Prehypertensive Participants Research Articles

Systems Approach to Investigate the Role of Fruit and Vegetable Types on Vascular Function in Pre-Hypertensive Participants: Protocol and Baseline Characteristics of a Randomised Crossover Dietary Intervention.

The evidence on the impact of fruits and vegetable types on cardiovascular risk factors remains limited. Specifically, the utilisation of biomarkers to objectively measure dietary compliance and metabolic responses is emerging. This protocol and baseline characteristics of a pilot randomised controlled, crossover, dietary intervention study aimed to examine the effects of citrus fruits, cruciferous vegetables, or common fruits and vegetables on cardiovascular risk factors. A total of 39 volunteers with untreated prehypertension was recruited and consumed a standardised, provided diet with eight daily portions of citrus fruits and cruciferous vegetables, common fruits and vegetables, or a low fruit and vegetable diet (two portions/d, control diet) in a random order for 2 weeks each, separated by a wash-out week. A targeted cohort-based recruitment strategy was utilised and resulted in 74% of participants recruited by re-contacting preselected individuals from two cohort studies with a 15% average enrolment rate. Participants had an average age of 54.4 years (±6.1 years), BMI of 27.9 kg/m2, and BP of 135/81 mmHg and were mainly male (67%). The primary outcome was office blood pressure; secondary outcomes included arterial stiffness, lipid profiles, inflammation, cognitive function, and subjective mood. Biofluids, i.e., 24 h urine, stool, and blood samples, were collected for biomarker measurements with multiple metabolomic platforms and the gut microbial composition, together with traditional dietary biomarkers.

Randomized, double-blind clinical trial evaluating the impact of freeze-dried garlic extract capsules on blood pressure, lipid profile, and nitric oxide levels in individuals at risk for hypertension.

Hypertension, substantially heightens the risk of cardiovascular disease. This study aims to evaluate the effectiveness of freeze-dried garlic extract in blood pressure and lipid profiles in prehypertensive individuals. Participants (age of 30-70 years) were allocated to intervention (n=47) or control (n=49) groups. The intervention group received two capsules of freeze-dried garlic extract daily for eight weeks, while the control group received identical placebo capsules. Primary outcomes, SBP, DBP, PP, MAP, TC, TG, LDL and HDL levels, serum NO levels, were assessed at baseline, four weeks, and eight weeks. At the end of study, results showed significant changes in the values of SBP, DBP, and MAP except for PP. In comparison to those who received the placebo, a significant drop in SBP, DBP (p<0.001), and MAP (p<0.001) was observed in the intervention group. Also, there were significant changes in TG, LDL, TC, and HDL levels in the interventional group. A noticeable decline was reported in TG (p<0.001), LDL (p<0.001), and TC (p<0.001), while HDL levels increased (p<0.001) in the intervention group compared to those receiving the placebo. Following garlic supplementation, a significant increase in blood NO levels was reported in the intervention group (p<0.001). The study showed that garlic supplementation was effective in lowering blood pressure, improving lipid profile, and increasing nitric oxide levels in prehypertensive participants. These results indicate that garlic could be a valuable complementary therapy for managing prehypertension.

Association between short-term daily temperature variability and blood pressure in the Chinese population: From the China hypertension survey

BackgroundWe aimed to evaluate the impacts of short-term daily temperature variability (DTV) on blood pressure (BP) among participants with normotension, prehypertension, and hypertension, respectively, and explore the effects in different climate zones and seasons. MethodsA representative population sample (n = 397,173) covering the subtropical, temperate continental, and temperate monsoon zones was obtained from the China Hypertension Survey. DTV was calculated as the standard deviation of daily minimum and maximum temperatures during the exposure days. The linear mixed effect regression model was used to estimate the associations between DTV exposure and BP among normotension, prehypertension, and hypertension, respectively, and further stratified analysis was performed by climate zones and seasons. ResultsAfter adjustment for confounders, per interquartile range (IQR) increase in DTV (2.28 °C) at 0–6 days of exposure was associated with an increase of 0.41 mmHg (95 % confidence interval [CI]: 0.07, 0.75) in systolic BP (SBP) and 0.41 mmHg (95 % CI: 0.09, 0.72) in pulse pressure (PP) among hypertensive participants in the subtropical zone. Similarly, DTV exposure was associated with an increase of 0.31 mmHg (95 % CI: 0.06, 0.55) in SBP and 0.59 mmHg (95 % CI: 0.24, 0.94) in PP among prehypertensive participants in the temperate continental zone. Additionally, during the warm season, DTV was positively associated with SBP among populations with prehypertension and hypertension, and with PP among all three populations. ConclusionShort-term DTV exposure was associated with an increase in SBP and PP among hypertensive and prehypertensive participants in the subtropical zone and the temperate continental zone. In addition, positive associations of DTV with SBP and PP were observed among participants with prehypertension and hypertension in the warm season. Comprehensive health education and effective intervention strategies should be implemented to mitigate the effects of temperature variations on BP, particularly among prehypertensive and hypertensive populations.

