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1.
Clin Sci (Lond) ; 134(2): 289-302, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31961431

RESUMEN

Preeclampsia (PE) is regarded as a pregnancy-associated hypertension disorder that is related to excessive inflammatory responses. Although the gut microbiota (GM) and short-chain fatty acids (SCFAs) have been related to hypertension, their effects on PE remain unknown. We determined the GM abundance and faecal SCFA levels by 16S ribosomal RNA (rRNA) sequencing and gas chromatography, respectively, using faecal samples from 27 patients with severe PE and 36 healthy, pregnant control subjects. We found that patients with PE had significantly decreased GM diversity and altered GM abundance. At the phylum level, patients with PE exhibited decreased abundance of Firmicutes albeit increased abundance of Proteobacteria; at the genus level, patients with PE had lower abundance of Blautia, Eubacterium_rectale, Eubacterium_hallii, Streptococcus, Bifidobacterium, Collinsella, Alistipes, and Subdoligranulum, albeit higher abundance of Enterobacter and Escherichia_Shigella. The faecal levels of butyric and valeric acids were significantly decreased in patients with PE and significantly correlated with the above-mentioned differential GM abundance. We predicted significantly increased abundance of the lipopolysaccharide (LPS)-synthesis pathway and significantly decreased abundance of the G protein-coupled receptor (GPCR) pathway in patients with PE, based on phylogenetic reconstruction of unobserved states (PICRUSt). Finally, we evaluated the effects of oral butyrate on LPS-induced hypertension in pregnant rats. We found that butyrate significantly reduced the blood pressure (BP) in these rats. In summary, we provide the first evidence linking GM dysbiosis and reduced faecal SCFA to PE and demonstrate that butyrate can directly regulate BP in vivo, suggesting its potential as a therapeutic agent for PE.


Asunto(s)
Ácidos Grasos Volátiles/análisis , Microbioma Gastrointestinal/fisiología , Hipertensión/fisiopatología , Preeclampsia/fisiopatología , Adulto , Animales , Bacterias/clasificación , Bacterias/genética , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Butiratos/administración & dosificación , Butiratos/análisis , Butiratos/metabolismo , Ácidos Grasos Volátiles/metabolismo , Heces/química , Heces/microbiología , Femenino , Microbioma Gastrointestinal/efectos de los fármacos , Microbioma Gastrointestinal/genética , Humanos , Hipertensión/metabolismo , Hipertensión/microbiología , Ácidos Pentanoicos/análisis , Ácidos Pentanoicos/metabolismo , Dinámica Poblacional , Preeclampsia/metabolismo , Preeclampsia/microbiología , Embarazo , ARN Ribosómico 16S/genética , Ratas Sprague-Dawley
2.
Hu Li Za Zhi ; 67(1): 66-80, 2020 Feb.
Artículo en Chino | MEDLINE | ID: mdl-31960398

RESUMEN

BACKGROUND: Coronary artery disease is associated with unhealthy lifestyles such as smoking, lack of physical activity, and consuming an unhealthy diet. Other risk factors include family history and comorbidities such as hypertension, diabetes, smoking, obesity, and hypercholesterolemia. PURPOSE: This study aims to investigate the effectiveness of mobile health care in improving the physiological index of patients with coronary artery disease. METHODS: This study used an experimental design. Convenience sampling was used to enroll 129 patients with coronary heart disease as participants, who were randomly assigned into the intervention group (n = 64) and control group (n = 65). The intervention group participants received a 12-week mobile health care intervention, while the control group participants received routine care in the outpatient department. The physiological index outcome variables included body mass index (BMI), lipid profile, and blood pressure. Data were analyzed using generalized estimating equation curve analysis. RESULTS: The mean triglyceride (TG) reduction value after the intervention in the experimental group was significantly higher (reduction of 39.27 mg/dl; p < .05) than in the control group. Moreover, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) reduction values in the experimental group were significantly higher (reductions of 8.32 mmHg and 4.24 mmHg; p < .01) than in the control group. Furthermore, the mean reduction in BMI value in the experimental group was significantly higher (reduction of 0.48 Kg/m2; p < .05) than in the control group. Finally, only the mean reduction in low density lipoprotein (LDL) values was greater (by 1.11 mg/dl) in the experimental group than in the control group. However, this reduction did not reach statistical significance. CONCLUSIONS: Mobile health care has the potential to reduce TG, blood pressure, and BMI in patients with coronary artery disease.


