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Clin Liver Dis ; 27(1): 71-84, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36400468


PoPH is a well-recognized complication of portal hypertension with or without cirrhosis and is classified as a subset of PAH. Identification of PoPH is crucial as it has a major impact on prognosis and liver transplant candidacy. Echocardiogram is the initial screening tool of choice and the patient should proceed to RHC for confirmation. PAH-directed therapy is the treatment of choice, allowing the patient to achieve a hemodynamic threshold to undergo a liver transplant safely.

Hipertensão Portal , Hipertensão Pulmonar , Transplante de Fígado , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/terapia , Hipertensão Portal/complicações , Hipertensão Portal/diagnóstico , Transplante de Fígado/efeitos adversos , Prognóstico
Cardiol Clin ; 41(1): 15-24, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36368808


Hypertension is a leading cardiovascular risk factor in athletes. Sport-specific behaviors including nonsteroidal anti-inflammatory use, stimulant use, and unhealthy diets may promote hypertension among athletes. Strength-trained athletes may be more susceptible to hypertension than endurance-trained athletes, although this may, in part, be due to body size differences and the more potent antihypertensive effects of aerobic exercise. With confirmed hypertension, young athletes require secondary hypertension evaluation while older athletes require full cardiovascular risk stratification. Calcium channel blockers and renin-angiotensin-system inhibitors are often preferred pharmacotherapy agents. Further selection of antihypertensives must include consideration of potential side effects and legality in specific sports.

Hipertensão , Esportes , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Hipertensão/terapia , Anti-Hipertensivos/uso terapêutico , Atletas , Bloqueadores dos Canais de Cálcio/uso terapêutico
J Sci Food Agric ; 103(1): 428-436, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36373790


BACKGROUND: Our previous study has demonstrated that the egg-white-derived peptide RVPSL can lower blood pressure in spontaneously hypertensive rats (SHRs), but its potential action mechanism remains unclear. In this work, the underlying mechanism of the antihypertensive effects of RVPSL in SHRs was elucidated using the widely targeted kidney metabolomics approach. RESULTS: Ten SHRs were divided into two groups: SHR-Untreated group (0.9% saline) and SHR-RVPSL group (50 mg kg-1 body weight RVPSL) for 4 weeks. After 4 weeks, kidney samples were collected and widely targeted (liquid chromatography-electrospray ionization-tandem mass spectrometry) metabolomics was used to detect metabolites. Fifty-six biomarkers were identified that may be associated with hypertension. Among them, 17 biomarkers were upregulated and 39 biomarkers were downregulated. The results suggested that eight potential biomarkers were identified in kidney samples: O-phospho-l-serine, tyramine, citric acid, 3-hydroxybutyrate, O-acetyl-l-serine, 15-oxo-5Z,8Z,11Z,13E-eicosatetraenoic acid (15-oxoETE), dopaquinone and 3,3',5-triiodo-l-thyronine. These potential biomarkers mainly involved carbon metabolism, thyroid hormone signaling pathway, tyrosine metabolism and arachidonic acid metabolism. CONCLUSION: The study suggested that RVPSL may exert antihypertensive effects through upregulation of O-phospho-l-serine, 3-hydroxybutyrate and 15-oxoETE, and downregulation of tyramine, citric acid, O-acetyl-l-serine, 3,3',5-triiodo-l-thyronine and dopaquinone. The antihypertensive effects of RVPSL may be related to carbon metabolism, thyroid hormone signaling pathway, tyrosine metabolism and arachidonic acid metabolism. RVPSL exhibited a potent antihypertensive effect, and the antihypertensive effects were associated with inhibition of vascular smooth muscle cell proliferation, vascular remodeling, vascular endothelium dysfunction, restoring reactive oxygen species, oxidative stress, inflammation and immune reaction. © 2022 Society of Chemical Industry.

Anti-Hipertensivos , Hipertensão , Ratos , Animais , Anti-Hipertensivos/farmacologia , Ratos Endogâmicos SHR , Ácido Araquidônico , Ácido 3-Hidroxibutírico , Hipertensão/tratamento farmacológico , Metabolômica , Rim , Pressão Sanguínea , Biomarcadores , Serina , Tironinas , Tiramina , Ácido Cítrico , Carbono , Tirosina
Biochim Biophys Acta Mol Basis Dis ; 1869(1): 166586, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36374802


Lenvatinib, a multitarget tyrosine kinase inhibitor (TKI), increases the incidence of severe hypertension and thus the incidence of cardiovascular complications. Inhibition of ferroptosis, a newly recognized type of cell death, alleviates endothelial dysfunction. Here, we report that lenvatinib-induced hypertension is associated with ferroptosis of endothelial cells. RNA sequencing (RNA-seq) showed that lenvatinib led to ferroptosis of endothelial cells and that administration of mouse with ferrostatin-1 (Fer-1), a specific ferroptosis inhibitor, dramatically ameliorated lenvatinib-induced hypertension and reversed lenvatinib-induced impairment of endothelium-dependent relaxation (EDR). Furthermore, lenvatinib significantly reduced glutathione peroxidase 4 (GPX4) expressions in the mouse aorta and human umbilical vein endothelial cells (HUVECs) and increased lipid peroxidation, lactate dehydrogenase (LDH) release, and malondialdehyde (MDA) levels in HUVECs. Immunofluorescence and Western blotting showed that lenvatinib significantly reduced Yes-associated protein (YAP) nuclear translocation but not cytoplasmic YAP expression in HUVECs. The data, generated from both in vivo and in vitro, showed that lenvatinib reduced total YAP (t-YAP) expression and increased the phosphorylation of YAP at both Ser127 and Ser397, without affecting YAP mRNA levels in HUVECs. XMU-MP-1 mediated YAP activation or YAP overexpression effectively attenuated the lenvatinib-induced decrease in GPX4 expression and increases in LDH release and MDA levels. In addition, overexpression of YAP in HUVECs ameliorated lenvatinib-induced decrease in the mRNA and protein levels of spermidine/spermine N (1)-acetyltransferase-1 (SAT1), heme oxygenase-1 (HO-1), and ferritin heavy chain 1 (FTH1). Taken together, our data suggest that lenvatinib-induced inhibition of YAP led to ferroptosis of endothelial cells and subsequently resulted in vascular dysfunction and hypertension.

