Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 53.490
Filtrar
1.
Medicine (Baltimore) ; 100(32): e26931, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397939

RESUMO

ABSTRACT: Peripheral arterial disease (PAD) is one of major vascular diseases which frequently coexists with coronary arterial disease and cerebrovascular disease. The patients with PAD have a poor prognosis when it progresses. A new blood pressure testing device enables to simultaneously measure brachial blood pressure (BP), central BP, and several vascular parameters, with easy and non-invasive, in a short time. Here, we aimed to evaluate these arterial stiffness parameters in patients with PAD.In this study, 243 consecutive patients who were suspected of having PAD and referred to our hospital from September 2016 to June 2019, were registered. Several parameters, such as brachial BP, central BP, aortic pulse wave velocity (aPWV), total vascular resistance (TVR), augmentation index (AI) and augmentation pressure (AP), were determined by Mobil-O-Graph. Ankle-brachial pressure index (ABI) was used to define PAD (ABI ≤ 0.9 as PAD). The relationship between PAD and central BP, aPWV, TVR, AI, or AP were investigated.One hundred sixty-two patients (67%) were categorized as the PAD group and 81 patients (33%) as the non-PAD group. In the PAD group, the systolic brachial BP and central systolic BP were significantly higher than those in the non-PAD group (138 ±â€Š24 mmHg vs 131 ±â€Š19 mmHg, P < .05, 125 ±â€Š22 mmHg vs 119 ±â€Š18 mmHg, P < .05, respectively). TVR, AI, and AP were significantly higher in the PAD group (1785 ±â€Š379 dyn s/cm5 vs 1661 ±â€Š317 dyn s/cm5, P < .05, 26.2 ±â€Š13.0% vs 22.2 ±â€Š13.3%, P < .05, 13.5 ±â€Š9.4 mmHg vs 10.7 ±â€Š7.2 mmHg, P < .05, respectively). No significant differences in diastolic BP, central diastolic BP, and aPWV were found between the groups. Multivariate logistic regression analysis revealed that PAD was significantly associated with TVR, AI, and AP (P < .05, respectively).TVR/AP/AI were significantly higher in the PAD group than in the non-PAD group.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Doença Arterial Periférica/fisiopatologia , Resistência Vascular/fisiologia , Rigidez Vascular/fisiologia , Idoso , Índice Tornozelo-Braço , Estudos Transversais , Feminino , Humanos , Masculino , Análise de Onda de Pulso , Estudos Retrospectivos
2.
Medicine (Baltimore) ; 100(32): e26935, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397942

RESUMO

ABSTRACT: Transplant renal artery stenosis (TRAS) is the most common (1%-23%) vascular complication following kidney transplantation. The aim of this study was to review our experience with an endovascular approach to treat TRAS.We retrospectively reviewed kidney transplant recipients who underwent percutaneous transluminal angioplasty (PTA) due to TRAS in our institute from January 2009 to December 2015. We analyzed the patient's baseline characteristics, postoperative renal function, blood pressure evolution, and the number of pre- and post-procedure antihypertensive drugs.A total of 21 patients (15 men, 6 women) were treated with the endovascular technique. The predominant presentation was graft dysfunction (76.2%). Stenosis or hemodynamic kinking was located at the anastomosis in 7 (33.3%) patients, proximal to the anastomosis in 13 (61.9%) patients, and distal the anastomosis in 1 (4.8%) patient. PTA without stent placement was performed in 7 patients (33.3%), and PTA with stent placement was performed in 14 patients (67.7%). Serum creatinine levels demonstrated no difference between the pre-procedure level and that on discharge day (1.61 mg/dl [0.47-3.29 mg/dl] vs 1.46 mg/dl [0.47-3.08 mg/dl]; P = .33). The glomerular filtration rate also showed no difference between the pre-procedure value and that on discharge day (53.6 ml/min [22.4-145.7 ml/min] vs 57.0 ml/min [17.56 -145 ml/min]; P = .084). Systolic blood pressure and diastolic blood pressure (DBP) varied from 137 mm Hg (120-160 mm Hg) and 84 mm Hg (70-100 mm Hg) pre-procedure to 129 mm Hg (90-150 mm Hg) and 79 mm Hg (60-90 mm Hg) at discharge, respectively (P = .124 and P = .07). The number of antihypertensive medications significantly decreased from 1.5 (0-6) pre-procedure to 0.5 (0-2) at discharge (P = .023). In our study, there were no technical failures, procedure-related complications or deaths. During the follow-up period, the free-from-reintervention rate was 100%, and graft failures occurred in 2 patients (9.5%) due to rejection.Endovascular procedures for TRAS show a high technical success rate with a low complication rate and a low reintervention rate. PTA showed a trend toward a positive impact on lowering serum creatinine, systolic blood pressure, and diastolic blood pressure and improving estimated glomerular filtration rate, and the number of antihypertensive medications could be significantly reduced after this procedure.


