Obesity Hypertension Research Articles

Leptin receptor downregulation in the carotid body treats obesity-induced hypertension.

Obesity and co-morbid sleep disordered breathing lead to high cardiovascular morbidity and mortality via multiple mechanisms including hypertension. Obesity also leads to high levels of leptin, which is produced in adipocytes. Increased leptin levels have also been implicated in increased sympathetic activity and the pathogenesis of hypertension in obesity. However, mechanisms for the effects of leptin on blood pressure are unclear. The carotid bodies (CB) express leptin receptor (Leprb), and diet-induced obesity (DIO) increases Leprb expression levels, but the mechanisms and consequences of leptin action in CB are poorly understood. We hypothesize that leptin signaling in CB in obesity leads to hypertension, which can be treated by Leprb knockdown specifically in CB. DIO male and female mice and lean male C57BL/6J mice were implanted with telemetry in the left femoral artery for continuous blood pressure monitoring. The adenoviral vectors carrying anti-sense RNA, Ad-LepR shRNA or Ad-scrambled control shRNA, were administered locally to the CB region. Blood pressure measurements were performed at baseline and 9-11 days after CB infection with the adenoviral vector. DIO male mice showed increased blood pressure compared to lean males and DIO females. Ad-LepR shRNA induced a 2-fold decrease in Leprb mRNA level in CB and abolished obesity-induced hypertension. Leprb knockdown was particularly effective during the light phase, when animals were predominantly asleep, decreasing mean arterial pressure by 8.5 mmHg. Control shRNA had no effect on DIO-induced hypertension. We conclude that inhibition of Leprb in the carotid bodies abolished obesity-induced hypertension.

HeartFailure in Atrial Fibrillation Subtypes in Women and Men in theTromsø Study.

Atrial fibrillation (AF) and heart failure (HF) often coexist and impact morbidity and mortality. There is limited knowledge on the association of AF subtypes with HF according to sex. The purpose of this study was to explore sex-specific associations between AF subtypes and subsequent HF, identifying HF risk factors in participants with AF, and exploring the combined impact on mortality. 14,790 women and 13,181 men from the Tromsø Study were enrolled between 1994 and 2008 and followed for incident AF and HF through 2016. Cox regression was conducted to provide HRs and 95%CIs. Those with AF had higher risk of subsequent HF in both sexes compared to those without AF. Women with permanent AF had higher relative risk of HF than men (HR: 10.52; 95%CI: 8.72-12.70, and HR: 7.65; 95%CI: 6.40-9.15, respectively). Risk factors for HF in participants with AF included smoking in all, higher diastolic blood pressure and hypertension in women, underweight, obesity, and low alcohol consumption in men. All-cause mortality was higher in women with both subtypes (paroxysmal/persistent: HR: 2.10; 95%CI: 1.78-2.48, permanent: HR: 1.40, 95%CI: 1.14-1.72) and in men with paroxysmal/persistent AF (HR: 1.66; 95%CI: 1.40-1.96). Subsequent HF increased risk of mortality in both sexes. All AF subtypes were associated with increased risk of HF. Smoking was a shared risk factor, while diastolic blood pressure and hypertension were specific to women, and underweight, obesity, and low alcoholintake were specific to men. Subsequent HF increased mortality risk in all.

Osteoarthritis associated with metabolic syndrome: epidemiology, pathogenesis, treatment

Metabolic syndrome (MS) is a complex of metabolic disorders, including insulin resistance, abdominal obesity, diabetes mellitus, hyperuricemia and arterial hypertension. According to the World Health Organization, the number of people with obesity worldwide is steadily increasing, taking on the characteristics of a “pandemic”. Against this backdrop, diseases pathogenetically linked to MS, such as osteoarthritis (OA), are gaining particular significance. Modern biochemical and molecular-genetic research has provided new data on the etiology and pathogenesis of OA, allowing the identification of phenotypes of the condition. One such phenotype is OA associated with MS, or metabolic OA. The development of this form of the disease is influenced by numerous factors, including hypersecretion of pro-inflammatory adipokines, transformation of synovial macrophages, direct effects of free fatty acids, biomechanical overload of joints, and others. Treatment of metabolic OA, in addition to standard approaches outlined in numerous clinical guidelines, has its own specific features. Particular emphasis is placed on weight reduction through lifestyle modification, strengthening of musculo-tendinous complexes, and concomitant therapy for metabolic disorders. These measures have demonstrated significant therapeutic effects, including pain reduction, decreased inflammation, and slowing of disease progression. One of the modern comprehensive remedies with phytonutritional components is Revocca capsules (“BIOTECHNOS”, Russia). Their composition in daily dosage includes phytosterols (calculated as β-sitosterol) at 100 mg, unsaponifiable compounds from avocado and soybean oils (in a 1:2 ratio) at 300 mg, rosehip extract at 300 mg, resveratrol at 70 mg, and zinc (as zinc citrate) at 12 mg. Given the increasing number of patients with the metabolic phenotype of OA, comprehensive hypolipidemic and anti-inflammatory therapy provided by multi-component drugs is becoming increasingly significant.

