RESUMEN
The study examined the antihypertensive effect of peptides derived from pepsin-hydrolyzed corn gluten meal, namely KQLLGY and PPYPW, and their in silico gastrointestinal tract digested fragments, KQL and PPY, respectively. KQLLGY and PPYPW showed higher angiotensin I-converting enzyme (ACE)-inhibitory activity and lower ACE inhibition constant (Ki) values when compared to KQL and PPY. Only KQL showed a mild antihypertensive effect in spontaneously hypertensive rats with -7.83 and - 5.71 mmHg systolic and diastolic blood pressure values, respectively, after 8 h oral administration. During passage through Caco-2 cells, KQL was further degraded to QL, which had reduced ACE inhibitory activity. In addition, molecular dynamics revealed that the QL-ACE complex was less stable compared to the KQL-ACE. This study reveals that structural transformation during peptide permeation plays a vital role in attenuating antihypertensive effect of the ACE inhibitor peptide.
Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina , Antihipertensivos , Digestión , Glútenes , Péptidos , Peptidil-Dipeptidasa A , Ratas Endogámicas SHR , Zea mays , Inhibidores de la Enzima Convertidora de Angiotensina/química , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/metabolismo , Antihipertensivos/química , Antihipertensivos/farmacología , Animales , Glútenes/química , Glútenes/metabolismo , Humanos , Zea mays/química , Zea mays/metabolismo , Ratas , Células CACO-2 , Péptidos/química , Péptidos/farmacología , Masculino , Digestión/efectos de los fármacos , Peptidil-Dipeptidasa A/química , Peptidil-Dipeptidasa A/metabolismo , Presión Sanguínea/efectos de los fármacos , Hipertensión/metabolismo , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Tracto Gastrointestinal/metabolismo , Hidrolisados de Proteína/química , Hidrolisados de Proteína/farmacología , HidrólisisRESUMEN
Cool dialysate has variable impact on hemodynamic stability and dialysis adequacy. Hemodynamic stability and dialysis adequacy are crucial indicators for better life expectancy and cardiovascular mortality. This research aims to evaluate the impact of cool dialysate temperature (35.5°C) compared to standard dialysate temperature (37°C) on blood pressures, pulse rate, and dialysis adequacy (Urea reduction ratio and online Kt/V) in a cross over design. Material and Methods. Consenting ESRD patients on maintenance haemodialysis (HD) with minimum 3 months dialysis vintage and functioning permanent vascular access are included for the study. Each participant had two sessions of HD at 37°C followed by two sessions at 35.5° C on a Fresenius 4008S HD machine. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and Pulse rate are measured pre-HD, every hourly and post dialysis. Pre-HD Blood urea nitrogen (BUN) and post-HD BUN are measured, and Urea reduction rate was calculated for each HD session. Kt/V was calculated by ionic conductance by HD machine for each session. Results. 25 patients (5 females and 20 males) were enrolled. The mean age was 54 ± 9.58 years. Dialysis vintage was 21.48 ± 6.9 months for study participants 10 patients (40%) were diabetic nephropathy, 9 patients (36%) were presumed chronic glomerulonephritis, 2 patients (8%) were lupus nephritis and 4 patients (16%) were chronic interstitial nephritis. There was statistically no difference between pre-HD BUN (p = 0.330), post-HD BUN (p = 0.776), URR (p = 0.718) and Kt/V (p = 0.534) among the dialysis sessions done at 37°C and 35.5°C. SBP variability in the low temperature (35.5°C) group at 4th hour and post dialysis assumed statistical significance with p = 0.05 and p = 0.025 respectively. DBP variability in the low temperature (35.5°C) group at 3rd hour, 4th hour and post-dialysis demonstrated statistical significance with p = 0.027, p = 0.36 and p = 0.016 respectively. Pulse rate variability was more in the low temperature (35.5°C) group at 3rd hour and 4th hour which showed statistical significance with p = 0.037 and p = 0.05 respectively. Conclusion. Cool dialysate is non inferior to standard dialysate temperature in terms of dialysis adequacy and is associated with less variability in diastolic blood pressure, systolic blood pressure and more pulse rate variability thereby contributing to better hemodynamic stability.
