Astaxanthin Ameliorates Blood Pressure in Salt-Induced Prehypertensive Rats Through ROS/MAPK/NF-κB Pathways in the Hypothalamic Paraventricular Nucleus.

Astaxanthin (AST) has a variety of biochemical effects, including anti-inflammatory, antioxidative, and antihypertensive functions. The aim of the present study was to determine whether AST ameliorates blood pressure in salt-induced prehypertensive rats by ROS/MAPK/NF-κB pathways in hypothalamic paraventricular nucleus.To explore the central effects of AST on the development of blood pressure, prehypertensive rats were induced by a high-salt diet (HS, 8% NaCl) and its control groups were treated with normal-salt diet (NS, 0.3% NaCl). The Dahl salt-sensitive (S) rats with HS diet for 6 weeks received AST or vehicle by gastric perfusion for 6 weeks. Compared to those with NS diet, rats with HS diet exhibited increased mean arterial pressure (MAP) and heart rate (HR). These increases were associated with higher plasma level of norepinephrine (NE), interleukin 1ß (IL-1ß), and interleukin 6 (IL-6); elevated PVN level of reactive oxygen species (ROS), NOX2, and NOX4, that of IL-1ß, IL-6, monocyte chemotactic protein 1 (MCP-1), tyrosine hydroxylase (TH), phosphorylation extracellular-signal-regulated kinase (p-ERK1/2), phosphorylation Jun N-terminal kinases (p-JNK), nuclear factor-kappa B (NF-κB) activity; and lower levels of IL-10, superoxide dismutase (SOD), and catalase (CAT) in the PVN. In addition, our data demonstrated that chronic AST treatment ameliorated these changes in the HS but not NS diet rats. These data suggested that AST could alleviate prehypertensive response in HS-induced prehypertension through ROS/MAPK/NF-κB pathways in the PVN.

Impact of different dietary fat sources on blood pressure in Chinese adults.

OBJECTIVES: To investigate the association between the source of dietary fat and blood pressure for Chinese people aged between 30-59 with the aim of elucidating methods of hypertension prevention. DESIGN: Prospective cohort study using national survey data. PARTICIPANTS: 1,104 adults aged between 30-59 with normal blood pressures in 2006 were included in the study. Adults with history of prehypertension, hypertension, or were taking hypertension drugs in 2006 were excluded. Participants with implausibly high or low daily total energy intakes (<600 kcal/d or >5000 kcal/d) were excluded. Pregnant women, breastfeeding women, and people with motor impairment were excluded. RESULTS: People with abnormal blood pressure ingested a lower percent of dietary fat taken from seafood (P < 0.001) and a higher percent of dietary fat taken from fast food (P < 0.001). Dietary fat obtained from seafood and dairy products can be protective against abnormal blood pressure with a RR = 0.01 (95% CI: 0.001 to 0.25; P = 0.004) for seafood, and RR = 0.14 (95% CI: 0.04 to 0.44; P = 0.001) for egg, milk, and dairy products. CONCLUSION: Seafood, egg, milk, and dairy products can be recommended as sources of dietary fat to reduce the incidence of hypertension and prehypertension while fast food should be avoided.

Effects of forest bathing on pre-hypertensive and hypertensive adults: a review of the literature.

The aim in this literature review was (1) to explore the physiologically and psychologically therapeutic benefits of forest bathing on adults suffering from pre-hypertension or hypertension, and (2) to identify the type, duration, and frequency of an effective forest bathing intervention in the management of pre-hypertension and hypertension, so as to provide directions for future interventions or research. The electronic databases PubMed, Cochrane Library, CINAHL, PsyINFO, and the China Academic Journals (CAJ) offered through the Full-text Database (CNKI) were searched for relevant studies published from the inception of the databases to April 2019. Of the 364 articles that were identified, 14 met the criteria for inclusion in this review. The synthesis of the findings in the included studies revealed that forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants. Forest walking and forest therapy programs were the two most effective forest bathing interventions. Studies reported that practicing a single forest walking or forest therapy program can produce short-term physiological and psychological benefits. It is concluded that forest bathing, particularly forest walking and therapy, has physiologically and psychologically relaxing effects on middle-aged and elderly people with pre-hypertension and hypertension.

Elevated Blood Pressure and Associations with Sodium Intake Among Multiethnic Youth in Edmonton, Canada: Findings from WHY ACT NOW.