Association of the triglyceride glucose index with obesity indicators and hypertension in American adults based on NHANES 2013 to 2018

This cross-sectional study aimed to investigate the association between the TyG index and both obesity indicators and hypertension among American adults. Data were drawn from 4,813 adults in the 2013–2018 National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models indicated significant associations between TyG and obesity-related indices with hypertension. Using Cox regression analysis, we examined the relationship between TyG and obesity-related indices in relation to hypertensive prognosis, employing threshold effect analysis and fitted smoothed curves for consistency. Subgroup analyses and interaction tests were conducted. Results showed strong correlations between TyG, TyG-BMI, TyG-WHtR, TyG-WC and hypertension, with odds ratios (ORs) of hypertension rising across TyG quartiles (Q1–Q4). Cardiovascular mortality analysis revealed that TyG (HR = 1.89, 95% CI (1.03,3.51), P < 0.05) and the Q2 group (HR = 4.93, 95% CI (1.29,18.80), P < 0.05) were significantly associated with increased risk. A positive correlation between TyG and hypertension was noted below a threshold of 8.1, with inverse associations beyond this point. The TyG-BMI, TyG-WHtR, and TyG-WC exhibited positive correlations with hypertension, although weakened after reaching a certain threshold. These findings suggested that TyG and related indices are associated with hypertension and may aid in understanding risk stratification in this context.

A CLINICAL COMPARATIVE STUDY OF RENAL PARAMETERS OF OBESE AND HYPERTENSIVE PATIENTS WITH NON-OBESE HYPERTENSIVE PATIENTS

Objective: Obesity is associated with an early onset of glomerulomegaly, hemodynamic changes of a hyper-filtering kidney, and increased albuminuria. It is an important risk factor for incident CKD and increase risk of ESRD. The aim of the present study is to compare the influence of renal parameters among the obese and non-obese hypertensive patients attended to a tertiary care hospital. Methods: The study was conducted on 120 patients who were divided into 4 groups Group ‘O’ comprises of obese individuals; Group ‘OH’, which comprises of 30 obese and hypertensive individuals; Group ‘NO, H’ which comprises of non-obese and hypertensive individuals and Group ‘C’ which comprises of 30 healthy control group having normal BMI. Results: The mean±SD of serum creatinine was 0.88±0.06; 1.13±0.1; 0.7±0.08; 0.7±0.06 of all the 4 groups and the Serum urea mean±SD was 26.4±3.8; 36.6±5.42; 21.2±3.2; 20.4±3.2 and the Serum uric acid mean±SD levels were 4.3±0.64; 4.3±0.56; 3.8±0.3; 3.7±0.26 of all the 4 groups and eGFR values were 139.5±1.8; 95.3±23.20; 116.2±7.4;118.6±6.2 in obese, obese hypertensive, non-obese hypertensive and control subjects respectively. The results showed that there was a significant influence of renal parameters among the four tested groups. Conclusion: The strategies to prevent weight gain and to induce weight loss in patients who are already obese would ultimately reduce the incidence of obesity-mediated renal disease.

Evaluation of some microRNAs dysregulation in obesity and obesity-related hypertension

Background MicroRNAs (miRNAs) are implicated in regulating obesity, but clinical trials have yielded conflicting results. Objective This study aimed to investigate the relationships between circulating levels of miRNA-221 and miRNA-222 in obesity and hypertension-related obesity in humans. This may shed light on the pathogenic pathways controlling obesity and provide noninvasive molecular indicators to identify and predict the disease. The relationships between circulating levels of the above miRNAs and variables related to adiposity and lipid profiles were further investigated. Patients and methods Using a quantitative real-time P technique, the expression levels of circulating miRNAs were determined in serum samples from 65 obese patients (35 without and 30 with hypertension) and 45 age-matched and sex-matched normal-weight individuals. Results and conclusion MiRNAs (221 and 222) have been shown to be differentially expressed in the sera of obese patients compared to controls. In addition, obese hypertensive patients were shown to have higher serum levels of miRNA-222 and miRNA-221 than healthy controls. Serum miRNA-221 was correlated with BMI, cholesterol, triglycerides, and low-density lipoprotein cholesterol. Thus, circulating levels of miRNA-221 and miRNA-222 inease in obesity and obesity-associated hypertension. These miRNAs may serve as markers for obesity and obesity-induced hypertension.