Asunto(s)
Enfermedad de la Arteria Coronaria/fisiopatología , Telemedicina , Presión Sanguínea/fisiología , Índice de Masa Corporal , Humanos , Resultado del Tratamiento , Triglicéridos/sangre
3.
Medicine (Baltimore) ; 99(2): e18440, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914017

RESUMEN

To investigate the relationship amongst human growth hormone (HGH), sex, and age groups.A cross-sectional study was conducted on a health check-up population from Wannan area of China from 2014 to 2016. The study involved 6843 individuals aged 23 to 85 years. Logistic regression analysis and smooth curve were applied to determine the relationship amongst age, sex, and HGH.The average level of HGH in the population was 0.37 ±â€Š0.59 ng/mL. There were significant differences in sex, age, body mass index (BMI), triglycerides (TG), total cholesterol (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and glucose (GLU) amongst different quartiles of HGH (P < .001). A U-shape relationship was established between HGH and age. After sex stratification, the results showed that the thresholds of age were 60 years in women, and 50 years in men, after adjusting for body mass index, triglycerides, total cholesterol, blood pressure, and blood glucose. Logistic regression showed that HGH level decreased in women aged <60 years (OR = 1.472, P < .001) and increased in men aged >50 years (OR = 0.711, P < .001). So the distributive characteristics of HGH concentration vary with sex and age group.


Asunto(s)
Presión Sanguínea/fisiología , Hormona de Crecimiento Humana/sangre , Triglicéridos/sangre , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales
4.
Mymensingh Med J ; 29(1): 43-47, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915334

RESUMEN

Hypertension is a major public health challenge to population in socio-economic and epidemiological transition. It is a risk factor for cardiovascular mortality which accounts for 20-50 per cent of all deaths. Hypertension has been recognized among young adults more frequently in recent years. Data regarding hypertension in Bangladesh is often insufficient. The purpose of the study was to find out the risk factors of hypertension in young adults of Bangladesh. The study was conducted among 322 purposively selected young adults aged 20 to 49 years attending in the outpatient department of one public and five private hospitals of Mymensingh and Dhaka division of Bangladesh during the period of January 2018 to December 2018. More than half (54.4%) of the patients were at or below the age of 40 years. Mean age of the patients was 38.7±7.8 years and 58.7% were male. Maximum patients (87.6%) were married and with variable educational and occupational status. More than three fourth of the patients (76.7%) were from urban area whereas 14.3% from rural and 9.0% were from sub-urban area. Family history of hypertension was positive in 86.6% of patients. Blood pressure was categorized according to JNC 7. About half (49.4%) of the patients were stage I hypertensive; 22.4% were stage II hypertensive and 28.3% were pre-hypertensive. The major risk factor was tobacco smoking (46.0%), obesity (29.2%), dyslipidaemia (25.2%), high salt intake 21.8% and use of chewable tobacco (13.7%). Serum creatinine was found raised in 11.5%, cardiomegaly in 2.2% and concentric left ventricular hypertrophy in 18.6% of patients. In 38.5% patients hypertension was complicated affecting heart (27.0%) and kidney (11.5%). Common comorbidities were ischaemic heart diseases (20.5%) and diabetes mellitus (13.4%). Tobacco use, obesity, dyslipidaemia and high salt intake are the major modifiable risk factors found in hypertensive young adults. In addition to medication these factors should be addressed for prevention and effective control of hypertension.


