First Pressure Readings on Mars

NASA Image and Video Library

2012-08-21

This graph shows readings for atmospheric pressure at the landing site of NASA Curiosity rover. The data were obtained by Curiosity Rover Environmental Monitoring Station from Aug. 15 to Aug. 18, 2012.

LB02.06: CLINICAL IMPLICATIONS OF THE DIASTOLIC BLOOD PRESSURE 'J CURVE' IN TREATED HYPERTENSIVE PATIENTS.

PubMed

Lip, S; McCallum, L; Touyz, R H; Dominiczak, A F; Padmanabhan, S

2015-06-01

Recent studies have shown that low diastolic blood pressure is associated with increased cardiovascular outcomes especially in those with pre-existing cardiovascular disease (DBP 'J' Curve). Whether this has practical implications in real life hypertension practice is unknown. We analysed the achieved blood pressure of 6,072 patients between years 2 and 5 following initial presentation to the Glasgow Blood Pressure Clinic. Patients were classified into nine groups based on the area under the curve(AUC) of at least 3 blood pressure(BP) readings during this period. Multivariable adjusted 30 years survival analysis was performed using Cox proportional hazards model. The age of first visit was 53±13 years, BMI 27.6 ± 5.2, baseline BP 169 ± 29/100 ± 18 mmHg, 52% were females, 60% drank more than 6 units of alcohol/week, 44% were ever smokers, 26% had prevalent CVD and 26% had eGFR<60. Of 6,072 individuals, 418(7%) achieved AUC-BP =<140/80; 365(12%) had isolated systolic hypertension(ISH) (>140/<80mmHg) of whom 98 had severe ISH (SBP>160/ DBP<80). There were only 199(0.7%) subjects with AUC-DBP<70 mmHg. 30 year survival data was available for 5,451 individuals with 1,662 all-cause deaths and 65,430 person-years of follow-up. Figure 1 presents the adjusted hazard ratios for cardiovascular mortality showing significant excess risk associated with DBP<80 only in subjects with SBP>160.(Figure is included in full-text article.) : In treated hypertensive patients, the DBP 'J 'curve is not apparent with achieved BP 2 - 5 years from presentation. This may be explained partly by the low likelihood of achieving DBP<70 2-5 years after commencing treatment.

Correlation of Noninvasive Blood Pressure and Invasive Intra-arterial Blood Pressure in Patients Treated with Vasoactive Medications in a Neurocritical Care Unit.

PubMed

Saherwala, Ali A; Stutzman, Sonja E; Osman, Mohamed; Kalia, Junaid; Figueroa, Stephen A; Olson, DaiWai M; Aiyagari, Venkatesh

2018-03-22

The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simultaneously measured NBP and IAP recordings in these patients. Prospective observational study of patients (N = 70) admitted to a neurocritical care unit receiving continuous vasopressor or antihypertensive infusions. Paired NBP/IAP observations along with covariate and demographic data were abstracted via chart audit. Analysis was performed using SAS v9.4. A total of 2177 paired NBP/IAP observations from 70 subjects (49% male, 63% white, mean age 59 years) receiving vasopressors (n = 21) or antihypertensive agents (n = 49) were collected. Paired t test analysis showed significant differences between NBP versus IAP readings: ([systolic blood pressure (SBP): mean = 136 vs. 140 mmHg; p < 0.0001], [diastolic blood pressure (DBP): mean = 70 vs. 68 mmHg, p < 0.0001], [mean arterial blood pressure (MAP): mean = 86 vs. 90 mmHg, p < 0.0001]). Bland-Altman plots for MAP, SBP, and DBP demonstrate good inter-method agreement between paired measures (excluding outliers) and demonstrate NBP-IAP SBP differences at extremes of blood pressures. Pearson correlation coefficients show strong positive correlations for paired MAP (r = 0.82), SBP (r = 0.84), and DBP (r = 0.73) recordings. An absolute NBP-IAP SBP difference of > 20 mmHg was seen in ~ 20% of observations of nicardipine, ~ 25% of observations of norepinephrine, and ~ 35% of observations of phenylephrine. For MAP, the corresponding numbers were ~ 10, 15, and 25% for nicardipine, norepinephrine, and phenylephrine, respectively. Despite overall strong positive correlations between paired NBP and IAP readings of MAP and SBP, clinically relevant differences in blood pressure are frequent. When

Influence of Baseline Diastolic Blood Pressure on Effects of Intensive Compared With Standard Blood Pressure Control.