Assuntos
Angioplastia/métodos , Procedimentos Endovasculares/métodos , Transplante de Rim/efeitos adversos , Complicações Pós-Operatórias , Obstrução da Artéria Renal/cirurgia , Stents , Grau de Desobstrução Vascular/fisiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Feminino , Seguimentos , Taxa de Filtração Glomerular/fisiologia , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Obstrução da Artéria Renal/diagnóstico , Obstrução da Artéria Renal/etiologia , Estudos Retrospectivos , Fatores de Tempo , Transplantados , Resultado do Tratamento
3.
Medicine (Baltimore) ; 100(33): e26988, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414978

RESUMO

ABSTRACT: With the declining use of the pulmonary artery catheter (PAC), transesophageal echocardiography (TEE) has become an appealing alternative to obtain pulmonary artery pressure non-invasively using the simplified Bernoulli equation. The validation of this method in the perioperative setting has been scarce with no clear recommendations about which view is the most accurate to estimate right ventricular systolic pressure (RVSP).Therefore, we performed a prospective, observer-blinded, diagnostic test accuracy study to assess the difference in systolic pulmonary artery pressure (sysPAP) measuring both, invasively sysPAP and estimated RVSP with TEE in 3 different views: the mid-esophageal (ME) 4Chamber, the ME right ventricular (RV) inflow-outflow and the ME modified bicaval view.To show a clinically significant difference of at least 10% in RVSP, we included 40 cardiac surgical patients divided into 3 subgroups: Patients with mild to moderate tricuspid regurgitation (TR) and mean PAP <25 mm Hg, patients with mild to moderate TR and mean PAP≥ 25 mm Hg, and patients with severe TR.For the whole cohort, bias of estimated RVSP compared to measured sysPAP was 5.27 mm Hg, precision was 7.96 mm Hg, limits of agreement were -10.66 to 21.19 mm Hg. The best agreement between the 2 methods was found in patients with severe TR and in the ME RV inflow-outflow and the modified bicaval view. Good Doppler signals were available in 35% and 46% in these views, and in 20% in the ME 4 chamber view.The estimation of the sysPAP by TEE cannot be considered reliable in the clinical perioperative setting. Only measurements that provide a full Doppler envelope show sufficient precision to provide accurate estimations.


Assuntos
Ecocardiografia Transesofagiana/métodos , Hipertensão Arterial Pulmonar/classificação , Pesos e Medidas/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/fisiologia , Ecocardiografia Transesofagiana/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Pesos e Medidas/instrumentação
4.
Nutrients ; 13(7)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34371815

RESUMO

High blood pressure is a crucial risk factor for many cardiovascular diseases, and a diet rich in whole-grain foods may modulate blood pressure. This study investigated the effects of dehulled adlay consumption on blood pressure in vivo. We initially fed spontaneous hypertensive rats diets without (SHR group) or with 12 or 24% dehulled adlay (SHR + LA and SHR + HA groups), and discovered that it could limit blood pressure increases over a 12-week experimental period. Although we found no significant changes in plasma, heart, and kidney angiotensin-converting enzyme activities, both adlay-consuming groups had lower endothelin-1 and creatinine concentrations than the SHR group; the SHR + HA group also had lower aspartate aminotransferase and uric acid levels than the SHR group did. We later recruited 23 participants with overweight and obesity, and they consumed 60 g of dehulled adlay daily for a six-week experimental period. At the end of the study, we observed a significant decrease in the group's systolic blood pressure (SBP), and the change in SBP was even more evident in participants with high baseline SBP. In conclusion, our results suggested that daily intake of dehulled adlay had beneficial effects in blood-pressure management. Future studies may further clarify the possible underlying mechanisms for the consuming of dehulled adlay as a beneficial dietary approach for people at risk of hypertension.