Asunto(s)
Presión Sanguínea/fisiología , Diabetes Mellitus/epidemiología , Cardiopatías/epidemiología , Hipertensión/epidemiología , Adulto , Bangladesh/epidemiología , Comorbilidad , Femenino , Humanos , Hipertensión/diagnóstico , Isquemia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Población Rural/estadística & datos numéricos , Clase Social , Población Urbana/estadística & datos numéricos , Adulto Joven
5.
Int J Sports Med ; 41(1): 3-11, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31791089

RESUMEN

This study evaluated the morphological changes of the lower limb and associated hemodynamic responses to different lower-body compression pressures (COMPs) in physically active, healthy individuals at rest. Each of the 32 participants underwent three trials with three different degrees of lower-body compression applied: "Low" (2.2±1.4 mmHg), "Medium" (12.9±3.9 mmHg), and "High" (28.8±8.3 mmHg). In each COMP, a cross-sectional area of leg muscles (CSAmuscle), subcutaneous fat (CSAfat), superficial vessels (SupV), deep arteries (DA), and deep veins (DV) at the calf, knee, and thigh levels were measured using magnetic resonance imaging (MRI). Additionally, blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) were measured using Doppler ultrasound (USCOM®). With High COMP, calf CSAmuscle and SupV were smaller (p<0.01), whereas DA and DV were larger (p<0.05). Calf CSAfat, however, was similar among all COMPs. There were no major changes in CSAmuscle and CSAfat at knee and thigh levels. CO (3.2±0.9 L/min) and SV (51.9±16.4 mL) were higher (p<0.05) only with High COMP, but other hemodynamic variables showed no significant changes across different COMPs. The High COMP at the lower limb induces leg morphological changes and increases associated hemodynamic responses of physically active healthy individuals at rest.


Asunto(s)
Hemodinámica/fisiología , Extremidad Inferior/fisiología , Medias de Compresión , Arterias/diagnóstico por imagen , Arterias/fisiología , Presión Sanguínea/fisiología , Estudios Cruzados , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Extremidad Inferior/irrigación sanguínea , Extremidad Inferior/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/fisiología , Volumen Sistólico/fisiología , Grasa Subcutánea/irrigación sanguínea , Grasa Subcutánea/diagnóstico por imagen , Grasa Subcutánea/fisiología , Ultrasonografía Doppler , Resistencia Vascular/fisiología , Venas/diagnóstico por imagen , Venas/fisiología , Adulto Joven
6.
Sports Health ; 12(1): 23-28, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31710820

RESUMEN

BACKGROUND: The physical activity vital sign (PAVS) is a simple, validated tool for assessing physical activity in adults that has not been previously studied in pediatrics. HYPOTHESIS: Reported physical activity utilizing the PAVS in pediatric patients should vary according to known associations with physical activity, such as age, sex, blood pressure, and body mass index (BMI). STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: All patients within a family medicine residency clinic were assessed via the PAVS from October 1, 2015, to October 31, 2016, including 255 consecutive pediatric patients aged 5 to 18 years. Associations were examined between PAVS, age, sex, blood pressure, and BMI using 1-way analysis of variance. RESULTS: The average PAVS reported for youth (5-11 years) was 384.9 ± 218.1 minutes per week, with 69.5% reporting sufficient physical activity (≥300 minutes per week). Adolescents (12-18 years) reported a mean PAVS of 278.3 ± 199.6 minutes per week, with 51.1% reporting sufficient physical activity. Physical activity was lower in older participants (P < 0.0001) and was higher in male patients (P < 0.03). Higher BMI was associated with lower PAVS (P < 0.005), while lower systolic blood pressure was associated with a greater number of days per week of physical activity (P < 0.005). CONCLUSION: The PAVS successfully identifies accepted associations between age, sex, and BMI in a pediatric population. CLINICAL RELEVANCE: The correlation of the PAVS with age, sex, BMI, and blood pressure may inform future strategies to address and prevent cardiometabolic disease in pediatric patients.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Ejercicio/fisiología , Adolescente , Factores de Edad , Presión Sanguínea/fisiología , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Factores Raciales , Factores de Riesgo , Factores Sexuales
7.
Heart Fail Clin ; 16(1): 99-106, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31735319

RESUMEN

Hypertension is possibly the most powerful, modifiable risk factor for the development of heart failure. Chronic hypertension drives cardiac remodeling within the left ventricle resulting in hypertensive heart disease, which ultimately manifests as heart failure. Early detection and appropriate management are necessary to prevent heart failure as well as other cardiovascular diseases. Achieving blood pressure goals in conjunction with using evidence-based treatments can improve clinical outcomes for patients with comorbid hypertension and heart failure.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/fisiología , Insuficiencia Cardíaca/prevención & control , Hipertensión/tratamiento farmacológico , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/fisiopatología , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Pronóstico
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(12): 1299-1304, 2019 Dec 06.
Artículo en Chino | MEDLINE | ID: mdl-31795590

