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1.
Nat Commun ; 12(1): 3296, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34075043

RESUMO

Zinc, an abundant transition metal, serves as a signalling molecule in several biological systems. Zinc transporters are genetically associated with cardiovascular diseases but the function of zinc in vascular tone regulation is unknown. We found that elevating cytoplasmic zinc using ionophores relaxed rat and human isolated blood vessels and caused hyperpolarization of smooth muscle membrane. Furthermore, zinc ionophores lowered blood pressure in anaesthetized rats and increased blood flow without affecting heart rate. Conversely, intracellular zinc chelation induced contraction of selected vessels from rats and humans and depolarized vascular smooth muscle membrane potential. We demonstrate three mechanisms for zinc-induced vasorelaxation: (1) activation of transient receptor potential ankyrin 1 to increase calcitonin gene-related peptide signalling from perivascular sensory nerves; (2) enhancement of cyclooxygenase-sensitive vasodilatory prostanoid signalling in the endothelium; and (3) inhibition of voltage-gated calcium channels in the smooth muscle. These data introduce zinc as a new target for vascular therapeutics.


Assuntos
Endotélio Vascular/metabolismo , Músculo Liso Vascular/fisiologia , Células Receptoras Sensoriais/metabolismo , Vasodilatação/fisiologia , Zinco/metabolismo , Idoso , Animais , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Canais de Cálcio Tipo N/metabolismo , Quelantes/farmacologia , Citoplasma/metabolismo , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/inervação , Etilenodiaminas/farmacologia , Feminino , Células HEK293 , Humanos , Masculino , Camundongos , Camundongos Knockout , Pessoa de Meia-Idade , Músculo Liso Vascular/efeitos dos fármacos , Técnicas de Patch-Clamp , Prostaglandina-Endoperóxido Sintases/metabolismo , Prostaglandinas/metabolismo , Ratos , Canal de Cátion TRPA1/genética , Canal de Cátion TRPA1/metabolismo , Vasodilatação/efeitos dos fármacos
2.
J Spec Oper Med ; 21(2): 11-17, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105115

RESUMO

BACKGROUND: Tourniquet training sometimes involves models, and a certification process is expected to use something other than human limbs; therefore, investigating model- and limb-pressure responses to force application is important. METHODS: Pressure response to force was collected for a 3.8cm-wide nonelastic strap and a 10.1cm-wide elastic strap placed over 14 objects. Each object was suspended; an inflated neonatal blood pressure cuff was placed atop the object with the strap over the bladder; and strap ends were connected below with 4.54kg weights attached at 20-second intervals to 27.24kg. RESULTS: Pressure-response curves differed by strap, thigh aspect (medial, lateral, ventral, dorsal; n = 2 subjects; p < .0001); subject (medial thigh; n = 3 subjects; p < .0001); and object (thighs; small and large pool noodles ± central metal rod, foam yoga roller, coffee can, 20% ballistic gel cylinder [Gel; Clear Ballistics; clearballistics.com] with central metal tubing, rolled pair of 5mm yoga mats ± central metal rod, hemorrhage-control training thigh [Z-Medica], sand-filled training manikin limb [Drumm Emergency Solutions]; p < .0001). Compliance, circumference, support techniques, and surface interactions, especially with the 10.1cm-wide elastic strap, affected pressure responses: smaller circumference, lower compliance, and lower surface coefficient of friction were associated with higher pressure/force applied. CONCLUSIONS: Different objects have different pressure-response curves. This may be important to acquisition and retention of limb tourniquet skills and is important for systems for certifying tourniquets.


Assuntos
Coxa da Perna , Torniquetes , Pressão Sanguínea , Hemorragia/terapia , Humanos , Recém-Nascido , Pressão
3.
J Frailty Aging ; 10(3): 219-225, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105704

