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High blood pressure [keywords]
- Seasonal Variation of Overall and Cardiovascular Mortality: A Study in 19 Countries from Different Geographic Locations. [JOURNAL ARTICLE]
- PLoS One 2014; 9(11):e113500.
Cardiovascular diseases (CVD) mortality has been shown to follow a seasonal pattern. Several studies suggested several possible determinants of this pattern, including misclassification of causes of deaths. We aimed at assessing seasonality in overall, CVD, cancer and non-CVD/non-cancer mortality using data from 19 countries from different latitudes.Monthly mortality data were compiled from 19 countries, amounting to over 54 million deaths. We calculated ratios of the observed to the expected numbers of deaths in the absence of a seasonal pattern. Seasonal variation (peak to nadir difference) for overall and cause-specific (CVD, cancer or non-CVD/non-cancer) mortality was analyzed using the cosinor function model. Mortality from overall, CVD and non-CVD/non-cancer showed a consistent seasonal pattern. In both hemispheres, the number of deaths was higher than expected in winter. In countries close to the Equator the seasonal pattern was considerably lower for mortality from any cause. For CVD mortality, the peak to nadir differences ranged from 0.185 to 0.466 in the Northern Hemisphere, from 0.087 to 0.108 near the Equator, and from 0.219 to 0.409 in the Southern Hemisphere. For cancer mortality, the seasonal variation was nonexistent in most countries.In countries with seasonal variation, mortality from overall, CVD and non-CVD/non-cancer show a seasonal pattern with mortality being higher in winter than in summer. Conversely, cancer mortality shows no substantial seasonality.
- Defective fatty acid oxidation in renal tubular epithelial cells has a key role in kidney fibrosis development. [JOURNAL ARTICLE]
- Nat Med 2014 Dec 1.
Renal fibrosis is the histological manifestation of a progressive, usually irreversible process causing chronic and end-stage kidney disease. We performed genome-wide transcriptome studies of a large cohort (n = 95) of normal and fibrotic human kidney tubule samples followed by systems and network analyses and identified inflammation and metabolism as the top dysregulated pathways in the diseased kidneys. In particular, we found that humans and mouse models with tubulointerstitial fibrosis had lower expression of key enzymes and regulators of fatty acid oxidation (FAO) and higher intracellular lipid deposition compared to controls. In vitro experiments indicated that inhibition of FAO in tubule epithelial cells caused ATP depletion, cell death, dedifferentiation and intracellular lipid deposition, phenotypes observed in fibrosis. In contrast, restoring fatty acid metabolism by genetic or pharmacological methods protected mice from tubulointerstitial fibrosis. Our results raise the possibility that correcting the metabolic defect in FAO may be useful for preventing and treating chronic kidney disease.
- Longitudinal Assessment of High Blood Pressure in Children with Nonalcoholic Fatty Liver Disease. [JOURNAL ARTICLE]
- PLoS One 2014; 9(11):e112569.
Nonalcoholic fatty liver disease (NAFLD) affects 9.6% of children and may put these children at elevated risk of high blood pressure and subsequent cardiovascular morbidity and mortality. Therefore, we sought to determine the prevalence of and risk factors for high blood pressure in children with NAFLD.Cohort study performed by the NIDDK NASH Clinical Research Network. There were 484 children with NAFLD ages 2 to 17 at enrollment; 382 children were assessed both at enrollment and 48 weeks afterwards. The main outcomes were high blood pressure at baseline and persistent high blood pressure at both baseline and 48 weeks.Prevalence of high blood pressure at baseline was 35.8% and prevalence of persistent high blood pressure was 21.4%. Children with high blood pressure were significantly more likely to have worse steatosis than children without high blood pressure (mild 19.8% vs. 34.2%, moderate 35.0% vs. 30.7%, severe 45.2% vs. 35.1%; P = 0.003). Higher body mass index, low-density lipoprotein, and uric acid were independent risk factors for high blood pressure (Odds Ratios: 1.10 per kg/m2, 1.09 per 10 mg/dL, 1.25 per mg/dL, respectively). Compared to boys, girls with NAFLD were significantly more likely to have persistent high blood pressure (28.4% vs.18.9%; P = 0.05).In conclusion, NAFLD is a common clinical problem that places children at substantial risk for high blood pressure, which may often go undiagnosed. Thus blood pressure evaluation, control, and monitoring should be an integral component of the clinical management of children with NAFLD.