Effectiveness of Mental and Physical Training on Blood Pressure and Resting Heart rate among Prehypertensive Young Adults

Mental and physical training (MAP) has been reported to improve outcomes related to mental health issues, but there is scarcity in current literature with regards to its effect on blood pressure (BP) in prehypertensive population. Therefore, aim of this study was to evaluate the effect of MAP on BP and resting heart rate (RHR) among prehypertensive young male adults. Methods – A single blinded randomized controlled trial with 43 prehypertensive (BP 120-139/80-89 mmHg) participants were divided into 2 experimental and 1 control groups. Mental training group (MT) participated in mindfulness meditation, while physical training group (PT) engaged in moderate intensity aerobic exercise. Both groups underwent training for 6-weeks, 3 sessions/week, each session lasting for 20 minutes. Control group did not participate in any training and was debriefed about Dietary Approaches to Stop Hypertension (DASH) eating plan. Participants in all 3 groups were instructed not to engage in any type of relaxation training or physical activity throughout this study. Systolic BP, diastolic BP, and RHR were assessed at baseline, at end of 3-weeks and 6-weeks intervention. Results – Mean age of participants in MT, PT and DASH group were 20.8±1.5, 20.1±1.8 and 19.8±1.8 respectively. Within group time effect demonstrated a significant difference in SBP (F=42.392, P=0.000), DBP (F=1836.863, P=0.000) and a non-significant difference in RHR (F=1.856, P=0.171), while between group analysis did not show significant difference in SBP (F=0.222, P=0.802); DBP (=0.325, P=0.739), and RHR (=0.63, P=0.939). Conclusions – All 3 interventions are equally effective in reducing the BP in pre-hypertensive young adults, however they did not have any effect on RHR.

The prevalence and influencing factors of coexisting prediabetes and prehypertension among Bangladeshi adults

BackgroundEarly detection of diabetes and hypertension is helpful to prevent and/or delay the onset of these diseases through proper interventions. Therefore, it is a prerequisite to know the prevalence of prediabetes and prehypertension and the factors associated with these conditions but people from developing countries including Bangladesh often remain undiagnosed and unaware of these conditions. In this study we investigate the prevalence of prediabetes and prehypertension and their associated factors in Bangladesh using nationally representative data.MethodWe used nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017–18 survey data, which included a total sample of 14,704 adults aged 18 years and more from whom blood pressure and fasting plasma glucose were collected. Chi-square test was used to examine the differences between sociodemographic and outcome variables. The univariate and multivariate logistic regression was performed to identify the factors associated with prediabetes and prehypertension.ResultsOverall, the prevalence of prediabetes and prehypertension was 8.6% with 14% of the sampled population having from prediabetes and prehypertension separately. Among the prediabetic and prehypertensive participants, one-fourth of the participant were from the richest families and around one-third were overweight/obese, while more than fifty percent had normal Body Mass Index (BMI) and completed secondary and higher education. In the univariate analysis, the richest wealth status (UOR 3.3, 95% CI: 2.46 -4.35) and overweight/obesity (UOR 3.2, 95% CI: 2.62–3.85) are the highest predictors for prediabetes and prehypertension. After adjusting the other variables, overweight/obesity remains the largest predictor for prediabetes and prehypertension (AOR:2.5, 95% CI:2.05–3.05). Further, people aged 31 and above and from the richest family had around 2 times and 1.8 times higher risk of being prediabetic and prehypertensive compared to the younger age people (18–30 years) and the poorest family (respectively).ConclusionThe coexistence of prediabetes and prehypertension is an early sign of a greater burden of noncommunicable diseases (NCDs) in the near future for Bangladesh. To reduce the higher burden of NCDs, our findings call for a multisectoral approach to identify the precondition of NCDs with particular attention to maintaining body weight.