Assuntos
Pressão Sanguínea/fisiologia , Coix , Dieta/métodos , Hipertensão/dietoterapia , Grãos Integrais , Adulto , Animais , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Hipertensão/etiologia , Masculino , Fenômenos Fisiológicos da Nutrição , Obesidade/complicações , Obesidade/dietoterapia , Obesidade/fisiopatologia , Sobrepeso/complicações , Sobrepeso/dietoterapia , Sobrepeso/fisiopatologia , Ratos , Ratos Endogâmicos SHR
8.
Lancet Glob Health ; 9(8): e1119-e1128, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34237265

RESUMO

BACKGROUND: Blood pressure measurement is a marker of antenatal care quality. In well resourced settings, lower blood pressure cutoffs for hypertension are associated with adverse pregnancy outcomes. We aimed to study the associations between blood pressure thresholds and adverse outcomes and the diagnostic test properties of these blood pressure cutoffs in low-resource settings. METHODS: We did a secondary analysis of data from 22 intervention clusters in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials (NCT01911494) in India (n=6), Mozambique (n=6), and Pakistan (n=10). We included pregnant women aged 15-49 years (12-49 years in Mozambique), identified in their community by trained community health workers, who had data on blood pressure measurements and outcomes. The trial was unmasked. Maximum blood pressure was categorised as: normal blood pressure (systolic blood pressure [sBP] <120 mm Hg and diastolic blood pressure [dBP] <80 mm Hg), elevated blood pressure (sBP 120-129 mm Hg and dBP <80 mm Hg), stage 1 hypertension (sBP 130-139 mm Hg or dBP 80-89 mm Hg, or both), non-severe stage 2 hypertension (sBP 140-159 mm Hg or dBP 90-109 mm Hg, or both), or severe stage 2 hypertension (sBP ≥160 mm Hg or dBP ≥110 mm Hg, or both). We classified women according to the maximum blood pressure category reached across all visits for the primary analyses. The primary outcome was a maternal, fetal, or neonatal mortality or morbidity composite. We estimated dose-response relationships between blood pressure category and adverse outcomes, as well as diagnostic test properties. FINDINGS: Between Nov 1, 2014, and Feb 28, 2017, 21 069 women (6067 in India, 4163 in Mozambique, and 10 839 in Pakistan) contributed 103 679 blood pressure measurements across the three CLIP trials. Only women with non-severe or severe stage 2 hypertension, as discrete diagnostic categories, experienced more adverse outcomes than women with normal blood pressure (risk ratios 1·29-5·88). Using blood pressure categories as diagnostic thresholds (women with blood pressure within the category or any higher category vs those with blood pressure in any lower category), dose-response relationships were observed between increasing thresholds and adverse outcomes, but likelihood ratios were informative only for severe stage 2 hypertension and maternal CNS events (likelihood ratio 6·36 [95% CI 3·65-11·07]) and perinatal death (5·07 [3·64-7·07]), particularly stillbirth (8·53 [5·63-12·92]). INTERPRETATION: In low-resource settings, neither elevated blood pressure nor stage 1 hypertension were associated with maternal, fetal, or neonatal mortality or morbidity adverse composite outcomes. Only the threshold for severe stage 2 hypertension met diagnostic test performance standards. Current diagnostic thresholds for hypertension in pregnancy should be retained. FUNDING: University of British Columbia, the Bill & Melinda Gates Foundation.


