Excess weight in children and adolescents is associated with altered subendocardial blood supply among girls but not boys.

Subendocardial viability ratio (SEVR) is a reliable index of myocardial supply-workload balance. This study sought to investigate whether overweight/obese children and adolescents have altered SEVR and to identify which are the associated factors. This cross-sectional study involved 789 individuals. Central haemodynamic was measured by radial applanation tonometry. Diastolic time was shorter (496 ± 122 vs 537 ± 140 ms, P = .014) and diastolic pressure-time index was lower (2681 ± 412 vs 2814 ± 423 mm Hg seconds, P = .024) in overweight/obese compared with eutrophic girls. SEVR was lower in girls than in boys (1.34 ± 0.39 vs 1.48 ± 0.41, P = .018) but only among overweight/obese. SEVR may be affected by small variations in the temporal determinants of cardiac cycle.

Gender-specific determinants of blood pressure elevation in Angolan adults.

BACKGROUND: Hypertension affects African-American adults more than any other ethnic group in the US. However, some of the black populations living outside Africa are well adapted to food and lifestyle. We aimed to describe the clinical characteristics underlying the gender-specific determinants of BP and the risk of hypertension in public-sector workers living in Angola. MATERIALS AND METHODS: 609 volunteers (48% men) were included in this cross-sectional and descriptive study. Demographic, socioeconomic and life style data were collected during an interview. Systolic BP (SBP) and diastolic BP (DBP) were measured, along with some anthropometric and clinical variables. RESULTS: The prevalence of hypertension is 45.2% without difference between genders. Obesity was more prevalent in women (29.2% vs. 8.9%, p < 0.05). The age-related increment in SBP is higher in women (14.2 ± 1.1 vs 9.5 ± 1.3 mmHg/decade, p < 0.05). In men, age, BMI, cholesterol and LDLc/HDLc explained 21, 4, 2.5 and 2.9% of SBP variability, respectively. In women, age, BMI and HC explain 27, 2 and 1% of SBP variability, respectively. The risk for hypertension is 5 × high among men aged ≥45 years, and 3.5× in those having BMI ≥25. Women aged 45 years or older have 8 × risk of hypertension and 2× the risk by having BMI ≥25. CONCLUSIONS: We found that advanced age (≥45) and overweight/obesity (BMI ≥25) are the main risk factors for hypertension in adults from Angola. However, our data suggest that age and BMI may have different influence on increasing BP in men and women.

Association between leisure-time physical activity and arterial stiffness in adults of the ELSA-Brasil study: a mediation analysis.

OBJECTIVES: We aimed at defining the direct and the mediated pathways for the association between leisure-time physical activity (LTPA) and carotid-to-femoral pulse wave velocity (cf-PWV), and also to identify whether these effects are influenced by sex and age. METHODS: Cross-sectional data from 13 718 adults (35-74 years) were obtained at the baseline of the ELSA-Brasil study. The cf-PWV was obtained by measuring the pulse transit time and the distance traveled by the pulse between the carotid and the femoral, as well as clinical and anthropometric parameters were measured. The levels of LTPA were determined by applying the long form of the International Physical Activity Questionnaire (IPAQ). RESULTS: Classical cardiovascular risk factors were independently associated with cf-PWV. Path analysis showed that increased levels of LTPA were directly associated with lower cf-PWV in both men and women (ß: -0.123 ±â€Š0.03 vs. 0.065 ±â€Š0.029, P for sex = 0.165), except for diabetes. Also, the mediated effect of LTPA on SBP and DBPs, heart rate, BMI, and fasting glucose, was associated with lower cf-PWV in men and women (ß: -0.113 ±â€Š0.016 vs. -0.104 ±â€Š0.016, P for sex = 0.692), except for diabetes. When age was tested as a moderator, the direct effect did not change significantly according to participants' age, regardless of sex. However, the mediated effect increases in both men and women over 50 years. CONCLUSION: Our findings support that LTPA in adults reduces cf-PWV by acting in different ways according to age. Physical activity in older individuals improves cardiometabolic risk factors and thus mitigates the stiffening of large arteries.

High triglyceride-glucose index and HOMA-IR are associated with different cardiometabolic profile in adults from the ELSA-Brasil study.