Asunto(s)
Estudios Cruzados , Hemodinámica , Fallo Renal Crónico , Diálisis Renal , Humanos , Femenino , Masculino , Diálisis Renal/métodos , Persona de Mediana Edad , Fallo Renal Crónico/terapia , Fallo Renal Crónico/fisiopatología , Presión Sanguínea , Soluciones para Diálisis/química , Soluciones para Hemodiálisis/química , Temperatura , Frecuencia Cardíaca , Anciano , Frío , Nitrógeno de la Urea SanguíneaRESUMEN
Introduction: during laparoscopic surgery, carbon dioxide (CO2) insufflation to create pneumoperitoneum increases blood pressure, heart rate and systemic vascular resistance. The purpose of our study was to investigate the efficacy of magnesium sulfate in preventing adverse hemodynamic reactions associated with pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. Methods: we conducted a prospective, randomized, double-blind, controlled clinical study of patients scheduled for laparoscopic cholecystectomy and divided into two equal groups: the Mg2+ group received slow intravenous magnesium sulfate 50 mg/kg injection prior to pneumoperitoneum insufflation while the S group received the same volume of 0.9 % saline. Our primary endpoint was intraoperative changes in systolic blood pressure (SBP) related to pneumoperitoneum, in particular at 1 minute after insufflation. The secondary endpoints were the haemodynamic effects of pneumoperitoneum in terms of systolic blood pressure (SP), diastolic blood pressure (DP), mean arterial pressure (MAP) and heart rate (HR) from 2 minutes after insufflation to extubation and postoperatively, and the presence of possible adverse reactions related to the administration of magnesium sulphate. Results: we included 70 patients divided into two groups of 35. SP was significantly higher in the S group at insufflation (T0), 3 min, 4 min and 5 min post-operative, and at 60 min after surgery. HR was significantly higher in patients in the S group compared to the Mg2+ group at 7 min and 8 min after insufflation. No significant differences in DP and MAP measurements were observed between the 2 groups. No adverse reactions related to magnesium administration were reported. Conclusion: magnesium sulfate administered prior to pneumoperitoneum insufflation provided improved intraoperative hemodynamic stability during laparoscopic surgery.
Asunto(s)
Presión Sanguínea , Colecistectomía Laparoscópica , Frecuencia Cardíaca , Hemodinámica , Sulfato de Magnesio , Neumoperitoneo Artificial , Humanos , Sulfato de Magnesio/administración & dosificación , Sulfato de Magnesio/farmacología , Estudios Prospectivos , Femenino , Masculino , Método Doble Ciego , Colecistectomía Laparoscópica/métodos , Colecistectomía Laparoscópica/efectos adversos , Neumoperitoneo Artificial/efectos adversos , Neumoperitoneo Artificial/métodos , Hemodinámica/efectos de los fármacos , Persona de Mediana Edad , Adulto , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Dióxido de Carbono/administración & dosificación , Adulto Joven , Insuflación/métodosRESUMEN
BACKGROUND: Although intensive blood pressure (BP) control has not been shown to slow the progression of chronic kidney disease (CKD), intensive BP control has been shown to reduce the risk for adverse cardiovascular outcomes in the CKD population. The aim of this post-hoc study was to study the interplay between a self-monitoring BP system and glomerular function. METHODS: In all, 949 participants with hypertension underwent visits at baseline, after eight weeks and 12 months. Half of the participants received a BP monitor and installed a program on their mobile phone. During eight weeks, they measured daily and reported their BP values. RESULTS: Within the intervention group, BP and systolic BP (SBP) decreased from baseline to eight weeks and 12 months (p < .001). Pulse pressure (PP) and mean arterial blood pressure (MAP) decreased from baseline to eight weeks (p = .021 and p = .004) vs 12 months (p = .035 and p = .008). Within the control group, a decrease was observed from baseline to 12 months for SBP, diastolic BP (DBP) and PP (p = .025, p = .023 and p = .036). In the intervention group, we observed an association between a decrease in SBP, DBP, PP and MAP and a decrease in eGFR (estimated glomerular filtration rate), (p < .001, p < .001, p = .013 and p < .001). In the control group, similar results were observed for PP only (p = .027). Within the intervention group, eGFR decreased (p < .001) but within the control group, the decrease was non-significant (p = .051). CONCLUSION: We observed an association between a decrease in all BP components and eGFR decline within the normal range in the intervention group but not in the controls. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov [NCT03554382].