INTRODUCTION: This study examined the prevalence of pre-hypertension (PHT) and hypertension (HT) in urban youth, and assessed the effects of sodium intake and obesity on blood pressure (BP) by ethnicity. METHODS: A convenience sample of 557 multiethnic youth, aged 11-23 years, was recruited from 12 schools and institutions in Edmonton, Alberta, Canada. Participants were divided by self-identified ethnicity into four groups (Indigenous, African and Middle Eastern (AME), Asian, and European). RESULTS: Between October 2013 and March 2014, one-on-one interviews were conducted to collect data on demographics, physical activity, diet, and Body Mass Index (BMI). BP was obtained at two different times during the interview and measured a third time in cases of high variability. The standard deviation scores (SDS) of systolic BP (SBP) and diastolic BP (DBP) were used to estimate associations with sodium intake (per 1000 mg/day). Overall, 18.2% and 5.4% of the participants had PHT and HT, respectively. Indigenous and AME participants showed the highest rates of PHT (23.1%). Indigenous and European participants showed higher rates of HT (8.3% and 5.3%, respectively) than other ethnic groups (AME = 4.4%, Asian = 3.9%). There was a positive association between 1000 mg/day increase in sodium intake and SDS of SBP by 0.041 (95% CI 0.007-0.083; p = 0.04) among pre-hypertensive participants. Over 85% of participants exceeded the recommended dietary sodium intake. Mean BMI and dietary sodium intake were higher among pre-hypertensive participants (4219 mg/day) than normotensive (3475 mg/day). CONCLUSIONS: The prevalence of HT varied by ethnicity. High dietary sodium intake was of concern. There is a need for culturally-tailored, population-based interventions to reduce sodium intake.

The management of prehypertension in young adults.

The incidence of prehypertension (blood pressure 120-139 and/or 80-89 mm Hg) in young adults worldwide ranges from ~37.5% to 77.1%. Identifying high-risk groups of prehypertension in young adults is helpful for early and effective interventions and treatments to reduce the occurrence of future hypertension and organ damage. This review summarized the epidemiological characteristics, disease intervention measures, and disease progression characteristics of prehypertension to provide a basis for the development of targeted intervention measures for young adults with prehypertension.

Nonalcoholic Fatty Liver Disease: An Emerging Driver of Hypertension.

Hypertension, a multifactorial disorder resulting from the interplay between genetic predisposition and environmental risk factors, affects ≈30% of adults. Emerging evidence has shown that nonalcoholic fatty liver disease (NAFLD), as an underestimated metabolic abnormality, is strongly associated with an increased risk of incident prehypertension and hypertension. However, the role of NAFLD in the development of hypertension is still obscure and is highly overlooked by the general public. Herein, we highlight the epidemiological evidence and putative mechanisms focusing on the emerging roles of NAFLD in hypertension, with the purpose of reinforcing the notion that NAFLD may serve as an independent risk factor and an important driving force in the development and progression of hypertension. Finally, we also briefly summarize the current potential treatments for NAFLD that might also be beneficial approaches against hypertension.

Raw garlic consumption is inversely associated with prehypertension in a large-scale adult population.

Previous studies have shown that allicin can lower blood pressure (BP) by reducing oxidative stress and inflammation. However, the association between habitual raw garlic intake (as allicin source) and prehypertension are unclear. The aim of this study was to investigate how raw garlic consumption is associated with prehypertension in an adult population. A cross-sectional study was conducted with 22,812 adults (mean [standard deviation] age: 39.4 [10.7] years; males, 47.7%) in Tianjin, China. Raw garlic consumption was assessed using a validated food frequency questionnaire. BP was measured at least twice by trained nurses using an automatic device. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg without taking antihypertensive medication. Multiple logistic regression models were used to assess the association between raw garlic consumption and prehypertension. The prevalence of prehypertension was 49.9%. After fully adjusting for potential confounders, the ORs (95% confidence intervals) of having prehypertension by increasing frequency of raw garlic consumption were 1.00 (reference) for ≤3 times/week, 0.96 (0.87, 1.06) for 4 times/week to 1 time/day, and 0.69 (0.52, 0.90) for ≥2 times/day (p for trend = 0.06). In contrast, no associations were observed between other kinds of allium vegetables consumption and prehypertension. In conclusion, our results suggested that a more frequent consumption of raw garlic was inversely associated with prehypertension. This is the first large-scale study on the association between raw garlic consumption and prehypertension in the general population.

Physical Activity to Prevent and Treat Hypertension: A Systematic Review.

