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1.
Medicine (Baltimore) ; 100(9): e24858, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655947

RESUMEN

BACKGROUND: Essential hypertension is the primary cause of death and disability and it has become a major public health problem globally. Yufeng Ningxin (YFNX) is a commonly used Chinese patent medicine in treating essential hypertension. The objective of this protocol is to evaluate the effectiveness and safety of YFNX for the treatment of essential hypertension. METHODS: Randomized controlled trials (RCTs) in relation to the effectiveness and safety of YFNX in the treatment of essential hypertension will be systematically searched and collected from the following databases: PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database from the database inception to January 1, 2021. The data screening and extraction will be carried out by 2 different reviewers. The quality of randomized controlled trials will be assessed based on the version 2 of the risk-of-bias tool for randomized trials (RoB 2) in the Cochrane Handbook. The reduction of systolic blood pressure (SBP) and diastolic blood pressure (DBP) will be served as the primary outcome. The secondary outcomes will include average SBP and average DBP during the day and the night measured by 24 hours ambulatory blood pressure monitoring, the clinical effectiveness rate, scores of traditional Chinese medicine syndrome, clinical symptoms, the quality of life and adverse events. Statistical analysis will be conducted with Review Manager 5.3 and STATA 14.0 software. CONCLUSION: This systematic review will provide strong evidence to assess the effectiveness and safety of YFNX in the treatment of essential hypertension. TRIAL REGISTRATION NUMBER: INPLASY202110059.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Hipertensión Esencial/tratamiento farmacológico , Isoflavonas/uso terapéutico , Medicina China Tradicional/métodos , Presión Sanguínea/fisiología , Monitoreo Ambulatorio de la Presión Arterial , Medicamentos Herbarios Chinos/uso terapéutico , Hipertensión Esencial/fisiopatología , Humanos , Calidad de Vida , Resultado del Tratamiento
2.
Medicine (Baltimore) ; 100(9): e25042, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655981

RESUMEN

BACKGROUND: Coronary heart disease (CHD) is one of the highest mortality diseases in the world, which seriously threatens human health and quality of life (QOL). The purpose of this study is to systematically analyze the effects of mind-body exercise on cardiopulmonary function, blood pressure and QOL in CHD patients, and to provide scientific evidence-based exercise prescription for patients with coronary heart disease. METHODS: This research review will include the following electronic databases from its establishment to December 2020: PubMed, EMBASE, Web of Science, Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, and Wanfang. Objective to search randomized controlled trials (RCTs) about the effects of mind-body exercise on cardiopulmonary function, blood pressure and QOL in patients with coronary heart disease. CONCLUSION: This systematic review and meta-analysis will provide strong evidence for the efficacy and safety of mind-body exercise in patients with coronary heart disease. SYSTEMATIC REVIEW REGISTRATION: INPLASY202120016. ETHICS AND DISSEMINATION: Ethical approval will not be necessary since this systematic review and meta-analysis will not contain any private information of participants or violate their human rights.


Asunto(s)
Presión Sanguínea/fisiología , Enfermedad Coronaria/terapia , Terapias Mente-Cuerpo/métodos , Calidad de Vida , Enfermedad Coronaria/fisiopatología , Terapia por Ejercicio/métodos , Humanos
3.
Int Heart J ; 62(2): 344-349, 2021 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-33731516

RESUMEN

Cardiovascular event rates of patients with a dipper blood pressure (BP) and dipper heart rate (HR) pattern are lower than those of patients with nondipper BP and HR patterns. However, how the pacemaker mode affects the diurnal BP and HR patterns remains unclear.We enrolled nine patients (average age 74.4 ± 6.6 years, 4 males and 5 females) with sick sinus syndrome who required atrial pacing. We investigated sequential 6-month pacing regimens (DDD mode at 60 bpm and sleep rate mode). We set the lower rate of sleep rate mode as follows: 60 bpm during the daytime and 50 bpm during the nighttime. The order of pacing mode was randomized, with crossover design. Ambulatory BP monitoring was performed at baseline, 6 months, and 12 months, BP category was classified into four groups (extreme dipper, dipper, nondipper, and riser pattern), and HR was classified into dipper and nondipper patterns.Nighttime HR during the sleep rate mode was significantly lower than that at DDD (57.1 ± 6.2 versus 63.5 ± 3.8 bpm, P = 0.001). The dipper HR pattern was increased in the sleep rate mode compared with those at baseline or DDD mode (versus baseline: 89% versus 44%, P = 0.035; versus DDD: 89% versus 22%, P = 0.004). The dipper BP pattern significantly increased in the sleep rate mode compared with the baseline (56% versus 11%, P = 0.035), but the difference between the sleep rate mode and DDD mode was statistically marginal (56% versus 22%, P = 0.081).The pacemaker settings in the sleep rate mode increased the dipper HR and BP patterns in pacemaker-dependent patients with sick sinus syndrome.


