Hypertensive Men Research Articles

Long-Term Health Outcomes of Korean Adults With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

There is a lack of studies regarding the long-term outcomes of Asian adults with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. We hypothesized that adults with CAH are at higher metabolic risk than their age-, and sex-matched controls. We further investigated the long-term health outcome-related factors in adults with CAH. We compared metabolic risk between adults with CAH (71 men, 93 women) and age-, and sex-matched controls (190 men, 261 women) from the Korean National Health and Nutrition Examination Survey data. The presence of obesity, testicular adrenal rest tumors (TARTs), and menstrual irregularity was assessed. Hormone status and treatment regimens were compared according to the presence of adverse outcomes. The median age was 27.0 y and 28.0 y for men and women, respectively. Adults with CAH had a higher waist circumference (88.0 vs. 82.3 cm in men, and 83.5 vs. 72.3 cm in women), and blood pressure (125.0 vs. 113.0 mmHg in men, and 120.0 vs. 104.0 mmHg in women) than age- and sex-matched controls (P<0.05 for all). The 2.7-fold increased risk for hypertension (men) and 2.0-fold increased risk for obesity (women) was significant in patients with CAH (P<0.05 for both). Obese adults with CAH showed significantly higher adrenal limb thicknesses (men) and 17-hydroxyprogesterone and dehydroepiandrosterone sulfate levels (women) (P<0.05 for both). TARTs occurred in 58.1% of men and did not differ by hormone or treatment regimen. Irregular menstruation was observed in 57.1% of women, with higher dehydroepiandrosterone sulfate levels in those with irregular periods. Adults with CAH had a higher metabolic risk than the general population. Poor disease control may increase their risk of metabolic morbidity and menstrual irregularity.

Impact of diverticular disease on prostate cancer risk among hypertensive men.

Prostate cancer (PCa) is a heterogenous disease with multiple etiological factors playing a role in its development. Recently, chronic and systemic inflammatory conditions such as inflammatory bowel disease were identified as key risk factors influencing its development. The study aimed to evaluate the relationship between diverticular disease (DD) (local and acute inflammation) and PCa. Hypertensive patients with DD and hypertensive controls were identified between 1995 and 2010 from the Statewide Planning and Research Cooperative System database. Cohorts were queried for PCa incidence through 2015. Univariable and multivariable logistic regression analyses were used for determining independent predictors of PCa diagnosis. A total of 51,353 patients with DD and 111,541 controls were identified. In all, 6.26% of DD developed PCa, and 3.71% of controls developed PCa (p < 0.01). DD was a significant risk factor for PCa (OR: 1.27 CI: 1.19-1.34, p < 0.01). On subgroup analysis, the patients diagnosed with DD <50 years old had an OR of 3.39 for PCa (CI: 2.52-4.56, p < 0.01), age 50-59 had an OR of 2.12 (CI: 1.86-2.15, p < 0.01), and age 60-69 had an OR of 1.20 (CI: 1.10-1.31, p < 0.01). Finally, age and race stratification showed that white patients <50 had an OR of 2.56 (CI: 1.75-3.76, p < 0.01), while black patients <50 had an OR of 3.98 (CI: 2.61-6.07, p < 0.01). The trend in differing odds between these populations was the same for age groups 50-59 and 60-69. Our analysis shows that DD is associated with diagnosis of PCa in hypertensive men. Importantly, the earlier the diagnosis of DD, the higher the odds for development of PCa, particularly in black men.

Clinical significance of 24-hour blood pressure monitoring in prediction of hypertension development in patients with gout