PURPOSE: This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS: We performed a systematic review to identify systematic reviews and meta-analyses involving adults with normal BP, prehypertension, and hypertension published from 2006 to February 2018. RESULTS: In total, 17 meta-analyses and one systematic review with 594,129 adults ≥18 yr qualified. Strong evidence demonstrates: 1) an inverse dose-response relationship between PA and incident hypertension among adults with normal BP; 2) PA reduces the risk of cardiovascular disease (CVD) progression among adults with hypertension; 3) PA reduces BP among adults with normal BP, prehypertension, and hypertension; and 4) the magnitude of the BP response to PA varies by resting BP, with greater benefits among adults with prehypertension than normal BP. Moderate evidence indicates the relationship between resting BP and the magnitude of benefit does not vary by PA type among adults with normal BP, prehypertension, and hypertension. Limited evidence suggests the magnitude of the BP response to PA varies by resting BP among adults with hypertension. Insufficient evidence is available to determine if factors such as sex, age, race/ethnicity, socioeconomic status, and weight status or the frequency, intensity, time, and duration of PA influence the associations between PA and BP. CONCLUSIONS: Future research is needed that adheres to standard BP measurement protocols and classification schemes to better understand the influence of PA on the risk of comorbid conditions, health-related quality of life, and CVD progression and mortality; the interactive effects between PA and antihypertensive medication use; and the immediate BP-lowering benefits of PA.

Hypertension and Pre-Hypertension Among Iranian Adults Population: a Meta-Analysis of Prevalence, Awareness, Treatment, and Control.

PURPOSE OF REVIEW: This meta-analysis and systematic review was conducted to evaluate hypertension and prehypertension prevalence, awareness, treatment, and control in Iranian adults population. RECENT FINDINGS: In this study, six international and national databases were searched from inception until August 30, 2018. Forty-eight studies performed on 417,392 participants were included in the meta-analysis. Based on the results of random effect method (95% CI), the overall prevalence of pre-hypertension, hypertension, awareness, treatment, and control were 31.6% (95% CI 24.9, 38.3; I2 = 99.7%), 20.4% (95% CI 16.5, 24.4; I2 = 99.9%), 49.3% (95% CI 44.8, 53.8; I2 = 98.5%), 44.8% (95% CI 28.3, 61.2; I2 = 99.9%), 37.4% (95% CI 29.0, 45.8; I2 = 99.3%), respectively. Considering the increasing prevalence of pre-hypertension, hypertension, as well as more than half of the participants were unaware of their disease and were not treated, the results of the present study can help policy-makers to increase hypertension awareness, control, and treatment, especially in high-risk individuals.

Arterial stiffness, plasma atherogenic index and soluble cell adhesion molecules in healthy young adults with reduced physical activity.

OBJECTIVE: To examine some anthropometric parameters, arterial stiffness, lipid profile, and soluble adhesion molecules in young adults with reduced physical activity. MATERIAL AND METHODS: The study is carried on 54 healthy young adults aged 20.97 ± 2.04 years. Two groups: 23 with reduced physical activity (INAC) and 31 with optimal physical activity (AC). Body mass index (BMI), basal metabolic rate (BMR), central aortic systolic blood pressure (CSBP, mmHg), plasma atherogenic index (AIP), and serum soluble cell adhesion molecules (sICAM-1, sVCAM-1) are followed up. RESULTS: CSBP [115.56 ± 10.22 vs. 105.13 ± 9.88*], AIP [-0.04 ± 0.18 vs. -0.08 ± 0.08**] and sICAM-1 [362.5 ± 49.95 vs. 281.75 ± 80.39**] are significantly higher, and BMR [1431 ± 297.9 vs. 1674.6 ± 365.57*] is significantly lower in the physically inactive young healthy adults. CONCLUSIONS: CSBP, AIP, and sICAM-1 are higher in young adults with reduced physical activity. This plays substantial role in the acceleration of atherogenic process and in long-term perspective could promote cardiovascular diseases.

[Arterial prehypertension in slave-descendant communities in southeast Bahia State, Brazil]. / Pré-hipertensão arterial em comunidades quilombolas do sudoeste da Bahia, Brasil.

Arterial prehypertension is a precursor of arterial hypertension and a risk factor for cardiovascular diseases. Vulnerable populations are more prone to this condition due to difficulties in access to health services. A previous study in quilombola communities (descendants of African slaves) reported a high prevalence of arterial hypertension. The current study aimed to estimate the prevalence of arterial prehypertension in quilombolas and to assess associated factors. This was a cross-sectional population-based study in individuals 18 years and older. Prehypertension was defined as arterial systolic pressure ≥ 121mmHg and < 140mmHg and/or diastolic ≥ 81mmHg and < 90mmHg. Multivariate Poisson regression with robust variance was used. Population-attributable fractions (PAF) were also calculated for the modifiable associated factors. Prevalence of prehypertension was 55% (95%CI: 50.2-59.7). Male gender (PR = 1.54), 1 to 4 complete years of schooling (PR = 1.44), and BMI classified as overweight (PR = 1.39) and obesity (PR = 1.87) showed positive association with prehypertension. Higher attributable fractions were observed in individuals with 1 to 4 years of schooling (13.7%) and those classified as overweight (9.35%) and obese (4.6%). Prevalence of prehypertension in quilombola communities was high, and its identification may allow screening and awareness-raising in a group with increased risk of cardiovascular disease and progression to full-blown hypertension. The study highlights the need for broad access to health services and specific measures for orientation, prevention, and health promotion in this population.