RESUMEN

The national health industry standard (WS/T 610-2018), 'the reference of screening for elevated blood pressure among children and adolescents aged 7-to 18-years-old', plays a significant role in the standardization of the blood pressure evaluation, the early detection of high blood pressure, and the early intervention of hypertension and other chronic non-communicable diseases among Chinese children and adolescents. This standard gives screening thresholds for blood pressure assessment of children and adolescents in different genders, ages, and heights. Given the complexity of applying this standard, it is error-prone and less efficient to evaluate blood pressure one by one or program this procedure. Therefore, this study provides a SPSS package based on the standard for researchers to download and use, combined with specific cases to guide the use of this package to evaluate the blood pressure of children and adolescents step by step, which could empower researchers to accurately and efficiently conduct blood pressure screening for children and adolescents in China.


Asunto(s)
Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Presión Sanguínea/fisiología , Hipertensión/diagnóstico , Adolescente , Determinación de la Presión Sanguínea , Niño , China/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Masculino , Prevalencia
9.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852069

RESUMEN

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Asunto(s)
Atención Ambulatoria , Presión Sanguínea/fisiología , Diabetes Mellitus/fisiopatología , Hipertensión/fisiopatología , Oscilometría/métodos , Análisis de la Onda del Pulso/métodos , Rigidez Vascular/fisiología , Brasil/epidemiología , Estudios Transversales , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Factores de Riesgo , Sístole
10.
Bratisl Lek Listy ; 120(12): 894-898, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31855047

RESUMEN

OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which directly influences organs such as brain, heart and kidneys and is related to organ damage. Its value increases with the aortic stiffness. The aim of this study was to analyze the relationships of CSBP to aortic stiffness parameters. METHODS: Central blood pressure (BP) and related parameters were measured by Arteriograph, working based on oscillometric principle, using pulse wave analysis (PWA) approach. We examined 123 patients (69 females, 54 males) with a primary hypertension. RESULTS: Using a linear correlation analysis, we found that CSBP was correlated to aortic pulse wave velocity (PWV), aortic and brachial pulse pressure (PP), aortic augmentation index, return time of reflected pressure wave (RT) and aortic and brachial augmentation indexes. Multivariate analysis defines the aortic pulse pressure (PPao) as the most powerful parameter influencing CSBP. By an individual analysis of BP in each patient separately, we defined two different types of central hemodynamics; those with a higher CSBP than brachial SBP occur in stiffer aorta. CONCLUSION: The CSBP increases with aortic PP, the most powerful stiffness parameter of aorta. Higher CSBP than brachial SBP usually accompanies a stiffer aorta (Tab. 5, Ref. 19).


Asunto(s)
Presión Sanguínea/fisiología , Análisis de la Onda del Pulso/métodos , Rigidez Vascular , Presión Arterial , Determinación de la Presión Sanguínea , Femenino , Humanos , Masculino
11.
J Physiol Anthropol ; 38(1): 15, 2019 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-31779708

RESUMEN

BACKGROUND: Although emotion-specific autonomic responses based on the discrete theory of emotion have been widely studied, studies on the reliability of physiological responses to emotional stimuli are limited. In this study, we aimed to assess the reliability of physiological changes induced by the six basic emotions (happiness, sadness, anger, fear, disgust, and surprise) that were measured during 10 weekly repeated experiments. METHODS: Twelve college students participated, and in each experiment, physiological signals were collected before and while participants were watching emotion-provoking film clips. Additionally, the participants self-evaluated the emotions that they experienced during the film presentation at the end of each emotional stimulus. To avoid adaptation of participants to identical stimuli during repeated measurements, we used 10 different film clips for each emotion, and thus a total of 60 film clips over 10 weeks were used. Physiological features, such as skin conductance level (SCL), fingertip temperature (FT), heart rate (HR), and blood volume pulse (BVP), were extracted from the physiological signals. Two reliability indices, Cronbach's alpha and intraclass correlation coefficient, were calculated from the physiological features to assess internal consistency and interrater reliability, respectively. RESULTS: We found that SCL, HR, and BVP measured during the emotion-provoking phase over the 10 weekly sessions were more reliable than those assessed at baseline. Furthermore, SCL, HR, and BVP from the emotion-provoking phase exhibited excellent internal consistency and interrater reliability. CONCLUSIONS: Our findings suggest that these features can be used as reliable physiological indices in emotion studies. The results also support the significance of physiological signals as meaningful indicators for emotion recognition in HCI (human computer interface) area.