RESUMO

BACKGROUND: Muscle provides a reservoir for water to maintain fluid volume and blood pressure, so older adults may be at risk for orthostatic hypotension due to muscle loss with age. OBJECTIVES: To evaluate the association between muscle loss with age and postural blood pressure. DESIGN: Longitudinal comparison of overnight changes in hydration, postural blood pressure, and strength. SETTING: Community field study. PARTICIPANTS: Sixty-nine men and women (76.0 ± 0.8 years) with low (Low) or normal (Normal) muscle based on the Lean Mass Index. MEASUREMENTS: Body composition was measured with bioelectrical impedance analysis. Postural blood pressure was measured sequentially (lying, sitting, standing). Strength was measured with a handgrip dynamometer, Arm Curl test, and Chair Stand test. RESULTS: On Day 1, Low had less hydration and a significant drop in postural systolic blood pressure compared to Normal (lying to standing: -11.06 ± 2.36 vs. +1.14 ± 2.20 mmHg, p < 0.001). Overnight, both groups lost significant total body water, while fluid volume was unchanged. On Day 2, both groups experienced significant drops in postural systolic blood pressure, although the drop in Low was more profound and significantly greater than Normal (lying to standing: -16.85 ± 2.50 vs. -3.89 ± 2.52 mmHg, p = 0.001). On both days, Normal compensated for postural changes with increases in postural diastolic blood pressure not observed in Low. Only Low experienced significant overnight decreases in all strength measures. CONCLUSIONS: In older men and women, muscle loss with age is accompanied by loss of hydration and less stable early morning postural systolic blood pressure that increase risk for orthostatic hypotension and can also increase risk for falls.


Assuntos
Hipotensão Ortostática , Idoso , Pressão Sanguínea , Feminino , Força da Mão , Humanos , Hipotensão Ortostática/epidemiologia , Masculino , Músculos , Postura
4.
Rev Med Chil ; 149(1): 88-97, 2021 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-34106139

RESUMO

Arterial hypertension is one of the biggest public health problems. The research in this area has been relentless and productive, allowing to identify new pathophysiological mechanisms from which new therapeutic options are under development. Despite the recognized efficacy and tolerability of currently available drugs, a high number of patients still do not comply with treatment and maintain inadequate blood pressure levels. This review summarizes the literature about new pharmacological alternatives to treat hypertension. The development state of these new medications ranges from a preclinical state to their clinical use in hypertensive patients. Technological strategies aiming at increasing the compliance with anti-hypertensive medications are also mentioned.


Assuntos
Hipertensão , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Humanos , Hipertensão/tratamento farmacológico , Cooperação do Paciente
5.
Sensors (Basel) ; 21(10)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069396

RESUMO

The availability of simple, accurate, and affordable cuffless blood pressure (BP) devices has the potential to greatly increase the compliance with measurement recommendations and the utilization of BP measurements for BP telemonitoring. The aim of this study is to evaluate the correlation between findings from routine BP measurements using a conventional sphygmomanometer with the results from a portable ECG monitor combined with photoplethysmography (PPG) for pulse wave registration in patients with arterial hypertension. METHODS: The study included 500 patients aged 32-88 years (mean 64 ± 7.9 years). Mean values from three routine BP measurements by a sphygmomanometer with cuff were selected for comparison; within one minute after the last measurement, an electrocardiogram (ECG) was recorded for 3 min in the standard lead I using a smartphone-case based single-channel ECG monitor (CardioQVARK®-limited responsibility company "L-CARD", Moscow, Russia) simultaneously with a PPG pulse wave recording. Using a combination of the heart signal with the PPG, levels of systolic and diastolic BP were determined based on machine learning using a previously developed and validated algorithm and were compared with sphygmomanometer results. RESULTS: According to the Bland-Altman analysis, SD for systolic BP was 3.63, and bias was 0.32 for systolic BP. SD was 2.95 and bias was 0.61 for diastolic BP. The correlation between the results from the sphygmomanometer and the cuffless method was 0.89 (p = 0.001) for systolic and 0.87 (p = 0.002) for diastolic BP. CONCLUSION: Blood pressure measurements on a smartphone-case without a cuff are encouraging. However, further research is needed to improve the accuracy and reliability of clinical use in the majority of patients.