Association of the mean platelet volume and heart rate variability in pre-hypertensive and hypertensive cases

Background: Hypertension is a multifactorial disease and pre-hypertension increases the risk of ischemic diseases. Alteration in the autonomic nervous system led to the development of prehypertension. Evaluating the heart rate variability is the effective tool to determine autonomic dysfunction in pre-hypertensive and hypertensive individuals. Aims and Objectives: The aim of the study was o determine the association between autonomic function and mean platelet volume (MPV) in pre-hypertensive and hypertensive individuals. Materials and Methods: A total of 120 participants of pre-hypertensive (n = 40, Group A), hypertensive (n = 40, Group B), and healthy control subjects (n = 40, Group C) between age group 31–50 years were recruited. All the study participants were subjected to blood pressure measurement either by palpatory or auscultatory method, variability of heart rate, and MPV. Results: The MPV was 9.76, 7.98, and 6.40 in Group A, B, and C, respectively, and the difference was statistically significant (P &lt; 0.05). The mean levels of RMSSD, SDNN, mean RR, NN50, and pNN50 were comparatively low in hypertensive group and high in pre-hypertensive participants and the difference was statistically significant (P &lt; 0.05). The mean levels of LF nu, HF nu, and LF/HF was statistically significant among study groups (P &lt; 0.05). There was a negative correlation between heart rate variables (HRV) and MPV in hypertensive group except between MPV and LFnu. Conclusion: The MPV was significantly high in hypertensive and pre-hypertensive participants that denote the risk of evolving cardiovascular diseases and cerebrovascular diseases. Timely assessment of HRV and adding this in a routine screening tool to predict the risk of hypertension at early stage.

Role of Yoga in Prehypertension and Hypertension

Background: The high prevalence of hypertension in India necessitates both pharmacological and nonpharmacological measures to control it. Here, we report the findings of a study to investigate the effectiveness of yoga therapy in lowering blood pressure (BP) in prehypertensive and hypertensive individuals. Methods: This was a single center, nonrandomized controlled clinical trial, of 200 hypertensives and 100 prehypertensives patients. The control group received the prescribed antihypertensive and lifestyle modification while the yoga group was additionally taught simple yogic exercise by a trained yoga teacher. This training included intensive supervised phase 2-h training sessions in Ujjayi breathing, Bhastrika Pranayama and chanting of “Om” for 10 lessons, followed by self-performed yogic exercise at home for 1 h till the end of study at 1 year. Results: The systolic BP (SBP) in the hypertensive yoga group was significantly lower (t = 3.04,P&lt; 0.01) than the control group at 6 months, but not so at 1 year (SBP t = 0.53,P&gt; 0.05). In the prehypertensive participants, at 6 months (t = 5.85,P= 0.00), and 1 year (t = 6.385,P&lt; 0.05) a significant difference was observed between SBP of the two groups However, no significant difference was observed between the diastolic BP among hypertensives or prehypertensives at 6 months and 1 year. Conclusion: Our present study indicates that yoga therapy is a viable adjunct to pharmacological intervention to reduce SBP in the management of hypertension and prehypertension and that yoga should be incorporated in the treatment regime of such patients, specifically for individuals who have prehypertension.