Resumo: A pré-hipertensão arterial é precursora da hipertensão arterial e fator de risco para doenças cardiovasculares. Populações vulneráveis estão mais propensas a esse tipo de agravo devido às dificuldades de acesso aos serviços de saúde. Pesquisa anterior realizada em comunidades quilombolas reportou elevada prevalência de hipertensão arterial. Este trabalho teve por objetivo estimar a prevalência de pré-hipertensão em quilombolas e avaliar fatores associados. Trata-se de um estudo transversal de base populacional realizado com indivíduos com 18 anos ou mais. A pré-hipertensão foi definida como pressão arterial sistólica ≥ 121mmHg e < 140mmHg e/ou diastólica ≥ 81mmgH e < 90mmHg. Empregou-se análise multivariada valendo-se de regressão de Poisson com variância robusta. Também foram calculadas frações atribuíveis populacionais (FAPs) para os fatores associados modificáveis. A prevalência de pré-hipertensão foi de 55% (IC95%: 50,2-59,7). O sexo masculino (RP = 1,54), a escolaridade de 1-4 anos completos de estudos (RP = 1,44) e as categorias de IMC sobrepeso (RP = 1,39) e obesidade (RP = 1,87) apresentaram associação positiva com a pré-hipertensão. Maiores frações atribuíveis foram observadas entre os indivíduos com escolaridade de 1-4 anos de estudos (13,7%) e entre os classificados com sobrepeso (9,35%) e obesidade (4,6%). A prevalência de pré-hipertensão nas comunidades quilombolas foi elevada, e sua identificação pode permitir o rastreamento e a sensibilização de um grupo com maior risco cardiovascular e de progressão para a hipertensão arterial. Observa-se a necessidade de amplo acesso a serviços de saúde e ações específicas voltadas à orientação, prevenção e promoção da saúde nessa população.

Resumen: La pre-hipertensión arterial es precursora de la hipertensión arterial y un factor de riesgo para enfermedades cardiovasculares. Las poblaciones vulnerables están más propensas a este tipo de problema de salud, debido a sus dificultades de acceso a los servicios de salud. La investigación anterior, realizada en comunidades quilombolas, reportó una elevada prevalencia de hipertensión arterial. Este trabajo tuvo como objetivo estimar la prevalencia de pre-hipertensión en quilombolas y evaluar sus factores asociados. Se trata de un estudio transversal de base poblacional, realizado con individuos con 18 años o más. La pre-hipertensión se definió como presión arterial sistólica ?≥ 121mmHg y < 140mmHg y/o diastólica ≥ 81mmHg y < 90mmHg. Se empleó un análisis multivariado, valiéndose de la regresión de Poisson con estimación robusta de la variancia. También se calcularon Fracciones Atribuibles Poblacionales (FAP) para los factores asociados modificables. La prevalencia de pre-hipertensión fue de un 55% (IC95%: 50,2-59,7). El sexo masculino (RP = 1,54), una escolaridad de 1 a 4 años completos de estudios (RP = 1,44) y las categorías de IMC sobrepeso (RP = 1,39) y obesidad (RP = 1,87) presentaron una asociación positiva con la pre-hipertensión. Mayores fracciones atribuibles se observaron entre los individuos con escolaridad de 1 a 4 años de estudios (13,7%) y entre los clasificados con sobrepeso (9,35%) y obesidad (4,6%). La prevalencia de pre-hipertensión en las comunidades quilombolas fue elevada, y su identificación puede permitir el rastreo y sensibilización de un grupo con mayor riesgo cardiovascular y con progresión hacia la hipertensión arterial. Se observa la necesidad de un amplio acceso a servicios de salud y acciones específicas dirigidas a la orientación, prevención y promoción de la salud en esa población.