Working conditions and health status in workers in oil refining production

Introduction. Identification and minimization of production risk factors and occupational and work-related diseases associated with their impact is the basis for preventing health disorders in the working population. Materials and methods. An analytical study of working conditions and health status (a cross-sectional continuous study based on periodic medical examination data) in workers in the oil refining industry with a fuel profile was conducted using hygienic and epidemiological analysis methods. Results. Workers in key occupations have been shown to be exposed to the complex effects of chemicals of hazard classes 2–4, noise, heating microclimate, physical and emotional overloads that form harmful working conditions (classes 3.1–3.3), causing occupational health risks of moderate and high categories depending on their occupation affiliation. The leading rank places in the structure of general morbidity were occupied by diseases of the musculoskeletal system and connective tissue (31.29%), eyes and their adnexa (25.07%), endocrine system, eating disorders and metabolic disorders (23.01%), and circulatory system (12.12%). The leading nosological diseases were dorsalgia of various locations (31.13%), refraction and accommodation disorders (23.31%), obesity (21.17%), and arterial hypertension (10.89%). Statistically significant cause-and-effect relationships of health disorders with working conditions were established: from medium to very high for diseases of the musculoskeletal system, connective tissue, and diseases of the eye and its adnexa; medium for diseases of the endocrine system, eating disorders and metabolic disorders, indicating the industrial causality of these pathologies. The levels of group occupational risk to workers’ health from exposure to working conditions ranged from medium (1.48 ∙ 10–2) to high (6.91 ∙ 10–2), being unacceptable and requiring the development and implementation of measures to eliminate them. Limitations. The limitations of the study are determined by the boundaries of the study of working conditions and health status of workers of one oil refinery. Conclusion. The research results form the basis for developing targeted preventive measures taking into account the occupational affiliation iw workers.

Associations between phenotypes of childhood and adolescent obesity and incident hypertension in young adulthood.

We investigated whether empirically derived childhood obesity phenotypes were differentially associated with risk of hypertension in young adulthood, and whether these associations differed by sex. Data came from 11,404 participants in the Growing Up Today Study, a prospective cohort study in the US established in 1996. We used a childhood obesity phenotype variable that was previously empirically derived using latent class analysis. The childhood obesity phenotypes included an early puberty phenotype (females only), a mothers with obesity phenotype, a high weight concerns phenotype, and a mixed phenotype. Participants without overweight or obesity in childhood or adolescence were the reference group. We then used logistic regression models with generalized estimating equations to examine associations of childhood obesity phenotypes with incident hypertension between ages 20-35 years. All analyses were stratified by sex. Among females, participants in all of the empirically derived childhood obesity phenotypes were more likely than their peers without childhood overweight/obesity to develop hypertension in young adulthood (early puberty subtype odds ratio (OR) = 2.52; 95% confidence interval (CI) = 1.75, 3.62; mothers with obesity (MO) subtype OR = 2.98; 95% CI = 1.93, 4.59; high weight concerns (WC) subtype OR = 2.33; 95% CI = 1.65, 3.28; mixed subtype OR = 1.66; 95% CI = 1.25, 2.20). Among males, the childhood obesity phenotypes were associated with a higher risk of developing hypertension, although males in the MO (OR = 2.65; 95% CI = 1.82, 3.87) and WC phenotypes (OR = 3.52; 95% CI = 2.38, 5.20) had a greater risk of developing hypertension than the mixed subtype (OR = 1.51; 95% CI = 1.23, 1.86) (p = 0.004). Risk for incident hypertension in young adulthood varied by childhood obesity phenotypes, as well as by biological sex. If replicated, these results may suggest that increased surveillance of specific childhood obesity phenotypes might help in targeting those at highest risk for hypertension.

Angiotensin-(1-7) and Central Control of Cardiometabolic Outcomes: Implications for Obesity Hypertension.

Hypertension is a leading independent risk factor for the development of cardiovascular disease, the leading cause of death globally. Importantly, the prevalence of hypertension is positively correlated with obesity, with obesity-related hypertension being difficult to treat due to a lack of current guidelines in this population as well as limited efficacy and adverse off-target effects of currently available antihypertensive therapeutics. This highlights the need to better understand the mechanisms linking hypertension with obesity to develop optimal therapeutic approaches. In this regard, the renin-angiotensin system, which is dysregulated in both hypertension and obesity, is a prime therapeutic target. While research and therapies have typically focused on the deleterious angiotensin II axis of the renin-angiotensin system, emerging evidence shows that targeting the protective angiotensin-(1-7) axis also improves cardiovascular and metabolic functions in animal models of obesity hypertension. While the precise mechanisms involved remain under investigation, in addition to peripheral actions, evidence exists to support a role for the central nervous system in the beneficial cardiometabolic effects of angiotensin-(1-7). This review will highlight emerging translational studies exploring the cardiovascular and metabolic regulatory actions of angiotensin-(1-7), with an emphasis on its central actions in brain regions including the brainstem and hypothalamus. An improved understanding of the central mechanisms engaged by angiotensin-(1-7) to regulate cardiovascular and metabolic functions may provide insight into the potential of targeting this hormone as a novel therapeutic approach for obesity-related hypertension.