Asunto(s)
Sistema Nervioso Autónomo/fisiopatología , Presión Sanguínea/fisiología , Ritmo Circadiano/fisiología , Atrios Cardíacos/fisiopatología , Frecuencia Cardíaca/fisiología , Marcapaso Artificial , Síndrome del Seno Enfermo/fisiopatología , Sueño/fisiología , Anciano , Monitoreo Ambulatorio de la Presión Arterial , Femenino , Humanos , Masculino , Síndrome del Seno Enfermo/terapia
4.
Int Heart J ; 62(2): 230-237, 2021 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-33731517

RESUMEN

Arterial stiffness contributes to the development of cardiovascular disease (CVD). However, the relationship between the arterial stiffness and exercise tolerance in CVD patients with preserved ejection fraction (pEF) and those with reduced EF (rEF) is unclear. We enrolled 358 patients who participated in cardiac rehabilitation and underwent cardiopulmonary exercise testing at Juntendo University Hospital. After excluding 195 patients who had undergone open heart surgery and 20 patients with mid-range EF, the patients were divided into pEF (n = 99) and rEF (n = 44) groups. Arterial stiffness was assessed using arterial velocity pulse index (AVI) and arterial pressure volume index (API) at rest. The patients in the pEF group were significantly older and had a higher prevalence of coronary artery disease than the rEF group. The pEF group had significantly lower AVI levels and higher API levels than the rEF group. In the pEF group, the peak oxygen uptake (peak VO2) and the anaerobic threshold was significantly higher than those in the rEF group. The peak VO2 was significantly and negatively correlated with AVI and API in the pEF group (All, P < 0.05), but not in the rEF group. Multivariate linear regression analyses demonstrated that AVI was independently associated with peak VO2 (ß = -0.34, P < 0.05) in the pEF group. In conclusion, AVI may be a useful factor for assessing exercise tolerance, particularly in CVD patients with pEF.


Asunto(s)
Rehabilitación Cardiaca/métodos , Enfermedades Cardiovasculares/terapia , Tolerancia al Ejercicio/fisiología , Volumen Sistólico/fisiología , Rigidez Vascular/fisiología , Anciano , Presión Sanguínea/fisiología , Enfermedades Cardiovasculares/fisiopatología , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Estudios Retrospectivos
5.
Biomed Environ Sci ; 34(2): 89-100, 2021 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-33685567

RESUMEN

Objective: The relationship between outdoor temperature and blood pressure (BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season. Methods: A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011-2015 were included in the study. A linear mixed-effect model and generalized additive mixed model (GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables. Results: The mean differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between summer and winter were 3.5 mmHg and 2.75 mmHg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mmHg (95% CI: 0.27-0.30) per 1 °C decrease in average temperature for SBP and a 0.16 mmHg (95% CI: 0.15-0.17) per 1 °C decrease in average temperature for DBP, respectively. The effects of the average temperature on both SBP and DBP were stronger in summer than in other seasons. The effects of the average temperature on BP were also greater if individuals were older, male, overweight or obese, a smoker or drinker, or had cardiovascular diseases (CVDs), hypertension, and diabetes. Conclusions: This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics (age, gender, BMI), unhealthy behaviors (smoking and alcohol consumption), and chronic disease status (CVDs, hypertension, and diabetes).


Asunto(s)
Presión Sanguínea/fisiología , Exposición a Riesgos Ambientales/estadística & datos numéricos , Adulto , China/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Estaciones del Año , Temperatura
6.
J Med Life ; 14(1): 105-110, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33767794

RESUMEN

According to the definition adopted by the international biological program, physical performance is characterized by maximum oxygen consumption (MOC). Profession, lifestyle, and sport affect the value of the MOC. For anatomy and physiology, oxygen delivery to muscle tissue depends on the state of the respiratory and cardiovascular system, the amount and composition of blood. In this case, the leading role belongs to the cardiac activity, namely to the magnitude of the shock and minute volumes of blood in working conditions. High values of MOC and, consequently, a large work capacity are characteristic of athletes specializing in cyclic sports with moderate and high power. The purpose of the research was to evaluate the adaptive response of the cardiovascular system of girls involved in cyclic and acyclic sports as well as those not involved in sports. The study was conducted in 2018. During the research, we used pulse oximetry and determination of blood pressure according to N.S. Korotkov, as well as an assessment of the adaptation of the cardiovascular system according to the Ruffier Index. Studies have shown differences in the level of performance of girls involved in cyclic sports (athletics) and acyclic sports (karate and taekwondo), as well as non-sports. During the experiments, heart rate and blood pressure indicators were recorded at rest and after exercise, and the Ruffier Index, which reflects the level of performance of the participants, was calculated.