- Association between Obesity and History of Abuse among American Indians in Rural California. [JOURNAL ARTICLE]
- J Obes Weight Loss Ther 2014.
To explore factors associated with obesity among American Indians.A cross-sectional survey of American Indian adults (N=459) was conducted at 13 rural reservation sites in California. Participants responded to a survey about their health and wellness perceptions. The Body Mass Index (BMI) was used to assess obesity. A predictive model for BMI was built using a generalized regression model.Having high blood pressure and having a history of verbal abuse in childhood were significant predictors of higher BMI. Participants with high blood pressure were likely to have 3.2 units of BMI higher on average than those who do not have high blood pressure (p-value <0.0001). Similarly, those with a history of childhood verbal abuse were likely to have 1.9 units higher BMI on average compared to those with no such history. Having a history of diabetes or sexual abuse in childhood trend towards increased BMI, although not statistically significant.Identifying childhood trauma and its impact on adult obesity rates among American Indians provides new avenues for intervention. Efforts to reduce over weight and obesity should include culturally sensitive interventions to ameliorate and repair what is lost through personal violations of stigma, abuse or neglect.
- Copy number variation of the Lipoprotein(a) (LPA) gene is associated with coronary artery disease in a southern Han Chinese population. [JOURNAL ARTICLE]
- Int J Clin Exp Med 2014; 7(10):3669-3677.
Copy number variations (CNVs), genomic duplication or deletion events occurring at larger than 1 kb scale, contribute to the complex diseases substantially. Lipoprotein(a) [Lp(a)] is a major inherited risk factor for atherosclerosis and coronary artery disease (CAD). We investigated the association between a CNV of the Lp(a) (LPA) gene and CAD. The case-control study included 271 CAD patients and 207 controls diagnosed by coronary angiography. A taqman real-time fluorescence PCR based technique was developed according to the 2 × 2(-ΔΔCt±SD) calculation method. We detected LPA CNVs with a range of 1, 2 and 3. The 1 copy number carriers had a significantly reduced risk of CAD compared with those with 2 copy number after adjusting for the confounding factors (P < 0.001, OR = 0.38, 95% CI 0.23-0.64). Further stratified analyses suggested a significant protective effect of the 1 copy number in the elderly population (P = 0.008), females (P = 0.007) as well as in populations with non-hyperlipidemia (P = 0.003), hypertension (P = 0.001), non-smoking (P < 0.001) and high Lp(a) (≥ 0.3 g/L) levels (P = 0.001). The 1 copy number of the LPA gene may be an independent protective factor of CAD in a southern Han Chinese population, particularly in females and the elderly.
- Does early use of bilevel positive airway pressure (bipap) in cardiothoracic intensive care unit prevent reintubation? [JOURNAL ARTICLE]
- Int J Clin Exp Med 2014; 7(10):3439-3446.
Introductıon: Non-invasive ventilation (NIV) is a preferred treatment in acute respiratory failure after operations. Our aim is to investigate the success of early use of bilevel positive airway pressure (BIPAP) after cardiac or thoracic surgeries to prevent reintubation.In a prospective randomized study, 254 patients were divided into two groups depending on the time period between extubation and the application of BIPAP. In Group 1 BIPAP was applied after extubation within 48 hours after surgery following fulfilling of acute respiratory failure criterias whereas, in Group 2, BIPAP was applied one hour after extubation for two episodes of 20 minute duration and 3 hours apart. Arterial blood gas values (pH, PaO2, PaCO2) at first and fourth hour after BIPAP were collected.In comparison between groups, no significant differences were observed for arterial blood gas values of pH and PaCO2 at baseline, one and four hours after BIPAP (p > 0.05) however, the PaO2 values at one and four hours after BIPAP were significantly better in Group 1 in comparison to Group 2 (p < 0.001, p < 0.001; respectively). Reintubation rate was 14 patients (11%) in Group 1 and 7 patients (5.5%) in Group 2 (p = 0.103). Conclusıons: The early and prophylactic use of BIPAP after cardiac or thoracic operations did not provide diminished rates in the postoperative complications such as reintubation.
- Microalbuminuria in untreated prehypertension and hypertension without diabetes. [JOURNAL ARTICLE]
- Int J Clin Exp Med 2014; 7(10):3420-3429.