Aim.The aim of the study was to develop the model for establishing early diagnosis of hypertension in patients with gout. The model was based on data of 24-hour blood pressure monitoring.Material and Methods.A total of 69 patients with gout were enrolled in a single-stage cross-sectional prospective study. Three study groups were assigned as follows: group 1 (main group) comprised hypertensive men with gout (n = 41); group 2 (comparison group) comprised normotensive men with gout (n = 28); group 3 (control) included relatively healthy men (n = 30). Daily blood pressure monitoring was performed on an outpatient basis using a BPLab device (Peter Telegin, Russia).Results. The significant intergroup differences were found in the following parameters: lowest, mean, and highest 24-hour systolic blood pressure (SBP) values in patients of main and comparison groups (р &lt; 0.001) and in patients of main and control groups (р &lt; 0.001); mean and maximum 24-hour diastolic blood pressure (DBP) values in patients of main and comparison groups (р &lt; 0.001) and in patients of main and control groups (р &lt; 0.001); lowest, mean, and highest 24-hour pulse blood pressure (PBP) values in patients of main and comparison groups (р &lt; 0.001) and in patients of main and control groups (р &lt; 0.001); mean, and maximum 24-hour PBP values in patients of comparison and control groups (р &lt; 0.001). Median values of the lowest, mean, and highest 24-hour SBP in hypertensive patients with gout were significantly higher than the corresponding values in normotensive patients with gout and healthy men of group 3 (p &lt; 0.001). Median values of mean and maximum 24-hour DBP in main group were higher than the corresponding values in comparison group and control group (p &lt; 0.001). Median values of the lowest, mean, and highest 24-hour PBP in hypertensive patients with gout exceeded the corresponding values of patients of control group (p &lt; 0.001). Median values of the mean and maximum 24-hour PBP in main group exceeded the corresponding values of patients of comparison group (p &lt; 0.001). Based on the binary logistic regression model, the prognostic algorithm for hypertension development in gout patients was created using the parameters of 24-hour blood pressure monitoring as predictors and the cut-off K value. If the value of K was &gt; 0.54, then the hypertension development was predicted in gout patients. The sensitivity of developed diagnostic model was 0.84, and the specificity was 0.95.Conclusion.Тhe proposed model, based on the assessment of average-daily values of the lowest, mean, and highest SBP, allowed to establish early diagnosis of hypertension in patients with gout with the accuracy of up to 90%.

Состояние диастолической функции левого желудочка у мужчин с гипертонической болезнью и андрогенным дефицитом

Актуальность. Изучение вопросов полового диморфизма в становлении и прогрессировании сердечно-сосудистых заболеваний остается актуальным. Роли андрогенов как потенциальных медиаторов кардиоваскулярного риска уделяется особое внимание многих исследователей. Цель исследования: изучение особенностей диастолической функции левого желудочка (ЛЖ) у мужчин с гипертонической болезнью в зависимости от уровня общего (ОТ) и свободного тестостерона (СТ). Материалы и методы. В исследование были включены 38 пациентов с установленным диагнозом гипертонической болезни и 16 практически здоровых мужчин, которые вошли в контрольную группу. Всем участникам исследования проведены физикальное обследование, трансторакальная эхокардиография, оценка сывороточной концентрации общего и свободного тестостерона методом иммуноферментного анализа. По результатам обследования 16 мужчин со сниженным уровнем ОТ вошли в группу 1, а 22 пациента с гипертонической болезнью с нормальным уровнем ОТ без выраженных клинических признаков дефицита андрогенов сформировали группу 2. Результаты. Относительно показателей систолической функции ЛЖ статистически значимых различий между пациентами обеих групп выявлено не было. По данным допплерографического обследования, у мужчин с низким уровнем СТ средняя скорость E’ была значительно ниже, а среднее значение E/E’ — выше. Доля пациентов с коэффициентом E/E’ более 15 в группе 1 была выше, чем в группе 2 (19,7 против 4,5 %), существенное повышение E/E’ чаще наблюдалось при уровне СТ менее 7 пг/мл. Статистически значимые корреляции обнаружены между уровнем СТ и Е’септ (R = 0,62; p &lt; 0,001), а также при соотношении Е/Е’ (R = –0,54; p &lt; 0,001). Выводы. Степень нарушения диастолической функции ЛЖ у мужчин с гипертонической болезнью коррелирует с концентрацией СТ и в меньшей степени с уровнем ОТ.

Gym and home-based combined training in men with primary hypertension: are they equally effective on functional fitness profile, body composition components, and biochemical parameters of hypertension?

ABSTRACT Objective This study aimed to compare the effects of 10 weeks of gym versus home-based combined training on the functional fitness, body composition, and biochemical parameters of hypertension in primary hypertensive men. Methods Forty-six patients (age 48 ± 9 years, BMI 30 ± 4 kg/m2) assigned into three groups: a gym-based combined training (GBCTr: n = 16; resistance at 60–80% of 1RM, using pin-loaded resistance equipment, aerobic at 40–60% HRR, and stretching), home-based combined training (HBCTr: n = 15; resistance at 12–15 RPE, using an elastic exercise band, aerobic at 40–60% HRR, and stretching), and control (CTR, n = 15). Results Following GBCTr and HBCTr, the functional aerobic capacity (P = .005 and P = .004, respectively), flexibility (P = .01 and P = .004, respectively), and lower limb muscle strength (P = .01 and P = .02, respectively) was increased significantly compared with the CTR group. The body weight (P = .02), body mass index (P = .008), hip circumference (P = .02), and nitric oxide level in GBCTr and HBCTr group (P = .002 and P = .02, respectively) was decreased significantly compared with the CTR group. No significant changes found in the plasma levels of NADPH oxidase 5, thioredoxin-2, thioredoxin reductase-2, and resting blood pressure after GBCTr and HBCTr compared with the CTR group. Conclusion These results suggest that in hypertensive men, HBCTr equally to GBCTr improved functional fitness and body composition remarkably without necessarily reducing resting blood pressure. Therefore, they can be advisable substitutes for gaining health benefits.