BACKGROUND AND AIMS: Insulin resistance (IR) is a risk factor for several cardiometabolic disorders; however, there is conflicting evidence about the reliability of certain IR markers. In this context, the triglyceride-glucose index (TyG) has been proposed as a surrogate marker for IR. This study aimed to compare the TyG index and homeostasis model assessment of insulin resistance (HOMA-IR). METHODS AND RESULTS: A cross-sectional analysis was conducted using baseline data from 11,314 adults (aged 35-74 years) from the ELSA-Brasil study. The correlation between TyG and HOMA-IR, their interrater reliability, and their predictive value in identifying metabolic syndrome (MetS) were assessed. The mean TyG and HOMA-IR in our sample were 8.81 ± 0.52 and 2.78 ± 1.58 for men, and 8.53 ± 0.48 and 2.49 ± 1.38 for women, respectively. TyG and HOMA-IR showed a weak to moderate correlation with each other (Pearson's r for men: 0.395 and 0.409 for women, p-value <0.05) and other markers of glycemic metabolism. Additionally, the area under the curve for the prediction of MetS was greater for TyG than HOMA-IR, regardless of sex (TyG: 0.836 for men and 0.826 for women; HOMA-IR: 0.775 for men and 0.787 for women). The concordance between these markers was low (Cohens kappa coefficient: 0.307 for men and 0.306 for women). Individuals with increased TyG exhibited mainly anthropometrical and glycemic metabolic alterations, whereas those with elevated HOMA-IR displayed mostly lipid-associated metabolic alterations. CONCLUSION: TyG and HOMA-IR might indicate different profiles of cardiometabolic disorders, showing poor agreement in classifying individuals (normal vs. altered) and a weak correlation. Therefore, further studies are needed to investigate the role of TyG as a surrogate marker of IR.

Prevalence of cardiovascular risk factors and socioeconomic level among public-sector workers in Angola.

BACKGROUND: Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. METHODS: We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. RESULTS: The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P < 0.05); hypertriglyceridemia, 10.6% (men 12.6%, women 8.7%, P > 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P < 0.05); diabetes, 5.7% (men 5.5%, women 5.9%, P > 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P < 0.05); sedentary lifestyle, 87.2% (men 83.0%, women 91,0%, P < 0.05); and left ventricular hypertrophy, 20% (men 32.0%, women 9.0%; P < 0.05). At least one risk factor was present in 27.7% of the sample; 15.2% had two risk factors, and 31.4% had three or more risk factors. Among the individuals with low socioeconomic status, 41.0% had three or more risk factors. CONCLUSIONS: The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in Angola. The workers in lower socioeconomic groups had higher incidences of hypertension, smoking, and left ventricular hypertrophy.

The high salt intake in adults with metabolic syndrome is related to increased waist circumference and blood pressure: the Brazilian Longitudinal Study of Adult Health study (ELSA-Brasil).

OBJECTIVES: The association between metabolic syndrome (MetS), a cluster of cardiometabolic risk factors, and salt consumption has fed intense debate in recent years, although it is yet to be fully elucidated. We aimed to evaluate whether individuals with MetS have a high salt consumption and to identify which components of the MetS diagnosis could be independently related to high salt consumption. METHODS: We analyzed data from 11 982 adults, ages 35 to 74 y, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort study, from which clinical and anthropometric data were assessed, and a validated 12-h overnight urine collection was used to estimate salt intake. MetS was defined according to the Adult Treatment Panel III criteria. RESULTS: Salt intake was increased in individuals with MetS compared with individuals without MetS, regardless of sex (men: 14.3 ± 6.4 g/d versus 12.2 ± 5.5 g/d, P < 0.001; women: 10.6 ± 4.9 g/d versus 8.9 ± 4.0 g/d, P < 0.001) and increased progressively as the MetS criteria accumulated. The high salt intake in MetS participants, however, was observed only in the presence of elevated waist circumference and/or blood pressure and not with the other MetS criteria (reduced high-density lipoprotein, increased triglycerides, and impaired fasting blood glucose), regardless of the presence of MetS. When diabetes was incorporated as a MetS criterion, increased salt intake was observed in men but not in women. CONCLUSIONS: Salt intake should be reduced worldwide, but strategies must be more intense in people with elevated blood pressure and waist circumference, regardless of MetS diagnosis, to avoid the associated morbidity and mortality.