Ferroptose , Hipertensão , Humanos , Camundongos , Animais , Pressão Sanguínea , Células Endoteliais da Veia Umbilical Humana , RNA Mensageiro
J Intensive Care Med ; 38(1): 5-10, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35892180


BACKGROUND: Critical illness in patients with chronic liver disease (CLD) is increasing in occurrence, and by virtue of its adverse effect on prognosis, its presence may influence the decision to offer admission to intensive care units (ICU). Our objective was to examine the determinants and outcome of patients with CLD admitted to ICU. METHODS: A retrospective cohort of patients admitted to four adult ICUs in Queensland, Australia from 2017 to 2019. Patients with mild or moderate-severe CLD were defined by the absence and presence of portal hypertension, respectively, and were was determined using granular ICU and state-wide administrative databases. The primary outcome was 90-day all cause case-fatality. RESULTS: We included 3836 patients in the analysis, of which, 60 (2%) had mild liver disease and 132 (3%) had moderate-severe liver disease . Patients with CLD had higher incidence of other co-morbidities with the median adjusted-Charlson co-morbidity index (CCI) was 1 (interquartile range; IQR 0-3) for no CLD, 2 (IQR 1.5-4) for mild CLD, and 3 (IQR 2-5) for moderate-severe CLD. Case-fatality rates at 90 days was 17% for no CLD, 25% for mild CLD, and 41% for moderate-severe CLD. Among those with mild and moderate-severe CLD, an increased co-morbidity burden as measured by an adjusted CCI score of low (0-3), medium (4-5), high (6-7) and very high (>7) resulted in increasing case-fatality rates of 24-40%, 11-28.5%, 33-62%, and 50% respectively. Moderate-severe CLD, but not mild CLD, was independently associated with increased case-fatality at 90 days (Odds Ratio 1.58; 95% confidence interval 1.01-2.48; p = 0.004) after adjusting for medical co-morbidities and severity of illness using logistic regression analysis. CONCLUSIONS: Although patients with moderate-severe CLD have an increased risk for 90-day case-fatality, patients with mild CLD are not at higher risk for death following ICU admission.

Estado Terminal , Hipertensão Portal , Adulto , Humanos , Estudos Retrospectivos , Unidades de Terapia Intensiva , Estudos de Coortes , Hipertensão Portal/complicações
Curr Probl Cardiol ; 48(1): 101428, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36191693


Transcutaneous aortic valve implantation (TAVI) has transformed the management of aortic stenosis (AS) and is increasingly being used for patients with symptomatic, severe aortic stenosis who are ineligible or at high risk for conventional cardiac surgery. PUBMED, Google Scholar, and SCOPUS databases were searched to identify studies reporting heart failure hospitalization after TAVI. Major factors evaluated for HF hospitalization were age, comorbidities such as hypertension, atrial fibrillation (AF), chronic pulmonary disease including COPD, chronic kidney disease, baseline LVEF before the procedure, NYHA symptom class, and society of thoracic surgeons (STS) score. Hazard ratio (HR) with a 95% confidence interval were computed using random-effects models. A total of eight studies were included comprising 77,745 patients who underwent TAVI for severe aortic stenosis. The presence of diabetes mellitus (HR: 1.39, 95% CI [1.17, 1.66], chronic kidney disease (CKD) (HR: 1.39, 95% CI [1.31, 1.48], atrial fibrillation (HR: 1.69, 95% CI [1.42, 2.01], chronic pulmonary disease (HR: 1.33, 95% CI [1.12, 1.58], and a high STS score (HR: 1.07, 95% CI [1.03, 1.11] were positive predictors of 1-year HF hospitalization after TAVI. Patients with diabetes mellitus, AF, CKD, chronic pulmonary disease, and a high STS score are at an increased risk of heart failure hospitalization at 1-year of TAVI, whereas increasing age, hypertension, LVEF <50%, and NYHA class III/IV symptoms did not predict HF hospitalization. Careful follow-up after TAVI in high-risk patients, with closer surveillance for HF particularly, is key to preventing HF hospitalizations and death.