Asunto(s)
Antropología Física/normas , Sistema Nervioso Autónomo/fisiología , Emociones/fisiología , Psicofisiología/normas , Adulto , Antropología Física/métodos , Presión Sanguínea/fisiología , Femenino , Respuesta Galvánica de la Piel/fisiología , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Psicofisiología/métodos , Reproducibilidad de los Resultados , Adulto Joven
12.
Croat Med J ; 60(5): 421-430, 2019 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-31686456

RESUMEN

AIM: To assess the effects of single nucleotide polymorphisms (SNPs) on blood pressure control in patients with obstructive sleep apnea (OSA). METHODS: This prospective observational cohort study, conducted between 2004 and 2014, examined the associations of SNPs of JAG1, GUCY1A3-GUCY1B3, SH2B3, and NPR3-C5orf23 genes with systolic and diastolic blood pressure (SBP, DBP) in 1179 adults evaluated for OSA with overnight polysomnography. Genotyping was performed by unlabeled probe melting analysis. RESULTS: The patients were predominantly male (69.6%, mean age 52±11 years, apnea-hypopnea index 34±31 episodes/h). Only JAG1 genotype was associated with SBP and DBP: compared with AA homozygotes, G allele carriers (pooled GG and AG genotype) had significantly higher morning SBP (132±19 vs 129±18 mm Hg; P=0.009) and morning and evening DBP (85±11 vs 83±10 mm Hg, P=0.004; 86±10 vs 84±10 mm Hg, P=0.012, respectively); the differences remained significant after the correction for multiple SNPs testing. In multivariate analyses, oxygen desaturation index and JAG1 genotype independently predicted morning SBP (P=0.001, P=0.003, respectively) and DBP (P<0.001, P=0.005, respectively), and evening SBP (P=0.019, P=0.048, respectively) and DBP (P=0.018, P=0.018, respectively). CONCLUSION: This is the first replication study of the SNPs recently linked to arterial hypertension in general population by genome-wide association studies. Our findings suggest that JAG1 genotype is related to blood pressure control in OSA: G allele was associated with higher morning and evening SBP and DBP.


Asunto(s)
Presión Sanguínea/fisiología , Hipertensión , Proteína Jagged-1/genética , Apnea Obstructiva del Sueño , Adulto , Femenino , Estudio de Asociación del Genoma Completo , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/genética
13.
Rev Port Cardiol ; 38(8): 547-555, 2019 08.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31708247

RESUMEN

INTRODUCTION: Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese population in 2015. METHODS: A national survey using a representative sample of 4911 individuals residing in Portugal and aged between 25 and 74 years was implemented. Trained nurses performed a health interview and a physical examination, including blood pressure measurement (right arm, three measurements at 1-min intervals). The prevalence of hypertension was stratified by gender, age group, marital status, education, occupation and type of residential area. Associations between hypertension prevalence and sociodemographic factors were assessed using bivariate and multivariate Poisson regression. RESULTS: The overall hypertension prevalence was 36.0%. The highest rates were observed in males (39.6%), in individuals aged between 65 and 74 years (71.3%), and in those with low levels of education (62.6%) and with no formal occupation (64.5%). Among hypertensive individuals, 69.8% were aware of their condition and 69.4% were under treatment, of whom 71.3% were controlled. Rates of awareness and medical treatment were significantly higher among women and older individuals. CONCLUSIONS: A large majority of the adult Portuguese population are likely to reach blood pressure levels defined as hypertension in adulthood. Significant differences in hypertension prevalence were found according to gender, age and socioeconomic status, which highlights the importance of population strategies in public health policies.