WHAT IS THE CONTEXTHypertension is a common risk factor and has been identified as the most important contributor to end stage renal disease (ESRD)At present, it is unclear if hypertension also plays a role in the gradual loss of kidney function that occurs with ageing in the general populationSome studies have found a link between baseline blood pressure and a decline in GFR (glomerular filtration rate), while others have shown no relationship or even higher GFRMost patients with hypertension attend primary care for diagnosis, treatment and follow-up. Home blood pressure monitoring in hypertension treatment is becoming increasingly commonThe PERson-centredness in Hypertension management using Information Technology (PERHIT) study was designed to evaluate the effect of supporting self-management on (home) blood pressure by the use of information technology and aimed to lower blood pressure in patients with hypertension in primary careThe aim of this sub-study was to evaluate whether a person-centred approach in the treatment of high blood pressure, according to PERHIT, will have an impact on kidney function in patients with hypertension.WHAT IS NEWBlood pressure reduction in the intervention group was associated with a greater fall of eGFR (estimated GFR)glomerular filtration rate), but within the normal range, present already after eight weeks.Our analyses showed significant interactions between improved treatment related to the blood pressure components and lowering of eGFR, suggesting that the association between blood pressure changes and eGFR reduction was most prominent in individuals undergoing more effective antihypertensive treatment.WHAT IS THE IMPACTOur study concerns a common patient group at primary healthcare centres. When blood pressure treatment is initiated, or when treatment is increased via the general practitioner, it is common practice to arrange for a follow-up check of kidney function estimates such as creatinine and eGFR. In many cases, unfortunately not in accordance with proven science and experience, hypertension medication might be discontinued, or the dose reduced due to a short-term deterioration of kidney function (eGFR) that often reverts to normal levels again. This is a development that must be observed and prevented.Our results show that intensified blood pressure control is associated with a reduction in glomerular function measured by eGFR, but within normal range.
Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea , Tasa de Filtración Glomerular , Hipertensión , Humanos , Masculino , Femenino , Persona de Mediana Edad , Hipertensión/fisiopatología , Anciano , Insuficiencia Renal Crónica/fisiopatologíaRESUMEN
The goal is to provide foundational data that could spearhead more extensive, prospective research into understanding the influences of micronutrient levels on the nocturnal patterns of hypertension, possibly aiding in identifying potential therapeutic strategies to reduce cardiovascular risk in this demographic. The research employed a retrospective design to analyze the micronutrient levels, including ferritin, folic acid, vitamin B12, and vitamin D, in a limited sample size from a single hospital. However, it is worth noting that the study did not scrutinize other potentially relevant micronutrients and biomarkers and lacked information on potential confounding factors such as lifestyle and dietary habits, physical activity levels, and specific details on antihypertensive medications used. The preliminary findings highlight a significant difference in ferritin levels between dipper and non-dipper groups, indicating a potential role in the development of non-dipper hypertension. Surprisingly, no notable difference was observed in vitamin D levels between the groups. The study underscores the increasing prevalence of hypertension and micronutrient deficiencies as age progresses. Despite its limitations, including limited sample size and potential influences from unaccounted variables, the study hints at a potential relationship between micronutrient levels and non-dipper hypertension. It emphasizes the necessity for larger scale, prospective research to delve deeper into the nature of this relationship, potentially fostering new therapeutic approaches in cardiovascular risk management within the elderly population.
Asunto(s)
Hipertensión , Micronutrientes , Vitamina D , Humanos , Hipertensión/epidemiología , Estudios Retrospectivos , Anciano , Micronutrientes/sangre , Masculino , Femenino , Vitamina D/sangre , Ácido Fólico/sangre , Ferritinas/sangre , Vitamina B 12/sangre , Presión Sanguínea/fisiología , Anciano de 80 o más Años , Persona de Mediana Edad , Ritmo Circadiano/fisiologíaAsunto(s)
Accidente Cerebrovascular Isquémico , Humanos , Accidente Cerebrovascular Isquémico/cirugía , Accidente Cerebrovascular Isquémico/terapia , Reperfusión/métodos , Metaanálisis como Asunto , Presión Sanguínea/efectos de los fármacos , Antihipertensivos/uso terapéutico , Revisiones Sistemáticas como Asunto , Resultado del TratamientoRESUMEN
BACKGROUND: Metabolic Syndrome (MetS) increases the risk of other serious health problems, particularly cardiovascular diseases and stroke. Sensory processing patterns (SPPs) are internal factors shaping behaviors and emotions, both healthy and unhealthy. There is a lack of studies directly examining the relationship between the SPPs and metabolic risk factors. METHOD: This study aimed to investigate SPPs and their association with metabolic risk factors in individuals with metabolic syndrome (MetS). One hundred and seventeen individuals with MetS completed questionnaires on demographic characteristics and the Thai Sensory Patterns Assessment-adult version. Data on metabolic risk factors, including fasting blood glucose, blood pressure, and waist circumference, were collected. RESULTS: The findings revealed high arousal levels in proprioceptive and auditory senses among the participants. The fasting blood glucose was significantly correlated with a preference in the tactile sense (r = -0.150, P<0.05), while waist circumference was associated with arousal level in the auditory and smell-taste senses (r = 0.140, -0.160, P<0.05). Moreover, the GLMM revealed that fasting blood glucose was associated with preferences in tactile, vestibular, and proprioceptive senses (r = -0.481, 0.726, -0.386, P<0.05). Furthermore, diastolic blood pressure was associated with preferences in vestibular sense (r = 0.099; P<0.05). CONCLUSION: The SPPs might be related to metabolic risk factors, so it is important to recognize how individual SPPs relate to metabolic risk factors. However, further studies using a larger sample may be needed to deeply explore the mechanisms underlying these associations.