Estenose da Valva Aórtica , Fibrilação Atrial , Insuficiência Cardíaca , Hipertensão , Pneumopatias , Insuficiência Renal Crônica , Substituição da Valva Aórtica Transcateter , Humanos , Valva Aórtica/cirurgia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Fibrilação Atrial/cirurgia , Readmissão do Paciente , Fatores de Risco , Estenose da Valva Aórtica/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/diagnóstico , Pneumopatias/etiologia , Pneumopatias/cirurgia , Resultado do Tratamento
Holist Nurs Pract ; 37(1): 24-33, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36378089


The purpose of the study was to examine the effects of auricular acupressure (AA) on physiological index, depression, anxiety, and stress in elderly people with hypertension. The verum group received verum AA therapy for 8 weeks. Five different acupressure sites were applied in each group. There was a significant difference in systolic blood pressure between the 2 groups after 8 weeks of AA, whereas a significant difference in pulse pressure was found between the 2 groups after 6 weeks of AA. This study is meaningful in comparing intervention and sham groups, verifying the effects by using physiological and psychological variables, and confirming the effects of repetitive measurement. AA therapy is expected to be a practical and efficient health care intervention for elderly people with hypertension.

Acupressão , Hipertensão , Humanos , Idoso , Depressão/terapia , Ansiedade/terapia , Hipertensão/terapia , Pressão Sanguínea
Chemosphere ; 311(Pt 1): 136995, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36330973


In rural areas of developing countries, solid fuels are still widely used for cooking, heating, and lighting purposes. This study investigates the effects of household air pollutants (HAPs) exposure on the occurrence of respiratory symptoms, blood pressure, and lung function. In this study, we randomly selected 123 (83 biomass and 40 clean fuel user) subjects to assess the impact of smoke generated from solid biomass fuel by assessing their health status along with the ventilation pattern of the kitchens and living rooms. HAPs (PM10, PM2.5, and CO) and different health parameters were measured along with monitoring of self-reported health symptoms for a consecutive period of eight months. Results revealed that the concentration of CO, PM2.5, and PM10 were found highest in biomass using households. Higher odds of the upper respiratory symptoms, runny nose (OR: 4.08, 95% CI: 1.22-22.14, p < 0.03), nasal congestion (OR: 9.07, 95% CI: 1.39-97.89, p < 0.01) and the odds of the lower respiratory symptoms like wheezing (OR: 1.62, 95% CI: 1.23-10.94, p < 0.01), breathlessness (OR: 4.44, 95% CI: 1.3-14.75, p < 0.01), chest tightness (OR: 4.89, 95% CI: 1.23-22.14, p < 0.03) and dry cough (OR: 3.661, 95% CI: 1.05-12.25, p < 0.04) were significantly higher in biomass fuel user. Similarly higher systolic (+11.41 mmHg), higher diastolic pressure (+3.3 mmHg), higher pulse pressure (+8.11 mmHg), and a 6 mmHg higher mean arterial pressure among biomass fuel using tribal women. The risk of hypertension was significantly (p < 0.03) higher (OR: 3.04; 95% CI: 1.18-7.89) among solid biomass fuel users. The lung abnormality was recorded 28.91% (OR: 5.02, 95% CI: 1.50 to 16.56, p < 0.01) among biomass fuel user. Finally, it is suggested that the use of efficient cookstoves, increase in cross ventilation, and cleaner fuel are urgently needed to curb the pollution load.

Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Hipertensão , Feminino , Humanos , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição do Ar em Ambientes Fechados/análise , Biomassa , Culinária/métodos , Poluentes Atmosféricos/análise , Fumaça/efeitos adversos , Pulmão/química , Material Particulado/análise
Rev. bras. med. esporte ; 29: e2021_0321, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1387964


ABSTRACT Introduction: The aim of this study was to evaluate whether a single session of high-intensity interval training (HIIT) would promote a hypotensive effect and cardiovascular risk in hypertensive women, in addition to increasing the bioavailability of nitric oxide. Methods: The sample consisted of 10 hypertensive women (63.7 ± 10.34 years; 66 ± 7.67 kg and 153.7 ± 9.08 cm) and the training load was established at 60% of the maximum aerobic speed. Results: We observed a very high hypotensive effect between the interaction moments during the intervention (Int. Pre: 122.40 ± 18.58; Int. Post: 143.00 ± 24.90; Int. Post 60min: 121.40 ± 13.87; p<0.001, η2P = 0.569). No cardiovascular risk was observed during the intervention (DP = Int. Pre: 9138.20 ± 1805.34; Int. Post: 14849.70 ± 3387.94; Int. Post 60min: 9615.90 ± 1124.41, p< 0.001, η2P = 0.739) and there was no increase in the bioavailability of nitric oxide. Conclusion: In conclusion, this work reveals that an HIIT session is capable of generating a hypotensive effect while not posing cardiovascular risk in hypertensive women. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals .

RESUMEN Introducción: El objetivo de este estudio fue evaluar si una única sesión de entrenamiento de intervalos de alta intensidad (HIIT) podría promover un efecto hipotensor y riesgo cardiovascular en mujeres hipertensas, así como aumentar la biodisponibilidad del óxido nítrico. Métodos: La muestra fue compuesta por 10 mujeres hipertensas (63,7 ± 10,34 años; 66 ± 7,67 kg y 153,7 ± 9,08 cm) y la carga de entrenamiento se estableció en el 60% de la velocidad aeróbica máxima. Resultados: Se observó un efecto hipotensor muy elevado entre los momentos de interacción durante la intervención (Int. Pre: 122,40 ± 18,58; Int. Post: 143,00 ± 24,90; Int. Post 60 min: 121,40 ± 13,87; p <0,001, η2P = 0,569). No se observó ningún riesgo cardiovascular durante la intervención (DP = Int. Pre: 9138,20 ± 1805,34; Int. Post: 14849,70 ± 3387,94; Int. Post 60 min: 9615,90 ± 1124,41, p <0,001, η2P = 0,739) y no hubo aumento de la biodisponibilidad de óxido nítrico. Conclusiones: En conclusión, este trabajo revela que una sesión de HIIT es capaz de generar efecto hipotensor sin presentar riesgo cardiovascular en mujeres hipertensas. Nivel de evidencia I; Estudio clínico aleatorizado de alta calidad con o sin diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.