Abstract 53: Results Of The Nashville Barber-pharmacist Hypertension Management Pilot Study

Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated that collaboration between barbers and pharmacists delivering hypertension management could significantly improve blood pressure as well as access to care. It is unknown if this model can be translated to other locations. This single-arm, proof-of-concept pilot study tested the development and implementation of a similar protocol in Nashville, TN (NCT04232124). Methods: Between 2019 and 2021, community stakeholders, clinicians, investigators, and the LABBPS team convened to adapt the study design and protocol. Established barbershops with barbers willing to be trained on study procedures were recruited as study sites. Non-Hispanic Black male clients, aged 35-79 years with systolic blood pressure (SBP) &gt; 140 mmHg on two screening days were eligible for participation. Enrolled participants met with a pharmacist for lifestyle and medication management at least once monthly for a six-month period. Barbers measured blood pressure during haircuts for additional monitoring. Results: Eight barbershops in business for an average of 20 (± 5) years participated in the trial. Barbers from each shop (range: 1-4) were trained. A total of 419 clients completed screening visit 1, 82 were eligible and 52 (12%) completed visit 2. We enrolled 36, with 30 completing the initial clinical visit and 27 had complete data at 6-months. Participants were on average age 50 (± 10) years, had a body mass index 33 (± 6), 44% were currently smoking, 52% with high school or less education, and 56% reported current primary care. Baseline BP 157.7±17.1/ 95.1±13.9 mmHg improved to 125.7±11.9/75.6±9.5, a change of -32.1±21.6/ -19.5±14.1, respectively. At 6-months 85% of the group had a BP&lt;140/90, 74% BP&lt;135/85, and 67% BP&lt;130/80. At baseline 15% of participants reported health as excellent/very good and this increased to 56% at 6-months (p=0.002). Adverse reactions reported were minimal. Conclusion: Implementation of the barber-pharmacist model of hypertension management and care delivery improved BP control among hypertensive Black men in Nashville. Lessons learned regarding adaptation overcoming unforeseen barriers will inform expansion into additional naïve locations for future research.

Sympathetic-transduction in untreated hypertension

Transduction of muscle sympathetic nerve activity (MSNA) into vascular tone varies with age and sex. Older normotensive men have reduced sympathetic transduction so that a given level of MSNA causes less arteriole vasoconstriction. Whether sympathetic transduction is altered in hypertension (HTN) is not known. We investigated whether sympathetic transduction is impaired in untreated hypertensive men compared to normotensive controls. Eight untreated hypertensive men and 10 normotensive men (age 50 ± 15 years vs. 45 ± 12 years (mean ± SD); p = 0.19, body mass index (BMI) 24.7 ± 2.7 kg/m2 vs. 26.0 ± 4.2 kg/m2; p = 0.21) were recruited. MSNA was recorded from the peroneal nerve using microneurography; beat-to-beat blood pressure (BP; Finapres) and heart rate (ECG) were recorded simultaneously at rest for 10 min. Sympathetic-transduction was quantified using a previously described method. The relationship between MSNA burst area and subsequent diastolic BP was measured for each participant with the slope of the regression indicating sympathetic transduction. MSNA was higher in the hypertensive group compared to normotensives (73 ± 17 bursts/100 heartbeats vs. 49 ± 19 bursts/100 heart bursts; p = 0.007). Sympathetic-transduction was lower in the hypertensive versus normotensive group (0.04%/mmHg/s vs. 0.11%/mmHg/s, respectively; R = 0.622; p = 0.006). In summary, hypertensive men had lower sympathetic transduction compared to normotensive individuals suggesting that higher levels of MSNA are needed to cause the same level of vasoconstrictor tone.