Asunto(s)
Síndrome Metabólico , Humanos , Síndrome Metabólico/fisiopatología , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Factores de Riesgo , Adulto , Glucemia/metabolismo , Anciano , Vida Independiente , Presión Sanguínea , Circunferencia de la Cintura , Encuestas y CuestionariosRESUMEN
BACKGROUND: To analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application. METHODS: A total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery. RESULTS: The HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05). CONCLUSIONS: BIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.
Asunto(s)
Anestesia General , Frecuencia Cardíaca , Hemodinámica , Humanos , Anestesia General/métodos , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Neoplasias Gástricas/cirugía , Anestesia Epidural/métodos , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Periodo PerioperatorioAsunto(s)
Angiotensinógeno , Hipertensión , ARN Interferente Pequeño , Animales , Humanos , Angiotensinógeno/genética , Angiotensinógeno/metabolismo , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/genética , Hipertensión/genética , Hipertensión/fisiopatología , Hipertensión/tratamiento farmacológico , Hipertensión/metabolismo , Interferencia de ARN , ARN Interferente Pequeño/uso terapéuticoRESUMEN
Cardiovascular-kidney-metabolic health reflects the interactions between metabolic risk factors, chronic kidney disease, and the cardiovascular system. A growing body of literature suggests that metabolic syndrome (MetS) in individuals of normal weight is associated with a high prevalence of cardiovascular diseases and an increased mortality. The aim of this study was to establish a non-invasive preclinical model of MetS in support of future research focusing on the effects of novel antidiabetic therapies beyond glucose reduction, independent of obesity. Eighteen healthy adult Beagle dogs were fed an isocaloric Western diet (WD) for ten weeks. Biospecimens were collected at baseline (BAS1) and after ten weeks of WD feeding (BAS2) for measurement of blood pressure (BP), serum chemistry, lipoprotein profiling, blood glucose, glucagon, insulin secretion, NT-proBNP, angiotensins, oxidative stress biomarkers, serum, urine, and fecal metabolomics. Differences between BAS1 and BAS2 were analyzed using non-parametric Wilcoxon signed-rank testing. The isocaloric WD model induced significant variations in several markers of MetS, including elevated BP, increased glucose concentrations, and reduced HDL-cholesterol. It also caused an increase in circulating NT-proBNP levels, a decrease in serum bicarbonate, and significant changes in general metabolism, lipids, and biogenic amines. Short-term, isocaloric feeding with a WD in dogs replicated key biological features of MetS while also causing low-grade metabolic acidosis and elevating natriuretic peptides. These findings support the use of the WD canine model for studying the metabolic effects of new antidiabetic therapies independent of obesity.
Asunto(s)
Modelos Animales de Enfermedad , Hipoglucemiantes , Síndrome Metabólico , Obesidad , Animales , Perros , Síndrome Metabólico/tratamiento farmacológico , Síndrome Metabólico/metabolismo , Obesidad/metabolismo , Obesidad/tratamiento farmacológico , Hipoglucemiantes/farmacología , Hipoglucemiantes/uso terapéutico , Masculino , Glucemia/metabolismo , Biomarcadores/sangre , Presión Sanguínea/efectos de los fármacos , Péptido Natriurético Encefálico/sangre , Péptido Natriurético Encefálico/metabolismo , Estrés Oxidativo/efectos de los fármacos , FemeninoRESUMEN
Endothelin-1 (ET-1) and its receptors are linked to increases in sensitivity of the chemoreceptors to hypoxic stress and the development of hypertension in preclinical models. We hypothesized ET receptor antagonism would lower resting blood pressure (BP) as well as the acute BP response to chemoreflex stress. Twenty-four men (31 ± 5 years, 26 ± 3 kg/m2) completed two study visits (control, bosentan). On each visit, BP was assessed under three conditions: (1) normoxia (FiO2 0.21), (2) chemoreflex excitation via hypoxia (FiO2 0.05-0.21), (3) chemoreflex inhibition via hyperoxia (FiO2 1.00). Bosentan increased plasma ET-1 (0.94 ± 0.90 to 1.27 ± 0.62 pg/mL, p = 0.004), supporting receptor blockade. Resting diastolic (73 ± 5 to 69 ± 7 mmHg, p = 0.007) and mean (93 ± 7 to 88 ± 7 mmHg, p = 0.005) BP were reduced following bosentan compared to control with no change in systolic BP (p = 0.507). The mean BP response to both acute hypoxia (-0.48 ± 0.38 to -0.25 ± 0.31 mmHg/%, p = 0.004) and hyperoxia (area under the curve -93 ± 108 to -27 ± 66 AU, p = 0.018) were attenuated following bosentan. Acute ET receptor inhibition attenuates the rise in BP during chemoreflex excitation as well as the fall in BP during chemoreflex inhibition in healthy young men. These data support a role for ET-1 in control of resting BP, possibly through a chemoreceptor-mediated mechanism.