Asunto(s)
Rendimiento Atlético/fisiología , Deportes , Presión Sanguínea/fisiología , Ejercicio Físico/fisiología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Estilo de Vida , Consumo de Oxígeno/fisiología
7.
J Vis Exp ; (168)2021 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-33645573

RESUMEN

Blood pressure (BP) and heart rate (HR) are both controlled by the autonomic nervous system (ANS) and are closely intertwined due to reflex mechanisms. The baroreflex is a key homeostatic mechanism to counteract acute, short-term changes in arterial BP and to maintain BP in a relatively narrow physiological range. BP is sensed by baroreceptors located in the aortic arch and carotid sinus. When BP changes, signals are transmitted to the central nervous system and are then communicated to the parasympathetic and sympathetic branches of the autonomic nervous system to adjust HR. A rise in BP causes a reflex decrease in HR, a drop in BP causes a reflex increase in HR. Baroreflex sensitivity (BRS) is the quantitative relationship between changes in arterial BP and corresponding changes in HR. Cardiovascular diseases are often associated with impaired baroreflex function. In various studies reduced BRS has been reported in e.g., heart failure, myocardial infarction, or coronary artery disease. Determination of BRS requires information from both BP and HR, which can be recorded simultaneously using telemetric devices. The surgical procedure is described beginning with the insertion of the pressure sensor into the left carotid artery and positioning of its tip in the aortic arch to monitor arterial pressure followed by the subcutaneous placement of the transmitter and ECG electrodes. We also describe postoperative intensive care and analgesic management. After a two-week period of post-surgery recovery long-term ECG and BP recordings are performed in conscious and unrestrained mice. Finally, we include examples of high-quality recordings and the analysis of spontaneous baroreceptor sensitivity using the sequence method.


Asunto(s)
Barorreflejo/fisiología , Presión Sanguínea/fisiología , Estado de Conciencia/fisiología , Electrocardiografía , Telemetría , Animales , Arterias Carótidas/fisiología , Ritmo Circadiano/fisiología , Electrodos Implantados , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Ratones Endogámicos C57BL , Procesamiento de Señales Asistido por Computador , Programas Informáticos
8.
Medicine (Baltimore) ; 100(7): e24761, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607824

RESUMEN

ABSTRACT: It is unclear whether antihypertensive treatment should be indicated after subarachnoid hemorrhage (SAH). Hence, we investigated the impact of blood pressure on inpatient outcomes after SAH rehabilitation.This retrospective cross-sectional study analyzed data of SAH inpatients, as obtained from the Japan Association of Rehabilitation Database for inpatients undergoing SAH rehabilitation. Inpatients admitted to a conventional ward with a diagnosis of cerebrovascular disease were voluntarily registered in this database between January 2006 and December 2013 from hospitals in Japan. Patients were categorized into hypertensive and non-hypertensive populations and assessed using the Barthel Index (BI) and the total BI score at hospital discharge. We compared the independent population (patients with the highest score for each activity) with its non-independent counterpart. Data on the patients' age, BI score on admission, total BI score, BI score increase, daily BI score increase, hospitalization duration, BI activities, patients' sex, and Brunnstrom recovery stage were compared.Eighty-eight patients with SAH were analyzed; 43 were hypertensive and 45 non-hypertensive. Hypertension was associated with increased non-independence levels (hypertensive versus non-hypertensive patients, transfers [bed to chair and back]: 15 versus 24, P = .03, odds ratio (OR) = 2.532 (95% confidence interval [CI], 1.065-6.024); toilet use: 15 versus 24, P = .03, OR = 2.532 (95% CI, 1.065-6.024); bathing: 23 versus 34, P = .0061, OR = 3.623 (95% CI, 1.414-9.259); stair climbing: 22 versus 31, P = .03, OR = 2.703 (95% CI, 1.114-6.579); and bladder control: 14 versus 24, P = .02, OR = 2.801 (95% CI, 1.170-6.711)). The total BI score of the hypertensive inpatients at discharge was lower than that of their non-hypertensive counterparts (0-75 versus 80-100, 30 versus 19, P = .03). Moreover, the BI score increase per day was significantly lower in the hypertensive group than in the non-hypertensive group (.67 versus 1.8, P = .02). The hypertensive group also had a significantly longer duration of hospitalization than the hypertensive group (52 versus 30 days, P = .02).Hypertension was associated with longer hospitalization and poorer outcomes post-discharge, suggesting the importance of strict blood pressure control in patients who have experienced SAH.


Asunto(s)
Actividades Cotidianas , Presión Sanguínea/fisiología , Hipertensión/complicaciones , Hemorragia Subaracnoidea/rehabilitación , Estudios de Casos y Controles , Estudios Transversales , Bases de Datos Factuales , Femenino , Humanos , Japón , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Hemorragia Subaracnoidea/complicaciones
9.
JAMA Netw Open ; 4(2): e2037209, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33576818