RESUMO Introdução: O objetivo deste estudo foi avaliar se uma única sessão de treinamento intervalado de alta intensidade (HIIT) promoveria efeito hipotensor e risco cardiovascular em mulheres hipertensas, bem como aumentar a biodisponibilidade de óxido nítrico. Métodos: A amostra foi composta por 10 mulheres hipertensas (63,7 ± 10,34 anos; 66, ± 7,67 kg e 153,7 ± 9,08 cm) e a carga de treinamento foi estabelecida em 60% da velocidade aeróbica máxima. Resultados: Observamos um efeito hipotensor muito alto entre os momentos de interação durante a intervenção (Int. Pré: 122,40 ± 18,58; Int. Pós: 143,00 ± 24,90; Int. Pós 60 min.: 121,40 ± 13,87; p < 0,001, η2P = 0,569). Nenhum risco cardiovascular foi observado durante a intervenção (DP = Int. Pré: 9138,20 ± 1805,34; Int. Pós: 14849,70 ± 3387,94; Int. Pós: 60 min.: 9615,90 ± 1124,41, p < 0,001, η2P = 0,739) e não houve aumento da biodisponibilidade de óxido nítrico. Conclusões: Em conclusão, este trabalho revela que uma sessão de HIIT é capaz de gerar efeito hipotensor sem apresentar risco cardiovascular em mulheres hipertensas. Nível de evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significativa, mas com intervalos de confiança estreitos .

Rev. bras. med. esporte ; 29: e2022_0163, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1394818


ABSTRACT Introduction: The obesity rate of Chinese adolescents has reached an alarming level, where about 11% of Chinese children are overweight, making them more prone to diseases such as hypertension, abnormal physiological metabolism, and high joint wear of the lower limbs. This public health problem can be alleviated with healthy habits, including aerobic exercise. Objective: Study the effect of aerobic exercise on obesity and lipid metabolism in adolescents. Methods: In this randomized controlled trial, 40 young volunteers were equally allocated into experimental and control groups. The control group received no intervention, while the experimental group was trained according to a professionally designed aerobic exercise protocol for 28 days. Training data were recorded before, during, and after the exercises. The information was processed, compared, and analyzed. Results: The control group failed to reduce body fat effectively; an aerobic exercise in the experimental group showed better effects in reducing body weight, body fat, waist-to-hip ratio, and weight loss; compared to the control group. Immediately after the intervention, the HDL level of the experimental group showed an upward trend, while the TC, TG, and LDL indices showed a downward trend. Conclusion: Aerobic exercise can effectively increase muscle mass and basal calorie and fat intake, reducing youth obesity. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução: A taxa de obesidade de adolescentes chineses atingiu um nível alarmante onde cerca de 11% das crianças chinesas estão acima do peso, tornando-se mais propensas a adquirirem doenças como hipertensão arterial, metabolismo fisiológico anormal e elevados desgastes articulares dos membros inferiores. Esse problema de saúde pública pode ser amenizado com hábitos saudáveis, incluindo o exercício aeróbico. Objetivo: Estudar o efeito do exercício aeróbico sobre obesidade e o metabolismo lipídico dos adolescentes. Métodos: Nesse ensaio clínico randomizado controlado, 40 jovens voluntários foram igualmente alocados em grupos experimental e controle. O grupo controle não recebeu intervenção alguma enquanto o grupo experimental foi treinado segundo um protocolo de exercícios aeróbicos elaborado por profissionais durante 28 dias. Foram registrados os dados de treinamento, antes durante e após os exercícios. As informações foram tratadas, comparadas e analisadas. Resultados: O grupo controle não conseguiu reduzir efetivamente a gordura corporal, o exercício aeróbico no grupo experimental apresentou melhores efeitos na redução do peso corporal, gordura corporal, relação cintura-quadril e perda de peso; em comparação com o grupo controle. Imediatamente após a intervenção, o nível de HDL do grupo experimental mostrou uma tendência de alta, enquanto os índices TC, TG e LDL apresentaram tendência de queda. Conclusão: O exercício aeróbico pode efetivamente aumentar a massa muscular, o consumo basal de calorias e gordura, alcançando a redução eficaz da obesidade juvenil. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La tasa de obesidad de los adolescentes chinos ha alcanzado un nivel alarmante en el que cerca del 11% de los niños chinos tienen sobrepeso, siendo más propensos a adquirir enfermedades como la hipertensión, un metabolismo fisiológico anormal y un elevado desgaste articular de las extremidades inferiores. Este problema de salud pública puede paliarse con hábitos saludables, entre ellos el ejercicio aeróbico. Objetivo: Estudiar el efecto del ejercicio aeróbico sobre la obesidad y el metabolismo lipídico en adolescentes. Métodos: En este ensayo controlado y aleatorizado, 40 jóvenes voluntarios fueron asignados por igual a los grupos experimental y de control. El grupo de control no recibió ninguna intervención, mientras que el grupo experimental fue entrenado según un protocolo de ejercicio aeróbico diseñado por profesionales durante 28 días. Los datos del entrenamiento se registraron antes, durante y después de los ejercicios. La información fue procesada, comparada y analizada. Resultados: El grupo de control no logró reducir eficazmente la grasa corporal, el ejercicio aeróbico en el grupo experimental mostró mejores efectos en la reducción del peso corporal, la grasa corporal, la relación cintura-cadera y la pérdida de peso; en comparación con el grupo de control. Inmediatamente después de la intervención, el nivel de HDL del grupo experimental mostró una tendencia al alza, mientras que los índices de TC, TG y LDL mostraron una tendencia a la baja. Conclusión: El ejercicio aeróbico puede aumentar eficazmente la masa muscular, la ingesta calórica basal y las grasas, logrando una reducción efectiva de la obesidad juvenil. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Rev. bras. med. esporte ; 29: e2022_0168, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1394832