Fasting Glucose, Glycated Hemoglobin, and 2h Post-load Blood Glucose Are Independently Associated With Arterial Stiffness in Diabetes: The ELSA-Brasil Study.

The association of diabetes with increased large artery stiffness is not definitively established. We aimed to describe the carotid-femoral pulse wave velocity (cf-PWV) in participants with and without diabetes and whether the cf-PWV could vary among the different laboratory-based criteria used. A cross-sectional analysis using baseline data from 13,912 adults was used. cf-PWV as well as anthropometric, biochemical, and clinical data were measured. Diabetes was defined by previous medical diagnosis, medication use, fasting glucose, an oral glucose tolerance test (GTT), or glycated hemoglobin (HbA1c). The prevalence of diabetes was 18.7%, higher in men than in women. After adjustment, participants with diabetes showed higher cf-PWV (men: 9.7 ± 1.7 vs 9.4 ± 1.7 m/s, P < .05; women: 9.4 ± 1.6 vs 9.1 ± 1.7 m/s, P < .05). We observed a progressive increase in cf-PWV as >1 laboratory-based criterion for diabetes diagnosis was reached. Also, participants with diabetes with alterations in any laboratory-based criteria had higher cf-PWV than participants without diabetes, regardless of sex. In summary, diabetes is associated with higher cf-PWV as is each laboratory-based parameter used for its diagnosis. These results support the strong consequences of glucose dysregulation on the vascular system and provide evidence to screen all parameters involved in glycemic metabolism to improve vascular health.

Granulocyte colony stimulating factor prevents kidney infarction and attenuates renovascular hypertension.

BACKGROUND: G-CSF is a critical regulator of hematopoietic cell proliferation, differentiation and survival. It has been reported that G-CSF attenuates renal injury during acute ischemia-reperfusion. In this study we evaluated the effects of G-CSF on the renal and cardiovascular systems of 2K1C hypertensive mice. METHODS: Male C57BL/6 mice were subjected to left renal artery clipping (2K1C) or sham operation and were then administered G-CSF (100 µg/kg/day) or vehicle for 14 days. RESULTS: Arterial pressure was higher in 2K1C + vehicle animals than in 2K1C + G-CSF (150±5 vs. 129±2 mmHg, p<0.01, n=8). Plasma angiotensin I, II and 1-7 concentrations were significantly increased in 2K1C + Vehicle when compared to the normotensive Sham group. G-CSF prevented the increase of these vasoactive peptides. The clipped kidney/contralateral kidney weight ratio showed a less atrophy of the ischemic kidney in the treated group (0.50±0.02 vs. 0.66±0.01, p<0.05). The infarction area in the clipped kidney was completely prevented in 7 out of 8 2K1C + G-CSF mice. Administration of G-CSF protected the clipped kidney from apoptosis. CONCLUSION: Our data indicate that G-CSF prevents kidney infarction and markedly attenuates the increases in plasma angiotensin levels and hypertension in 2K1C mice, reinforcing the protective effect of G-CSF on kidney ischemia.

Poor physical fitness is associated with impaired memory, executive function, and depression in institutionalized older adults: a cross-sectional study.

OBJECTIVE: To analyze the association between physical fitness, cognitive function, and depressive symptoms among older adults in long-term care facilities (LTCFs). METHODS: Seventy-six institutionalized male and female elderly individuals (65 years and older) living in LTCFs participated of this study. Physical fitness (aerobic capacity and strength), cognitive functions (global cognition, short-term and working and semantic memories, and executive function), and depressive symptoms were assessed. Linear regression and contingency analyses were performed. Significance was accepted at p-values ≤ 0.05. RESULTS: Aerobic capacity predicted 32% of variance in global cognition (p < 0.01) and 25% of variance in semantic fluency/executive function (p < 0.01). Low levels of upper limb strength, lower limb strength, and aerobic capacity were associated with semantic fluency/executive function (OR = 1.38, p = 0.01, OR = 1.26, p = 0.03, and OR = 1.07, p = 0.01, respectively) and depressive symptoms (OR = 1.06, p < 0.01). CONCLUSION: Poor physical fitness is associated with cognition and depressive symptoms in institutionalized older adults. Low levels of strength and aerobic fitness increase the odds of presenting with impaired semantic fluency and executive function, possibly denoting an increased risk of developing dementia.