RESUMEN

Importance: Conducted electrical weapons (CEWs) are used broadly as a less-lethal force option for police officers. However, there is no clear picture of the possible health risks in humans on the basis of rigorously assessed scientific evidence from the international peer-reviewed literature. Objective: To synthesize and systematically evaluate the strength of published evidence for an association between exposure to different models of CEWs and adverse acute as well as chronic conditions. Evidence Review: Following a preregistered review protocol, the literature search strategy was based on a search of reviews published between January 1, 2000, and April 24, 2020, of PubMed, MEDLINE, EMBASE, Web of Science, PsycINFO, and Cochrane Library, as well as relevant online databases and bibliographic sources, such as reference sections of recent publications. The identified studies were independently assessed in terms of scope, relevance, methodologic bias, and quality. Peer-reviewed publications of human studies were included, using original data and with a focus on the use of taser CEWs in the context of law enforcement. Eligible studies examined clearly defined health outcomes as dependent variables following exposure to a CEW. The review followed the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. A meta-analysis could not be conducted. Findings: Of the 1081 unique records screened, 33 relevant studies were identified, all of them of experimental design and conducted in the US. Eleven studies had a low risk of bias and 22 had a higher bias risk. Studies focused on outcomes such as physiologic stress responses, heart rate, blood pressure, arrhythmias, or cognitive performance. Independently of bias risk, the studies reported few or no acute health problems, apart from the wounds caused by the darts. Furthermore, no long-term outcomes were studied. Most of the studies were performed on healthy, physically fit individuals (eg, police officers) in a controlled setting, with short exposure duration (5 seconds). Half of the studies, mainly those with a higher risk of bias, were at least partly funded by the manufacturer. Conclusions and Relevance: Based on the findings of the reviewed studies, the risk for adverse health outcomes due to CEW exposure can be currently estimated as low. However, most of the reviewed studies had methodologic limitations. Considering that recruited participants were not representative of the population that usually encounters a CEW deployment, it is not possible to draw conclusions regarding exposure outcomes in potentially vulnerable populations or high-risk groups, such as those under the influence of substances.


Asunto(s)
Presión Sanguínea/fisiología , Cognición/fisiología , Lesiones por Armas Conductoras de Energía/fisiopatología , Frecuencia Cardíaca/fisiología , Armas , Acidosis Láctica/epidemiología , Acidosis Láctica/etiología , Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/etiología , Enfermedad Crónica , Lesiones por Armas Conductoras de Energía/complicaciones , Voluntarios Sanos , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , Policia , Apoyo a la Investigación como Asunto , Medición de Riesgo , Factores de Tiempo
10.
Life Sci ; 272: 119242, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33607155

RESUMEN

AIMS: Recent studies have shown that enhancement of fatty acid utilization through feeding animals a high fat diet (HFD) attenuated cardiac dysfunction in heart failure (HF). Here, we aimed to examine the temporal effects of HFD feeding on cardiac function in mice with heart failure and its underlying mechanism. MAIN METHODS: Pressure overload-induced HF was established via transverse aortic constriction (TAC) surgery. After surgery, the mice were fed on either normal diet or HFD for 8 or 16 weeks. KEY FINDINGS: HFD feeding exerted opposite effects on cardiac function at different time points post-surgery. Short-term HFD feeding (8 wk) protected the heart against pressure overload, inhibiting cardiac hypertrophy and improving cardiac function, while long-term HFD feeding (16 wk) aggravated cardiac dysfunction in TAC mice. Short-term HFD feeding elevated cardiac fatty acid utilization, while long-term HFD feeding showed no significant effects on cardiac fatty acid utilization in TAC mice. Specifically, an increase in cardiac fatty acid utilization was accompanied with activated mitophagy and improved mitochondrial function. Palmitic acid treatment (400 µM, 2 h) stimulated fatty acid oxidation and mitophagy in neonatal myocytes. Mechanistically, fatty acid utilization stimulated mitophagy through upregulation of Parkin. Cardiac-specific knockdown of Parkin abolished the protective effects of short-term HFD feeding on cardiac function in TAC mice. SIGNIFICANCES: These results suggested that short-term but not long-term HFD feeding protects against pressure overload-induced heart failure through activation of mitophagy, and dietary fat intake should be used with caution in treatment of heart failure.


Asunto(s)
Insuficiencia Cardíaca/metabolismo , Insuficiencia Cardíaca/prevención & control , Mitofagia/fisiología , Animales , Presión Sanguínea/fisiología , Cardiomegalia/metabolismo , China , Dieta Alta en Grasa/métodos , Modelos Animales de Enfermedad , Metabolismo Energético , Ácidos Grasos/metabolismo , Insuficiencia Cardíaca/fisiopatología , Masculino , Ratones , Ratones Endogámicos C57BL , Miocardio/metabolismo , Miocitos Cardíacos/metabolismo , Oxidación-Reducción
11.
Isr Med Assoc J ; 23(2): 107-110, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33595216

RESUMEN

BACKGROUND: Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy characterized by an acute reversible left ventricular dysfunction with typical apical ballooning, usually with subsequent complete spontaneous recovery. TTS shares several features with acute coronary syndrome (ACS), including clinical presentation, ECG changes, and elevated troponin. OBJECTIVES: To identify different features that may help differentiate between TTS and ACS with presentation based on presenting symptoms and physical examination. METHODS: We compared 35 patients who TTS had been diagnosed with 60 age- and sex- matched patients with ACS (both ST and non-ST segment elevation myocardial infarction) who were hospitalized in Galilee Medical Center through 2011-2015.Basic characteristics and clinical features of the two groups were compared using appropriate statistical tests. RESULTS: Of the patients with TTS, 21 (60%) reported an emotional trigger (60%) before admission, although they did not have increased prevalence of psychiatric disease compared to ACS patients (5.7% vs. 5%, P = 0.611). There was no difference in the type of chest pain or accompanied symptoms between the groups. Of notice, ECG changes in the TTS group were prominent in the anterior leads, and the patients presented with higher heart rate (86 ± 17 vs. 79 ± 15, P = 0.029) and lower systolic blood pressure (129 ± 26 vs. 142 ± 30, P = 0.034) on admission compared to the ACS group. CONCLUSIONS: There was no reliable feature that could distinguish TTS from ACS based on clinical presentation. TTS should always be in the differential diagnosis in patients with acute chest pain, especially in elderly women.