Assuntos
Hipertensão , Fotopletismografia , Pressão Sanguínea , Determinação da Pressão Arterial , Eletrocardiografia , Humanos , Hipertensão/diagnóstico , Análise de Onda de Pulso , Reprodutibilidade dos Testes , Smartphone
6.
Clin Med (Lond) ; 21(3): e275-e282, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34001585

RESUMO

Orthostatic hypotension (OH) is very common in older people and is encountered daily in emergency departments and medical admissions units. It is associated with a higher risk of falls, fractures, dementia and death, so prompt recognition and treatment are essential. In this review article, we describe the physiology of standing (orthostasis) and the pathophysiology of orthostatic hypotension. We focus particularly on aspects pertinent to older people. We review the evidence and consensus management guidelines for all aspects of management. We also tackle the challenge of concomitant orthostatic hypotension and supine hypertension, providing a treatment overview as well as practical suggestions for management. In summary, orthostatic hypotension (and associated supine hypertension) are common, dangerous and disabling, but adherence to simple structures management strategies can result in major improvements.


Assuntos
Hipertensão , Hipotensão Ortostática , Acidentes por Quedas , Idoso , Pressão Sanguínea , Humanos , Hipotensão Ortostática/diagnóstico , Hipotensão Ortostática/terapia
7.
Maturitas ; 148: 24-32, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34024348

RESUMO

BACKGROUND: Menopause and its associated decline in oestrogen is linked to chronic conditions like cardiovascular disease and osteoporosis, which may be difficult to disentangle from the effects of ageing. Further, post-menopausal women are at increased risk of cerebrovascular disease, linked to declines in cerebral blood flow (CBF) and cerebrovascular reactivity (CVR), yet the direct understanding of the impact of the menopause on cerebrovascular function is unclear. The aim of this systematic review and meta-analysis was to examine the literature investigating CBF and CVR in pre- compared with post-menopausal women METHODS: Five databases were searched for studies assessing CBF or CVR in pre- and post-menopausal women. Meta-analysis examined the effect of menopausal status on middle cerebral artery velocity (MCAv), and GRADE-assessed evidence certainty RESULTS: Nine studies (n=504) included cerebrovascular outcomes. Six studies (n=239) reported negligible differences in MCAv between pre- and post-menopausal women [2.11cm/s (95% CI: -8.94 to 4.73, p=0.54)], but with a "low" certainty of evidence. MCAv was lower in post-menopausal women in two studies, when MCAv was adjusted for blood pressure. CVR was lower in post- compared with pre-menopausal women in two of three studies, but high-quality evidence is lacking. Across outcomes, study methodology and reporting criteria for menopause were inconsistent CONCLUSIONS: MCAv was similar in post- compared with pre-menopausal women. Methodological differences in characterising menopause and inconsistent reporting of cerebrovascular outcomes make comparisons difficult. Comprehensive assessments of cerebrovascular function of the intra- and extracranial arteries to determine the physiological implications of menopause on CBF with healthy ageing is warranted.


Assuntos
Velocidade do Fluxo Sanguíneo , Artérias Cerebrais/fisiologia , Circulação Cerebrovascular/fisiologia , Transtornos Cerebrovasculares/fisiopatologia , Menopausa , Pressão Sanguínea , Feminino , Humanos , Pré-Menopausa
8.
Nutrients ; 13(5)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946888

RESUMO

The effect of selenium on hypertension is inconclusive. We aimed to study the relationship between selenium intake and incident hypertension. Adults (age ≥20 years) in the China Health and Nutrition Survey were followed up from 1991 to 2011 (N = 13,668). The latent class modeling method was used to identify trajectory groups of selenium intake. A total of 4039 respondents developed hypertension. The incidence of hypertension was 30.1, 30.5, 30.6, and 31.2 per 1000 person-years among participants with cumulative average selenium intake of 21.0 ± 5.1, 33.2 ± 2.8, 43.8 ± 3.6, and 68.3 ± 25.2 µg/day, respectively. Region and selenium intake interaction in relation to hypertension was significant. In the multivariable model, cumulative intake of selenium was only inversely associated with the incident hypertension in northern participants (low selenium zone), and not in southern participants. Compared to selenium intake trajectory Group 1 (stable low intake), all three trajectory groups had a low hazard ratio for hypertension among the northern participants. However, Group 4 (high intake and decreased) showed an increasing trend of hypertension risk in the south. In conclusion, the association between selenium intake and the incidence of hypertension varied according to regions in China. In the low soil selenium zone, high selenium intake might be beneficial for hypertension prevention.