Asunto(s)
Presión Sanguínea , Bosentán , Endotelina-1 , Hiperoxia , Hipoxia , Humanos , Masculino , Hiperoxia/fisiopatología , Presión Sanguínea/efectos de los fármacos , Adulto , Hipoxia/fisiopatología , Endotelina-1/sangre , Bosentán/farmacología , Antagonistas de los Receptores de Endotelina/farmacología , Sulfonamidas/farmacologíaRESUMEN
Previous studies report contradicting age-related neurovascular coupling (NVC). Few studies assess postural effects, but less investigate relationships between age and NVC within different postures. Therefore, this study investigated the effect of age on NVC in different postures with varying cognitive stimuli. Beat-to-beat blood pressure, heart rate and end-tidal carbon dioxide were assessed alongside middle and posterior cerebral artery velocities (MCAv and PCAv, respectively) using transcranial Doppler ultrasonography in 78 participants (31 young-, 23 middle- and 24 older-aged) with visuospatial (VST) and attention tasks (AT) in various postures at two timepoints (T2 and T3). Between-group significance testing utilized one-way analysis-of-variance (ANOVA) (Tukey post-hoc). Mixed three-way/one-way ANOVAs explored task, posture, and age interactions. Significant effects of posture on NVC were driven by a 3.8% increase from seated to supine. For AT, mean supine %MCAv increase was greatest in younger (5.44%) versus middle (0.12%) and older-age (0.09%) at T3 (p = 0.005). For VST, mean supine %PCAv increase was greatest at T2 and T3 in middle (10.99%/10.12%) and older-age (17.36%/17.26%) versus younger (9.44%/8.89%) (p = 0.004/p = 0.002). We identified significant age-related NVC effects with VST-induced hyperactivation. This may reflect age-related compensatory processes in supine. Further work is required, using complex stimuli while standing/walking, examining NVC, aging and falls.
Asunto(s)
Envejecimiento , Acoplamiento Neurovascular , Postura , Humanos , Masculino , Femenino , Acoplamiento Neurovascular/fisiología , Adulto , Persona de Mediana Edad , Anciano , Postura/fisiología , Envejecimiento/fisiología , Adulto Joven , Atención/fisiología , Ultrasonografía Doppler Transcraneal/métodos , Presión Sanguínea/fisiología , Circulación Cerebrovascular/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Frecuencia Cardíaca/fisiología , Arteria Cerebral Media/fisiología , Arteria Cerebral Media/diagnóstico por imagenRESUMEN
BACKGROUND: Higher cruciferous vegetable intake is associated with lower cardiovascular disease risk in observational studies. The pathways involved remain uncertain. We aimed to determine whether cruciferous vegetable intake (active) lowers 24-h brachial systolic blood pressure (SBP; primary outcome) compared to root and squash vegetables (control) in Australian adults with mildly elevated BP (SBP 120-160 mmHg inclusive). METHODS: In this randomized, controlled, crossover trial, participants completed two 2-week dietary interventions separated by a 2-week washout. Cruciferous vegetables were compared to root and squash vegetables (~ 300 g/day) consumed with lunch and dinner meals. Participants were blinded to which interventions were the active and control. Adherence was assessed using food diaries and biomarkers (S-methyl cysteine sulfoxide (SMCSO, active) and carotenoids (control)). Twenty-four-hour brachial ambulatory SBP and secondary outcomes were assessed pre- and post each intervention. Differences were tested using linear mixed effects regression. RESULTS: Eighteen participants were recruited (median (IQR) age: 68 (66-70); female: n = 16/18; mean ± SD clinic SBP: 135.9 ± 10.0 mmHg). For both interventions, 72% participants had 100% adherence (IQR: 96.4-100%). SMCSO and carotenoids were significantly different between interventions (mean difference active vs. control SMCSO: 22.93 mg/mL, 95%CI 15.62, 30.23, P < 0.0001; carotenoids: - 0.974 mg/mL, 95%CI - 1.525, - 0.423, P = 0.001). Twenty-four-hour brachial SBP was significantly