Asunto(s)
Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/fisiopatología , Electrocardiografía , Cardiomiopatía de Takotsubo/fisiopatología , Anciano , Anciano de 80 o más Años , Presión Sanguínea/fisiología , Dolor en el Pecho/epidemiología , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Cardiomiopatía de Takotsubo/diagnóstico , Troponina/metabolismo
12.
Medicine (Baltimore) ; 100(5): e24127, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592863

RESUMEN

BACKGROUND: It is well known that morning blood pressure surge increases the risk of myocardial events in the first several hours post-awakening. This meta-analysis was performed to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge. METHODS: Articles in 4 databases about clinical trials of ingestion time of antihypertensive drugs were searched and performed a meta-analysis to evaluate the different effects on morning blood pressure and absolute blood pressure (BP) reduction from baseline of between bedtime administration (experimental group) and morning awaking administration (control group). RESULTS: The aim of this study is to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge. CONCLUSIONS: The bedtime will provide evidence support for clinicians and patients for reducing morning blood pressure surge. ETHICS AND DISSEMINATION: This study does not require ethical approval.


Asunto(s)
Antihipertensivos , Cronoterapia de Medicamentos , Hipertensión , Antihipertensivos/administración & dosificación , Antihipertensivos/farmacocinética , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Monitoreo Ambulatorio de la Presión Arterial/métodos , Humanos , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
13.
Health Psychol ; 40(3): 196-206, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33630641

RESUMEN

Meta-analyses suggest a small association between cardiovascular responses to acute stressors and cardiovascular disease, but a recent review suggests that this effect may be underestimated due to insufficient consideration of individual differences in habituation to repeated stressors. OBJECTIVE: The present article reports new analyses of a published randomized controlled trial comparing the effects of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and a passive control condition on blood pressure habituation-a secondary outcome. Psychological mediators of intervention effects were examined. METHOD: Participants (138 healthy adults reporting moderate/high stress) were randomly assigned to 6-week MBSR, CBT, or a waitlist control. Analyses were conducted on 86 participants who subsequently completed stressful speech and mental arithmetic tasks during two posttreatment visits scheduled 48 hr apart. Blood pressure was measured -15, +0, +5, +10, +25, +35, and +60 min poststressor onset. RESULTS: There were no between-condition differences in blood pressure habituation (all ps > .05). However, both MBSR and CBT led to increased perceived control over thoughts, F(2, 72) = 5.20, p = .008, and individuals who displayed a greater change in perceived control over thoughts also displayed greater habituation to the speech portion of the stressor, F(6, 799) = 2.32, p = .020. Results implied an indirect effect of stress reduction interventions on blood pressure habituation via change in perceived control over thoughts (b = -3.93, SE = 1.98, 95% CI: [-8.392, -0.701]). CONCLUSION: Stress reduction interventions that increase perceived control over thoughts may benefit cardiovascular health by promoting blood pressure habituation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Presión Sanguínea/fisiología , Atención Plena/métodos , Estrés Psicológico/terapia , Adulto , Índice de Masa Corporal , Terapia Cognitivo-Conductual/métodos , Femenino , Promoción de la Salud , Humanos , Masculino , Meditación/métodos , Persona de Mediana Edad , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto Joven
14.
Ecotoxicol Environ Saf ; 213: 112028, 2021 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-33607335

RESUMEN

The associations of vanadium exposure with hypertension risk in animal studies are inconsistent. Furthermore, epidemiologic studies on this topic are scarce. We aimed to assess the associations of vanadium exposure with hypertension prevalence and blood pressure levels in a general Chinese population. We measured urinary vanadium concentrations in 1867 participants to evaluate their internal exposure levels. The associations of urinary vanadium concentrations, categorized into quartiles or treated as continuous variables by logarithm transformation (log2), with hypertension prevalence and blood pressure levels were assessed by the multivariable logistic and linear regression models, respectively. We used the restricted cubic spline model to evaluate the dose-response relationship. Compared with the bottom quartile of vanadium, participants in the third and fourth quartile had an adjusted odds ratio of 2.04 (95% CI:1.40, 2.96) and 2.08 (95% CI:1.42, 3.06) for hypertension, with a linear dose-response relationship. The corresponding number for a doubling of vanadium concentrations was 1.25 (95% CI:1.12, 1.39). Besides, a doubling of vanadium concentrations was associated with a 0.66 (95% CI: 0.01, 1.31) and 0.90 (95% CI: 0.50, 1.31) mm Hg increased systolic and diastolic blood pressure level, respectively. Vanadium exposure was associated with increased hypertension prevalence and blood pressure levels. Prospective studies are needed to confirm our findings in other populations.