Socioeconomic status and education level are associated with dyslipidemia in adults not taking lipid-lowering medication: a population-based study.

BACKGROUND: Socio-economic disparities account for changes in the lipid profile in developing countries. We aimed to investigate the association between blood lipids and socio-economic and educational strata in adults not taking lipid-lowering medications. METHODS: A cross-sectional, population-based study enrolled 1614 individuals not taking lipid-lowering medications. Sociodemographic characteristics, monthly income, education level and the number of consumer goods available at home were obtained and individuals were classified into five socio-economic categories. Blood lipids were obtained in fasting participants. RESULTS: In men, the higher the socio-economic or educational stratum, the higher the total cholesterol, low-density lipoprotein cholesterol (LDL-c) and triglyceride (TG) levels and the lower the high-density lipoprotein cholesterol (HDL-c), after controlling for age, body mass index, hypertension, smoking habit and physical activity. In women, the higher socio-economic strata were associated with elevated total cholesterol and HDL-c, while lower total cholesterol, LDL-c and TG levels were found in those with higher education levels. Also, individuals in the upper socio-economic strata had higher levels of total cholesterol and LDL-c, showing more than two times higher odds of having multiple alterations in blood lipids (men: OR 2.99 [95% CI 1.23 to 5.07]; women: OR 2.31 [95% CI 1.09 to 5.83]). CONCLUSIONS: Dyslipidemia is highly prevalent in developing countries. Individuals in the highest socio-economic category are the ones at higher risk for dyslipidemia. This phenomenon calls for strategies to stimulate healthy diet habits and a physically active lifestyle to minimize health problems.

L-NAME treatment enhances exercise-induced content of myocardial heat shock protein 72 (Hsp72) in rats.

BACKGROUND/AIM: Nitric oxide (NO) modulates the expression of the chaperone Hsp72 in the heart, and exercise stimulates both NO production and myocardial Hsp72 expression. The main purpose of the study was to investigate whether NO interferes with an exercise-induced myocardial Hsp72 expression. METHODS: Male Wistar rats (70-100 days) were divided into control (C, n=12), L-NAME-treated (L, n=12), exercise (E, n=13) and exercise plus L-NAME-treated (EL, n=20) groups. L-NAME was given in drinking water (700 mg·L(-1)) and the exercise was performed on a treadmill (15-25 m·min(-1), 40-60 min.day(-1)) for seven days. Left ventricle (LV) protein Hsp content, NOS and phosphorylated-NOS (p-NOS) isoforms were measured using Western blotting. The activity of NOS was assayed in LV homogenates by the conversion of [(3)H]L-arginine to [(3)H]L-citrulline. RESULTS: Hsp72 content was increased significantly (223%; p < 0.05) in the E group compared to the C group, but exercise alone did not alter the NOS content, p-NOS isoforms or NOS activity. Contrary to our expectation, L-NAME enhanced (p < 0.05) the exercise-induced Hsp72 content (EL vs. C, L and E groups = 1019%, 548% and 457%, respectively). Although the EL group had increased stimulatory p-eNOS(Ser1177) (over 200%) and decreased inhibitory p-nNOS(Ser852) (ñ50%) compared to both the E and L groups (p < 0.05), NOS activity was similar in all groups. CONCLUSIONS: Our results suggest that exercise-induced cardiac Hsp72 expression does not depend on NO. Conversely, the in vivo L-NAME treatment enhances exercise-induced Hsp72 production. This effect may be due to an increase in cardiac stress.

A sex-related mediating effect of uric acid in the association between body composition and blood pressure in children and adolescents.