Assuntos
Hipertensão/epidemiologia , Hipertensão/etiologia , Selênio/administração & dosagem , Adulto , Pressão Sanguínea/efeitos dos fármacos , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais
9.
Curr Hypertens Rep ; 23(5): 25, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33961145

RESUMO

PURPOSE OF REVIEW: To incorporate novel findings on pathophysiology and treatment of posttransplant hypertension. RECENT FINDINGS: (1) The sodium retaining effects of CNIs are mediated by stimulation of the thiazide-sensitive sodium chloride co-transporter in the distal convoluted tubule and in this regard chlorthalidone was proven to be an effective antihypertensive drug in renal transplantation. (2) Local and not systemic activation of the renin-angiotensin-aldosterone system plays a crucial role in the pathogenesis of posttransplant hypertension. (3) Recent randomized controlled trials failed to prove the presumed superiority of renin-angiotensin blockers in kidney transplantation. (4) Steroid-free and mammalian target of rapamycin-based immunosuppressive drug combinations did not show favorable effects on blood pressure control. (5) In a recent report the risk of non-melanoma skin cancer was higher with thiazide diuretics. But the increased cancer risk in transplant recipients is mainly attributed to comorbidities, such as diabetes and hypertension and of course to the transplantation condition itself or the obligatory application of immunosuppression, and has little to do with the antihypertensive medication Actual recommendations about BP targets in adult renal transplant recipients are coming from a post hoc analysis of a large randomized trial with another primary endpoint. Unless convincing studies on treatment of hypertension after renal transplantation are available, the ESC/ESH Guidelines 2018 should apply for these patients.


Assuntos
Hipertensão , Transplante de Rim , Adulto , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Clortalidona , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etiologia , Transplante de Rim/efeitos adversos , Inibidores de Simportadores de Cloreto de Sódio
10.
Curr Hypertens Rep ; 23(5): 26, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33961147

RESUMO

PURPOSE OF REVIEW: The aim of this review article was to summarize the cardiovascular and blood pressure profile regarding Parkinson disease patients and to provide an update on the recent advancements in the field of the diagnosis and management of blood pressure abnormalities in these patients. Our goal was to guide physicians to avoid pitfalls in current practice while treating patients with Parkinson disease and blood pressure abnormalities. For this purpose, we searched bibliographic databases (PubMed, Google Scholar) for all publications published on blood pressure effects in Parkinson disease until May 2020. Furthermore, we highlight some thoughts and potential perspectives for the next possible steps in the field. RECENT FINDINGS: Blood pressure dysregulation in patients with Parkinson's disease has several implications in clinical practice and presents an ongoing concern. Compared with chronic essential hypertension, the syndrome of combined neurogenic orthostatic hypotension and supine hypertension in Parkinson's disease has received little attention. If left untreated, hypertension may lead to cardiovascular disease whereas hypotension may lead to fall-related complications, with tremendous impact on the quality of life of affected individuals. The effect of blood Epressure control and the risk of death from cardiovascular disease in Parkinson disease are largely unexplored. Blood pressure abnormalities in Parkinson disease present bidirectional relationship and the rationale for treating and controlling hypertension in persons with Parkinson disease and concurrent neurogenic orthostatic hypotension and/or supine hypertension is compelling. Further research is warranted in order to clarify the mechanisms, clinical implications, and potential reversibility of compromised cardiovascular function, in persons with Parkinson disease.


Assuntos
Hipertensão , Hipotensão Ortostática , Doença de Parkinson , Pressão Sanguínea , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipotensão Ortostática/etiologia , Doença de Parkinson/complicações , Qualidade de Vida
11.
Curr Cardiol Rep ; 23(6): 64, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33961163

RESUMO

PURPOSE OF REVIEW: The present narrative review focuses on the up-to-date clinical data on the correlations between olive oil consumption and cardiovascular (CV) diseases (i.e., CHD, stroke, and peripheral artery disease). RECENT FINDINGS: Olive oil contains monounsaturated fats, several antioxidant phenols, and other micronutrients that mediate CV-protective effects via improvements in oxidative stress, endothelial dysfunction, inflammation, thrombosis, blood pressure, and lipid and carbohydrate metabolism. High consumption of olive oil, and in particular the extra-virgin, which is rich in phenolic antioxidants, has been suggested to prevent against coronary heart disease (CHD). The olive oil-induced cardioprotection was further supported by the findings of a very recent analysis of 2 large US prospective cohort studies showing that a higher olive oil intake was related to a lower risk of CV morbidity and mortality after 24 years of follow-up and that replacement of dairy fat, margarine, butter, or mayonnaise with the equivalent amount of olive oil significantly reduced CV risk. There is evidence for associations between olive oil consumption and lower risk for CV diseases. Both health policy makers and physicians should be aware of these associations and thus promote the intake of olive oil in both primary and secondary prevention settings to minimize individual's CV risk.