Asunto(s)
Presión Sanguínea/fisiología , Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/orina , Hipertensión/epidemiología , Vanadio/orina , Adulto , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Estudios Prospectivos
15.
Cochrane Database Syst Rev ; 2: CD013501, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33629376

RESUMEN

BACKGROUND: Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets have gained popularity and there is a need to synthesise existing clinical trial evidence for their potential in CVD prevention. OBJECTIVES: To determine the effectiveness of following a vegan dietary pattern for the primary and secondary prevention of CVD. SEARCH METHODS: We searched the following electronic databases on 4 February 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Web of Science Core Collection. We also searched ClinicalTrials.gov in January 2021. We applied no language restrictions. SELECTION CRITERIA: We selected randomised controlled trials (RCTs) in healthy adults and adults at high risk of CVD (primary prevention) and those with established CVD (secondary prevention). A vegan dietary pattern excludes meat, fish, eggs, dairy and honey; the intervention could be dietary advice, provision of relevant foods, or both. The comparison group received either no intervention, minimal intervention, or another dietary intervention. Outcomes included clinical events and CVD risk factors. We included only studies with follow-up periods of 12 weeks or more, defined as the intervention period plus post-intervention follow-up. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, extracted data and assessed risks of bias. We used GRADE to assess the certainty of the evidence. We conducted three main comparisons: 1. Vegan dietary intervention versus no intervention or minimal intervention for primary prevention; 2. Vegan dietary intervention versus another dietary intervention for primary prevention; 3. Vegan dietary intervention versus another dietary intervention for secondary prevention. MAIN RESULTS: Thirteen RCTs (38 papers, 7 trial registrations) and eight ongoing trials met our inclusion criteria. Most trials contributed to primary prevention: comparisons 1 (four trials, 466 participants randomised) and comparison 2 (eight trials, 409 participants randomised). We included only one secondary prevention trial for comparison 3 (63 participants randomised). None of the trials reported on clinical endpoints. Other primary outcomes included lipid levels and blood pressure. For comparison 1 there was moderate-certainty evidence from four trials with 449 participants that a vegan diet probably led to a small reduction in total cholesterol (mean difference (MD) -0.24 mmol/L, 95% confidence interval (CI) -0.36 to -0.12) and low-density lipoprotein (LDL) cholesterol (MD -0.22 mmol/L, 95% CI -0.32 to -0.11), a very small decrease in high-density lipoprotein (HDL) levels (MD -0.08 mmol/L, 95% CI -0.11 to -0.04) and a very small increase in triglyceride levels (MD 0.11 mmol/L, 95% CI 0.01 to 0.21). The very small changes in HDL and triglyceride levels are in the opposite direction to that expected. There was a lack of evidence for an effect with the vegan dietary intervention on systolic blood pressure (MD 0.94 mmHg, 95% CI -1.18 to 3.06; 3 trials, 374 participants) and diastolic blood pressure (MD -0.27 mmHg, 95% CI -1.67 to 1.12; 3 trials, 372 participants) (low-certainty evidence). For comparison 2 there was a lack of evidence for an effect of the vegan dietary intervention on total cholesterol levels (MD -0.04 mmol/L, 95% CI -0.28 to 0.20; 4 trials, 163 participants; low-certainty evidence). There was probably little or no effect of the vegan dietary intervention on LDL (MD -0.05 mmol/L, 95% CI -0.21 to 0.11; 4 trials, 244 participants) or HDL cholesterol levels (MD -0.01 mmol/L, 95% CI -0.08 to 0.05; 5 trials, 256 participants) or triglycerides (MD 0.21 mmol/L, 95% CI -0.07 to 0.49; 5 trials, 256 participants) compared to other dietary interventions (moderate-certainty evidence). We are very uncertain about any effect of the vegan dietary intervention on systolic blood pressure (MD 0.02 mmHg, 95% CI -3.59 to 3.62)  or diastolic blood pressure (MD 0.63 mmHg, 95% CI -1.54 to 2.80; 5 trials, 247 participants (very low-certainty evidence)). Only one trial (63 participants) contributed to comparison 3, where there was a lack of evidence for an effect of the vegan dietary intervention on lipid levels or blood pressure compared to other dietary interventions (low- or very low-certainty evidence). Four trials reported on adverse events, which were absent or minor. AUTHORS' CONCLUSIONS: Studies were generally small with few participants contributing to each comparison group. None of the included studies report on CVD clinical events. There is currently insufficient information to draw conclusions about the effects of vegan dietary interventions on CVD risk factors. The eight ongoing studies identified will add to the evidence base, with all eight reporting on primary prevention. There is a paucity of evidence for secondary prevention.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Dieta Vegana , Prevención Primaria , Prevención Secundaria , Adulto , Sesgo , Presión Sanguínea/fisiología , Colesterol/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevención Primaria/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia , Prevención Secundaria/estadística & datos numéricos , Triglicéridos/sangre
16.
Cochrane Database Syst Rev ; 2: CD008823, 2021 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-33630309