DEVELOPMENT OF OCCLUSIVE ARTERIAL DISEASSE OF LOWER EXTREMITIES IN PATIENTS WITH DIABETES MELITUS TYPE 2 IN CORRELATION WITH HBA1C LEVEL AND INDPENDENT RISK FACTOR

In clinical practice, the development of peripheral artery complications in the lower extremities is a significant issue among patients with type 2 diabetes. The progression of stenotic-occlusive disease can be predicted based on the SCORE risk factor assessment and HbA1c levels. Color Doppler findings are crucial for evaluating hemodynamic flow in the arteries of the lower extremities. Aim: To determine HbA1c levels in patients with stenotic-occlusive disease of the lower extremities, correlate risk factor scores and HbA1c levels in the progression of stenotic-occlusive disease, and assess the significance of elevated HbA1c levels in relation to the clinical grade of stenotic-occlusive disease. Patient and methods: The study included 113 patients with type 2 diabetes (52.1%) and 104 non-diabetic patients (47.9%) as the control group, making a total of 217 participants. Both groups were classified as high-risk due to the presence of independent risk factors such as hyperlipidemia, smoking, obesity, and arterial hypertension. When the cumulative SCORE risk factor for the total group of participants (n=217) was analyzed, the results indicated a high level of risk with statistical significance, p&lt;0.0001. Results: Patients with predominantly occlusive changes in the type 2 diabetes group had HbA1c values of 8.25%, which was significantly higher compared to those with stenotic changes, whose HbA1c values were 7.3% (p=0.002). According to the SCORE tables, a value &gt;5% indicates high risk for developing cardiovascular disease, while a SCORE value of 7% was identified as a predictor for disease progression in patients with type 2 diabetes, with high significance (p=0.0001). In the non-diabetic group, lower values of peak systolic velocity (PSV) in the superficial femoral artery (p=0.051) were observed. In the type 2 diabetes group, PSV values in the profunda femoral artery were lower (p=0.053), while significantly lower PSV values were recorded in the anterior tibial artery (p=0.008). Occlusive disease of the lower extremity arteries was present in 89.6% of cases in the type 2 diabetes group, with 90 patients affected, which was significantly higher compared to stenotic disease (p&lt;0.0001). Conclusion: Subjects in the DM2T group with dominant occlusive changes had significantly higher HbA1c values ​​compared to the HbA1c group with dominant stenotic changes p&lt;0,002. The risk factor score for the examined group, DM2T, was 7% (SCORE of high cardiovascular risk), and in the control group, non-diabetics, it was 8%, and both groups are high risk. HbA1c can be a predictor for the development of occlusions on the arteries of the lower extremities in subjects with DM2T.4. DM2T group subjects with occlusive changes had high HbA1c values, ≥8.25.

Применение β-адреноблокаторов у пациентов с метаболическим синдромом и сахарным диабетом

Metabolic syndrome, which includes a decrease in insulin sensitivity, obesity, and arterial hypertension is highly prevalent around the world and associated with development of diabetes mellitus and cardiovascular diseases, accelerated atherosclerosis, terminal cardiovascular events of myocardial infarction and stroke, with increased mortality risk. ß-blockers are proven to be an important pillar to improve the prognosis and reduce mortality in population with cardiovascular diseases and metabolic syndrome or diabetes mellitus. At the same time, the use of traditional β-blockers (metoprolol, atenolol) in patients with diabetes mellitus is controversial because of fear of deterioration of glycemic control, blunting of the symptoms of hypoglycemia, and weight gain. Currently, consistent evidence supports metabolic advantages of carvedilol and nebivolol, the third-generation β-blockers with vasodilatory effects due to α1-adrenoceptor-blocking activity or enhancing and bioavailability of nitric oxide along with antioxidant properties, that have potential to be a valuable tool for treatment of arterial hypertension, coronary artery disease and heart failure in patients with metabolic syndrome and diabetes mellitus.