Assuntos
Doenças Cardiovasculares , Pressão Sanguínea , Doenças Cardiovasculares/prevenção & controle , Humanos , Azeite de Oliva , Estresse Oxidativo , Estudos Prospectivos
12.
Nat Genet ; 53(5): 630-637, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33958779

RESUMO

The kidney is an organ of key relevance to blood pressure (BP) regulation, hypertension and antihypertensive treatment. However, genetically mediated renal mechanisms underlying susceptibility to hypertension remain poorly understood. We integrated genotype, gene expression, alternative splicing and DNA methylation profiles of up to 430 human kidneys to characterize the effects of BP index variants from genome-wide association studies (GWASs) on renal transcriptome and epigenome. We uncovered kidney targets for 479 (58.3%) BP-GWAS variants and paired 49 BP-GWAS kidney genes with 210 licensed drugs. Our colocalization and Mendelian randomization analyses identified 179 unique kidney genes with evidence of putatively causal effects on BP. Through Mendelian randomization, we also uncovered effects of BP on renal outcomes commonly affecting patients with hypertension. Collectively, our studies identified genetic variants, kidney genes, molecular mechanisms and biological pathways of key relevance to the genetic regulation of BP and inherited susceptibility to hypertension.


Assuntos
Predisposição Genética para Doença , Genômica , Hipertensão/genética , Rim/patologia , Processamento Alternativo/genética , Pressão Sanguínea/genética , Metilação de DNA/genética , Variação Genética , Estudo de Associação Genômica Ampla , Humanos , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único/genética , Locos de Características Quantitativas/genética
13.
Medicine (Baltimore) ; 100(21): e26128, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032760

RESUMO

BACKGROUND: Early out-of-bed mobilization may improve acute post-intracerebral hemorrhage (ICH) outcomes, but hemodynamic instability may be a concern. Some recent studies have showed that an increase in mean systolic blood pressure (SBP) and high blood pressure variability (BPV), high standard deviation of SBP, may lead to negative ICH outcomes. Therefore, we investigated the impact of an early mobilization (EM) protocol on mean SBP and BPV during the acute phase. METHODS: The study was an assessor-blinded, randomized controlled non-inferiority study. The participants were in An Early Mobilization for Acute Cerebral Hemorrhage trial and were randomly assigned to undergo EM or a standard early rehabilitation (SER) protocol within 24 to 72 hour after ICH onset at the stroke center. The EM and SER groups each had 30 patients. 24-measurement SBP were recorded on days 2 and 3 after onset, and SBP were recorded three times daily and during rehabilitation on days 4 through 7. The two groups' mean SBP and BPV under three different time frames (days 2 and 3 during the acute phase, and days 4 through 7 during the late acute phase) were calculated and compared. RESULTS: At baseline, the two groups' results were similar, with the exception being that the mean time to first out-of-bed mobilization after symptom onset was 51.60 hours (SD 14.15) and 135.02 hours (SD 33.05) for the EM group and SER group, respectively (P < .001). There were no significant differences in mean SBP and BPV during the acute and late acute phase between the two groups for the three analyses (days 2, 3, and 4 through 7) (P > .05). CONCLUSIONS: It is safe to implement the EM protocol within 24 to 72 hour of onset for mild-moderate ICH patients during the acute phase.