reduced following the active vs. control (mean difference - 2.5 mmHg, 95%CI - 4.2, - 0.9, P = 0.002; active pre: 126.8 ± 12.6 mmHg, post: 124.4 ± 11.8 mmHg; control pre: 125.5 ± 12.1 mmHg, post: 124.8 ± 13.1 mmHg, n = 17), driven by daytime SBP (mean difference - 3.6 mmHg, 95%CI - 5.4, - 1.7, P < 0.001). Serum triglycerides were significantly lower following the active vs. control (mean difference - 0.2 mmol/L, 95%CI - 0.4, - 0.0, P = 0.047). CONCLUSIONS: Increased intake of cruciferous vegetables resulted in reduced SBP compared to root and squash vegetables. Future research is needed to determine whether targeted recommendations for increasing cruciferous vegetable intake benefits population health. TRIAL REGISTRATION: Clinical trial registry ACTRN12619001294145. https://www.anzctr.org.au.
Asunto(s)
Presión Sanguínea , Estudios Cruzados , Verduras , Humanos , Femenino , Masculino , Presión Sanguínea/fisiología , Presión Sanguínea/efectos de los fármacos , Anciano , Australia , Persona de Mediana Edad , Hipertensión/dietoterapia , Hipertensión/fisiopatologíaRESUMEN
Lifestyle habits are key determinants for premature death. The Swedish model of health dialogues, which has been developed since 1985, aims to promote a healthy lifestyle by inviting everybody in specific age groups to primary care for health dialogues combined with community-oriented efforts. In the first systematic review of the model, seven studies were identified, all with a control/reference group and follow-up of at least one year. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used to assess the quality of evidence. Results showed that the model reduced premature all-cause and cardiovascular mortality (moderate evidence/+++), reduced blood pressure, cholesterol, fasting blood glucose, waist size and BMI (moderate/low evidence) and improved dietary habits (moderate evidence/+++). Health benefits were greater when health dialogues were combined with community-oriented efforts.
Asunto(s)
Enfermedades Cardiovasculares , Promoción de la Salud , Humanos , Suecia , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/mortalidad , Estilo de Vida Saludable , Atención Primaria de Salud , Presión Sanguínea , Mortalidad Prematura , Estilo de Vida , Conducta AlimentariaRESUMEN
BACKGROUND: Hypertension is a significant global public health concern, with unique risk factors affecting those in the banking sector due to their work environment. This study aimed to determine the prevalence of hypertension among bank employees and identify specific contributing risk factors. MATERIALS AND METHODS: A cross-sectional survey of 250 bank employees used pretested structured questionnaires. Various measurements, including body mass index (BMI), blood pressure, lipid profile parameters and cardiovascular events, were recorded. Data were analysed using SPSS software. Categorical variables are presented as frequencies and percentages. Binary logistic regression was employed to identify independent predictors of hypertension (P < 0.05). RESULTS: The study participants had a mean age of 37.56 ± 8.98, with 54.5% being female. The majority (98.8%) had tertiary education, and 94.7% resided in urban areas. The prevalence of hypertension was 33.3%. Higher BMI is significantly associated with increased odds of hypertension. For each unit increase in BMI, the odds of having hypertension are approximately 1.98 times higher. Hypertension was also significantly more prevalent in those participants with prior hypertension diagnosis, those with a family history of hypertension, smokers and those who added salt to their food on the table (P < 0.05). CONCLUSION: The alarmingly high prevalence of hypertension underscores the need for targeted intervention and health promotion initiatives. With recognised risk factors, emphasis must be placed on the importance of lifestyle modifications and workplace wellness programmes to mitigate the burden of hypertension.