Left atrial volume in obesity and hypertension: an innovative "ideal human" index allows for weighing their impact - a non-contrast cardiac CT study

Abstract Left atrial (LA) enlargement is a common and early feature of cardiac involvement in the natural history of obesity and arterial hypertension (AH). Mechanisms involved in this process are cumulative, and partly shared, thus separating and balancing their contributions is challenging. In a proportion of patients referred for coronary artery calcium (CAC) scoring, these clinical entities are present. The LA volume (LAV) is relatively easy to quantify from a CT scan. Measured LAV values can be misleading unless constitutional parameters (height (h) or body size area (BSA), are considered. We introduced a new indexing parameter, consisting of height and the difference between numerical values of height and BSA. In the "ideal human", the difference is zero. Any deviation from this value determines the share of body mass regardless of height. Aim We hypothesize that a novel indexation approach allows for earlier detection of the increased LAV in normotensive and AH patients considering the body mass index. Method We retrospectively analyzed CT data from 2535 patients, 1658 w (64±10 ys), and 876 m (aged 6±11ys), with CAC scoring over the last 15 years The LAV was determined by using commercially available software. The raw and indexed (for h, BSA, and the novel parameter [h+ (h-BSA)]) LAV volumes were compared in patients with normal BMI (&amp;lt;25kg/msg), overweight (25-29.9), and obesity (≥30) who with normal blood pressure or with AH. Results The LAV was larger in high BMI categories than in normal BMI. In non-AH subjects, the LAV increased from an average of 71 ml (normal) to 80 ml (overweight) and 90 ml (obese). In AH, the LAV increase showed a similar trend of averages (77, 88, 94 ml, F=2.59,p&amp;lt;0.01). Indexing LAVs were non-concordant, as shown in Figure. Thus, one can recognize that LAV normalization for the new index has brought the differences most evident and persuasive. In normal BMI, indexation ways did not significantly affect the LAV estimation. Whilst the body weight increased, no difference could be recognized for values indexing for BSA (red). The LAV indexation for height (blue) cannot help diagnose its increase in obesity. The distinguishing strength can be seen while using the [h-(h-BSA)] denominator (green). It indicates that in any scenario, body mass gain plays a greater role in the LAV increase than AH does. Conclusions Body mass is a more important factor that is associated with LAV than AH.. Common methods of LAV indexing, especially referred to as BSA, introduce errors leading to values mimicking normality in non-healthy people and should be forbidden. The proposed indexation way can help overcome the observed discrepancies and support early recognition of the consequences of obesity and hypertension.

The Association Between Overweight Obesity Status and Hypertension in a Rural Community in Dang District, Gujarat, India: A Cross-Sectional Study.

Background The relationship betweenoverweight obesity status and hypertension is well-known throughout the world, especially in low socioeconomic communities and developing countries. Both high blood pressure and obesity are preventable risk factors for noncommunicable disease, death, and disability. The prevalence of obesity-overweight status in India is increasing faster than the global average, and diabetes in Southeast Asia has surged over the past few decades. There have been few systematic studies focusing onpublic health development in rural communities of India, like the Dang District.This study explores the association between overweight-obesity status and hypertension prevalence in a rural community in Dang district, Gujarat, India. Methods A cross-sectional design was utilized for this study, involving 1012 adult patient charts collected from medical camps in December 2018 and 2019. Patients with incomplete information for measurements of blood pressure, height, weight, age, and sex were omitted from the analysis (n=953).Data on BMI and blood pressure were analyzed to examine the relationship between overweight-obesity status and hypertension. Hypertension was defined by the American Heart Association (AHA) cut-offs for measured blood pressure. Both World Health Organization (WHO) and South Asian cut-offs were used for BMI. Binary logistic regression was used to assess the association between hypertension and overweight-obesity status, adjusted for age and sex. Results Most patients were hypertensive, with males having a higher prevalence (63.3%) than females (55.1%). The prevalence of hypertension among participants increased with age. This was true for both sexes, except for males 45-54 years of age. The average BMI for both sexes was 22.4.Results indicated that overweight and obese individuals had a significantly higher prevalence of hypertension compared to their normal-weight counterparts, suggesting a strong association between the two conditions. A binary logistic regression found that males were 1.35 times more likely to have hypertension than females (95% CI 1.03 - 1.79), and increasing age and BMI were associated with an increased likelihood of hypertension. Conclusion The association between hypertension and BMI is positive and is stronger when using South Asian cut-offs. Using these cut-offs will include a wider range of people at risk for hypertension. With males and older adults especially at risk, targeting public health awareness campaigns to reduce BMI and help lower the burden of hypertension can improve the health and quality of life in this community.

Cervical osteomyelitis in the setting of multiple comorbidities: a complex anatomical approach. Illustrative case.