PubMed

Beddhu, Srinivasan; Chertow, Glenn M; Cheung, Alfred K; Cushman, William C; Rahman, Mahboob; Greene, Tom; Wei, Guo; Campbell, Ruth C; Conroy, Margaret; Freedman, Barry I; Haley, William; Horwitz, Edward; Kitzman, Dalane; Lash, James; Papademetriou, Vasilios; Pisoni, Roberto; Riessen, Erik; Rosendorff, Clive; Watnick, Suzanne G; Whittle, Jeffrey; Whelton, Paul K

2018-01-09

In individuals with a low diastolic blood pressure (DBP), the potential benefits or risks of intensive systolic blood pressure (SBP) lowering are unclear. SPRINT (Systolic Blood Pressure Intervention Trial) was a randomized controlled trial that compared the effects of intensive (target <120 mm Hg) and standard (target <140 mm Hg) SBP control in 9361 older adults with high blood pressure at increased risk of cardiovascular disease. The primary outcome was a composite of cardiovascular disease events. All-cause death and incident chronic kidney disease were secondary outcomes. This post hoc analysis examined whether the effects of the SBP intervention differed by baseline DBP. Mean baseline SBP and DBP were 139.7±15.6 and 78.1±11.9 mm Hg, respectively. Regardless of the randomized treatment, baseline DBP had a U-shaped association with the hazard of the primary cardiovascular disease outcome. However, the effects of the intensive SBP intervention on the primary outcome were not influenced by baseline DBP level ( P for interaction=0.83). The primary outcome hazard ratio for intensive versus standard treatment was 0.78 (95% confidence interval, 0.57-1.07) in the lowest DBP quintile (mean baseline DBP, 61±5 mm Hg) and 0.74 (95% confidence interval, 0.61-0.90) in the upper 4 DBP quintiles (mean baseline DBP, 82±9 mm Hg), with an interaction P value of 0.78. Results were similar for all-cause death and kidney events. Low baseline DBP was associated with increased risk of cardiovascular disease events, but there was no evidence that the benefit of the intensive SBP lowering differed by baseline DBP. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01206062. © 2017 American Heart Association, Inc.

The transcription factor DBP affects circadian sleep consolidation and rhythmic EEG activity.

PubMed

Franken, P; Lopez-Molina, L; Marcacci, L; Schibler, U; Tafti, M

2000-01-15

Albumin D-binding protein (DBP) is a PAR leucine zipper transcription factor that is expressed according to a robust circadian rhythm in the suprachiasmatic nuclei, harboring the circadian master clock, and in most peripheral tissues. Mice lacking DBP display a shorter circadian period in locomotor activity and are less active. Thus, although DBP is not essential for circadian rhythm generation, it does modulate important clock outputs. We studied the role of DBP in the circadian and homeostatic aspects of sleep regulation by comparing DBP deficient mice (dbp-/-) with their isogenic controls (dbp+/+) under light-dark (LD) and constant-dark (DD) baseline conditions, as well as after sleep loss. Whereas total sleep duration was similar in both genotypes, the amplitude of the circadian modulation of sleep time, as well as the consolidation of sleep episodes, was reduced in dbp-/- under both LD and DD conditions. Quantitative EEG analysis demonstrated a marked reduction in the amplitude of the sleep-wake-dependent changes in slow-wave sleep delta power and an increase in hippocampal theta peak frequency in dbp-/- mice. The sleep deprivation-induced compensatory rebound of EEG delta power was similar in both genotypes. In contrast, the rebound in paradoxical sleep was significant in dbp+/+ mice only. It is concluded that the transcriptional regulatory protein DBP modulates circadian and homeostatic aspects of sleep regulation.

One Reading Specialist's Response to High-Stakes Testing Pressures

ERIC Educational Resources Information Center

Assaf, Lori

2006-01-01

Pressures to help students pass high-stakes tests affect teachers' reading instruction, their responsiveness to students' learning needs, and their professional effectiveness. This article reports on how one reading specialist responded to testing pressures in her urban elementary school. She believed that what was "right" for her…

Simultaneous blood pressure measurement in both arms in hypertensive and nonhypertensive adult patients.