The increase in blood pressure (BP) during somatic growth might have direct determinants but also mediating factors. We investigated whether uric acid (UA) and other metabolic factors would mediate the association between body composition components and BP. A cross-sectional study was conducted in 928 children and adolescents (aged 6-18 years), in which body composition and blood biochemistry were evaluated. Structural equation modeling was performed to test the direct and indirect pathways between systolic blood pressure (SBP) and body composition parameters. Muscle mass (MM) showed a strong direct effect on BP, regardless of sex. In girls, a mediating pathway through UA was not significant, but the association between fat mass (FM) and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA, but not via the cluster of metabolic factors. The association between body composition and BP in children and adolescents has a complex design and also has a sex-specific mediating component. The increase in the UA levels may affect BP levels early in boys. Also, metabolic changes elicited by FM contribute to the increase in BP at an early age in girls. Novelty: MM showed a strong direct effect on BP, regardless of sex. In girls, the association between FM and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA.

Muscle mass is the main somatic growth indicator associated with increasing blood pressure with age in children and adolescents.

Studies have shown that lean mass must be an important determinant of blood pressure value in children and adolescents. The absence of adjustment for the collinearity between lean and fat mass (FM), restricted age span, and lack of separate analysis by sex leave a gap in the literature. This study determined direct and indirect effects of the somatic growth indicators linked to the association between age and systolic blood pressure (SBP) in boys and girls. This is a cross-sectional study comprising 1,510 participants (6-18 years). Path analysis was used to test a model in which the association between age and SBP would have a direct and independent component, but also indirect mediating paths through muscle mass (MM), FM, and height. There was no significant association between age and SBP (unstandardized ß ± SE) for both girls (0.072 ± 0.236, P = .761) and boys (0.238 ± 0.264, P = .368). Height was not a mediator for the association between age and SBP in both girls (-0.291 ± 0.156, P = .062) and boys (-0.015 ± 0.187, P = .935). Mediating effect of MM was significant for both girls (0.909 ± 0.137, P < .001) and boys (1.341 ± 0.161, P < .001), whereas mediating path through FM was significant only for boys (0.069 ± 0.023, P = .003). In conclusion, muscle mass was the strongest somatic growth indicator associated with the blood pressure value in children and adolescents. Further increase in body fat mass may affect systolic blood pressure more in boys than in girls.

Arterial stiffness in black adults from Angola and Brazil.

Ethnicity is an important determinant of blood pressure levels, being black individuals affected more than any other ethnic group. Arterial stiffening, an independent risk factor for hypertension, is also influenced by ethnicity. However, whether black individuals from different continents would have different patterns of arterial stiffening is still unknown. Thus, the authors aimed to compare pulse wave velocity (PWV) in black subjects living in Angola and Brazil. A total of 677 black individuals from two independent cross-sectional studies conducted in Brazil and Angola were included in this analysis. Carotid-to-femoral PWV was measured following the same protocols for both studies, as well as clinical and anthropometric variables. Adjusted PWV was higher in Brazilian blacks than in Angolans, regardless of sex (men from Brazil: 10.7 ± 1.8 vs men from Angola: 9.9 ± 1.8 m/s, P < .001; women from Brazil: 10.3 ± 1.5 vs women from Angola: 9.2 ± 1.3 m/s, P < .001). Although the cf-PWV was higher in Brazilian blacks, the age-related increase in cf-PWV was higher in Angolan men compared to Brazilians, but not in women. SBP showed the strongest association with cf-PWV, regardless of sex and country. However, age was associated with cf-PWV in all groups, except in Brazilian men. Our results clearly show a difference in PWV between two black populations, and highlight for sex differences in the hemodynamic parameters that might affect blood pressure levels in these populations.

Efficacy of Flecainide in Catecholaminergic Polymorphic Ventricular Tachycardia Is Mutation-Independent but Reduced by Calcium Overload.