ABSTRACT Introduction: Several programs to encourage physical activity has been encouraged to reduce the sedentary lifestyle in China. Running is among them because it has potentially positive effects on cardiovascular diseases, hypertension, diabetes mellitus, and hypercholesterolemia, in addition to the intrinsic psychological and social benefits of outdoor sports. Objective: Explore the protective effect of running on the cardiac system by analyzing strategies for cultivating exercise health awareness. Methods: A group of ten healthy volunteers, five women aged 25-35 years, underwent a 45-minute running program, performed four times a week for three weeks. Data collected by spirometry and cardiac monitoring were collected, treated, compared, and discussed. This paper introduced the concept of subjective exercise intensity to find the best analysis and judgment of Cardiac Function. Finally, a quantitative investigation involving the analysis of 315 questionnaires explored the current status of sports health awareness in running fans. Results: Heart rate amplitude during running remained in the range of 120-160, belonging to the normal heart rate range for the surveyed audience. In most cases, women's heart rate was higher than men's (P<0.05). The exercise intensity was fixed at a frequency below the value of 16, which is a slightly strenuous stage, and the relative exercise intensity was controlled between 50% and 71.5%. Conclusion: Running has a good cardiac protective effect, and its followers are highly aware of sports health. Due to the beneficial effect of sports practice, its dissemination is recommended as a form of physical and social therapeutic activity. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Com o intuito de reduzir o índice de sedentarismo na China, diversos programas de incentivo à atividade física foram estimulados. A corrida está dentre eles pois tem potenciais efeitos positivos nas doenças cardiovasculares, hipertensão arterial, diabetes mellitus e hipercolesterolemia, além dos benefícios psicológicos e sociais intrínsecos na prática esportiva ao ar livre. Objetivo: Explorar o efeito protetor da corrida no sistema cardíaco analisando as estratégias para a cultura da consciência sanitária do exercício. Métodos: Um grupo de dez voluntários saudáveis, com cinco mulheres e idade entre 25 a 35 anos foram submetidos a um programa de corrida por 45 minutos, realizado quatro vezes por semana, durante três semanas. Dados coletados por espirometria e monitoramento cardíaco foram coletados, tratados, comparados e discutidos. Este artigo introduziu o conceito de intensidade de exercício subjetivo para encontrar a melhor análise e julgamento da Função Cardíaca. Por fim, uma investigação quantitativa envolvendo a análise de 315 questionários explorou a situação atual da conscientização em saúde esportiva em adeptos da corrida. Resultados: A amplitude de frequência cardíaca durante a corrida manteve-se na faixa de 120-160, pertencente à faixa normal de frequência cardíaca ao público pesquisado. A frequência cardíaca das mulheres foi maior do que a dos homens na maioria dos casos (P<0,05). A intensidade do exercício fixou-se numa frequência inferior ao valor de 16, que é um estágio ligeiramente extenuante, e a intensidade relativa do exercício ficou controlada entre 50% e 71,5%. Conclusão: A corrida apresenta um bom efeito protetor cardíaco, seus adeptos possuem elevada conscientização da saúde esportiva. Devido ao efeito salutar da prática esportiva, recomenda-se a sua divulgação como forma de atividade terapêutica física e social. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Con el fin de reducir el estilo de vida sedentario en China, se han estimulado varios programas para fomentar la actividad física. La carrera se encuentra entre ellos porque tiene potenciales efectos positivos sobre las enfermedades cardiovasculares, la hipertensión, la diabetes mellitus y la hipercolesterolemia, además de los beneficios psicológicos y sociales intrínsecos del deporte al aire libre. Objetivo: Explorar el efecto protector de correr sobre el sistema cardíaco analizando las estrategias para cultivar la conciencia de la salud del ejercicio. Métodos: Un grupo de diez voluntarios sanos, cinco mujeres, con edades comprendidas entre los 25 y los 35 años, fueron sometidos a un programa de carrera durante 45 minutos, realizado cuatro veces por semana durante tres semanas. Los datos recogidos por la espirometría y la monitorización cardíaca fueron recogidos, tratados, comparados y discutidos. Este trabajo introdujo el concepto de intensidad subjetiva del ejercicio para encontrar el mejor análisis y juicio de la Función Cardíaca. Por último, una investigación cuantitativa que incluyó el análisis de 315 cuestionarios exploró el estado actual de la conciencia de la salud deportiva en los aficionados a las carreras. Resultados: La amplitud de la frecuencia cardíaca durante la carrera se mantuvo en el rango de 120-160, perteneciendo al rango de frecuencia cardíaca normal para el público encuestado. La frecuencia cardíaca de las mujeres fue mayor que la de los hombres en la mayoría de los casos (P<0,05). La intensidad del ejercicio se fijó en una frecuencia inferior al valor de 16, que es una etapa ligeramente agotadora, y la intensidad relativa del ejercicio se controló entre el 50% y el 71,5%. Conclusión: La acción de correr presenta un buen efecto cardioprotector, sus adeptos poseen alta conciencia de la salud deportiva. Debido al efecto saludable de la práctica deportiva, se recomienda su difusión como forma de actividad terapéutica física y social. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Doenças Cardiovasculares/prevenção & controle , Exercício Físico/fisiologia , Diabetes Mellitus/prevenção & controle , Frequência Cardíaca/fisiologia , Hipercolesterolemia/prevenção & controle
J Invest Surg ; 36(1): 1-7, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36345736