Asunto(s)
Presión Sanguínea/fisiología , Encuestas Epidemiológicas , Hipertensión/epidemiología , Medición de Riesgo/métodos , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Portugal/epidemiología , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Tasa de Supervivencia/tendencias
14.
Presse Med ; 48(11 Pt 1): 1244-1248, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31732361

RESUMEN

Before menopause, women are protected from the risk of hypertension and atherosclerosis by endogenous estrogens. Estrogens have a vasoprotective role, while progesterone seems to have a neutral effect. Exogenous estrogens used in menopausal treatment have vascular effects. These effects depend of type, dose and administration type, and with age and atherosclerosis stages. Synthetic progestins have varying clinical effects. Each drug must be evaluated separately.


Asunto(s)
Aterosclerosis/prevención & control , Estrógenos/farmacología , Estrógenos/fisiología , Hipertensión/prevención & control , Premenopausia , Progestinas/farmacología , Arterias/efectos de los fármacos , Arterias/fisiología , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Terapia de Reemplazo de Estrógeno , Etinilestradiol/farmacocinética , Etinilestradiol/farmacología , Femenino , Humanos , Menopausia/fisiología , Premenopausia/fisiología , Progesterona/fisiología , Moduladores Selectivos de los Receptores de Estrógeno/farmacología
15.
Int Heart J ; 60(6): 1366-1372, 2019 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-31735775

RESUMEN

The Kihon Checklist (KCL) is a reliable tool for determining frailty status in the elderly. However, there is no information in the literature about the relationship between frailty status and exercise capacity. Here, we examined the associations between cardiopulmonary exercise testing parameters and frailty status in elderly patients with stable heart failure (HF).Ninety-two elderly patients with stable HF were evaluated using cardiopulmonary exercise testing and the KCL. A KCL score of 0-3 was classified as robust, 4-7 as pre-frail, and ≥ 8 as frail.Mean age, peak VO2, and KCL score were 81.7 years, 13.2 mL/kg/minute, and 10.7, respectively. KCL score was significantly correlated with peak VO2 (r = -0.527, P < 0.001) and peak work rate (r = -0.632, P < 0.001). In patients with frailty (n = 63), the peak work rate (WR) was significantly lower than it was in patients without frailty (n = 29; 39.9 versus 69.5 W, respectively; P < 0.001). Multivariate analysis revealed that peak WR and peak systolic blood pressure were significant, independent predictors of frailty (ß = -0.108 and -0.045, respectively). In a diagnostic performance plot analysis, a cutoff value for peak WR of 51.9 W was the best predictor of frailty.Frailty status was significantly associated with peak WR and peak systolic blood pressure in elderly patients with stable HF. Therefore, cardiopulmonary exercise testing may be useful for assessing frailty status in this patient population.


Asunto(s)
Tolerancia al Ejercicio/fisiología , Ejercicio/fisiología , Fragilidad/diagnóstico , Fragilidad/fisiopatología , Insuficiencia Cardíaca/fisiopatología , Anciano , Anciano de 80 o más Años , Presión Sanguínea/fisiología , Lista de Verificación , Prueba de Esfuerzo , Femenino , Fragilidad/complicaciones , Insuficiencia Cardíaca/complicaciones , Humanos , Masculino , Consumo de Oxígeno/fisiología , Valor Predictivo de las Pruebas
16.
BMC Health Serv Res ; 19(1): 748, 2019 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-31651309

RESUMEN

BACKGROUND: Despite the growing evidence base supporting intensive lifestyle and medical treatments for severe obesity, patient engagement in specialist obesity services is difficult to achieve and poorly understood. To address this knowledge gap, we aimed to develop a model for predicting non-completion of a specialist multidisciplinary service for clinically severe obesity, termed the Metabolic Rehabilitation Programme (MRP). METHOD: Using a case-control study design in a public hospital setting, we extracted data from medical records for all eligible patients with a body mass index (BMI) of ≥35 kg/m2 with either type 2 diabetes or fatty liver disease referred to the MRP from 2010 through 2015. Non-completion status (case definition) was coded for patients whom started but dropped-out of the MRP within 12 months. Using multivariable logistic regression, we tested the following baseline predictors hypothesised in previous research: age, gender, BMI, waist circumference, residential distance from the clinic, blood pressure, obstructive sleep apnoea (OSA), current continuous positive airway pressure (CPAP) therapy, current depression/anxiety, diabetes status, and medications. We used receiver operating characteristics and area under the curve to test the performance of models. RESULTS: Out of the 219 eligible patient records, 78 (35.6%) non-completion cases were identified. Significant differences between non-completers versus completers were: age (47.1 versus 54.5 years, p < 0.001); residential distance from the clinic (21.8 versus 17.1 km, p = 0.018); obstructive sleep apnoea (OSA) (42.9% versus 56.7%, p = 0.050) and CPAP therapy (11.7% versus 28.4%, p = 0.005). The probability of non-completion could be independently associated with age, residential distance, and either OSA or CPAP. There was no statistically significant difference in performance between the alternate models (69.5% versus 66.4%, p = 0.57). CONCLUSIONS: Non-completion of intensive specialist obesity management services is most common among younger patients, with fewer complex care needs, and those living further away from the clinic. Clinicians should be aware of these potential risk factors for dropping out early when managing outpatients with severe obesity, whereas policy makers might consider strategies for increasing access to specialist obesity management services.