Assuntos
Pressão Sanguínea/fisiologia , Pré-Eclâmpsia/epidemiologia , Gravidez/fisiologia , Adolescente , Adulto , Criança , Serviços de Saúde Comunitária , Feminino , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Moçambique/epidemiologia , Paquistão/epidemiologia , Valores de Referência , Medição de Risco/métodos , Adulto Jovem
9.
Int J Mol Sci ; 22(13)2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34203369

RESUMO

Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disorder affecting one in 500 of the general population. Atrial fibrillation (AF) is the most common arrhythmia in patients with HCM. We sought to characterize the atrial electrophysiological and structural substrate in young and aging Gly203Ser cardiac troponin-I transgenic (HCM) mice. At 30 weeks and 50 weeks of age (n = 6 per strain each group), the left atrium was excised and placed on a multi-electrode array (MEA) for electrophysiological study; subsequent histological analyses and plasma samples were analyzed for biomarkers of extracellular matrix remodeling and cell adhesion and inflammation. Wild-type mice of matched ages were included as controls. Young HCM mice demonstrated significantly shortened atrial action potential duration (APD), increased conduction heterogeneity index (CHI), increased myocyte size, and increased interstitial fibrosis without changes in effective refractory periods (ERP), conduction velocity (CV), inflammatory infiltrates, or circulating markers of extracellular matrix remodeling and inflammation. Aging HCM mice demonstrated aggravated changes in atria electrophysiology and structural remodeling as well as increased circulating matrix metalloproteinases (MMP)-2, MMP-3, and VCAM-1 levels. This model of HCM demonstrates an underlying atrial substrate that progresses with age and may in part be responsible for the greater propensity for AF in HCM.


Assuntos
Fibrilação Atrial/metabolismo , Cardiomiopatia Hipertrófica/metabolismo , Átrios do Coração/metabolismo , Troponina I/metabolismo , Potenciais de Ação/fisiologia , Animais , Fibrilação Atrial/genética , Remodelamento Atrial/genética , Remodelamento Atrial/fisiologia , Pressão Sanguínea/fisiologia , Eletrofisiologia Cardíaca , Cardiomiopatia Hipertrófica/genética , Modelos Animais de Doenças , Eletrofisiologia , Feminino , Átrios do Coração/patologia , Frequência Cardíaca/fisiologia , Humanos , Masculino , Mutação , Troponina I/genética
10.
Afr J Prim Health Care Fam Med ; 13(1): e1-e7, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34212744

RESUMO

BACKGROUND: Hypertension is a public health threat of global concern with increasing prevalence in many countries, including Nigeria. AIM: The aim of the study was to determine the prevalence and determinants of hypertension in a rural agrarian community in Edo North, Nigeria. SETTING: The study was carried out in Ayua, a community in Edo North, southern Nigeria. METHODS: This cross-sectional descriptive study involved the use of a structured interviewer-administered questionnaire to obtain relevant data. Body mass index (BMI), blood pressure and glucose were recorded. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. RESULTS: Two hundred and nineteen participants aged 15 years completed the study with a mean age of 54.03 ± 16.61 years and females comprising 159 (72.6%) of the total. The prevalence of hypertension was 27.9% (in 61 participants). Twenty-one (9.8%) respondents gave a family history of hypertension. The mean BMI amongst respondents was 27.10 ± 6.61 kg/m2. Obesity and pre-obesity were found in 58 (26.5%) and 71(32.4%) respondents, respectively. The determinants of hypertension were age and BMI. Compared with those who were less than 40 years old, those aged 40-65 years and 65 years had 1.9 and 4.2 times increased odds of developing hypertension, respectively. Similarly, compared with the non-obese, obese participants had 2.3 times increased odd of having hypertension. CONCLUSION: Hypertension was highly prevalent in this rural community. Health sensitisation and intervention programmes are recommended in rural communities for early detection and management of hypertension, especially amongst older and obese adults.


Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Determinantes Sociais da Saúde , Adulto , Idoso , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Hipertensão/etnologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/complicações , Obesidade/etnologia , Obesidade/psicologia , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
11.
Int J Mol Sci ; 22(14)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34299228

RESUMO

Moderation in the use of salt (sodium chloride) in food and food preparations prevents the tendency of blood pressure to increase with age, and this is documented by many studies in current literature [...].