Asunto(s)
Índice de Masa Corporal , Enfermedades Cardiovasculares , Hipertensión , Humanos , Hipertensión/epidemiología , Femenino , Nigeria/epidemiología , Masculino , Adulto , Prevalencia , Estudios Transversales , Persona de Mediana Edad , Enfermedades Cardiovasculares/epidemiología , Factores de Riesgo , Cuenta Bancaria , Encuestas y Cuestionarios , Factores de Riesgo de Enfermedad Cardiaca , Presión Sanguínea/fisiologíaRESUMEN
Vascular endothelial growth factor receptor inhibitors (VEGFRis) improve cancer survival but are associated with treatment-limiting hypertension, often attributed to endothelial cell (EC) dysfunction. Using phosphoproteomic profiling of VEGFRi-treated ECs, drugs were screened for mitigators of VEGFRi-induced EC dysfunction and validated in primary aortic ECs, mice, and canine cancer patients. VEGFRi treatment significantly raised systolic blood pressure (SBP) and increased markers of endothelial and renal dysfunction in mice and canine cancer patients. α-Adrenergic-antagonists were identified as drugs that most oppose the VEGFRi proteomic signature. Doxazosin, one such α-antagonist, prevented EC dysfunction in murine, canine, and human aortic ECs. In mice with sorafenib-induced-hypertension, doxazosin mitigated EC dysfunction but not hypertension or glomerular endotheliosis, while lisinopril mitigated hypertension and glomerular endotheliosis without impacting EC function. Hence, reversing EC dysfunction was insufficient to mitigate VEGFRi-induced-hypertension in this mouse model. Canine cancer patients with VEGFRi-induced-hypertension were randomized to doxazosin or lisinopril and both agents significantly decreased SBP. The canine clinical trial supports safety and efficacy of doxazosin and lisinopril as antihypertensives for VEGFRi-induced-hypertension and the potential of trials in canines with spontaneous cancer to accelerate translation. The overall findings demonstrate the utility of phosphoproteomics to identify EC-protective agents to mitigate cardio-oncology side effects.
Asunto(s)
Doxazosina , Células Endoteliales , Hipertensión , Receptores de Factores de Crecimiento Endotelial Vascular , Animales , Perros , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/metabolismo , Hipertensión/fisiopatología , Doxazosina/farmacología , Doxazosina/uso terapéutico , Células Endoteliales/efectos de los fármacos , Células Endoteliales/metabolismo , Receptores de Factores de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Receptores de Factores de Crecimiento Endotelial Vascular/metabolismo , Proteómica/métodos , Presión Sanguínea/efectos de los fármacos , Ratones , Ratones Endogámicos C57BL , Lisinopril/farmacología , Lisinopril/uso terapéutico , Masculino , Neoplasias/tratamiento farmacológico , Neoplasias/metabolismo , Antihipertensivos/farmacología , Antihipertensivos/uso terapéutico , Inhibidores de Proteínas Quinasas/farmacología , Inhibidores de Proteínas Quinasas/uso terapéutico , Antagonistas de Receptores Adrenérgicos alfa 1/farmacología , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapéutico , Sorafenib/farmacología , Sorafenib/uso terapéuticoRESUMEN
The research on the role of plasminogen activator inhibitor-1 (PAI-1) in cardiovascular and metabolic diseases is insufficient. We aimed to explore whether elevated blood PAI-1 levels are significantly related to increased cardiovascular and metabolic risk factors in a midlife women population. Data were obtained from baseline characteristics in Study of Women's Health Across the Nation (SWAN) study. Multivariable linear regression models were performed to examine for the trends of associations between PAI-1 and cardiovascular and metabolic risk factors (systolic BP, diastolic BP, fasting blood glucose, insulin, HDL-C, LDL-C, TG and TC), respectively. Smooth curve demonstrated gradual upward trends on associations of blood PAI-1 levels with LDL-C, TG, TC, fasting blood glucose, insulin, systolic BP and diastolic BP (all P < 0.05) and a gradual downward trend of PAI-1 levels with HDL-C (P < 0.05). Multivariable linear regression models still indicated that increased blood PAI-1 levels were associated with higher cardiovascular and metabolic risk after confounding factors including age, race/ethnicity, ever smoked regularly, alcohol in last 24 h, menopausal status, total family income and BMI were controlled for. Moreover, we observed that the independent associations between blood levels of PAI-1 and cardiovascular and metabolic risk factors examined by stratified analysis were not influenced by age, smoking status, menopausal status and BMI, respectively. Our analysis showed that increased blood PAI-1 levels were associated with higher level for cardiovascular and metabolic risk factors which mainly causes to higher possibility of cardio-cerebrovascular diseases in a large-sample midlife women subjects.