Acute Stress-Induced Blood Lipid Reactivity in Hypertensive and Normotensive Men and Prospective Associations with Future Cardiovascular Risk.

Hyperreactivity to stress may be one explanation for the increased risk of cardiovascular disease (CVD) in individuals with essential hypertension. We investigated blood lipid reactivity to the Montreal Imaging Stress Task (MIST), a psychosocial stressor, in hypertensive and normotensive men and tested for prospective associations with biological risk factors. Fifty-six otherwise healthy and medication-free hypertensive and normotensive men underwent the MIST. We repeatedly measured cortisol and blood lipid profiles (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)) immediately before and up to 1 h after stress. Lipid levels were corrected for stress hemoconcentration. Thirty-five participants completed follow-up assessment 2.9 ± 0.12 (SEM) years later. CVD risk was assessed by prospective changes in TC/HDL-C ratio, IL-6, D-dimer, and HbA1c from baseline to follow-up. The MIST induced significant changes in all parameters except TC (p-values ≤ 0.043). Compared with normotensives, hypertensives had higher TC/HDL-C-ratio and TG (p-values ≤ 0.049) stress responses. Blood lipid stress reactivity predicted future cardiovascular risk (p = 0.036) with increases in HbA1c (ß = 0.34, p = 0.046), IL-6 (ß = 0.31, p = 0.075), and D-dimer (ß = 0.33, p = 0.050). Our results suggest that the greater blood lipid reactivity to psychosocial stress in hypertensives, the greater their future biological CVD risk. This points to lipid stress reactivity as a potential mechanism through which stress might increase CVD risk in essential hypertension.

Five years of cardio-ankle vascular index (CAVI) and CAVI0: how close are we to a pressure-independent index of arterial stiffness?

Pulse wave velocity, a common metric of arterial stiffness, is an established predictor for cardiovascular events and mortality. However, its intrinsic pressure-dependency complicates the discrimination of acute and chronic impacts of increased blood pressure on arterial stiffness. Cardio-ankle vascular index (CAVI) represented a significant step towards the development of a pressure-independent arterial stiffness metric. However, some potential limitations of CAVI might render this arterial stiffness metric less pressure-independent than originally thought. For this reason, we later introduced CAVI0. Nevertheless, advantages of one approach over the other are left debated. This review aims to shed light on the pressure (in)dependency of both CAVI and CAVI0. By critically reviewing results from studies reporting both CAVI and CAVI0 and using simple analytical methods, we show that CAVI0 may enhance the pressure-independent assessment of arterial stiffness, especially in the presence of large inter-individual differences in blood pressure.

Effects of acute moderate-intensity exercise at different duration on blood pressure and endothelial function in young male patients with stage 1 hypertension

ABSTRACT Purpose The studies regarding the effects of exercise duration on blood pressure have reported inconsistent and conflicting results. Nitric oxide (NO) is a well-known vasodilator released by endothelial cells, and endothelial microparticles (EMPs) are membranous vesicles released into the circulation from activated or apoptotic endothelial cells, both of whose level can reflect the endothelial function. But few studies have been done to explore the effect of exercise duration on blood pressure and endothelial function, especially, the EMPs response to exercise in young male patients with hypertension. This study aimed to investigate the blood pressure response during moderate-intensity exercise performed in different durations and the acute effects on post-exercise hypotension and endothelial function in hypertensive patients. Methods Eighteen young male hypertensive patients who did not take antihypertensive drugs were recruited in this study. They randomly performed twice exercises on a cycle ergometer at a moderate intensity of 40%–50% of their HR reserve; one was 20 min (E20 session), the other one was 40 min (E40 session); there was 1-week break between the two exercises. Blood pressure was monitored by the YUWELL blood pressure monitor at rest, every 5 min during exercise, and 3 and 6 min post-exercise. The level of NO (nitrate/nitrite reduction) and EMPs (flow cytometry) in plasma were detected before and immediately following exercise. CD31+/CD42b− events were classified as EMPs and events per microliter plasma were calculated. This study was approved by the Beijing Sport University Institutional Review Board (protocol number 2019087 H). Results Mean age of patients was 34.8 ± 3.5 yrs, and BMI was 27.6 ± 2.7 kg/m2. Systolic blood pressure (SBP) in the two sessions increased significantly during exercise. The SBP in the E20 session increased by 37 mmHg (P < .01) at 5 min during exercise and remained stable afterward. In the E40 session, the SBP increased by 35 mmHg (P < .01) at 5 min during exercise and was stable at 5 through 25 min, decreased by 8 mmHg at 25 through 35 min during exercise, and then stabilized (P < .01). There was no obvious change of diastolic blood pressure (DBP) in the two sessions during exercise. In the E20 session, SBP at 6 min following exercise was no different from the rest; in the E40 session, SBP at 6 min following exercise was 14 mmHg lower than at the rest (P < .01). DBP in the E20 session was the same as rest at 3 min following exercise and decreased by 4 mmHg at 6 min following exercise compared with the rest (P < .05), while DBP in the E40 session decreased by 3 mmHg at 3 min following exercise compared with the rest (P < .05). The plasma NO levels of E20 and E40 increased significantly following exercise (P < .01 for both). There was no difference in plasma NO level between the two sessions pre- and post-exercise, but the increased magnitude of NO level in E40 was greater than that in E20 (24.47% vs. 9.24%, P < .01). The plasma EMPs level of E20 and E40 decreased significantly following exercise (P < .01 for both). There was no difference in plasma EMPs level between the two sessions pre- and post-exercise, but the decreased magnitude of EMPs level in E40 was greater than that in E20 (15.66% vs. 8.00%, P < .01). Conclusion There is no exaggerated blood pressure response to 20-min and 40-min acute moderate-intensity exercise in young hypertensive men with no antihypertensive drugs. Both 20-min and 40-min acute moderate exercise can reduce the rest blood pressure, and improve endothelial function by increasing NO and decreasing EMPs in young male patients with hypertension, and the effects of 40-min exercise on lowering SBP and improving endothelial function are better than that of 20-min.