Pré-hipertensão arterial em comunidades quilombolas do sudoeste da Bahia, Brasil / Arterial prehypertension in slave-descendant communities in southeast Bahia State, Brazil / Pre-hipertensión arterial en comunidades quilombolas del sudoeste de Bahía, Brasil

Resumo: A pré-hipertensão arterial é precursora da hipertensão arterial e fator de risco para doenças cardiovasculares. Populações vulneráveis estão mais propensas a esse tipo de agravo devido às dificuldades de acesso aos serviços de saúde. Pesquisa anterior realizada em comunidades quilombolas reportou elevada prevalência de hipertensão arterial. Este trabalho teve por objetivo estimar a prevalência de pré-hipertensão em quilombolas e avaliar fatores associados. Trata-se de um estudo transversal de base populacional realizado com indivíduos com 18 anos ou mais. A pré-hipertensão foi definida como pressão arterial sistólica ≥ 121mmHg e < 140mmHg e/ou diastólica ≥ 81mmgH e < 90mmHg. Empregou-se análise multivariada valendo-se de regressão de Poisson com variância robusta. Também foram calculadas frações atribuíveis populacionais (FAPs) para os fatores associados modificáveis. A prevalência de pré-hipertensão foi de 55% (IC95%: 50,2-59,7). O sexo masculino (RP = 1,54), a escolaridade de 1-4 anos completos de estudos (RP = 1,44) e as categorias de IMC sobrepeso (RP = 1,39) e obesidade (RP = 1,87) apresentaram associação positiva com a pré-hipertensão. Maiores frações atribuíveis foram observadas entre os indivíduos com escolaridade de 1-4 anos de estudos (13,7%) e entre os classificados com sobrepeso (9,35%) e obesidade (4,6%). A prevalência de pré-hipertensão nas comunidades quilombolas foi elevada, e sua identificação pode permitir o rastreamento e a sensibilização de um grupo com maior risco cardiovascular e de progressão para a hipertensão arterial. Observa-se a necessidade de amplo acesso a serviços de saúde e ações específicas voltadas à orientação, prevenção e promoção da saúde nessa população.

Abstract: Arterial prehypertension is a precursor of arterial hypertension and a risk factor for cardiovascular diseases. Vulnerable populations are more prone to this condition due to difficulties in access to health services. A previous study in quilombola communities (descendants of African slaves) reported a high prevalence of arterial hypertension. The current study aimed to estimate the prevalence of arterial prehypertension in quilombolas and to assess associated factors. This was a cross-sectional population-based study in individuals 18 years and older. Prehypertension was defined as arterial systolic pressure ≥ 121mmHg and < 140mmHg and/or diastolic ≥ 81mmHg and < 90mmHg. Multivariate Poisson regression with robust variance was used. Population-attributable fractions (PAF) were also calculated for the modifiable associated factors. Prevalence of prehypertension was 55% (95%CI: 50.2-59.7). Male gender (PR = 1.54), 1 to 4 complete years of schooling (PR = 1.44), and BMI classified as overweight (PR = 1.39) and obesity (PR = 1.87) showed positive association with prehypertension. Higher attributable fractions were observed in individuals with 1 to 4 years of schooling (13.7%) and those classified as overweight (9.35%) and obese (4.6%). Prevalence of prehypertension in quilombola communities was high, and its identification may allow screening and awareness-raising in a group with increased risk of cardiovascular disease and progression to full-blown hypertension. The study highlights the need for broad access to health services and specific measures for orientation, prevention, and health promotion in this population.

Resumen: La pre-hipertensión arterial es precursora de la hipertensión arterial y un factor de riesgo para enfermedades cardiovasculares. Las poblaciones vulnerables están más propensas a este tipo de problema de salud, debido a sus dificultades de acceso a los servicios de salud. La investigación anterior, realizada en comunidades quilombolas, reportó una elevada prevalencia de hipertensión arterial. Este trabajo tuvo como objetivo estimar la prevalencia de pre-hipertensión en quilombolas y evaluar sus factores asociados. Se trata de un estudio transversal de base poblacional, realizado con individuos con 18 años o más. La pre-hipertensión se definió como presión arterial sistólica ?≥ 121mmHg y < 140mmHg y/o diastólica ≥ 81mmHg y < 90mmHg. Se empleó un análisis multivariado, valiéndose de la regresión de Poisson con estimación robusta de la variancia. También se calcularon Fracciones Atribuibles Poblacionales (FAP) para los factores asociados modificables. La prevalencia de pre-hipertensión fue de un 55% (IC95%: 50,2-59,7). El sexo masculino (RP = 1,54), una escolaridad de 1 a 4 años completos de estudios (RP = 1,44) y las categorías de IMC sobrepeso (RP = 1,39) y obesidad (RP = 1,87) presentaron una asociación positiva con la pre-hipertensión. Mayores fracciones atribuibles se observaron entre los individuos con escolaridad de 1 a 4 años de estudios (13,7%) y entre los clasificados con sobrepeso (9,35%) y obesidad (4,6%). La prevalencia de pre-hipertensión en las comunidades quilombolas fue elevada, y su identificación puede permitir el rastreo y sensibilización de un grupo con mayor riesgo cardiovascular y con progresión hacia la hipertensión arterial. Se observa la necesidad de un amplio acceso a servicios de salud y acciones específicas dirigidas a la orientación, prevención y promoción de la salud en esa población.