Asunto(s)
Enfermedades Cardiovasculares , Inhibidor 1 de Activador Plasminogénico , Humanos , Femenino , Inhibidor 1 de Activador Plasminogénico/sangre , Persona de Mediana Edad , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Adulto , Factores de Riesgo , Factores de Riesgo de Enfermedad Cardiaca , Glucemia/metabolismo , Glucemia/análisis , Presión Sanguínea , HDL-Colesterol/sangreRESUMEN
Systemic arterial hypertension is accompanied by autonomic impairments that, if not contained, promotes cardiac functional and morphological damages. Pyridostigmine bromide (PYR) treatment results in positive effects on autonomic control and beneficial cardiac remodeling. These findings were also observed after aerobic physical training (APT). However, little is known about PYR effects on left ventricular contractility, mainly when it is combined with APT. We aimed to investigate the effects of chronic acetylcholinesterase inhibition on cardiac autonomic tone balance, coronary bed reactivity, and left ventricular contractility in spontaneously hypertensive rats (SHR) submitted to APT. Male SHR (18 weeks) were divided into two groups (N = 16): untrained and submitted to APT for 14 weeks (18th to 32nd week). Half of each group was treated with PYR (15 mg/kg/day) for two weeks (31st to 32nd week). The experimental protocol consisted of recording hemodynamic parameters, double autonomic blockade with atropine and propranolol, and assessment of coronary bed reactivity and ventricular contractility in isolated hearts using the Langendorff technique. PYR and APT reduced blood pressure, heart rate, and sympathetic influence on the heart. The Langendorff technique showed that APT increased coronary perfusion pressure and left ventricle contractility in response to coronary flow and ß-agonist administration. However, treatment with PYR annulled the effects of APT. In conclusion, although chronic treatment with PYR reduces cardiac sympathetic tonic influence, it does not favor coronary bed reactivity and cardiac contractility gains. PYR treatment in the trained SHR group nullified the coronary vascular reactivity and cardiac contractility gains.
Asunto(s)
Inhibidores de la Colinesterasa , Hipertensión , Contracción Miocárdica , Condicionamiento Físico Animal , Bromuro de Piridostigmina , Ratas Endogámicas SHR , Animales , Inhibidores de la Colinesterasa/farmacología , Masculino , Ratas , Contracción Miocárdica/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Bromuro de Piridostigmina/farmacología , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Vasos Coronarios/efectos de los fármacos , Vasos Coronarios/fisiopatología , Función Ventricular Izquierda/efectos de los fármacos , Acetilcolinesterasa/metabolismoRESUMEN
(1) Background: This study utilized a 24-week intervention incorporating heart rate sensors for real-time monitoring of intervention training, aiming to comprehensively assess the effects of Tai Chi on vascular endothelial function, atherosclerosis progression, and lipid metabolism. The insights gained may inform personalized non-pharmacological interventions to enhance the management of cardiovascular health in this population to provide sustainable benefits and improve quality of life. (2) Methods: Forty postmenopausal middle-aged and elderly women were randomly assigned to an exercise or control group. The exercise group underwent a 24-week Tai Chi (BaFa WuBu) training intervention with real-time heart rate monitoring using Polar sensors. Pre- and post-intervention assessments included body composition, blood pressure, vascularity, and blood parameters measured with the Inbody 720, Vascular Endothelial Function Detector, and Arteriosclerosis. Data were analyzed using SPSS 26.0 and mixed-design ANOVA to assess the effects of time, group, and their interactions on study outcomes. (3) Results: After training through 24 weeks of Tai Chi (BaFa WuBu) intervention, compared with the control group, systolic blood pressure in the exercise group was significantly lower (p < 0.05), and the difference between left and right arm pulse pressure, left and right ankle mean arterial pressure, left and right side baPWV, left and right side ABI, TC, TG, LDL, and blood pressure viscosity were all very significantly lower (p < 0.01), and the diastolic blood pressure was significantly higher (p < 0.05). Compared with baseline values in the exercise group, systolic blood pressure, right and left arm pulse pressure difference, right and left ankle mean arterial pressure, right and left side baPWV, right and left side ABI, TC, TG, LDL, and blood pressure viscosity decreased very significantly (p < 0.01) and diastolic blood pressure and FMD increased very significantly (p < 0.01) in the exercise group after the intervention. (4) Conclusions: In our study, a 24-week Tai Chi (BaFa WuBu) program significantly improved vascular health in middle-aged and older postmenopausal women. This simplified Tai Chi form is gentle and effective, ideal for older adults. Regular practice led to reduced vascular obstruction, improved lipid metabolism, and enhanced vascular endothelial function, crucial for preventing vascular diseases. The real-time heart rate sensors used were pivotal, enabling precise monitoring and adjustment of exercise intensity, thereby enhancing the study's scientific rigor and supporting Tai Chi (BaFa WuBu) as a beneficial therapeutic exercise.