Aldosterone hyperreactivity to acute psychosocial stress induction in men with essential hypertension

Essential hypertension is a pivotal risk factor for the development of cardiovascular disease (CVD). Hypertensives exhibit greater stress-induced responses in various physiological systems considered to contribute to CVD progression. Whether this stress hyperreactivity extends to the adrenal hormone aldosterone has not yet been investigated in essential hypertension. Here, we investigated reactivity of plasma aldosterone to acute psychosocial stress induction in hypertensive and normotensive men. 21 hypertensive men and 25 normotensive controls underwent the standardized Trier-Social-Stress-Test (TSST). We repeatedly assessed plasma aldosterone before and up to 1 h after TSST cessation. Acute psychosocial stress induced significantly greater increases in hypertensives as compared to normotensives (F(3.60, 158.50) = 3.75; p = .008, f = 0.29). Our findings suggest stress-induced hyperreactivity of aldosterone in essential hypertension. Potential implications for stress-related cardiovascular risk remain to be elucidated.

Prevalence of hypertension among young men: fifteen-year trends

Objective. The aim of the study was to assess the changes in the prevalence of hypertension (HTN) among young men according to two screenings of independent samples of an open urban population.Design and methods. The study is based on two cross-sectional studies, over a fifteen year range, among males in the Central Administrative District of Tyumen. Representative samples were formed according to a single protocol from electoral lists among men 25–64 years old by the method of “random numbers” — 1000 people each (250 people each in four decades of life), the response was 79,5 % and 85,0 %, respectively, in the first and second screening. As part of cardiac screenings, the prevalence of HTN, mean values and percentile distribution for systolic and diastolic blood pressure (SBP, DBP) were determined in two groups of young age 25–34 and 35–44 years.Results. Young men of an open population of a moderately urbanized city of Western Siberia have high blood pressure (BP) levels with a significant increase in average levels and percentile distribution of SBP and DBP in the age range from the third to the fourth decade of life. According to the results of two cross-sectional studies in the range of fifteen years, we found a tendency towards a decrease in SBP and the prevalence of HTN in men in the third decade of life in an open population of a moderately urbanized city of Western Siberia. At the same time, the levels of SBP, DBP and the prevalence of HTN in the fourth decade of life remain stable.Conclusions. We found high levels of BP and the prevalence of HTN among young men in a medium-urbanized city of Western Siberia and a positive fifteen-year dynamics in reduced prevalence of HTN in young people. The latter is a favorable factor and opens up opportunities for targeted impact on other conventional and non-conventional cardiovascular risk factors in this age group.