The effects of Aronia berry (poly)phenol supplementation on arterial function and the gut microbiome in middle aged men and women: Results from a randomized controlled trial

Berry (poly)phenol consumption has been associated with cardioprotective benefits, however little is known on the role the gut microbiome may play on such health benefits. Our objective was to investigate the effects of aronia berry (poly)phenol consumption on cardiometabolic health and gut microbiome richness and composition in prehypertensive middle-aged men and women. A total of 102 prehypertensive participants were included in a parallel 12-week randomized double-blind placebo-controlled trial. Volunteers were randomly allocated to daily consume an encapsulated (poly)phenol-rich aronia berry extract (Aronia, n=51) or a matched maltodextrin placebo (Control, n=51). Blood pressure (BP) and arterial function (office and 24h), endothelial function (measured as flow-mediated dilation), serum biochemistry (including blood lipids), plasma and urine (poly)phenol metabolites as well as gut microbiome composition through shotgun metagenomic sequencing were monitored over the study period. Relationships between vascular outcomes, (poly)phenol metabolites and gut microbiome were investigated using an integrated multi-levels approach. A significant improvement in arterial indices measured as augmentation index (AIx) and pulse wave velocity (PWV) was found in the Aronia compared to Control group (awake Δ PWV=-0.24m/s; 95% CI:-0.79,-0.01m/s, P<0.05; 24h peripheral Δ AIx=-6.8;-11.2,-2.3, %, P=0.003; 24h central Δ AIx=-3.3;-5.5,-1.0, %, P=0.006). No changes in BP, endothelial function or blood lipids were found following the intervention. Consumption of aronia (poly)phenols led to a significant increase in gut microbiome gene richness and in the abundance of butyrate-producing species such as Lawsonibacter asaccharolyticus and Intestinimonas butyriciproducens species, compared to Control group. Results from an approach including metabolomic, metagenomic and clinical outcomes highlighted associations between aronia-derived phenolic metabolites, arterial stiffness, and gut microbiome. Aronia berry (poly)phenol consumption improved arterial function in prehypertensive middle-aged individuals, possibly via modulation of gut microbiome richness and composition based on the associations observed between these parameters. The National Institutes of Health (NIH)-randomized trial records held on the NIH ClinicalTrials.gov website (NCT03434574). Aronia Berry Consumption on Blood Pressure.

Respiratory muscle endurance training improves exercise performance but does not affect resting blood pressure and sleep in healthy active elderly

PurposeAgeing is associated with increased blood pressure (BP), reduced sleep, decreased pulmonary function and exercise capacity. The main purpose of this study was to test whether respiratory muscle endurance training (RMET) improves these parameters.MethodsTwenty-four active normotensive and prehypertensive participants (age: 65.8 years) were randomized and balanced to receive either RMET (N = 12) or placebo (PLA, N = 12). RMET consisted of 30 min of volitional normocapnic hyperpnea at 60% of maximal voluntary ventilation while PLA consisted of 1 inhalation day−1 of a lactose powder. Both interventions were performed on 4–5 days week−1 for 4–5 weeks. Before and after the intervention, resting BP, pulmonary function, time to exhaustion in an incremental respiratory muscle test (incRMET), an incremental treadmill test (IT) and in a constant-load treadmill test (CLT) at 80% of peak oxygen consumption, balance, sleep at home, and body composition were assessed. Data was analyzed with 2 × 2 mixed ANOVAs.ResultsCompared to PLA, there was no change in resting BP (independent of initial resting BP), pulmonary function, IT performance, sleep, body composition or balance (all p > 0.05). Performance significantly increased in the incRMET (+ 6.3 min) and the CLT (+ 3.2 min), resulting in significant interaction effects (p < 0.05).ConclusionIn the elderly population, RMET might be used to improve respiratory and whole body endurance performance either as an adjunct to physical exercise training or as a replacement thereof for people not being able to intensively exercise even if no change in BP or sleep may be expected.

Proinflammatory and Anti-inflammatory Cytokine Response to Isometric Handgrip Exercise and the Effects of Duration and Intensity of the Isometric Efforts in Prehypertensive Participants

ObjectiveThe purpose of this study was to investigate the responses of selected inflammatory cytokines to isometric handgrip exercise and identify possible effects of intensity and duration of the isometric effort on these variables. MethodsA total of 192 sedentary prehypertensive Nigerian participants aged between 30 and 50 years were recruited into the study and randomly distributed into 3 groups of 64 participants each. The participants performed 24 consecutive days of isometric handgrip exercise at 30% maximum voluntary contraction. At the end of the 24 days, group 1 discontinued the exercise protocol, while group 2 continued the exercise protocol for another 24 consecutive days, and group 3 continued with the exercise protocol for another 24 consecutive days but at 50% maximum voluntary contraction. The parameters used to assess the inflammatory cytokine variables included interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α). ResultsThere was an increase in the resting values of IL-10 across the 3 groups, while the resting values of IL-6 and TNF-α were reduced significantly across groups. Generally, the exercise-induced changes in the levels of these cytokines (TNF-α, IL-6, and IL-10) should improve inflammatory and metabolic abnormalities. ConclusionThe isometric handgrip exercise protocols in this study resulted in elevation of anti-inflammatory cytokine (IL-10) and reductions in the values of proinflammatory cytokines TNF- α and IL-6.