BACKGROUND: The dual Na+ and cardiac Ca2+-release channel inhibitor, Flecainide (FLEC) is effective in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT), a disease caused by mutations in cardiac Ca2+-release channels (RyR2), calsequestrin (Casq2), or calmodulin. FLEC suppresses spontaneous Ca2+ waves in Casq2-knockout (Casq2-/-) cardiomyocytes, a CPVT model. However, a report failed to find FLEC efficacy against Ca2+ waves in another CPVT model, RyR2-R4496C heterozygous mice (RyR2R4496C+/-), raising the possibility that FLEC efficacy may be mutation dependent. OBJECTIVE: To address this controversy, we compared FLEC in Casq2-/- and RyR2R4496C+/- cardiomyocytes and mice under identical conditions. METHODS: After 30 min exposure to FLEC (6 µM) or vehicle (VEH), spontaneous Ca2+ waves were quantified during a 40 s pause after 1 Hz pacing train in the presence of isoproterenol (ISO, 1 µM). FLEC efficacy was also tested in vivo using a low dose (LOW: 3 mg/kg ISO + 60 mg/kg caffeine) or a high dose catecholamine challenge (HIGH: 3 mg/kg ISO + 120 mg/kg caffeine). RESULTS: In cardiomyocytes, FLEC efficacy was dependent on extracellular [Ca2+]. At 2 mM [Ca2+], only Casq2-/- myocytes exhibited Ca2+ waves, which were strongly suppressed by FLEC. At 3 mM [Ca2+] both groups exhibited Ca2+ waves that were suppressed by FLEC. At 4 mM [Ca2+], FLEC no longer suppressed Ca2+ waves in both groups. Analogous to the results in myocytes, RyR2R4496C+/- mice (n = 12) had significantly lower arrhythmia scores than Casq2-/- mice (n = 9), but the pattern of FLEC efficacy was similar in both groups (i.e., reduced FLEC efficacy after HIGH dose catecholamine challenge). CONCLUSION: FLEC inhibits Ca2+ waves in RyR2R4496C+/- cardiomyocytes, indicating that RyR2 channel block by FLEC is not mutation-specific. However, FLEC efficacy is reduced by Ca2+ overload in vitro or by high dose catecholamine challenge in vivo, which could explain conflicting literature reports.

Probiotics as Beneficial Dietary Supplements to Prevent and Treat Cardiovascular Diseases: Uncovering Their Impact on Oxidative Stress.

The gut microbiota, the ecosystem formed by a wide symbiotic community of nonpathogenic microorganisms that are present in the distal part of the human gut, plays a prominent role in the normal physiology of the organism. The gut microbiota's imbalance, gut dysbiosis, is directly related to the origin of various processes of acute or chronic dysfunction in the host. Therefore, the ability to intervene in the gut microbiota is now emerging as a possible tactic for therapeutic intervention in various diseases. From this perspective, evidence is growing that a functional dietary intervention with probiotics, which maintain or restore beneficial bacteria of the digestive tract, represents a promising therapeutic strategy for interventions in cardiovascular diseases and also reduces the risk of their occurrence. In the present work, we review the importance of maintaining the balance of the intestinal microbiota to prevent or combat such processes as arterial hypertension or endothelial dysfunction, which underlie many cardiovascular disorders. We also review how the consumption of probiotics can improve autonomic control of cardiovascular function and provide beneficial effects in patients with heart failure. Among the known effects of probiotics is their ability to decrease the generation of reactive oxygen species and, therefore, reduce oxidative stress. Therefore, in this review, we specifically focus on this antioxidant capacity and its relationship with the beneficial cardiovascular effects described for probiotics.

The association between salt intake and arterial stiffness is influenced by a sex-specific mediating effect through blood pressure in normotensive adults: The ELSA-Brasil study.

High salt intake is known to increase blood pressure (BP) and also to be associated with carotid-femoral pulse wave velocity (cf-PWV). However, recent data showed a sex-specific pattern in the salt-induced rise of BP. Thus, we aimed to investigate whether the association between salt intake and arterial stiffness also has a sex-specific pattern. A total of 7755 normotensive participants with a validated 12-h overnight urine collection in which daily salt intake was estimated were included. cf-PWV, as well as clinical and anthropometric parameters, was measured. Salt intake positively correlated with cf-PWV, in which the linear regression was steeper in women than in men (0.0199 ± 0.0045 vs 0.0326 ± 0.0052 m/s per gram of salt, P < .05). cf-PWV increases over the salt quartiles in men and women. However, after adjustment for confounders, the association remained significant only for men. In the path analysis, the direct path (men: 0.048 P < .001, women: 0.029 P = .028) was higher in men while that mediated by SBP (men: 0.020 P < .001, women: 0.034 P < .001) was higher in women. We clearly demonstrated that high salt intake has a direct and independent effect increasing arterial stiffness regardless of sex. Also, the association between salt intake and arterial stiffness is more dependent on BP in normotensive women than it is in normotensive men. These results highlight the need for a sex-specific approach in the evaluation of cardiovascular risk associated with dietary habits.