Vertebral osteomyelitis (VO), also known as spinal osteomyelitis or spondylodiscitis, is a rather rare yet serious disease comprising 3%-5% of all osteomyelitis cases, with only 3%-6% of this subset affecting the cervical spine. Risk factors include an advanced age, diabetes, immunosuppression, and intravenous (IV) drug use. The incidence of VO has increased over recent decades, with high-risk patients experiencing higher mortality rates. Treatment guidelines for VO are not standardized and rely on physician preference, often starting with IV antibiotics and progressing to surgery, if necessary. A 54-year-old female with tracheostomy-dependent obesity hypoventilation syndrome, hypertension, and morbid obesity presented with upper back pain after a fall. Imaging revealed early C6-7 discitis osteomyelitis, which was initially managed conservatively with IV antibiotics. Her condition worsened, leading to anterior corpectomy of C6-7, followed by posterior cervical fusion from C5 to T2 in the sitting position. This approach was chosen due to the patient's complex anatomy and tracheostomy. This case underscores the need for unique surgical approaches in high-risk patients with complex anatomy. It highlights the importance of interdisciplinary care when managing VO, especially in patients with multiple comorbidities. Given the increasing rates of morbid obesity, this case provides valuable insights for neurosurgical decision-making in similar future cases. https://thejns.org/doi/10.3171/CASE24448.

Inhibition of HDAC6 mitigates high-fat diet-induced kidney inflammation and hypertension via reduced infiltration of macrophages

Obesity-mediated hypertension is a worldwide problem. Recent research has indicated that chronic inflammation is associated with the pathogenesis of obese hypertension. Activated immune cells infiltrate target organs, such as arteries, kidneys, and brain, causing end-organ damage and hypertension. Histone deacetylase 6 (HDAC6) regulates the inflammatory cell activity mediating the production of inflammatory cytokines and may play a role in the crosstalk between inflammation and hypertension. In this study, we investigated the roles of HDAC6 in high-fat diet (HFD)-induced kidney inflammation and hypertension. Nine-week-old male C57BL/6 mice were fed either a normal diet (ND) or HFD for 15 weeks. HFD-induced hypertension with increased HDAC6 activities in the kidney and bone marrow-derived macrophages (BMDM). When HFD group reached the hypertensive phase, each group of mice was intraperitoneally injected with vehicle or selective HDAC6 inhibitor Tubacin (1 mg/kg/day) for 14 days. Tubacin treatment lowered blood pressure (BP) of HFD-fed mice to the normal level with successful inhibition of HDAC6 activity. Immunohistochemical staining of F4/80, which is known as a macrophage marker, revealed that HFD promoted macrophage infiltration into the kidney. Consequently, pro-inflammatory factors TNFα and IL-6 gene expressions in the kidney were increased by HFD. Tubacin canceled HFD-induced macrophage infiltration and inflammation in the kidney. HDAC6 gene silencing and Tubacin treatment in Raw 264.7 cells also blocked the chemoattractant-stimulated cell migration in vitro. The results reveal the novel role of HDAC6 in BMDM migration, kidney inflammation, and high BP induced by HFD providing HDAC6 inhibitors as a therapeutic option for obesity-mediated hypertension.

8081 Case report of sympathetic paraganglioma presenting as chronic catecholamine induced cardiomyopathy

Abstract Disclosure: Z. Tan: None. A. Taiwo: None. Background: Sympathetic paragangliomas are rare neuroendocrine tumors (&amp;lt;1/100,000) arising from extra-adrenal autonomic paraganglia, generally in the thorax, abdomen, and pelvis. They secrete catecholamines predominantly norepinephrine, which can cause a rare complication of catecholamine-induced cardiomyopathy. Clinical Case: A 33-year-old male, with history of obesity and borderline hypertension not on medication, presented with dyspnea on exertion, worsening paroxysmal nocturia dyspnea of 1 month duration and sudden onset of severe right flank pain. Work up for his chronic shortness of breath revealed: Troponin negative. EKG showed sinus tachycardia. Echocardiogram revealed enlarged left ventricle, severely decreased LV systolic function of 25-30%. Given the absence of angina symptoms, negative troponin, and EKG findings, his new-onset cardiomyopathy was presumed to be non-ischemic. CT chest, abdomen and pelvis was performed for the new onset right flank pain, which revealed a 4.1 cm x 4.0 cm centrally necrotic aortocaval soft tissue mass. This raise a concern about malignancy. A CT-guided Fine-Needle Aspiration of the retroperitoneal mass suggested paraganglioma. Further investigation showed plasma normetanephrine at 5.56 nmol/L (Reference range: 0-0.89 nmol/L), 24 hour urine normetanephrine at 2411 ug/d (Reference range: 114-865 ug/d), and 24 hour urine norepinephrine at 179 ug/d (Reference range: 14-20 ug/d). Plasma metanephrines and plasma dopamine were within the normal range. A gallium DOTATE PET/CT revealed a necrotic aortocaval mass with peripheral uptake, consistent with the known paraganglioma. He was diagnosed with sympathetic paraganglioma complicated with chronic catecholamine-induced cardiomyopathy and had exploratory laparotomy excision of his paraganglioma. Preoperatively, he was treated with phenoxybenzamine and carvedilol. However, his post-surgical course was complicated by acute on chronic heart failure and pneumonia, and he subsequently passed away from a pulseless electrical activity arrest. Conclusion: Although sympathetic paragangliomas rarely presents as catecholamine-induced cardiomyopathy, this case emphasizes the importance of considering hormonal abnormalities in patients who present with non-ischemic cardiomyopathy without high risk factors. Reference: 1. Alessandra Giavarini, Antoine Chedid et al. Acute catecholamine cardiomyopathy in patients with phaechromocytoma or functional paraganglioma. Heart 2013; 99: 1438-1444. Presentation: 6/2/2024

Clinical outcomes of bariatric surgery in patients with obesity and idiopathic intracranial hypertension.