Hypertension (HT) and prehypertension (preHT) were independent predictors of cardiovascular diseases. Urinary albumin leakage is a manifestation of generalized vascular damage. B-type natriuretic peptide (BNP) is a vasoactive peptide secreted by left ventricle in response to myocytic stretch. We aimed to investigate relationship between microalbuminuria (MA) and BNP in untreated elevated blood pressures.Of 105 untreated prehypertensive subjects (53 men, 52 women), 100 hypertensive subjects (51 men, 49 women) and 57 normotensive subjects (32 men, 25 women) none had history of diabetes. Urine albumin excretion was measured by immunoradiometric assay in morning urine sample.The prevalence of MA was higher in hypertensive group than in prehypertensive group and in normotensive group (Hypertensive group; 33.9%, prehypertensive; 25.9%, normotensive; 10%). Subjects with HT had higher prevalence of microalbminuria; larger body mass index, higher levels of triglycerides, blood glucose and creatinin were more common in subjects with HT than in those with preHT. In hypertensive group; patients with microalbuminuria had higher systolic blood pressure (SBP), BNP, LVMI and lower eGFR as compared to those without MA. MA was significantly correlated with LVMI, BNP and SBP. In multivariate regression analysis, SBP (β: 0.361; P < 0.001), LVMII (β: 0.267; P = 0.011) and BNP (β: 0.284; P = 0.005) were independent variables associated with MA in hypertensives. In prehypertensive group; patients with microalbuminuria had higher SBP, BNP, LVMI and lower eGFR as compared to those without MA. MA was significantly correlated with LVMI, BNP and SBP. In multivariate regression analysis, SBP (β: 0.264; P = 0.002), LVMI (β: 0.293; P = 0.001) and BNP (β: 0.168; P = 0.045) were associated with MA in prehypertensives.In preHT and HT, SBP, BNP and LVMI are associated with MA. In the evaluation of increased blood pressures, in case of increased BNP and LVMI, MA should be investigated even in prehypertensive stages. The subjects with increased blood pressures should get medical treatment to prevent the effects on vascular structure and myocardium even in prehypertensive phase.
- Vascular relaxation induced by Eucommiae Ulmoides Oliv. and its compounds Oroxylin A and wogonin: implications on their cytoprotection action. [JOURNAL ARTICLE]
- Int J Clin Exp Med 2014; 7(10):3164-3180.
The vascular relaxation action of Eucommiae Ulmoides Oliv. also known as Duzhong has been seen on arteries of the heart such as the aorta and the coronary artery which are elastic in nature. Duzhong is historically an active ingredient commonly used in hypertensive herbal prescriptions in China. This work investigated the vasodilating effect of Duzhong and its compounds (wogonin 10 μM and oroxylin-A) in the isolated intact rat heart, perfused retrograde according the method of Langendorff and the cytoprotective effect in EA.hy926 cell lines Coronary perfusion pressure was monitored with a pressure transducer connected to a side-arm of the aortic perfusion cannula. Duzhong induced vasorelaxation in a dose dependent manner, on precontracting the vessels with endothelin-1, Duzhong 10 mg/ml, wogonin 10 μM and oroxylin-A 10 μM could significantly lower the perfusion pressure in reference to positive control SNP, Duzhong induced vasodilation was not inhibited by L-NAME (nitric oxide inhibitor), but was significantly inhibited by Tetraethyl ammonium (TEA, a K(+) channel blocker and almost abolished by potassium chloride. The underlying mechanism was carried out in EA.hy926 cell lines. When these cells were treated with H2O2, there was higher expression of NOX-4, TNF-α and COX-2 mRNA. However, wogonin treatment attenuated the mRNA of NOX-4, TNF-α and COX-2. Wogonin also upregulated the mRNA expression of CAT, SOD-1 and GSR in oxidative stress induced by H2O2 EA.hy926 cells. Duzhong and compounds can exert an in vitro relaxation effect of the coronary artery and improve the heart function in Langendorff apparatus. This action appears to be endothelium dependent but not NO mediated. Cell culture findings indicated that wogonin can exert vascular and cellular protection by scavenging Reactive Oxygen Species.
- [Hydatid cyst of the liver: report of an exceptional mode of revelation]. [Journal Article]
- Pan Afr Med J 2014.:158.