Effect of Intensive Periodontal Therapy on Blood Pressure and Endothelial Microparticles in Patients With Prehypertension and Periodontitis: A Randomized Controlled Trial.

BACKGROUND: Although some studies show a positive association between periodontitis and blood pressure (BP) elevation, research on the effect of intensive periodontal treatment on decline in BP levels and endothelial microparticles (EMPs) without any antihypertensive management is lacking. Therefore, the present clinical trial explores whether intensive periodontal therapy would lower BP levels and EMPs of patients with prehypertension with periodontitis. METHODS: From a total 107 patients, 95 underwent randomization (47 assigned to control-treatment [CT] group and 48 assigned to intensive-treatment [IT] group) and completed the trial. Patients received intervention for 4 consecutive weeks and were followed for 6 months. Levels of BP and EMPs were evaluated at baseline and 1, 3, and 6 months after intervention. RESULTS: Periodontal conditions were significantly improved (P <0.05) 6 months after intensive periodontal treatment. In parallel, the primary outcomes including systolic and diastolic BP and EMPs were markedly reduced in the IT group compared with the CT group (absolute difference: 12.57 and 9.65 mm Hg and 581.59/µL, respectively; 95% confidence intervals: 10.45 to 14.69, 7.06 to 12.24, and 348.12 to 815.06, respectively; P <0.05). Reduction in BP levels and EMPs was related to improvement in probing depth (r = 0.358, 0.363, and 0.676, respectively, by the Pearson product-moment correlation; P = 0.009, 0.008, and P <0.001, respectively). CONCLUSION: To the best knowledge of the authors, the present study demonstrates for the first time that intensive periodontal intervention without any antihypertensive medication therapy may be an effective means to lower levels of BP and EMPs in patients with prehypertension with periodontitis.

Body mass index, fat free mass, uric acid, and renal function as blood pressure levels determinants in young adults.

AIM: We assessed some major determinants of blood pressure (BP) in young adulthood to plan a lifestyle changes policy METHODS: A cross sectional survey was held, involving 2373 high school people (age 18-21), measuring BP, body mass index (BMI), waist circumference (WCirc), fat free mass (FFM); alcohol and smoking habits were evaluated by a questionnaire. In a subset of this population (n = 60) uric acid (UA), estimated glomerular filtration rate (eGFR) were also evaluated. RESULTS: Smoking and not alcohol was correlated to systolic blood pressure (SBP) through quartiles (31.7%, 39.1%, 46.5%, 45.5%). Systolic BP was significantly correlated with FFM in the whole population (r = 0.51) as well as in SBP quartiles (r = 0.243, 0.138, 0.118, 0.204). FFM-SBP cluster analysis gave two centroids corresponding to sexes; females n = 998; coordinates (116.4 mmHg, 38.9 kg) and males n = 1068; coordinates (131.3 mmHg, 56.7 kg). In the n = 60 substudy a multiple linear regression model (multiple R = 0.741) with SBP as dependent variable and UA, FFM, BMI, eGFR as explicative ones, only UA (ß coefficent = 0.363, partial r = 0.240, P < 0.01) was the determinant of BP particularly in men. Moreover in the same group we found an inverse relationship between eGFR (albeit always in the normal range) and UA, as well as for women (r = -0.54, P < 0.01) and men (r = -0.43, P < 0.01) analyzed separately. CONCLUSIONS: A significant correlation exists between BP and FFM; UA has proven to be the most important SBP determinant. At variance with paediatric age UA was negatively correlated with renal function. Dietary intervention on UA and alcohol habits in young adults seems advisable to prevent hypertension.

Montmorency Tart cherries (Prunus cerasus L.) modulate vascular function acutely, in the absence of improvement in cognitive performance.

Cerebral blood volume and metabolism of oxygen decline as part of human ageing, and this has been previously shown to be related to cognitive decline. There is some evidence to suggest that polyphenol-rich foods can play an important role in delaying the onset or halting the progression of age-related health disorders such as CVD and Alzheimer's disease and to improve cognitive function. In the present study, an acute, placebo-controlled, double-blinded, cross-over, randomised Latin-square design study with a washout period of at least 14 d was conducted on twenty-seven, middle-aged (defined as 45-60 years) volunteers. Participants received either a 60 ml dose of Montmorency tart cherry concentrate (MC), which contained 68·0 (sd 0·26) mg cyanidin-3-glucoside/l, 160·75 (sd 0·55) mean gallic acid equivalent/l and 0·59 (sd 0·02) mean Trolox equivalent/l, respectively, or a placebo. Cerebrovascular responses, cognitive performance and blood pressure were assessed at baseline and 1, 2, 3 and 5 h following consumption. There were significant differences in concentrations of total Hb and oxygenated Hb during the task period 1 h after MC consumption (P≤0·05). Furthermore, MC consumption significantly lowered systolic blood pressure (P≤0·05) over a period of 3 h, with peak reductions of 6±2 mmHg at 1 h after MC consumption relative to the placebo. Cognitive function and mood were not affected. These results show that a single dose of MC concentrate can modulate certain variables of vascular function; however, this does not translate to improvements in cognition or mood.