Impact of urinary iodine concentration on blood glucose levels and blood pressure: a nationwide population-based study.

Iodine is a vital trace element for systemic metabolic control as well as thyroid hormone synthesis. Though iodine has significant antioxidant and anti-inflammatory effects, reports on its effects on metabolic disorders are limited and inconsistent. Impact of urinary iodine concentrations (UICs) on fasting blood glucose (FBG) levels and blood pressure (BP) in the general Korean population was evaluated adjusting for covariates including thyrotropin level and presence of thyroid diseases. The median UIC was 302.3μg/L in all participants and was significantly lower in those with dysglycemia (303.6μg/L in normal participants, 285.1μg/L in participants with FBG levels of 100-125mg/dL, and 261.8μg/L in participants with FBG levels ≥ 126mg/dL; p = 0.002). Similarly, the UIC was lower in participants with higher BP (311.6μg/L in normal participants, 288.7μg/L in prehypertensive participants, and 265.8μg/L in hypertensive participants; p < 0.001). The multiple linear regression model showed a negative correlation between the UIC and FBG levels (p = 0.002), and the UIC and systolic BP (p < 0.001). One standard deviation increase in the UIC showed odds ratios of 0.84 (95% confidence interval [CI] = 0.73-0.98) for elevated FBG levels (≥ 100mg/dL) and 0.94 (95% CI = 0.88-0.99) for elevated SBP (≥ 120mm Hg) after full adjustment. Higher UICs were associated with lower FBG and BP levels, independent of thyroid function and other confounding factors in Korea, an iodine-replete country.

An Epigenomic Signature in Children Born Small for Gestational Age (SGA) With “Catch-up” Growth Is Present From Birth and Predicts Early Adulthood Pre-Hypertension

Abstract Background: Cardiometabolic conditions in adulthood are more common in children born SGA1. The relationship of the transcriptome (gene expression) and epigenome (DNA methylation) to birth size and the future development of cardiometabolic disease has not been characterized. Aims: To identify I) the relationship between epigenome at age 0, 7 and 17 years, transcriptome at age 9 years and birth size in a normal population; II) links between the transcriptome and epigenome in childhood and adult cardiometabolic risk. Study Design: Normal children (n=6487) from the Avon Longitudinal Study of Parents and Children were assigned to groups based on birth size using bodyweight (BW) and gestation and divided into groups using the population 10th centile. Adverse cardiometabolic risk at age 17 years was defined by the National Heart Lung and Blood Institute criteria of prehypertension using systolic and diastolic blood pressure as well as HDL and LDL2. Blood transcriptome at age 9 and blood epigenome at age 0, 7, and 17 years and were available from 980 and 947 children, respectively. Hypernetworks were used to integrate differentially expressed genes in the transcriptome (DEGs) and differentially methylated points (DMPs) in the epigenome, identifying functional links. Random Forest, a machine learning approach, was used to determine the predictive value of ‘omic data presented as the area under the curve (AUC) of the receiver operating characteristic. Results: Pre-hypertensive participants at age 17 years were distinguished from normotensive participants and this group was enriched for children born small who caught up by age 7 years (155/611 unhealthy/healthy SGA compared to 1979/12746 in all other BW groups; 1.6-fold, p&amp;lt;1x10-5). This group had a greater height velocity during their catch-up period than the normotensive participants (1.2-fold, p=0.027). Hypernetwork integration of ‘omic data identified a functional relationship between 55 DEGs at age 9 years and DMPs at age 7 years. Random forest analysis was able to accurately predict the presence of pre-hypertensive young adults from the age 9 transcriptome (AUC: 0.973). Using a gene-level contraction of DMPs which map to the 55 DEGs (i.e. cis-DMPs), we demonstrated accurate classification of pre-hypertensive young adults from their blood methylome at age 0 (AUC [95% CI]: 0.92 [0.89-0.95]), 7 (0.90 [0.87-0.93]), and 17 (0.91 [0.88-0.94]) years. Conclusions: Through the integration of transcriptome and epigenome, we have identified a set of genes with an epigenomic and transcriptomic signature which predict pre-hypertension in children born SGA who catch up. Specifically, we have shown that the associated epigenomic signature tracks from birth to early adulthood, indicating the possibility of early detection of risk and primordial prevention. 1 Barker etal. (1988) BMJ 297(6641):134-135. 2 Chobanian etal. (2003) JAMA 289(19):2560-2571.