AIM: To compare the short- and long-term treatment outcomes of open radiofrequency ablation combined with splenectomy and pericardial devascularization versus liver transplantation for hepatocellular carcinoma patients with portal hypertension and hypersplenism. METHODS: During the study period, the treatment outcomes of consecutive HCC patients with portal hypertension and hypersplenism who underwent open radiofrequency ablation, splenectomy and pericardial devascularization (the study group) were compared with the treatment outcomes of a case-matched control group of HCC patients who underwent liver transplantation. RESULTS: The study group consisted of 32 patients, and the control group comprised 32 patients selected from 155 patients who were case-matched by tumor size, age, gender, MELD sore, tumor location, TNM classification, degree of splenomegaly and Child-Pugh staging. Baseline data on preoperative laboratory tests and tumor characteristics were comparable between the two groups. The mean follow-up was 43.2 ± 5.3 months and 44.9 ± 5.8 months for the study and control groups, respectively. Although the disease-free survival rates of the control group were better than those of the study group (P < 0.001), there was no significant difference in the cumulative overall survival time or the incidence of portal vein thrombosis between the two groups (P = 0.670, 0.083). Compared with the control group, the study group had significantly less intraoperative blood loss, and lower incidences of postoperative pleural effusion and pneumonia (all P < 0.05). CONCLUSION: Open radiofrequency ablation, splenectomy and pericardial devascularization for small HCCs with portal hypertension and hypersplenism can be an alternative therapy for a subset of carefully selected patients under the shortage of liver donors.

Carcinoma Hepatocelular , Hiperesplenismo , Hipertensão Portal , Neoplasias Hepáticas , Transplante de Fígado , Ablação por Radiofrequência , Humanos , Hiperesplenismo/etiologia , Hiperesplenismo/cirurgia , Esplenectomia/efeitos adversos , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/cirurgia , Transplante de Fígado/efeitos adversos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos , Hipertensão Portal/complicações , Hipertensão Portal/cirurgia , Ablação por Radiofrequência/efeitos adversos , Resultado do Tratamento , Cirrose Hepática
J Biomech Eng ; 145(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35900832


We propose a relatively simple two-dimensional mathematical model for maladaptive inward remodeling of resistive arteries in hypertension in terms of vascular solid mechanics. The main premises are: (i) maladaptive inward remodeling manifests as a reduced increase in the arterial mass compared to the case of adaptive remodeling under equivalent hypertensive pressures and (ii) the pressure-induced circumferential stress in the arterial wall is restored to its basal target value as happens in the case of adaptive remodeling. The rationale for these assumptions is the experimental findings that elevated tone in association with sustained hypertensive pressure down-regulate the normal differentiation of vascular smooth muscle cells from contractile to synthetic phenotype and the data for the calculated hoop stress before and after completion of remodeling. Results from illustrative simulations show that as the hypertensive pressure increases, remodeling causes a nonmonotonic variation of arterial mass, a decrease in inner arterial diameter, and an increase in wall thickness. These findings and the model prediction that inward eutrophic remodeling is preceded by inward hypertrophic remodeling are supported by published observations. Limitations and perspectives for refining the mathematical model are discussed.

Hipertensão , Artérias , Humanos , Modelos Teóricos , Remodelação Vascular
Ann Pharmacother ; 57(1): 16-28, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35645169


BACKGROUND: For decades, conflicting results were published regarding the increased risk of Prostate cancer (PCa) among calcium channel blocker (CCB) users. OBJECTIVE: We aimed to evaluate the association between PCa and CCB exposure and assess moderating factors. METHODS: We performed a systematic literature search in PubMed, Embase, and Cochrane databases for observational and randomized studies published until November 2020 with no language limitations, including data on the risk for PCa in CCB users compared with non-CCB users. We applied a random-effects model meta-analysis to pool results. In addition, we investigated potential moderating factors, such as CCB type, study type, participants' age, and duration of exposure, using meta-regression methods. RESULTS: In our primary analysis, we included 18 studies. A statistically significant 5% increase in the risk for PCa was observed among CCB users (risk ratio [RR] = 1.05; 95% confidence interval [CI]: 1.01-1.10), with no significant association between the duration of exposure to CCBs and the risk for PCa (RR = 1.08; 95% CI: 0.98-1.19 for exposure for < 5years and RR = 1.01; 95% CI: 0.9-1.14 for exposure ≥ 5 years). The association remained statistically significant for the subgroup of dihydropyridines (RR = 1.13; 95% CI: 1.05-1.22). In addition, the association was not influenced by participants' age. CONCLUSION AND RELEVANCE: CCBs are an important modality in treating hypertension. The 5% increased risk observed in the current meta-analysis could be influenced by residual confounding factors and should not affect hypertension treatment guidelines until more studies provide additional clinical information.