Sex-specific patterns in the association between salt intake and blood pressure: The ELSA-Brasil study.

Blood pressure (BP) is a strong cardiovascular risk factor, predicting cardiovascular mortality in the general population. High salt consumption is a major contributor of increased BP and hypertension. However, there is a controversy on whether BP response to salt intake would be sex-specific. Thus, we aimed to verify the changes in BP according to different salt intake in men and women in a large sample of adults. The present analysis refers to 12 813 participants (from 35 to 64 years) with a validated 12-hour overnight urine collection in which salt intake was estimated. A set of questionnaires, clinical examination, and laboratory tests were carried out during a single visit to one of the six investigation centers involved. Salt intake was 12.9 ± 5.9 g/d in men and 9.3 ± 4.3 g/d in women. BP increases as salt intake increases, regardless of using BP-lowering medication. The slope of increase in BP elicited by salt intake was significantly higher in women than in men. Thus, the increase in BP by salt intake was stepper in women even after controlling for confounders, regardless of using BP-lowering medication or being hypertensive. In conclusion, salt intake is elevated in this large sample of Brazilian adults in which only a few participants are compliant with the recommendation. Also, women have a higher responsiveness of BP according to salt intake than men, and it is not associated with age, BP level, or the use of BP-lowering medication.

Granulocyte colony-stimulating factor reduces mortality by suppressing ventricular arrhythmias in acute phase of myocardial infarction in rats.

Our aim was to evaluate the effects of granulocyte colony-stimulating factor (G-CSF) on early cardiac arrhythmias after myocardial infarction (MI) and the impact on survival. Male Wistar rats received repeated doses of 50 mug/kg G-CSF (MI-GCSF group) or vehicle (MI group) at 7, 3, and 1 days before surgery. MI was induced by permanent occlusion of left coronary artery. The electrocardiogram was obtained before occlusion and then for 30 minutes after surgery. Events and duration of ventricular arrhythmias were analyzed. The levels of connexin43 (Cx43) were measured by Western blot immediately before MI production. Survival was significantly increased in MI-GCSF pretreated group (74% versus 52.9% MI, P < 0.05). G-CSF pretreatment also significantly reduced the ventricular premature beats when compared with the untreated-MI group (201 +/- 47 versus 679 +/- 117, P < 0.05). The number and the duration of ventricular tachycardia were smaller in the MI-G-CSF group, as well as the number of ventricular fibrillation episodes (10% versus 69% in MI, P < 0.05). Cx43 levels were significantly increased by G-CSF treatment (1.27 +/- 0.13 versus 0.86 +/- 0.11; P < 0.05). The MI size 24 hours after occlusion was reduced by G-CSF pretreatment (36 +/- 3% versus 44 +/- 2% of left ventricle in MI group; P < 0.05). The increase of Cx43 expression in the heart may explain the reduced incidence in ventricular arrhythmias in the early phases after coronary artery occlusion in rats, thus increasing survival after MI.

Distribution of Serum Uric Acid in Black Africans and Its Association With Cardiovascular Risk Factors.

Hyperuricemia is associated with cardiovascular disease and its prevalence is unknown in black Africans. This study reports hyperuricemia distribution and its association with cardiovascular risk factors in a selected Angolan population. A cross-sectional study in 585 black Africans was performed. Hyperuricemia was defined as uric acid >7.0 mg/dL in men or >5.7 mg/dL in women. Overall prevalence was 25%. Hyperuricemia was associated with hypertension (odds ratio [OR], 2.20; confidence interval [CI], 95% 1.41-3.47), high waist circumference (OR, 1.67; CI, 95% 1.05-2.65), and metabolic syndrome (OR, 1.66; CI, 95% 1.07-2.57). Compared to those with uric acid levels in the first quartile, individuals in the fourth quartile showed higher body mass index, waist circumference, systolic blood pressure, and plasma levels of creatinine and triglycerides. Hypertension, high waist circumference, and metabolic syndrome were the major cardiovascular risk factors associated with hyperuricemia.