Obesity is a major risk factor for idiopathic intracranial hypertension (IIH). Effective therapeutics for preventing disease progression and alleviating symptoms are limited. This study aims to examine the effects of bariatric surgery on clinical outcomes of IIH. We retrospectively collected data from the medical record of 97 patients with obesity and an existing diagnosis of IIH who underwent primary bariatric surgery at the Cleveland Clinic health system in the USA between 2005 and 2023. Pre- and postoperative data on presence of symptoms and clinical markers of IIH (headaches, visual field defects, papilledema, visual symptoms), intracranial pressure, andusage of IIH medications were compared. A total of 97 patients (98% female, median age 46.7years, median BMI 48.3kg/m2) with IIH who underwent bariatric surgery including Roux-en-Y gastric bypass (n = 66, 68%), sleeve gastrectomy (n = 27, 27.8%), and gastric banding (n = 4, 4.1%) were analyzed. In a median follow-up time of 3.0years, the median total weight loss was 24% (interquartile range, 13-33%). There was a significant improvement in headache, papilledema, visual field deficits, and visual symptoms after bariatric surgery. The mean lumbar opening pressure before and after bariatric surgery was 34.8 ± 8.2cm CSF and 24.2 ± 7.6cm CSF, respectively, with a mean reduction of 10.7 cm CSF (95% confidence interval, 4.7 to 16.6), p = 0.003. The dosage of acetazolamide and topiramate, as well as the number of medications taken for IIH, decreased significantly after bariatric surgery (p < 0.001). For patients who have obesity, bariatric surgery is a viable treatment modality for alleviation or improvement of symptoms of IIH.

A-311 Evaluating the Predictive Value of the sFlt-1/PlGF Ratio in Hypertensive Pregnancies for Preeclampsia

Abstract Background Preeclampsia (PE) is a hypertensive pregnancy disorder affecting around 5% of all pregnancies, and it continues to be a leading cause of maternal and neonatal morbidity and mortality in the United States. The incidence of hypertensive pregnancies is on the rise, attributed to the increasing prevalence of obesity and chronic hypertension. The development of a straightforward diagnostic test to accurately differentiate PE from gestational or chronic hypertension is crucial to avoid unnecessary hospitalizations. Despite the ongoing development of prediction models for PE, conventional clinical and laboratory measures have not been effective in predicting disease progression. Recent research has focused on the ratio of two serum biomarkers: soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), particularly in patients with a clinical suspicion of PE in acute settings. These studies have shown promise, with many indicating that the sFlt-1/PlGF ratio can effectively predict the presence or absence of PE. This study was conducted to assess the predictive value of the sFlt-1/PlGF ratio in pregnancies complicated by hypertension, aiming to contribute to the early detection and management of PE. Methods Pregnant individuals with hypertensive disorders at or above the age of 18 receiving prenatal care at NewYork-Presbysterian-Weill Cornell Hospital were enrolled in this study. We measured the levels of sFlt-1 and PlGF using fully automated Elecsys immunoassays (Roche Diagnostics). Subsequently, a prospective analysis of the serum sFlt-1/PlGF ratio was performed. A receiver operating characteristic (ROC) curve was used to calculate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ratio in predicting PE. To assess the prognostic accuracy of the sFlt-1/PlGF ratio, patients were randomly assigned to a development and a validation cohort at a ratio of 30:70. Results We collected a total of 137 serum samples of hypertensive pregnancies, with all ≥20 weeks of gestational age (GA). Of these, 47 (34.3%) developed PE within 2 weeks. The samples were divided into two cohorts: 98 were included in the development cohort, and 39 in the validation cohort. Within these groups, 34 (34.7%) of the development cohort and 13 (33.3%) of the validation cohort developed PE within 2 weeks, respectively. In the development cohort, the median sFlt-1/PlGF ratio was 85 (Interquartile range, [IQR], 44-164) among pregnant women who developed PE within 2 weeks. This was significantly higher compared to a median ratio of 8 (IQR, 3-35) observed in those who did not develop PE (p&amp;lt;0.001). The area under the ROC curve was 0.87, indicating good discriminative ability. An optimized cutoff ratio of 38 was determined, based on the max of combined sensitivity and specificity. When applied into the validation cohort, this cutoff yields a 90% (95% confidence interval [CI], 70-97) NPV and 58% (95%CI, 37-76) PPV with an 85% sensitivity (95%CI, 58-96) and a 69% specificity (95%CI, 50-83). Conclusions In women with a hypertensive disorder of pregnancy presenting GA≥20 weeks of gestation, the measurement of serum sFlt-1/PlGF ratio demonstrated clinical value in predicting the development of PE.