Di-Hidropiridinas , Hipertensão , Neoplasias da Próstata , Masculino , Humanos , Bloqueadores dos Canais de Cálcio/efeitos adversos , Di-Hidropiridinas/efeitos adversos , Hipertensão/tratamento farmacológico , Razão de Chances , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/induzido quimicamente , Neoplasias da Próstata/tratamento farmacológico
J Ethnopharmacol ; 300: 115633, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36031104


ETHNOPHARMACOLOGICAL RELEVANCE: Lagenaria siceraria Stand. (Family: Cucurbitaceae), popularly known as bottle gourd, is traditionally used in Ayurvedic medicine as a food plant, especially in hypertension and obesity. AIM OF THE STUDY: Investigations were undertaken to assign novel lead combinations from this common food plant to multi-molecular modes of actions in the complex disease networks of obesity and hypertension. LC-MS/MS based metabolite screening, in-vivo high fat diet induced hyperlipidemia animal study and network pharmacology explorations of the mechanism of action for lipid lowering effects including a neighbourhood community approach for molecular combinations were performed. MATERIAL AND METHODS: Major chemical constituents of the fruits of LS (LSFE) were analysed by HPLC-DAD-MS/MS-QTOF. Wistar albino rats (n = 36), divided into 6 groups (n = 6) received either no treatment or a high-fat diet along with LSFE or Atorvastatin. Lipid profiles and biochemical parameters were evaluated. In silico cross-validated network analyses using different databases and Cytospace were applied. RESULTS: Profiling of LSFE revealed 18 major constituents: phenolic acids like p-Coumaric acid and Ferulic acid, the monolignolconferyl alcohol, the flavonoid glycosides hesperidin and apigenin-7-glucoside. Hyperlipidemic animals treated with LSFE (200 mg/kg, 400 mg/kg, 600 mg/kg) showed a significant improvement of their lipid profiles after 30 days of treatment. Network pharmacology analyses for the major 18 compounds revealed enrichment of the insulin and the ErbB signalling pathway. Novel target node combinations (e.g. AKR1C1, AGXT) including their connection to different pathways were identified in silico. CONCLUSIONS: The combined in vivo and bioinformatics analyses propose that lead compounds of LSFE act in combination on relevant targets of hyperlipidemia. Perturbations of the IRS→Akt→Foxo1 cascade are predicted which suggest further clinical investigation towards development of safe natural alternative to manage hyperlipidemia.

Cucurbita , Hesperidina , Hiperlipidemias , Hipertensão , Insulinas , Animais , Atorvastatina , Cromatografia Líquida , Flavonoides/uso terapêutico , Glicosídeos/uso terapêutico , Hesperidina/uso terapêutico , Hiperlipidemias/tratamento farmacológico , Hipertensão/tratamento farmacológico , Insulinas/uso terapêutico , Farmacologia em Rede , Obesidade/tratamento farmacológico , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Proteínas Proto-Oncogênicas c-akt , Espectrometria de Massas em Tandem
J Ethnopharmacol ; 300: 115703, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36096347


ETHNOPHARMACOLOGICAL RELEVANCE: Integrated Chinese herbal medicine (CHM) and Western Medicine (WM) treatments have been used for primary hypertension (PHTN) patients in China. Currently, there are many randomized control trials (RCTs) published regarding the effect of CHM and WM on PHTN, which indicated that combining Chinese with WM was effective and safe for PHTN when compared with WM alone, but the quality of evidence was insufficient, and there is no clear information and summary are available for these RCTs assessing the effectiveness of CHM with WM versus WM in patients with PHTN. OBJECTIVES: This systematic study and meta-analysis aimed to evaluate the effectiveness and safety of CHM combined with WM in comparison with WM in reducing systolic and diastolic blood pressure for patients with PHTN. METHODS: The information of this study was searched from electronic databases (PubMed, COCHRANE, EMBASE, Ovid, CNKI, VIP, Wanfang, and CBM). The markedly effective and effective terms were according to Guiding Principles for Clinical Research of New Chinese Medicines. Two investigators independently reviewed each trial. The Cochrane risk of bias assessment tool was used for quality assessment, and RevMan 5.4 was used for meta-analysis. RESULTS: In this study, a total of 29 studies that included 2623 patients were recorded. The study results displayed that the clinical effectiveness in the treatment of hypertension patients from the integrated medicines was considerably higher than that with WM alone, clinical effective (RR 1.23, 95% CI [1.17, 1.30], P < 0.00001), and markedly effective (ME) in the patients (RR 1.66, 95% CI [1.52, 1.80], and P < 0.00001). Random effect in SBP (MD 7.91 mmHg,[6.00, 983], P < 0.00001) and DBP (MD 5.46 mmHg, [3.88, 6.43], P < 0.00001), a subgroup analysis was carried out based on the type of intervention, duration of treatment, and CHM formulas that showed significance. Furthermore, no severe side effects were reported, and no patients stopped treatment or withdrawal due to any severe adverse events. CONCLUSION: Compared to WM alone, the therapeutic effectiveness of CHM combined with WM is significantly improved in the treatment of hypertension. Additionally, CHM with WM may safely and efficiently lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) in individuals with PHTN. However, rigorous randomized controlled trials with a large sample, high quality, long duration of treatment, and follow-up are recommended to strengthen this clinical evidence.