Association between cardiorespiratory fitness and health care costs in hypertensive men

Background and aimsHypertension increases healthcare costs, but the impact of cardiorespiratory fitness (CRF) on these costs is unknown. This study explored the association between healthcare costs and CRF among hypertensive and normotensive men. MethodsWe studied 9794 male subjects aged 58.5 ± 11.3 years from the Palo Alto Veterans Affairs Medical Center, including 6413 with and 3381 without hypertension. CRF was classified into four age-stratified categories according to metabolic equivalents (METs) derived from exercise testing: low fit (4.6 ± 1.2 METs; n = 2481), moderate fit (6.6 ± 1.2 METs; n = 2412), fit (8.0 ± 1.3 METs; n = 2505), and high fit (10.8 ± 2.1 METs; n = 2396). Annual costs per subject were quantified over eight years. ResultsTotal annual healthcare costs were higher in subjects with hypertension ($34,794, 95% CI, 32,828 to 36,761) in comparison to non-hypertensive subjects ($30,221, 95% CI, 26,104 to 32,450) (p < 0.01). In hypertensive subjects, a graded reduction in annual healthcare costs was observed as CRF was higher; costs were $40,346 for low fit, $35,939 for moderate fit, $32,312 for fit, and $29,277 for high fit subjects (p < 0.001). For each 1-MET increase in CRF, annual costs per subject (USD) were $1752 (95% CI, −2476 to −1,027, p < 0.001) lower among those with hypertension and $1025 (95% CI, −2047 to −2, p < 0.05) lower in those without hypertension. ConclusionsHigher CRF is associated with lower healthcare costs in men with and without hypertension. The impact of CRF on healthcare costs is more striking in those with hypertension.

Altered Cardiovascular Reactivity to and Recovery from Cold Face Test-Induced Parasympathetic Stimulation in Essential Hypertension.

Essential hypertension is associated with increased sympathetic and diminished parasympathetic activity as well as impaired reactivity to sympathetic stimulation. However, reactivity and recovery from parasympathetic stimulation in hypertension are unknown. We investigated reactivity and recovery to primarily parasympathetic stimulation by Cold Face Test (CFT) in essential hypertension. Moreover, we tested whether chronic stress modulates CFT-reactivity dependent on hypertension status. The CFT was conducted by applying a cold face-mask for 2 min in 24 unmedicated, otherwise healthy hypertensive men and in 24 normotensive controls. Systolic and diastolic blood pressure (BP) and heart rate (HR) were measured repeatedly. Chronic stress was assessed with the Trier-Inventory-for-Chronic-Stress-Screening-Scale. Hypertensives did not exhibit diastolic BP decreases after CFT-cessation (p = 0.59) as did normotensives (p = 0.002) and failed to show HR decreases in immediate response to CFT (p = 0.62) when compared to normotensives (p < 0.001). Systolic BP reactivity and recovery patterns did not differ between hypertensives and normotensives (p = 0.44). Chronic stress moderated HR (p = 0.045) but not BP CFT-reactivity (p′s > 0.64) with chronically stressed normotensives showing similar HR reactivity as hypertensives. Our findings indicate impaired diastolic BP and HR reactivity to and recovery from CFT in hypertensives and a moderating effect of chronic stress on HR reactivity potentially reflecting reduced relaxation ability of the cardiovascular system.

The Impact of Telmisartan on Cardiometabolic Risk Factors in Hypertensive Male Siblings of Women With Polycystic Ovary Syndrome.

Brothers of women with polycystic ovary syndrome (PCOS) were found to be at increased risk for cardiometabolic disorders. This risk may be exacerbated by concurrent poorly controlled hypertension. Angiotensin II receptor blockers are the most frequently used antihypertensive drugs. The aim of the present study was to compare blood pressure-lowering and pleiotropic effects of telmisartan between male siblings of PCOS probands and unrelated men. The study included 2 age-, blood pressure-, and mass index-matched groups of men with grade 1 hypertension: 24 brothers of women with PCOS (group A) and 26 brothers of healthy women (group B). All subjects were treated with telmisartan (80 mg daily). Blood pressure, glucose homeostasis markers, and plasma lipids, as well as plasma levels of total testosterone, bioavailable testosterone, androstenedione, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen, and 25-hydroxyvitamin D were measured before and after 12 weeks of therapy. At entry, there were between-group differences in the degree of insulin resistance, plasma levels of high-density lipoprotein-cholesterol, triglycerides, calculated bioavailable testosterone, androstenedione, hsCRP, and 25-hydroxyvitamin D. Although telmisartan reduced blood pressure in both study groups, this effect was stronger in group B. Irrespective of the study group, the drug improved insulin sensitivity and reduced circulating levels of uric acid and homocysteine, but these effects were more pronounced in group B than group A. Only in group B, telmisartan decreased hsCRP and fibrinogen, as well as increased 25-hydroxyvitamin D. The obtained results suggest that hypertensive male relatives of PCOS probands may gain less benefit from telmisartan treatment than unrelated hypertensive men.