Assuntos
Dieta Hipossódica/tendências , Cloreto de Sódio na Dieta/efeitos adversos , Cloreto de Sódio/efeitos adversos , Pressão Sanguínea/fisiologia , Dieta/métodos , Dieta/tendências , Dieta Hipossódica/métodos , Humanos , Hipertensão/fisiopatologia , Cloreto de Sódio/metabolismo
13.
Eur J Endocrinol ; 185(4): 507-514, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34324433

RESUMO

Background: Despite adequate presurgical management, blood pressure fluctuations are common during resection of pheochromocytoma or sympathetic paraganglioma (PPGL). To a large extent, the variability in blood pressure control during PPGL resection remains unexplained. Adrenomedullin and B-type natriuretic peptide, measured as MR-proADM and NT-proBNP, respectively, are circulating biomarkers of cardiovascular dysfunction. We investigated whether plasma levels of MR-proADM and NT-proBNP are associated with blood pressure fluctuations during PPGL resection. Methods: Study subjects participated in PRESCRIPT, a randomized controlled trial in patients undergoing PPGL resection. MR-proADM and NT-proBNP were determined in a single plasma sample drawn before surgery. Multivariable linear and logistic regression analyses were used to explore associations between these biomarkers and blood pressure fluctuations, use of vasoconstrictive agents during surgery as well as the occurrence of perioperative cardiovascular events. Results: A total of 126 PPGL patients were included. Median plasma concentrations of MR-proADM and NT-proBNP were 0.51 (0.41-0.63) nmol/L and 68.7 (27.9-150.4) ng/L, respectively. Neither MR-proADM nor NT-proBNP were associated with blood pressure fluctuations. There was a positive correlation between MR-proADM concentration and the cumulative dose of vasoconstrictive agents (03B2 0.44, P =0.001). Both MR-proADM and NT-proBNP were significantly associated with perioperative cardiovascular events (OR: 5.46, P =0.013 and OR: 1.54, P =0.017, respectively). Conclusions: plasma MR-proADM or NT-proBNP should not be considered as biomarkers for the presurgical risk assessment of blood pressure fluctuations during PPGL resection. Future studies are needed to explore the potential influence of these biomarkers on the intraoperative requirement of vasoconstrictive agents and the perioperative cardiovascular risk.


Assuntos
Neoplasias das Glândulas Suprarrenais , Adrenomedulina/sangue , Pressão Sanguínea/fisiologia , Peptídeo Natriurético Encefálico/sangue , Feocromocitoma , Neoplasias das Glândulas Suprarrenais/sangue , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/tratamento farmacológico , Neoplasias das Glândulas Suprarrenais/cirurgia , Antagonistas Adrenérgicos/uso terapêutico , Adulto , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Feminino , Seguimentos , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Complicações Intraoperatórias/sangue , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/fisiopatologia , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Feocromocitoma/sangue , Feocromocitoma/diagnóstico , Feocromocitoma/tratamento farmacológico , Feocromocitoma/cirurgia , Prognóstico , Medição de Risco , Resultado do Tratamento
14.
Biomolecules ; 11(6)2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34207942

RESUMO

Blood pressure (BP) follows a circadian rhythm, it increases on waking in the morning and decreases during sleeping at night. Disruption of the circadian BP rhythm has been reported to be associated with worsened cardiovascular and renal outcomes, however the underlying molecular mechanisms are still not clear. In this review, we briefly summarized the current understanding of the circadian BP regulation and provided therapeutic overview of the relationship between circadian BP rhythm and cardiovascular and renal health and disease.