Assuntos
Pressão Sanguínea , Hemorragia Cerebral/fisiopatologia , Hemorragia Cerebral/terapia , Deambulação Precoce , Adulto , Anti-Hipertensivos/uso terapêutico , Hemorragia Cerebral/tratamento farmacológico , Deambulação Precoce/efeitos adversos , Estudos de Equivalência como Asunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
14.
Georgian Med News ; (312): 46-52, 2021 Mar.
Artigo em Russo | MEDLINE | ID: mdl-33964825

RESUMO

Objective - to determine the features of the daily profile of blood pressure (BP), blood lipid spectrum, features of left ventricular remodeling in patients with hypertension in combination with RA and to evaluate the effectiveness of using medium doses of rosuvastatin to correct dyslipidemia in this group of patients. 70 patients aged 40-65 years were examined (average - M±m - 54.88±0.96 years). Hypertensive disease in combination with rheumatoid arthritis was found in 50 patients, which made up the main group. The patients were divided into 2 subgroups: the first group included 25 patients with essential hypertension in combination with rheumatoid arthritis, who took valsartan at a dose of 80 mg at home, indapamide 1.5 mg, rosuvastatin 20 mg. The second subgroup included 25 patients who took valsartan at a dose of 80 mg / day, amlodipine at a dose of 5 mg, rosuvastatin at a dose of 20 mg. The control group (comparison) consisted of 20 patients with arterial hypertension without RA, matched by sex and age with the main groups. (3 people, 17 women, average age 55.65±1.19 years). 1. Valsartan therapy and its combination with indapamide in hypertensive patients in combination with rheumatoid arthritis led to regression of LVH in all patients, normalization of LV geometry in 33% of patients, improvement of LV diastolic function in 88.2%. 2. The addition of indapamide to therapy led to a further decrease in the average values of blood pressure at night, increased the number of patients who achieved normalization of blood pressure from 50 to 75%, while therapy with amlodipine with indapamide did not change the severity of the circadian rhythm of blood pressure and the degree of nighttime decrease in SBP and in general the group remained inadequate. 3. Changes in the diurnal blood pressure profile, found in the majority of patients with arterial hypertension in combination with rheumatoid arthritis, were characterized by increased mean daily, mean systolic blood pressure levels, increased daytime variability, and a lower degree of nocturnal decrease in comparison with patients without RA. 4. The use of 20 mg rosuvastatin as part of complex therapy in patients with hypertension in combination with RA contributed to the achievement of target levels of lipid spectrum in the blood in most patients.ent of target levels of lipid spectrum in the blood in most patients.


Assuntos
Artrite Reumatoide , Aterosclerose , Hipertensão , Adulto , Idoso , Anlodipino/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Feminino , Ventrículos do Coração , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade
15.
Medicine (Baltimore) ; 100(18): e25826, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950991

RESUMO

ABSTRACT: There is evidence that serum 25-hydroxyvitamin D [25-(OH) D] levels may be associated with cardiovascular disease and its risk factors. This study aimed to investigate the relationship between 25-(OH) D levels and blood pressure (BP), blood lipids, and arterial elasticity in middle-aged and elderly cadres in China.In this retrospective study, we included 401 civil servants and cadres aged >42 years who underwent medical examinations at Guiyang Municipal First People's Hospital, China in 2018. The participants were assigned to deficiency (≤20 ng/mL), insufficiency (20-30 ng/mL), and sufficiency (≥30 ng/mL) groups according to 25-(OH) D levels in their blood. Demographics, brachial-ankle pulse wave velocity (baPWV), BP, ankle-brachial index (ABI), and blood lipids were compared among groups. The associations between 25-(OH) D and other parameters were evaluated using linear regression analysis.Median (range) 25-(OH) D levels in the deficiency (n = 162), insufficiency (n = 162), and sufficiency (n = 77) groups were 15.32 (2.93-19.88), 25.12 (20.07-29.91), and 33.91 (30.23-82.42) ng/mL, respectively. There were significant differences in systolic BP, pulse pressure, baPWV (left and right sides), ABI (left side), high-density lipoprotein-cholesterol, and triglycerides (TGs; all P < .05) among groups. Multivariate linear regression revealed that TG, left baPWV, and right baPWV were significantly negatively correlated with 25-(OH) D levels (all P < .05).In this study, 25-(OH) D levels were found to be associated with TG, left baPWV, and right baPWV values. 25-(OH) D deficiency may be associated with reduced arterial elasticity.