RESUMEN

BACKGROUND: Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low-cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings. OBJECTIVES: To determine the effect of walking as a physical activity intervention on blood pressure and heart rate. SEARCH METHODS: We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA: Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non-intervention control on blood pressure and heart rate were included. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings. MAIN RESULTS: A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias. Primary outcome We found moderate-certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n = 5060). We found moderate-certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD -4.41 mmHg, 95% CI -6.17 to -2.65; 14 studies, n = 491), and low-certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD -3.79 mmHg, 95% CI -5.64 to -1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD -4.30 mmHg, 95% CI -6.17 to -2.44, 24 studies, n = 2610). We also found low certainty-evidence suggesting that walking reduces SBP in both females (MD -5.65 mmHg, 95% CI -7.89 to -3.41; 22 studies, n = 1149) and males (MD -4.64 mmHg, 95% CI -8.69 to -0.59; 6 studies, n = 203). Secondary outcomes We found low-certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n = 4711) and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n = 1747). We found moderate-certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD -3.01 mmHg, 95% CI -4.44 to -1.58; 14 studies, n = 491) and low-certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD -1.74 mmHg, 95% CI -2.95 to -0.52; 32 studies, n = 1730) and those aged 60 years and over (MD -1.33 mmHg, 95% CI -2.40 to -0.26; 23 studies, n = 2490). We found moderate-certainty evidence that suggests walking reduces DBP for males (MD -2.54 mmHg, 95% CI -4.84 to -0.24; 6 studies, n = 203) and low-certainty evidence that walking reduces DBP for females (MD -2.69 mmHg, 95% CI -4.16 to -1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times. AUTHORS' CONCLUSIONS: Moderate-certainty evidence suggests that walking probably reduces SBP. Moderate- or low-certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low-certainty evidence suggests that walking may reduce DBP and heart rate. Moderate- and low-certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.


Asunto(s)
Presión Sanguínea/fisiología , Frecuencia Cardíaca/fisiología , Hipertensión/terapia , Caminata/fisiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Sesgo , Diástole , Femenino , Humanos , Traumatismos de la Rodilla/etiología , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Sístole , Factores de Tiempo , Caminata/clasificación , Adulto Joven
17.
Menopause ; 28(3): 255-262, 2021 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-33570873

RESUMEN

OBJECTIVE: To examine whether blood pressure (BP) accelerates more rapidly during the menopause transition for women with a history of preterm or term small for gestational age (SGA) delivery compared to women with all term and appropriate for gestational age (AGA) births. METHODS: A longitudinal analysis was conducted with 1,008 parous women who had BP data at ≥2 study visits. We used generalized linear modeling to examine BP before the final menstrual period, at the final mentrual period, and up to 10 years after the final menstrual period, according to pregnancy group. We assessed maternal changes in BP over time in relation to years near the final menstrual period using a piece-wise linear model, consistent with menopause-induced changes. Models were adjusted for socio-demographics, body mass index, smoking, physical activity, medications, parity, age at first birth, gestational diabetes, and gestational hypertension/preeclampsia. RESULTS: At baseline, women were on average 46 years old, 101 (10%) reported a prior preterm birth, and 102 (10.1%) reported a term SGA birth. Compared to women with all term AGA births, women with a term SGA birth had higher BP before the final menstrual period, at the final menstrual period, and up to 10 years after the final menstrual period; women with a preterm birth had higher BP in the postmenopausal years. Annual rate of change in BP during the menopause transition did not differ between pregnancy groups. CONCLUSIONS: Women with a history preterm and term SGA delivery have higher BP than women with all term AGA births during the menopause transition, but rate of change in BP does not differ in these groups relative to final menstrual period.


Asunto(s)
Presión Sanguínea/fisiología , Hipertensión/complicaciones , Menopausia/fisiología , Nacimiento Prematuro/epidemiología , Premenopausia/fisiología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Persona de Mediana Edad , Vigilancia de la Población , Embarazo , Factores de Riesgo , Salud de la Mujer
18.
Br J Radiol ; 94(1119): 20200796, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33476176

RESUMEN

OBJECTIVE: To identify the gender-specific differences in carotid artery structural and stiffening parameters by radiofrequency ultrasound (RFU) with an automatic arterial stiffness analyzing system. METHODS: Seventy-two consecutive individuals (32 males and 40 females, age range from 36 to 62 years) with no history of significant cardiovascular diseases or carotid artery plaques were enrolled between September and December 2017. Quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) parameters were automatically computed, including pulse wave velocity (PWV), vascular distension, compliance coefficient (CC), distensibility coefficient (DC), stiffness index α and ß, augmentation pressure (AP), and augmentation index (AIx). Those parameters were compared between males and females. Multiple linear regression analysis was performed to assess the independent association between gender and RFU parameters. RESULTS: The mean age had no difference between males and females (47.8 ± 3.3 vs 50.0 ± 8.5 years, p = 0.19). Females had higher systolic blood pressure (134.53 ± 9.65 vs 127.78 ± 6.12 mm Hg) and diastolic blood pressure (85.83 ± 3.94 vs 78.03 ± 5.22 mm Hg), greater carotid QIMT (598.73 ± 72.16 vs 550.84 ± 29.37 µm), advanced PWV (8.08 ± 1.60 vs 6.24 ± 0.70 m/s), higher stiffness index α (6.21 ± 1.94 vs 3.95 ± 0.78) and ß (9.43 ± 3.17 vs 6.38 ± 0.78), higher AP (6.68 ± 2.24 vs 3.64 ± 1.22 mm Hg) and AIx (7.42 ± 2.08 vs 4.69 ± 1.26%), all p < 0.001. Multiple linear regression analysis demonstrated gender was independently associated with carotid structural and elastic parameters. CONCLUSION: Gender independently impacts carotid structure and function, with females more vulnerable to the progression of arterial aging. Awareness of the gender differences on the risk stratification of carotid artery disease will benefit reliable assessments and specific management recommendations in clinical practice. ADVANCES IN KNOWLEDGE: (1) RFU provides an µm-unit quality IMT measurement and multiple quality arterial stiffness parameters. (2) Gender is an independent determinant in both the arterial structural and elastic aspects, with females of stiffer arteries in low CVD risk individuals.