Elevation of Fasting Ghrelin in Healthy Human Subjects Consuming a High-Salt Diet: A Novel Mechanism of Obesity?

Overweight/obesity is a chronic disease that carries an increased risk of hypertension, diabetes mellitus, and premature death. Several epidemiological studies have demonstrated a clear relationship between salt intake and obesity, but the pathophysiologic mechanisms remain unknown. We hypothesized that ghrelin, which regulates appetite, food intake, and fat deposition, becomes elevated when one consumes a high-salt diet, contributing to the progression of obesity. We, therefore, investigated fasting ghrelin concentrations during a high-salt diet. Thirty-eight non-obese and normotensive subjects (aged 25 to 50 years) were selected from a rural community in Northern China. They were sequentially maintained on a normal diet for three days at baseline, a low-salt diet for seven days (3 g/day, NaCl), then a high-salt diet for seven days (18 g/day). The concentration of plasma ghrelin was measured using an immunoenzyme method (ELISA). High-salt intake significantly increased fasting ghrelin levels, which were higher during the high-salt diet (320.7 ± 30.6 pg/mL) than during the low-salt diet (172.9 ± 8.9 pg/mL). The comparison of ghrelin levels between the different salt diets was statistically-significantly different (p < 0.01). A positive correlation between 24-h urinary sodium excretion and fasting ghrelin levels was demonstrated. Our data indicate that a high-salt diet elevates fasting ghrelin in healthy human subjects, which may be a novel underlying mechanism of obesity.

Effectiveness of an mHealth intervention to improve the cardiometabolic profile of people with prehypertension in low-resource urban settings in Latin America: a randomised controlled trial.

BACKGROUND: Poor diet and physical inactivity strongly affect the growing epidemic of cardiovascular disease worldwide. Mobile phone-based health interventions (mHealth) have been shown to help promote weight loss and increase physical activity and are an attractive approach for health-care systems with limited resources. We aimed to assess whether mHealth with advice for lifestyle improvements would reduce blood pressure, promote weight loss, and improve diet quality and physical activity in individuals with prehypertension living in low-resource urban settings in Latin America. METHODS: In this parallel-group, randomised controlled trial, we recruited individuals (aged 30-60 years) with systolic blood pressure between 120 and 139 mm Hg, diastolic blood pressure between 80 and 89 mm Hg, or both from health-care centres, workplaces, and community centres in low-resource urban settings in Argentina, Guatemala, and Peru. Participants were randomly assigned to receive either monthly motivational counselling calls and weekly personalised text messages to their mobile phones about diet quality and physical activity for 12 months, or usual care. Randomisation was stratified by country, and we applied minimisation by sex and age groups. Study personnel collecting and analysing data were masked to group assignment. The primary outcomes were mean between-group differences in the changes in systolic and diastolic blood pressure from baseline to 12 months in an intention-to-treat analysis of all participants who completed assessments at 12 months. Secondary outcome measures were changes in bodyweight, waist circumference, and self-reported target behaviours from baseline to 12 months. The trial is registered with ClinicalTrials.gov, number NCT01295216. FINDINGS: Between March 1, 2012, and Nov 30, 2012, we randomly assigned 637 participants to receive intervention (n=316) or usual care (n=321). 266 (84%) participants in the intervention group and 287 (89%) in the control group were assessed at 12 months. The intervention did not affect change in systolic blood pressure (mean net change -0·37 mm Hg [95% CI -2·15 to 1·40]; p=0·43) or diastolic blood pressure (0·01 mm Hg [-1·29 to 1·32]; p=0·99) compared with usual care. However, we noted a significant net reduction in bodyweight (-0·66 kg [-1·24 to -0·07]; p=0·04) and intake of high-fat and high-sugar foods (-0·75 [-1·30 to -0·20]; p=0·008) in the intervention group compared with the control group. In a prespecified subanalysis, we found that participants in the intervention group who received more than 75% of the calls (nine or more, from a maximum of 12) had a greater reduction of bodyweight (-4·85 [-8·21 to -1·48]) and waist circumference (-3·31 [-5·95 to -0·67]) than participants in the control group. Additionally, participants in the intervention group had an increase in the intake of fruits and vegetables and a decrease in diets high in sodium, fat, and simple sugars relative to participants in the control group. However, we found no changes in systolic blood pressure, diasatolic blood pressure, or physical activity in the group of participants who received more than 75% of the calls compared with the group who received less than 50% of the calls. INTERPRETATION: Our mHealth-based intervention did not result in a change in blood pressure that differed from usual care, but was associated with a small reduction in bodyweight and an improvement in some dietary habits. We noted a dose-response effect, which signals potential opportunities for larger effects from similar interventions in low-resource settings. More research is needed on mHealth, particularly among people who are poor and disproportionally affected by the cardiovascular disease epidemic and who need effective and affordable interventions to help bridge the equity gap in the management of cardiometabolic risk factors. FUNDING: National Heart, Lung, and Blood Institute (US National Institutes of Health) and the Medtronic Foundation.