Assuntos
Doenças Cardiovasculares/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adulto , Idoso , Índice Tornozelo-Braço , Artérias/fisiopatologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/fisiopatologia , China/epidemiologia , Elasticidade/fisiologia , Feminino , Empregados do Governo/estatística & dados numéricos , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Estudos Retrospectivos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico
16.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(2): 278-282, 2021 Apr 28.
Artigo em Chinês | MEDLINE | ID: mdl-33966710

RESUMO

Elabela is a newly discovered peptide in recent years.It is the endogenous ligand of Apelin receptor(APJ)and plays an important role in embryonic development and adult organs.Elabela-APJ axis is closely related to organ fibrosis.Elabela can protect the functions of heart and kidney by antagonizing renin-angiotensin system and regulating blood pressure.In addition,it can prevent kidney and heart fibrosis by down-regulating the expression of fibrosis and inflammatory factors.However,there is a positive correlation between the level of Elabela and the degree of liver fibrosis,suggesting that Elabela may play a role in promoting liver fibrosis.This review aims to explore the role of Elabela-APJ axis in renal fibrosis,cardiac fibrosis,and liver fibrosis,and to provide a new therapeutic target for organ fibrosis.


Assuntos
Hormônios Peptídicos , Apelina , Receptores de Apelina , Pressão Sanguínea , Feminino , Fibrose , Humanos , Gravidez
17.
Wei Sheng Yan Jiu ; 50(2): 210-216, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-33985628

RESUMO

OBJECTIVE: To explore the association between different types of obesity and blood pressure in adolescents aged 12-17 years in eastern China. METHODS: Using multi-stage stratified random sampling, a total of 8279 adolescents aged between 12 and 17 years in eastern China were selected as the research objects from the "Nutrition and Health Surveillance for Chinese Children and Nursing Mothers" project from 2016 to 2017. According to BMI and WHtR, the subjects were divided into four types: non-obesity, general obesity, simple abdominal obesity and combined obesity. The normal high blood pressure and high blood pressure of people with different types of obesity were determined according to Blood Pressure Standards for Children at 3-17 Years Old Per Year and Height in China. The relationship between different types of obesity and the prevalence of high blood pressure was analyzed by χ~2 test, analysis of variance, multi-level linear model and multi-level Logistic regression model. RESULTS: The prevalence of high normal blood pressure was 13. 66%(1069), and the prevalence of high blood pressure was 18. 79%(1782) in adolescents aged 12 to 17 years in eastern China. In the non-obese group, the prevalence of high normal blood pressure was 12. 85%(732), and the prevalence of high blood pressure was 13. 79%(999). In the general obesity group, the prevalence of high normal blood pressure was 20. 45%(99), and the prevalence of high blood pressure was 23. 62%(160). In the central obesity group, the prevalence of high normal blood pressure was 6. 95%(32), and the prevalence of high blood pressure was 14. 64%(87). The prevalence of high normal blood pressure was 16. 68%(206), and the prevalence of high blood pressure was 42. 42%(536) in the complex obesity group. The prevalence of high blood pressure(χ~2=8. 05, P<0. 01) the difference was statistically significant. Results of the multi-level model showed that the risk of high blood pressure in central obesity group was significantly higher in girls than in non-obese group(OR=1. 50, 95%CI 1. 12-2. 02). The risk of high normal blood pressure(OR=2. 05, 95%CI 1. 62-2. 58; OR=1. 83, 95%CI 1. 38-2. 42) and high blood pressure(OR=2. 06, 95%CI 1. 59-2. 67; OR=1. 57, 95%CI 1. 15-2. 14) in obese boys and girls were significantly higher than those in non-obese group. The risk of high normal blood pressure(OR=3. 80, 95%CI 3. 19-4. 51; OR=2. 79, 95%CI 2. 30-3. 37), high blood pressure(OR=4. 07, 95%CI 3. 39-4. 88; OR=2. 84, 95%CI 2. 32-3. 46) in both boys and girls with compound obesity was significantly higher than that in the non-obese group. CONCLUSION: Different types of obesity have varying degrees of correction with different blood pressure levels in adolescents aged 12-17 years, combined obesity has the highest risk of elevated blood pressure.