Asunto(s)
Presión Sanguínea/fisiología , Arterias Carótidas/diagnóstico por imagen , Ultrasonografía/métodos , Rigidez Vascular/fisiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales
19.
Life Sci ; 268: 118991, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33417955

RESUMEN

AIMS: The objective of this study was to investigate the effects of administering sacran, a sulfated polysaccharide, on liver biology, gut microbiota, oxidative stress, and inflammation on stroke-prone spontaneously hypertensive (SHRSP5/Dmcr) rats that develop fibrotic steatohepatitis with histological similarities to that of non-alcoholic steatohepatitis (NASH). MAIN METHODS: Four groups of 8-week-old SHRSP5/Dmcr rats were fed a high fat-cholesterol (HFC) diet for 4 and 8 weeks and administered either sacran (80 mg/kg/day) or a non-treatment, respectively. Liver function was evaluated by biochemical and histopathological analyses. Hepatic inflammatory markers were measured using mRNA expression. Fecal microbial profiles were determined via 16S rRNA sequencing. A triglyceride (TG) absorption test was administered to the 8-week-old Sprague-Dawley (SD) rats. KEY FINDING: Sacran administration was observed to decrease the extent of oxidative stress and hepatic biochemical parameters in serum and hepatic injury with the levels of transforming growth factor-beta (TGF-ß1) and tumor necrosis factor-alpha (TNF-α), being increased compared to those of the non-treatment group. At the genus level, sacran administration caused a significant decrease in the harmful Prevotella genus, and a significant increase in the useful Blautia genus was observed. Sacran administration also decreased the serum TG increase that was induced by administering corn oil to the SD rats. SIGNIFICANCE: We conclude that sacran administration has the potential to reduce the absorption of lipids into blood and to improve several gut microbiotas, in the gastrointestinal tract, thereby inhibiting the subsequent development of oxidative stress and hepatic markers in the systematic circulation on NASH.


Asunto(s)
Microbioma Gastrointestinal/efectos de los fármacos , Lípidos/farmacocinética , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Polisacáridos/farmacología , Animales , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Peso Corporal/efectos de los fármacos , Dieta Alta en Grasa/efectos adversos , Modelos Animales de Enfermedad , Microbioma Gastrointestinal/fisiología , Metabolismo de los Lípidos/efectos de los fármacos , Lípidos/sangre , Masculino , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Enfermedad del Hígado Graso no Alcohólico/microbiología , Ratas Endogámicas SHR , Ratas Sprague-Dawley
20.
J Clin Hypertens (Greenwich) ; 23(2): 238-244, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33491247

RESUMEN

Arterial hypertension represented one of the most common comorbidities in patients with COVID-19. However, the impact of hypertension on outcome in COVID-19 patients is not clear. Close connections between inflammation and blood pressure (BP) have been described, and inflammation plays a key role in the outcome for patients with COVID-19. Whether hypertension impairs the relationship between inflammation, BP, and outcomes in this context is not known. The aim of this study was to examine the effects of the interactions between inflammation and hypertension status on BP and clinical outcome in patients hospitalized with COVID-19. We designed a retrospective study in 129 patients hospitalized with COVID-19 at Toulouse University Hospital. The hospital outcome was admission to the intensive care unit or death. The inflammatory markers were blood C-reactive protein level (CRP), neutrophil to lymphocyte, and platelet to lymphocyte ratios. We identified strong correlations between CRP (P < .01) and the other inflammatory markers recorded on admission (P < .001) with mean BP within 3 days after admission in normotensive patients, whereas these correlations were absent in patients with hypertension. Also, we observed after multivariate adjustment (P < .05) that CRP level predicted a worse prognosis in hypertensive patients (relative risk 2.52; 95% confidence intervals [1.03- 6.17]; P = .04), whereas CRP was not predictive of outcome in patients without hypertension. In conclusion, the study revealed that in COVID-19 patients, hypertension impairs the relationship between inflammation and BP and interacts with inflammation to affect prognosis. These findings provide insights that could explain the relationship between hypertension and outcomes in COVID-19 patients.


Asunto(s)
Presión Sanguínea/fisiología , Hipertensión/fisiopatología , Mediadores de Inflamación/sangre , Adulto , Biomarcadores/sangre , Presión Sanguínea/efectos de los fármacos , Proteína C-Reactiva/análisis , /epidemiología , Estudios de Casos y Controles , Femenino , Francia/epidemiología , Hospitalización , Humanos , Hipertensión/complicaciones , Masculino , Pronóstico , Estudios Retrospectivos , /genética
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