The Association between Diet Quality and Metabolic Syndrome among Older African American Women.

Diet is a modifiable lifestyle factor that could impact the development of Metabolic Syndrome (MetS) and its components. MetS prevalence is high and diet quality is suboptimal among older African American women. MetS has been associated with many individual food groups, however, emerging research suggests that analyzing overall diet quality provides insight into the synergistic effects of food groups on health outcomes. In the current cross-sectional study, we examined the relationship between diet quality and MetS, and investigated associations between diet quality and MetS components among older African American women. This study was based on 357 African American women between 45 and 65 years from the NHANES 2011-2018 datasets. This analysis utilized the NCEP ATP III (2001) criteria for women to diagnose MetS. MetS was dichotomized in addition to a MetS z-score being calculated for each participant using a sex- and race-specific equation. Participants' diet quality was measured using the HEI-2015. Linear and logistic regressions were performed to assess the association between HEI-2015 diet quality and metabolic syndrome and its components. 65% of African American women aged 45-65 in the NHANES 2011-2018 had MetS. Study participants had an average HEI-2015 score of 55.4 out of 100. As HEI-2015 quartiles increased, the mean MetS z-score decreased (p-value: 0.0011). Age-adjusted models demonstrated statistically significant inverse relationships between HEI-2015 and waist circumference (β: -0.217; 95% CI: -0.372, -0.063), systolic blood pressure (β: -0.215; 95% CI: -0.359, -0.072), blood glucose (β: -0.344; 95% CI: -0.681, -0.0066), and triglycerides (β: -0.652; 95% CI: -1.05, -0.251). Significant associations could not be established between MetS and diet quality, assessed with the HEI-2015, among African American women aged 45-65 enrolled in NHANES 2011-2018. However, statistically significant relationships were observed between increased HEI-2015 scores and lowered risks of abdominal obesity, hyperglycemia, hypertriglyceridemia, and systolic hypertension. The findings of this study affirm the necessity of public health strategies to improve diet quality among African-American women which could help to reduce their risks of chronic diseases.

Abstract MP28: Advanced Lipid Status Parameters in Women With Preeclampsia

Preeclampsia (PE) is a hypertensive disorder associated with pregnancy, usually occurring after the 20th week of gestation, followed by proteinuria or signs of end-organ dysfunction. Early-onset preeclampsia is associated with placental dysfunction, while late-onset preeclampsia is recognized as a maternal disorder, influenced by risk factors like maternal obesity, diabetes mellitus, or chronic hypertension. During physiological pregnancy, lipid metabolism changes to adequately supply the fetoplacental unit with nutrients and energy, consequently changing the composition of LDL and HDL particles. However, in preeclampsia, these changes become atherogenic. The study aimed to examine changes in advanced lipid status parameter concentrations and the dominant diameter of LDL and HDL particles during pregnancies affected by PE. In this study, 92 pregnant women at high risk for complication development were followed longitudinally throughout the first (T1), second (T2), and third (T3) trimesters. They were classified into high-risk (HR) (72 women) and PE (20 women) groups based on pregnancy outcomes. Total cholesterol (TC), HDL-C, triglycerides (TG), apoAI, and apoB concentrations were measured using commercial kits, while LDL-C concentrations and the atherogenic index of plasma (AIP) were calculated using established equations. Dominant LDL and HDL particle sizes were determined by gradient gel electrophoresis. TG levels were significantly higher in the PE group compared to the HR group across all trimesters (p&lt;0.05; p&lt;0.05; p&lt;0.01), while AIP was significantly elevated in T2 (p&lt;0.01) and T3 (p&lt;0.01). HDL-C levels were lower in the PE group than in the HR group in T2 (p&lt;0.05). In the HR group during pregnancy, concentrations of TC, TG, LDL-C, apoB, as well as HDL-C increased significantly (p&lt;0.05 for all parameters), while the dominant LDL diameter decreased markedly (p&lt;0.001) between all trimesters, without changes in the dominant HDL diameter. There were no changes in HDL-C concentration during pregnancy in the PE group. In contrast, TG concentrations increased significantly (p&lt;0.01), accompanied by a significant decrease in dominant LDL particle diameter (p&lt;0.05). In conclusion, pregnant women with PE exhibit atherogenic changes in lipid status parameters, including no increase in HDL-C concentration, potentially leading to a loss of HDL's protective effect.