only reported through in vitro and animal studies, which reinforces the need for further evaluation of these effects via human clinical investigations.

A study on prevalence of intraocular pressure variation in relation to age, gender and systemic comorbid condition of hypertension and diabetes among the patients attending a tertiary care hospital, Bhubaneswar, Odisha

A study on prevalence of intraocular pressure variation in relation to age, gender and systemic comorbid condition of hypertension and diabetes among the patients attending a tertiary care hospital, Bhubaneswar, Odisha

Activation of angiotensin converting enzyme 2 promotes hippocampal neurogenesis via activation of Wnt/β-catenin signaling in hypertension

Hypertension-induced brain renin-angiotensin system (RAS) activation and neuroinflammation are hallmark neuropathological features of neurodegenerative diseases. Previous studies from our lab have shown that inhibition of ACE/Ang II/AT1R axis (by AT1R blockers or ACE inhibitors) reduced neuroinflammation and accompanied neurodegeneration via up-regulating adult hippocampal neurogenesis. Apart from this conventional axis, another axis of RAS also exists i.e., ACE2/Ang (1–7)/MasR axis, reported as an anti-hypertensive and anti-inflammatory. However, the role of this axis has not been explored in hypertension-induced glial activation and hippocampal neurogenesis in rat models of hypertension. Hence, in the present study, we examined the effect of ACE2 activator, Diminazene aceturate (DIZE) at 2 different doses of 10 mg/kg (non-antihypertensive) and 15 mg/kg (antihypertensive dose) in renovascular hypertensive rats to explore whether their effect on glial activation, neuroinflammation, and neurogenesis is either influenced by blood-pressure. The results of our study revealed that hypertension induced significant glial activation (astrocyte and microglial), neuroinflammation, and impaired hippocampal neurogenesis. However, ACE2 activation by DIZE, even at the low dose prevented these hypertension-induced changes in the brain. Mechanistically, ACE2 activation inhibited Ang II levels, TRAF6-NFκB mediated inflammatory signaling, NOX4-mediated ROS generation, and mitochondrial dysfunction by upregulating ACE2/Ang (1–7)/MasR signaling. Moreover, DIZE-induced activation of the ACE2/Ang (1–7)/MasR axis upregulated Wnt/β-catenin signaling, promoting hippocampal neurogenesis during the hypertensive state. Therefore, our study demonstrates that ACE2 activation can effectively prevent glial activation and enhance hippocampal neurogenesis in hypertensive conditions, regardless of its blood pressure-lowering effects.