Asunto(s)
Manejo de la Obesidad/estadística & datos numéricos , Obesidad Mórbida/terapia , Cooperación del Paciente/estadística & datos numéricos , Ansiedad/etiología , Presión Sanguínea/fisiología , Índice de Masa Corporal , Estudios de Casos y Controles , Presión de las Vías Aéreas Positiva Contínua , Depresión/etiología , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Hospitalización/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Obesidad Mórbida/complicaciones , Obesidad Mórbida/psicología , Factores de Riesgo , Apnea Obstructiva del Sueño/complicaciones
17.
BMC Neurol ; 19(1): 251, 2019 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-31653207

RESUMEN

BACKGROUND: Elevated blood pressure (BP) at emergency department (ED) presentation and advancing age have been associated with risk of ischemic stroke; however, the relationship between BP, age, and transient ischemic attack/minor stroke (TIA/MS) is not clear. METHODS: A multi-site, prospective, observational study of 1084 ED patients screened for suspected TIA/MS (symptom onset < 24 h, NIHSS< 4) between December 2013 and April 2016. Systolic and diastolic BP measurements (SBP, DBP) were taken at ED presentation. Final diagnosis was consensus adjudication by stroke neurologists; patients were diagnosed as either TIA/MS or stroke-mimic (non-cerebrovascular conditions). Conditional inference trees were used to define age cut-points for predicting binary diagnosis (TIA/MS or stroke-mimic). Logistic regression models were used to estimate the effect of BP, age, sex, and the age-BP interaction on predicting TIA/MS diagnosis. RESULTS: Over a 28-month period, 768 (71%) patients were diagnosed with TIA/MS: these patients were older (mean 71.6 years) and more likely to be male (58%) than stroke-mimics (61.4 years, 41%; each p < 0.001). TIA/MS patients had higher SBP than stroke-mimics (p < 0.001). DBP did not differ between the two groups (p = 0.191). SBP was predictive of TIA/MS diagnosis in younger patients, after accounting for age and sex; an increase of 10 mmHg systolic increased the odds of TIA/MS 18% (odds ratio [OR] 1.18, 95% CI 1.00-1.39) in patients < 60 years, and 23% (OR 1.23, 95% CI 11.12-1.35) in those 60-79 years, while not affecting the odds of TIA/MS in patients ≥80 years (OR 0.99, 95% CI 0.89-1.07). CONCLUSIONS: Raised SBP in patients younger than 80 with suspected TIA/MS may be a useful clinical indicator upon initial presentation to help increase clinicians' suspicion of TIA/MS. TRIAL REGISTRATION: ClinicalTrials.gov NCT03050099 (10-Feb-2017) and NCT03070067 (3-Mar-2017). Retrospectively registered.