Assuntos
Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/fisiopatologia , Ritmo Circadiano/fisiologia , Nefropatias/fisiopatologia , Doenças Cardiovasculares/metabolismo , Sistema Cardiovascular/fisiopatologia , China , Humanos , Hipertensão/fisiopatologia , Rim/fisiopatologia , Nefropatias/metabolismo
15.
Nutrients ; 13(7)2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34201442

RESUMO

The goal of this study was to test the feasibility of time restricted eating (TRE) in adults with overweight and obesity. Participants (n = 50) logged all eating occasions (>0 kcal) for a 2-week run-in period using a smartphone application. Participants with eating duration ≥14 h enrolled in an open label, non-randomized, prospective 90-day TRE intervention, with a self-selected reduced eating window of 10 h. No dietary counseling was provided. Changes in anthropometrics, eating patterns and adherence after TRE were analyzed using t-tests or Wilcoxon Rank-Sum Test. The mean duration of the baseline eating window was 14 h 32 m ± 2 h 36 m (n = 50) with 56% of participants with duration ≥14 h. TRE participants (n = 16) successfully decreased their eating window from 16 h 04 m ± 1 h 24 m to 11 h 54 m ± 2 h 06 m (p < 0.001), and reduced the number of daily eating occasions by half (p < 0.001). Adherence to logging and to the reduced eating window was 64% ± 22% and 47% ± 19%, respectively. TRE resulted in decreases in body weight (-2.1 ± 3.0 kg, p = 0.017), waist circumference (-2.2 ± 4.6 cm, p = 0.002) and systolic blood pressure (-12 ± 11 mmHg, p = 0.002). This study demonstrates the feasibility and efficacy of TRE administered via a smartphone, in adults with overweight and obesity.


Assuntos
Pressão Sanguínea/fisiologia , Peso Corporal , Jejum , Obesidade/fisiopatologia , Smartphone , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Cardiovasc Ther ; 2021: 6622651, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34257706

RESUMO

Objectives: To assess mean systolic and diastolic blood pressure (SBP and DBP) levels in patients ≥50 years with uncontrolled hypertension (HTN) and evaluate the correlation between BP and stroke risk. It also assessed therapeutic drug classes prescribed in these patients. Methods: A cross-sectional, observational study was conducted at 176 outpatient centers across India, including patients aged ≥50 years with elevated SBP (≥140 mmHg). The relationship between stroke risk, calculated using Stroke Riskometer™, and mean SBP, mean DBP, and other risk factors was evaluated using Pearson correlation coefficient and logistic regression analysis. Results: The study included 3791 patients (men, 60.0%; mean age: 62.1 ± 8.3 years; mean BMI: 27 kg/m2) with mean SBP 157.3 ± 12.8 mmHg and mean DBP 89.8 ± 9.7 mmHg. Five-year stroke risk in 33.9% and 10-year stroke risk in 70% patients were moderate to severe. A ~4% increase in both 5- and 10-year stroke risk with each 1 mmHg increase in mean SBP (p < 0.0001) was seen. However, mean DBP did not exhibit any significant correlation with 5-year (p = 0.242) or 10-year (p = 0.8038) stroke risk. There was a positive correlation between mean SBP and patient age, comorbid diabetes, and smoking and alcohol habits (p < 0.0001). Comorbid diabetes and smoking increased 5- and 10-year stroke risk by 2- to 5-fold. Irrespective of the risk category, most patients received antihypertensive therapy with an angiotensin receptor blocker. Conclusion: Findings corroborate an association between stroke risk and mean SBP. These real-world clinical findings indicate that efforts are required to improve primary prevention of stroke and reduce the prevalence of recurrent stroke in India.


Assuntos
Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
17.
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
18.
J Zoo Wildl Med ; 52(2): 479-489, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34130390