Dietary proteins improve endothelial function under fasting conditions but not in the postprandial state, with no effects on markers of low-grade inflammation.

Endothelial dysfunction (ED) and low-grade inflammation (LGI) have a role in the development of CVD. The two studies reported here explored the effects of dietary proteins and carbohydrates on markers of ED and LGI in overweight/obese individuals with untreated elevated blood pressure. In the first study, fifty-two participants consumed a protein mix or maltodextrin (3×20 g/d) for 4 weeks. Fasting levels and 12 h postprandial responses of markers of ED (soluble intercellular adhesion molecule 1 (sICAM), soluble vascular cell adhesion molecule 1 (sVCAM), soluble endothelial selectin and von Willebrand factor) and markers of LGI (serum amyloid A, C-reactive protein and sICAM) were evaluated before and after intervention. Biomarkers were also combined into mean Z-scores of ED and LGI. The second study compared 4 h postprandial responses of ED and LGI markers in forty-eight participants after ingestion of 0·6 g/kg pea protein, milk protein and egg-white protein. In addition, postprandial responses after maltodextrin intake were compared with a protein mix and sucrose. The first study showed significantly lower fasting ED Z-scores and sICAM after 4 weeks on the high-protein diet (P≤0·02). The postprandial studies found no clear differences of ED and LGI between test meals. However, postprandial sVCAM decreased more after the protein mix compared with maltodextrin in both studies (P≤0·04). In conclusion, dietary protein is beneficial for fasting ED, but not for fasting LGI, after 4 weeks of supplementation. On the basis of Z-scores, postprandial ED and LGI were not differentially affected by protein sources or carbohydrates.

Higher Maternal Plasma n-3 PUFA and Lower n-6 PUFA Concentrations in Pregnancy Are Associated with Lower Childhood Systolic Blood Pressure.

BACKGROUND: Suboptimal maternal diet during pregnancy might lead to fetal cardiovascular adaptations with persistent consequences in the offspring. OBJECTIVE: We assessed the associations of maternal polyunsaturated fatty acid (PUFA) concentrations during pregnancy with childhood blood pressure. METHODS: In a population-based prospective cohort study among 4455 mothers and their children, we measured maternal second-trimester n-3 (ω-3) and n-6 (ω-6) PUFA concentrations in plasma glycerophospholipids and expressed n-3 and n-6 PUFAs as proportions of total PUFAs (wt%). Childhood blood pressure was measured at the median age of 6.0 y (95% range: 5.7-7.9 y). We used linear regression models to assess the associations of maternal PUFA wt% with childhood blood pressure at 6 y. RESULTS: Higher total maternal n-3 PUFA wt% and, specifically, docosahexaenoic acid (DHA; 22:6n-3) wt% were associated with lower childhood systolic blood pressure [differences: -0.28 (95% CI: -0.54, -0.03) and -0.29 mm Hg (95% CI: -0.54, -0.03) per SD increase of total n-3 PUFAs and DHA wt%, respectively], but not with childhood diastolic blood pressure. Total maternal n-6 PUFA wt% was positively associated with childhood systolic blood pressure [differences: 0.36 mm Hg (95% CI: 0.09, 0.62) per SD increase of total n-6 PUFA wt%], but not with childhood diastolic blood pressure. A higher n-6:n-3 PUFA ratio was associated with higher childhood systolic blood pressure (P < 0.05). Pregnancy and childhood characteristics only partly explained the observed associations. CONCLUSIONS: Higher maternal plasma n-3 PUFA and lower n-6 PUFA concentrations during pregnancy are associated with a lower systolic blood pressure in childhood. Further studies are needed to replicate these findings, explore the underlying mechanisms, and examine the long-term cardiovascular consequences.