High-intensity interval training vs. hydrochlorothiazide on blood pressure, cardiovascular health and cognition: Protocol of a non-inferiority trial

BackgroundWhile the number of people with hypertension (HBP) continues to increase, the therapeutic target for optimal blood pressure (BP) has been revised to a lower level. Studies have suggested that High-Intensity Interval Training (HIIT) could be as efficient as BP-lowering drugs, but no study has compared their efficacy in a randomized trial. The aim of this protocol is to determine if HIIT is as efficient as Hydrochlorothiazide (HCTZ) in lowering 24 h ambulatory BP in prehypertensive older adults. Moreover, the secondary aim is to determine if HIIT is associated with greater cardiovascular and cognitive benefits than HCTZ. MethodsThis study is an interventional, single-center, non-inferiority trial, with two randomized parallel groups of prehypertensive participants aged 60 years or more. One group will be prescribed daily doses of 12.5 mg of HCTZ for 12 weeks, and the other group will follow thrice-weekly HIIT for 12 weeks. Each group will be composed of 30 participants. The primary outcome is 24 h ambulatory BP. Secondary outcomes are scores on neuropsychological assessments, balance and gait performances, maximal oxygen uptake, peripheral endothelial function, and arterial stiffness. Non-inferiority tests will be performed on the primary outcome, and secondary outcomes will be compared using independent t-tests. ConclusionThis study will determine if HIIT is at least as efficient as HCTZ in lowering BP in prehypertensive older adults. This study will also determine if HIIT provides greater benefits in terms of cardiovascular and cognitive status (NCT04103411).

Reduced heart-rate variability and increased risk of hypertension-a prospective study of the ELSA-Brasil.

Although autonomic disturbances are known to precede hypertension onset, the risks underlying different ranges of blood pressure and impaired cardiac autonomic modulation are still unknown. This study aimed to identify the risk of hypertension incidence related to low heart-rate variability profile in normotensive blood pressure subcategories: normal (<120/80 mmHg) and prehypertension (120/80-139/89 mmHg) in a 4-year follow-up. 7665 participants free of hypertension at baseline were examined. They were allocated into one of two groups (<P25 and ≥P25) based on age-specific value distributions of heart-rate variability ranges presented in the literature. The relationship between heart-rate variability parameters (SDNN, RMSSD, VLF, LF, and HF) and hypertension incidence was analyzed using Poisson regression. The reference for the independent variable in these regressions was the dataset with all HRV values ≥P25. After full adjustments for age, sex, ethnicity, educational level, body mass index, smoking status, glucose, insulin, dyslipidemia, alcohol consumption, and physical activity, low values for all heart-rate variability indices were significantly associated with an increased relative risk of developing hypertension in the overall sample. Individuals with normal BP levels presented an increased risk for low SDNN, VLF, and LF values, whereas the risk in prehypertensive participants was only verified for low VLF. In conclusion, cardio autonomic disturbances precede the incidence of clinical hypertension and are potentially involved in its pathophysiological basis and progression. Even individuals with normal blood pressure may be at an increased risk for future hypertension in the presence of reduced cardio autonomic control.