Medicamentos de Ervas Chinesas , Hipertensão , Medicina Integrativa , Anti-Hipertensivos/uso terapêutico , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Hipertensão/induzido quimicamente , Hipertensão/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto
Methods Mol Biol ; 2565: 129-151, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36205892


The spontaneously hypertensive rat (SHR) is a model widely used to investigate the causal mechanisms of essential hypertension. The enhanced catecholamine (CA) release reported in adrenal glands from adult SHRs raised considerable interest for its possible implication in the genesis of hypertension. The use of powerful techniques such as calcium imaging, electrophysiology, and single-cell amperometry to monitor in real time the key steps in CA secretion has allowed a better understanding of the role of chromaffin cells (CC) in the pathophysiology of hypertension, although several questions remain. Additionally, the implementation of these techniques in preparations in situ, such as the acute adrenal gland slice, which maintains the microenvironment, cell-to-cell communication, and anatomical structure similar to that of the intact adrenal gland, yields data that may have even greater physiological relevance. Here, we describe the procedures to measure the blood pressure of rats in a noninvasive manner, how to obtain primary cultures of adrenal chromaffin cells and acute adrenal slices, and how to perform amperometric recordings and intracellular calcium imaging in these preparations.

Células Cromafins , Hipertensão , Glândulas Suprarrenais , Animais , Pressão Sanguínea , Cálcio , Catecolaminas , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY
J Hazard Mater ; 443(Pt A): 130147, 2023 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-36283217


Hypertension is the most common chronic non-infectious disease and a severe problem for public health in China. There were 244.5 million people aged over 18 years in China who had hypertension in 2015, and hypertension-related death accounted for more than 25 % of all causes of death in China every year. To monitor the hypertension prevalence in near real-time, a wastewater-based epidemiology (WBE) approach by using metoprolol acid as a biomarker was conducted in 164 cities in China. LC-MS/MS was utilized to quantify metoprolol acid in sewage, and satisfactory method validation results were achieved. The average concentration of metoprolol acid in sewage was 943.1 ± 671.1 ng/L, and the back-calculated consumption of metoprolol based on metoprolol acid was 932.0 ± 390.5 mg/day/1000inh on average, ranging from 76.7 to 3275.7 mg/day/1000inh. The prevalence of metoprolol was estimated to be 0.83 % ± 0.35 %, and the estimated hypertension prevalence in the population aged over 15 years was ultimately assessed to be 28.56 % ± 10.44 % ranging from 14.28 % to 44.28 % and was consistent with the China Hypertension Survey result of 27.9 %. This research demonstrated that estimating hypertension prevalence by WBE with metoprolol acid as a biomarker is feasible in Chinese cities.

Hipertensão , Vigilância Epidemiológica Baseada em Águas Residuárias , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Cidades/epidemiologia , Cromatografia Líquida , Esgotos , Prevalência , Metoprolol , Águas Residuárias/análise , Espectrometria de Massas em Tandem , China/epidemiologia , Hipertensão/epidemiologia , Biomarcadores
J Sci Food Agric ; 103(1): 64-72, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35804485


BACKGROUND: Table olives are a food with a high content of bioactive compounds with cardioprotective properties, such as oleic acid, polyphenols, and pentacyclic triterpenes. Here, we investigate the effect of the intake of table olives on blood pressure (BP) and body weight in spontaneously hypertensive rats (SHR) and their normotensive controls, Wistar Kyoto (WKY) rats. 'Arbequina' table olives (3.85 g kg-1 ) were administered by gavage to SHR and WKY rats in short-term (1 day) and long-term (7 weeks) experiments. BP was measured by the tail-cuff method, and polyphenols and triterpenes were determined in olives and plasma by liquid chromatography-mass spectrometry. RESULTS: Administration of 'Arbequina' olives to WKY rats did not exert any change in BP in any of the experiments. However, in SHR, the single dose induced a transient reduction in BP of approximately 15 mmHg, from the second to the tenth hour after the administration. In the long-term assay, a similar decrease was established in the second week and was maintained throughout the experiment. Moreover, the daily administration of olives to rats did not affect their body weight when compared with controls in either the WKY rats or SHR. The determination of polyphenols and triterpenes in plasma indicated that, at the end of the experiment, only maslinic acid, oleanolic acid, hydroxytyrosol, and luteolin were found, all of them being compounds with already described capacity to decrease BP. CONCLUSION: The results suggest that the daily intake of table olives could decrease BP in hypertension without affecting body weight, indicating that table olives could contribute to improving cardiovascular health. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Hipertensão , Olea , Ratos , Animais , Ratos Endogâmicos SHR , Anti-Hipertensivos/farmacologia , Olea/química , Ratos Endogâmicos WKY , Pressão Sanguínea , Hipertensão/tratamento farmacológico , Polifenóis/farmacologia , Polifenóis/análise , Peso Corporal , Triterpenos Pentacíclicos