Assuntos
Hipertensão , Obesidade , Adolescente , Pressão Sanguínea , Índice de Massa Corporal , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Obesidade/epidemiologia , Sobrepeso , Prevalência , Fatores de Risco
18.
Adv Gerontol ; 34(1): 39-47, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33993660

RESUMO

With age, the incidence of cardiovascular diseases is steadily increasing worldwide. Living in the harsh climatic and geographical conditions of the Arctic is associated with premature aging, earlier and more frequent development of age-associated diseases. Apparently, these processes are caused by functional changes in large vessels, the state of which has not yet been studied. Aim and methods: to identify correlations of aging and biological age indicators with the parameters of central hemodynamics and arterial stiffness measured using applanation tonometry by the «Sphygmocor¼ device in middle-aged men living in the European North of Russia. For the first time, positive associations of parameters of peripheral and central blood pressure, augmentation index, and negative correlation of the time of return of the reflected wave and pulse pressure amplification with indicators of aging were noted, which indicates an age-related decrease in arterial elasticity. There was also a negative association of the subendocardial viability ratio with the northern experience and biological age. Theoretically considered, the results demonstrate the potential involvement of blood vessels in the pathogenesis of premature aging. The practical significance of the work is related to the need to develop preventive measures aimed at controlling blood pressure, reducing arterial stiffness and cardiovascular risk in middle-aged northerners.


Assuntos
Rigidez Vascular , Envelhecimento , Pressão Sanguínea , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Federação Russa/epidemiologia
19.
Adv Gerontol ; 34(1): 71-75, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33993664

RESUMO

A comparative study of three anthropometric indices as generalized characteristics of the morphological status of elderly women of Belgorod (sample size 50) in the connection with blood pressure (BP) was conducted. The age of the participants ranges from 50 to 79, with the average age of 61. In modern scientific literature, the problem of choosing among anthropometric indices the most reliable predictor of metabolic disorders and related diseases, including high BP, is widely discussed. The paper considers three most widely used anthropometric indices - body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WtHR). BMI and WtHR better reflect morphological specificity of the sample, with a tendency to increased body mass and girths. The highest and most reliable associations with BP are identified for BMI. The results of the study confirm the high predictive value of BMI as an indicator of the risk of arterial hypertension and associated metabolic disorders.


Assuntos
Hipertensão , Razão Cintura-Estatura , Idoso , Antropometria , Pressão Sanguínea , Índice de Massa Corporal , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Fatores de Risco , Relação Cintura-Quadril
20.
J Pak Med Assoc ; 71(2(B)): 590-595, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33941941

RESUMO

Objectives: The Pain Rating index (PRi) is a new parameter for regulating analgesic depth of anaesthesia based on wavelet analysis. The aim of this study was to investigate the feasibility of PRi for depth regulation of sevoflurane anaesthesia. METHODS: We conducted a monocentric randomized controlled study from September 2017 to June 2018 in patients undergoing anterior cervical discectomy and fusion (ACDF) (n=44). Patients were randomly allocated into two groups and assigned 22 cases to each group: systolic blood pressure group (SBP group) and pain rating index group (PRi group). In SBP group, sevoflurane inhalation concentration (Cs) was adjusted to maintain SBP values at baseline values -20%~+20%; in PRi group, Cs was adjusted to maintain PRi values between 50 and 70. The primary endpoint was anaesthesia recovery time. Secondary endpoints included extubation time, sevoflurane consumption, number of intraoperative haemodynamic instability events /interventions, number of adverse events and postoperative visual analogue scale for pain. RESULTS: Patient demographic characteristics, surgical time and anaesthesia time did not differ between groups. Anaesthesia recovery time was shorter in PRi group than in SBP group (17.5±3.8min vs 21.5±2.8 min; P=0.001). Extubation time was also shorter in PRi group than in SBP group (21.9±1.7min vs 24.1±2.5min; P=0.001). Sevoflurane consumption was lower in PRi group than in SBP group (15.5±4.1ml vs 20.0±2.5ml; P=0.001). CONCLUSIONS: PRi was feasible to regulate depth of sevoflurane anaesthesia, which could shorten anaesthesia recovery time and extubation time, reduce sevoflurane consumption during general anaesthesia in patients undergoing cervical vertebra surgery.


Assuntos
Anestésicos Inalatórios , Éteres Metílicos , Período de Recuperação da Anestesia , Anestésicos Inalatórios/farmacologia , Pressão Sanguínea , Humanos , Éteres Metílicos/farmacologia , Dor , Sevoflurano/farmacologia
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