A comparative study of autonomic reactivity in normotensive and pre-hypertensive young adult Indian males

Background: Hypertension is a non-communicable disease of major concern. Research evidence from both, animal and human studies, indicates that deranged autonomic function may contribute to development and sustenance of hypertension. Aims and Objectives: To study the progressive changes in autonomic reactivity, this study was planned to compare autonomic reactivity in normotensives and pre-hypertensives. Materials and Methods: A total of 60 (30 normotensives and 30 pre-hypertensive) young adult males participated in this study. Parasympathetic reactivity tests (expiration/inspiration ratio, 30/15 and IV/II ratios) were done using single-channel student physiograph machine. Sympathetic reactivity was tested by cold pressor test and handgrip dynamometry test. Results: There was a statistically significant increase in sympathetic reactivity by handgrip dynamometry test in pre-hypertensive participants as compared to normotensive. Furthermore, a decrease in parasympathetic reactivity was found in pre-hypertensives compared to normotensives, although values were not significant statistically. Conclusion: As the blood pressure increases, sympathetic reactivity increases while parasympathetic reactivity gradually decreases. These autonomic changes may underlie the development of human hypertension.

Effects of herbs and spices on blood pressure: a systematic literature review of randomised controlled trials.

: Hypertension is a major risk factor for cardiovascular disease, affecting 1 billion people worldwide. Literature suggests some herbs and spices have cardiovascular benefits, such as decreasing blood pressure; yet evidence is inconsistent. This article reviewed randomized controlled trials investigating effects of herbs and spices on blood pressure in normotensive, pre-hypertensive and hypertensive participants. Ovid Medline, Embase, Biological abstracts, CINAHL and Cochrane Collaboration were systematically searched. After inclusion and exclusion criteria were applied, nine articles were included for analysis. Overall, three of the nine studies reported statistically significant results, including one of the two studies on hypertensive participants and two of the six studies on pre-hypertensive participants. The remaining study was conducted on normotensive participants and reported no change in blood pressure. There is evidence to suggest certain herbs and spices can reduce blood pressure in a hypertensive and pre-hypertensive population and may not induce hypotension in a normotensive population.

A3278 Taurine supplementation improves vascular function in prehypertension

Objectives: Taurine is well known to lower blood pressure (BP) in hypertensive animal models. However, no rigorous clinical trial has validated whether this beneficial effect of taurine can be used to treat prehypertension in human, a key stage in the development of hypertension. Methods: In this randomized, double-blind, placebo-controlled study, we assessed the effects of taurine intervention on BP and vascular function in prehypertension. We randomly assigned 120 eligible prehypertensive participants to receive either taurine supplementation (1.6 g per day) or a placebo for 12 weeks. Results: Taurine significantly decreased the clinic and 24-h ambulatory BPs, especially in those high-normal BP participants. Furthermore, pulse wave velocity (PWV, > 1400 cm/s) was positive correlated with both systolic BP and mean ambulatory systolic BP before taurine treatment in participants. After taurine treatment for 12 weeks, the correlation between PWV and systolic BP disappeared in these participants. In addition, PWV were positive correlated with both the Intima media thick and number of plaques in participants before taurine treatment, however this correlation was not found after taurine treatment. Changes in BP were negatively correlated with both the plasma H2S and taurine levels in taurine-treated participants. PWV was also negatively correlated with the ratio of abdominal subcutaneous adipose tissue / visceral adipose tissue and plasma H2S in these participants. After taurine treatment, abdominal obesity and plasma H2S were improved compared with before in prehypertensive participants. Conclusion: The antihypertensive effect of taurine supplementation shows promise in the improvement of BP and vascular function in prehypertensive participants, which is associated with increasing plasma H2S.

A1446 Association between salt intake and uric acid, and its interaction on the risk of prehypertension among Chinese young adults

Objectives: High uric acid (UA) level and high salt intake are reportedly associated with cardiovascular disease. This study investigated the association between UA and daily salt intake, as well as its interaction on the risk of prehypertension. Methods: A total of 1869 participants without hypertension were recruited from a previously established cohort in Shaanxi Province, China. The participants were classified as normotensive or prehypertensive on the basis of their blood pressure. Salt intake was estimated from early-morning urine specimens using an equation validated for this study population. Results: Increasing quartiles of salt intake were associated with high urinary UA/creatinine levels in prehypertensive participants. Estimated salt intake positively correlated with urinary UA/creatinine excretions in the prehypertensive group. In addition, the prehypertensive group had higher levels of salt intake and serum UA than the normotensive group. The multivariate-adjusted odds ratios (95% confidence interval) for prehypertension compared with normotension were 1.68 (1.27–2.22) for salt intake and 1.71 (1.21–2.42) for serum UA. Increasing salt intake and serum UA were associated with higher risk of prehypertension. Compared with the lowest quartiles, the highest salt intake and serum UA quartiles entailed 3.48 times greater risk of prehypertension. Conclusion: Salt intake is associated with urinary UA excretion in prehypertensive participants. High levels of salt intake and serum UA simultaneously are associated with a higher risk of prehypertension.