RESUMO

The effects of α-2 agonists on echocardiographic findings in great apes are not well documented, and knowledge of these effects would expand the understanding of cardiac examinations of chimpanzees under anesthesia with protocols using these drugs. Ten adult chimpanzees (Pan troglodytes), four males and six females, underwent echocardiographic examinations after anesthesia with dexmedetomidine, midazolam, and ketamine (phase 1). Four animals required isoflurane to achieve an adequate plane of anesthesia. Atipamezole was used to antagonize dexmedetomidine, and all remaining animals were placed on isoflurane (phase 2), and then a second echocardiogram was performed. Direct arterial blood pressure was monitored during the anesthetic event. Measurements and recordings were assessed for statistically significant differences between the two phases and sex. There were no significant differences between phases or sex for any two-dimensional echocardiographic measurement of systolic function, although interventricular septum thickness at end systole approached a significant decrease from phase 1 to phase 2 (P = 0.058) when sex was considered a between-subject factor. Left ventricular outflow tract (P = 0.017) and pulmonary artery (P = 0.028) velocities increased after reversal of the dexmedetomidine. Diastolic transmitral flow was consistent with grade 3 diastolic dysfunction (median early to late ventricular filling velocities (E/A) of 2.02, interquartile range [IQR], 1.53-2.13) with a nonsignificant decrease of E velocity and increase in A velocity and decreased E/A after reversal. Trace mitral and tricuspid regurgitation were common findings in the sample population. Arterial blood pressure significantly decreased between phase 1 and phase 2 (P < 0.01). All chimpanzees entered a hypotensive state (mean arterial pressure < 60 mm Hg) during phase 2. Although limited by the small number of chimpanzees, this study showed an increase in afterload, potential diastolic dysfunction, and a decrease in blood pressure after the antagonism of dexmedetomidine. Additional studies to further assess the effects of α-2 agonists in chimpanzees are warranted.


Assuntos
Anestesia/veterinária , Pressão Sanguínea/fisiologia , Dexmedetomidina/farmacologia , Ecocardiografia/veterinária , Imidazóis/farmacologia , Pan troglodytes , Antagonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Antagonistas de Receptores Adrenérgicos alfa 2/farmacologia , Anestésicos Inalatórios/administração & dosagem , Anestésicos Inalatórios/farmacologia , Animais , Monitores de Pressão Arterial , Dexmedetomidina/administração & dosagem , Feminino , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/farmacologia , Imidazóis/administração & dosagem , Isoflurano/administração & dosagem , Isoflurano/farmacologia , Masculino
19.
Physiology (Bethesda) ; 36(4): 220-234, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34159807

RESUMO

Much excitement exists over the cardioprotective and life-extending effects of caloric restriction (CR). This review integrates population studies with experimental animal research to address the positive and negative impact of mild and severe CR on cardiovascular physiology and pathophysiology, with a particular focus on the renin-angiotensin system (RAS). We also highlight the gaps in knowledge and areas ripe for future physiological research.


Assuntos
Pressão Sanguínea/fisiologia , Restrição Calórica , Fenômenos Fisiológicos Cardiovasculares , Sistema Renina-Angiotensina/fisiologia , Animais , Sistema Cardiovascular/metabolismo , Humanos
20.
Clin Interv Aging ; 16: 997-1005, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34113085

RESUMO

Background and Aim: Any single discrete blood pressure (BP) measurement is not enough to estimate adverse cardiovascular events. We aim to comprehensively investigate the association between BP indicators and stroke. Methods: An observational cohort study was conducted among 2888 Shanghai community-aged residents from 2014 to 2018, and a nested case-control study was designed to identify the association between BP indicators and stroke. In total 415 cases of stroke detected during the study period were selected as the case group and 415 non-stroke subjects, matched with factors of age and gender, were randomly selected from the cohort as control group. Results: Multivariate logistic regression analysis revealed that systolic blood pressure (SBP) (adjusted odds ratio [AOR] 1.02, 95% confidence interval [CI] 1.02-1.03), pulse pressure (PP) (AOR 1.03, 95% CI 1.02-1.04), mean arterial pressure (MAP) (AOR1.02, 95% CI 1.01-1.04) and pulse pressure index (PPI) (AOR 25.68, 95% CI 3.19-206.90) increased the risk of stroke, respectively. After fitting both BP indicators and covariates, isolated abnormal SBP (AOR 2.55, 95% CI 1.74-3.72) or PP ≥50 mmHg (AOR 1.66, 95% CI 1.08-2.56) independently increased risk of stroke. Conclusion: Besides SBP, PP and multiple factors, assessment should be taken into account comprehensively for stroke prevention and management.


Assuntos
Pressão Arterial , Hipertensão/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Estudos de Casos e Controles , China , Estudos de Coortes , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Fatores de Risco , Acidente Vascular Cerebral/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...