Asunto(s)
Presión Sanguínea , Hipertensión/epidemiología , Ataque Isquémico Transitorio , Accidente Cerebrovascular , Anciano , Presión Sanguínea/fisiología , Servicio de Urgencia en Hospital , Femenino , Humanos , Ataque Isquémico Transitorio/fisiopatología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Accidente Cerebrovascular/fisiopatología
18.
Medicine (Baltimore) ; 98(42): e17597, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31626136

RESUMEN

Hyperuricemia has received increasing attention as a major public health problem. This study aims to investigate the risk factors for hyperuricemia and to explore the relationship between changes in biochemical variables and incident hyperuricemia.A cross-sectional and subsequently prospective study was performed among adults who took their health checkups at Zhejiang University Hospital. The participants who were free of hyperuricemia at baseline received annual follow-up examinations during a 6-year period. Cox proportional hazards regression analyses were conducted to calculate the risks for incident hyperuricemia.Of the 9238 participants enrolled, 1704 (18.4%) were diagnosed as hyperuricemia. During 21,757 person-years of follow-up, 1492 incident hyperuricemia cases were identified. The incidence of hyperuricemia was 68.58 cases per 1000 person-year of follow-up in the overall participants. The prevalence and the incidence of hyperuricemia increased greatly in female older than 50 years. High levels of BMI, SBP, FPG, TG, LDL-C, ALT, BUN, and creatinine increased the risk of hyperuricemia. Suffering fatty liver also increased the risk of hyperuricemia. Subjects with increasing DBP, TG, BUN, creatinine, or decreasing HDL-C were more likely to incident hyperuricemia.This study revealed that the change of diastolic blood pressure (DBP), serum triglycerides (TG), blood urea nitrogen (BUN), creatinine, and high-density lipoprotein cholesterol (HDL-C) level were independently associated with incident hyperuricemia.


Asunto(s)
HDL-Colesterol/sangre , LDL-Colesterol/sangre , Creatinina/sangre , Hiperuricemia/etiología , Triglicéridos/sangre , Ácido Úrico/sangre , Adulto , Biomarcadores/sangre , Presión Sanguínea/fisiología , Nitrógeno de la Urea Sanguínea , Índice de Masa Corporal , China/epidemiología , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Hiperuricemia/sangre , Hiperuricemia/epidemiología , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo
19.
Rev Lat Am Enfermagem ; 27: e3177, 2019.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31596412

RESUMEN

OBJECTIVE: analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students. METHOD: this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed. RESULTS: female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity. CONCLUSION: overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.


Asunto(s)
Sobrepeso/psicología , Estrés Psicológico/epidemiología , Estudiantes de Enfermería/psicología , Adulto , Presión Sanguínea/fisiología , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/prevención & control , Obesidad/psicología , Sobrepeso/prevención & control , Circunferencia de la Cintura
20.
J Sports Med Phys Fitness ; 59(9): 1593-1598, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31610642

RESUMEN

BACKGROUND: Central systolic blood pressure (cSBP), a measure of arterial stiffness, determines the afterload of the heart and provides greater prognostic significance regarding cardiovascular outcomes than peripheral systolic blood pressure (pSBP). Physical exercise is associated with an acute hypotensive effect on pSBP, but the significance of exercise on cSBP is missing. This study investigates the effect of a single exercise bout on pSBP and cSBP during a 24-hour ambulatory blood pressure monitoring (ABPM). METHODS: In 25 healthy male individuals (27.5±5.5 years) baseline pSBP and cSBP values were determined in a supine position using the oscillometric Mobil-O-Graph device. Afterward, they performed a maximum cardiopulmonary exercise test (CPET) on a bicycle ergometer. The 24-hour ABPM was launched 15 minutes after terminating CPET. RESULTS: Significant dipping of cSBP was found compared to baseline values in the first (-6.8 [-9.9 to -3.7] mmHg; P<0.001) second (-7.4 [-10.6 to -4.2] mmHg; P<0.001) and third hour (-6.4 [-11.5 to -1.3]; P=0.016) after exercise. Afterwards, cSBP continuously increases but remains significant reduced to baseline in the third (-6.4 [-11.5 to -1.3] mmHg; P=0.016), and fifth hour (-4.3 [-8.2 to -0.4] mmHg; P=0.033). There were only significant changes in pSBP compared to baseline values after 10 hours till the night period. The dipping pattern in the night period was similar in pSBP and cSBP. CONCLUSIONS: 24-h postexercise responses of pSBP and cSBP differs significantly. This suggests a different regulatory mechanism of exercise on the peripheral and central arteries that have further be elucidated.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial/métodos , Presión Sanguínea/fisiología , Ejercicio/fisiología , Adulto , Prueba de Esfuerzo/métodos , Humanos , Masculino , Adulto Joven
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