Association of blood pressure components with mortality and cardiovascular events in prehypertensive individuals: a nationwide population-based cohort study

Background: The effects of each blood pressure index [systolic and diastolic blood pressure (SBP, DBP), pulse pressure (PP), mean arterial pressure (MAP)] on the occurrence of mortality and cardiovascular (CV) events have not yet been investigated in prehypertensive populations.Methods: A total of 30,258 prehypertensive Korean participants underwent periodic health examination between 2003 and 2004 were enrolled, and the associations of BP components with mortality and CV events were investigated. Moreover, based on the DBP [80 ≤ DBP <90 mmHg (N = 21,323) and DBP <80 mmHg (N = 8,935)], the effects of BP components were also evaluated.Results: Multivariate Cox analyses in prehypertensive group revealed that the hazard ratios (HRs) were 1.121 and 1.130 per 10 mmHg increase in SBP and PP for mortality, respectively. Additionally, 10 mmHg increase of SBP (HR:1.090) was still significantly, but increase of PP (HR:1.060) was marginally associated with higher incidence of CV events. However, there were no significant associations with increase in DBP or MAP on adverse clinical outcomes in prehypertensive group. In the prehypertensive subjects with DBP <80 mmHg, CV events more frequently occurred by 38.8% and 28.5% per 10 mmHg increase in SBP and PP, respectively.Conclusions: Prehypertensive subjects might need to be cautioned when they have high SBP or PP with low DBP even in healthy populations.Key messagePrehypertensive subjects should be cautioned when they have high-systolic blood pressure or pulse pressure with low-diastolic blood pressure, even without previous hypertension, diabetes mellitus or chronic kidney disease.

ASSOCIATION BETWEEN SALT INTAKE AND URIC ACID, AND ITS INTERACTION ON THE INCIDENCE OF PREHYPERTENSION AMONG CHINESE YOUNG ADULTS

Objective: High uric acid (UA) level and high salt intake are reportedly associated with cardiovascular disease. This study investigated the association between UA and daily salt intake, as well as its interaction on the risk of prehypertension. Design and method: A total of 1869 participants without hypertension were recruited from a previously established cohort in Shaanxi Province, China. The participants were classified as normotensive or prehypertensive on the basis of their blood pressure. Salt intake was estimated from early-morning urine specimens using an equation validated for this study population. Results: Increasing quartiles of salt intake were associated with high urinary UA/creatinine levels in prehypertensive participants (from quartile 1 to quartile 4: 0.12, 0.17, 0.24, and 0.33, P for trend < 0.001)). Estimated salt intake positively correlated with urinary UA/creatinine excretions in the prehypertensive group (r = 0.496; P < 0.001). In addition, the prehypertensive group had higher levels of salt intake and serum UA than the normotensive group [salt intake: 13.22 ± 3.52 vs. 12.35 ± 3.42 g/day, P < 0.001; serum UA: 290.0 (233.6–340.6) vs. 255.6 (211.6–305.0) μmol/L, P < 0.001]. The multivariate-adjusted odds ratios (95% confidence interval) for prehypertension compared with normotension were 1.68 (1.27–2.22) for salt intake and 1.71 (1.21–2.42) for serum UA. Increasing salt intake and serum UA were associated with higher risk of prehypertension. Compared with the lowest quartiles, the highest salt intake and serum UA quartiles entailed 3.48 times greater risk of prehypertension.Conclusions: Salt intake is associated with urinary UA excretion in prehypertensive participants. High levels of salt intake and serum UA simultaneously are associated with a higher risk of prehypertension.