Do Socioeconomic and Risk Factors Play Different Roles Among Men and Women in Case of Diabetes in India? A Cross-Sectional Analysis

Background: Many studies have supported the fact that the burden of diabetes is shared differently by different genders due to different factors associated with it. This study aims at capturing whether women and men with a similar background, dietary & smoking habits, and biological conditions (blood pressure and body mass index (BMI)) are being affected equally or differently by diabetes. Data & methods: We have used cross-sectional data of NFHS-4 by covering the age group 15-49 years. Association between socioeconomic background, dietary habits, biological conditions, and diabetes has been estimated by using two separate multivariate logistic regression models. Result: Results show that the overall prevalence of diabetes is higher among men (2.63%) than women (2.35%). Whereas, women belonging to urban areas (3.53%), Christian category (3.92%), richer section (3.22%), women with no schooling (2.51%), those reported to never consume pulses (2.66%) and green vegetables (2.40%) and daily consuming eggs (3.66%) and chicken or meat (3.54%) are more affected by diabetes than their men counterparts. Whereas men residing in rural areas (2.30%), belonging to the General category (3.12%), SCs (2.37%) and STs (1.72%) are more affected than their women counterparts. Results have also shown a higher prevalence of diabetes among obese men (11.46%), non-vegetarian (2.71%) and who watch television almost every day (3.03%) as compared to their women counterparts. Regression analyses show that richest, hypertensive, and obese women and men are significantly more likely to suffer from diabetes. Conclusion: We can conclude from our findings that women and men with similar socioeconomic status and dietary pattern are being affected differently by diabetes. Thus, there is a need of gender dimension in research to understand and validate the differences to have the needed interventions for diabetes control in India.

Tissue Factor and Tissue Factor Pathway Inhibitor in Men and Women Affected with Hypertension

Hypertension is one of the most common chronic diseases characterized with continuous elevation of bloodpressure. The present study involved tested 45 hypertensive men and 45 hypertensive women. Sixty (60)apparently healthy subjects (30 men and 30 women) were also included to serve as a control group. All menand women were subdivided into three groups according to their ages (41-50, 51-60, 61-70 years old).Results yield from present study indicated a significant decrease (p&lt;0.05) in the levels of testosterone andestradiol in first age group of hypertensive men and women respectively and there were nonsignificantdifferences (p&gt;0.05) in second and third age groups of patients compared to healthy groups.A significant progressive increase (p&lt;0.05) in the levels of tissue factor (TF) in all groups of hypertensivemen and women compared to healthy groups. In contrast, values of tissue factor pathway inhibitor (TFPI)confirmed a significant lowering (p&lt;0.05) in all age groups of hypertensive men and women when comparedwith those healthy subjects. In conclusion, data obtained from this study can be attributed to damage ofvascular system resulted from continuous increase blood pressure, drop of sexual hormones, and aging

An Investigation of the Effect of Age, Severity of Hypertension and Duration of Hypertension for Erectile Dysfunction

Introduction: Hypertension (HTN) is one of the most common diseases of the cardiovascular system. It is an increasingly important medical and public health problem. Hypertension is regarded as an indicator for erectile dysfunction. That is why problems with erectile function are an important concern in the treatment of hypertension. Objective: To investigate the frequency and severity of erectile dysfunction among hypertensive and normotensive married men attending a tertiary care hospital of Bangladesh. Material &amp; Methods: It was a cross sectional comparative study. The study was done at Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh in the department of Medicine from July 2019 to January 2021. A total of 150 patients were selected as a study population. Purposive sampling was applied to collect the sample as per inclusion and exclusion criteria. The participants who were excluded from the study declined to give their consent, didn’t complete the questionnaire and there was difficulties in fulfilling the inclusion and exclusion criteria. After collecting the data, it was checked and rechecked for omission, inconsistencies and improbabilities. Data analysis was performed by Statistical Package for Social Science (SPSS), version-22. Results: Analysis was done with the data of 150 cases. Out of the total 150 cases 75 were hypertensive and 75 were normotensive. The respondents were further sub grouped into an age matched manner. The predominant respondent age group was 40 to 49 years which included 42 in normotensive group and 42 in hypertensive group. The age range of the normotensive was 33-55 years in the study population and the mean age of them was (42.65 ± 5.53) years. On spot measurement of blood pressure 26 patients were found in an uncontrolled state of BP. Fifteen (15) subjects was in grade I and 11 subjects were in grade II. Among them 53.3% of grade 1 had ED and 90.9% with grade II suffered from ED. None was found in the range of grade III or ....

The onset of paroxysmal non-valvular atrial fibrillation in men with hypertension is associated with an increase in blood levels of transforming growth factor beta 1

Abstract Funding Acknowledgements Type of funding sources: None. Background. Patients with essential hypertension (H), primarily men, are characterized by early formation of left ventricular hypertrophy (LVH) followed by left atrial (LA) enlargement, which significantly increases the risk of development non-valvular atrial fibrillation (nAF). The most important pathogenic factor in the development of nAF is fibrosis of the LA myocardium. One of the key profibrogenic factors is transforming growth factor beta 1(TGF-beta1). Purpose. To evaluate the blood levels of TGF-beta1 in hypertensive men with paroxysmal nAF and without AF. Methods.The study included 57 men with H grade 2–3 and with LVH (age 48 ± 4 years), of those 26 with paroxysmal nAF and 31 without AF. Controls were 26 practically healthy men. All patients with paroxysmal nAF had an at least one episode of paroxysmal AF attack with spontaneous return to normal sinus rhythm and were in sinus rhythm at the time of the assessment. Patients with valvular heart disease, heart failure, ischemic heart disease, cardiomyopathy, cardiac surgery, thyroid disease, diabetes mellitus, obesity, anemia, infectious or pulmonary diseases were not included. The examination of patients include standard methods as well as echocardiography. Levels of TGF-beta1 in blood serum were measured by immune enzyme assay. All patients included in the study received standard antihypertensive therapy. Results. It was found that the blood levels of TGF-beta1 in whole group of men with H were significantly higher (13,2 [5,3;22,5] ng/mL, р=0,034 ) than in practically healthy men (7,3 [2,3;16,5] ng/mL ). The highest blood levels of TGF-beta1 were found in hypertensive men with paroxysmal nAF (18,4 [9,2;31,8] ng/mL ) and significantly exceeded (р=0,018) those in hypertensive men without AF ( 11,6 [ 4,5;19,7] ng/mL ). The following positive correlations were found in whole group of men with H between TGF-beta1 blood levels and a number of echocardiographic parameters: LA size (LA volume/height2 ) (r = 0,510, р=0,012), LV mass index ( LV mass/BSA (g/m2) ( r = 0,411, р=0,027) and E/e′ (averaged) ratio (r = 0,357, р=0,036). Conclusion. The data obtained indicate that TGF-beta1 can play an important role, both in the pathogenesis of pathological remodeling of the LV and LA in men with H, and in the development of AF in these patients.

Urinary sodium/potassium ratio as a screening tool for hyperaldosteronism in men with hypertension

Among individuals with hypertension, the prevalence of secondary hypertension has been reported to be ≈10%. More than half of individuals with secondary hypertension have associated hyperaldosteronism. However, given the current clinical environment, these patients often remain undiagnosed. We hypothesized that the urinary sodium/potassium ratio (Na/K) could be used as a simple, low-cost method of screening for hyperaldosteronism among individuals with hypertension in primary care and health examination settings. We recruited hypertensive individuals aged 30–69 years old who were not taking any antihypertensive medications from among participants in health examinations. Urinary Na and K were measured using second morning urine samples, and the plasma aldosterone concentration (PAC) was also measured. We evaluated the association of the second morning urine Na/K ratio (SMU Na/K) with a high PAC, defined as ≥90th percentile (24.3 ng/dL), using receiver operating characteristic (ROC) curves. Overall, 160 participants (108 men and 52 women) with a mean age of 54.3 years were eligible for this study. The area under the ROC curve for the relationship between SMU Na/K and high PAC was 0.77 (95% confidence interval [CI]: 0.59–0.95) in men and 0.64 (95% CI: 0.36–0.93) in women. In men, SMU Na/K values <1.0 could detect hyperaldosteronism with a sensitivity of 45.5%, a specificity of 97.9%, a positive predictive value of 71.4%, and a negative predictive value of 94.1%. The use of the urinary Na/K ratio may be appropriate as a method of screening for hyperaldosteronism in hypertensive men.