PubMed

Fonseca-Reyes, Salvador; Forsyth-MacQuarrie, Avril M; García de Alba-García, Javier Eduardo

2012-08-01

When blood pressure (BP) is taken for the first time, it should be measured in both arms; follow-up measurements should be taken in the arm with the highest BP. However, in clinical practice, this recommendation is rarely followed. Identify the degree of differences in BP between the right and the left arm in individuals with normal and high BP. We measured BP in 111 hypertensive and 80 normotensive patients in both arms at the same time using identical Omron HEM 725 CIC automatic sphygmomanometers. The devices were then switched to the other arm and another set of readings was taken. The absolute and relative difference in BP between arms was calculated from the average of these two readings. We categorized differences as at least 5, at least 10, and at least 20 mmHg for systolic blood pressure/diastolic blood pressure (SBP/DBP). The BP was higher in the right arm, with no statistical significance. The relative differences were also not significant: SBP 1.1±7.1 and DBP 0.21±5.0. However, the absolute differences were significant at an individual level, with a systolic difference of 5.4±4.8 mmHg and a diastolic difference of 3.9 ±3.2 mmHg. The percentages of absolute SBP/DBP differences more than 5 mmHg (21.4%/20.4%) and more than 10 mmHg (15.7%/4.7%) were considerable. The range of arm differences was clinically significant; in hypertensives, the SBP/DBP was -13.2 to +15/-9.2 to +9.6 mmHg and in nonhypertensives it was -12.9 to +15.6/-9.7 to +10.1 mmHg. Although on average there was no clinically significant relative difference between arms, absolute differences at an individual level were often clinically significant. Failure to determine interarm BP differences will lead to erroneous clinical decisions.

Upregulation of human DNA binding protein A (dbpA) in gastric cancer cells.

PubMed

Wang, Guo-rong; Zheng, Yan; Che, Xiang-ming; Wang, Xin-yang; Zhao, Jia-hui; Wu, Kai-jie; Zeng, Jin; Pan, Chen-en; He, Da-lin

2009-10-01

To determine the effect of human DNA binding protein (dbpA) on the biology of gastric cancer cells. DbpA expression was analyzed by Western blot analysis and immunofluorescence staining in gastric cancer tissues and cell lines. A dbpA-specific small interference (si) RNA was designed and synthesized. Suppressive effect of siRNA on dbpA expression was assessed by real-time RT-PCR. Transwell migration and colony formation assays were used to assess the inhibitory effects of dbpA siRNA on cell invasion and tumorigenesis in vitro. Drug-sensitivity was evaluated using a conventional 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The expression of dbpA was upregulated in gastric cancer tissues and cell lines as compared to adjacent normal tissues or gastric epithelial cells. siRNA treatment successfully silenced dbpA expression. Silencing of dbpA increased expression of E-cadherin, decreased expression of adenomatous polyposis coli (APC), beta-catenin and cyclin D1, but had no effect on expression of NF-kappaB. Silencing of dbpA also suppressed cell invasion and colony formation of SGC7901 cells, and enhanced their chemosensitivity to 5-fluorouracil. DbpA plays an important role in the pathogenesis and development of gastric cancer, and the process involves E-cadherin, APC, beta-catenin and cyclin D1. Silencing of dbpA might be a novel therapeutic strategy for increasing chemosensitivity to 5-fluorouracil in gastric cancer.

Impact of Autologous Stem Cell Transplantation on Blood Pressure and Renal Function in Multiple Myeloma Patients.

PubMed

Balsam, Leah; Saad, Chadi; Arsene, Camelia; Fogel, Joshua

2017-01-01

Autologous stem cell transplantation (ASCT) reverses kidney failure in one-third of multiple myeloma (MM) patients, which may lead to blood pressure (BP) improvement. We evaluate the long term impact of ASCT on BP and renal function in MM patients. We studied 192 MM patients that underwent ASCT. We compared BP readings and glomerular filtration rate (GFR) at 4 weeks before ASCT, on day of ASCT and post-ASCT at 30, 100 and 180 days. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) on day of ASCT and at both 30 and 100 days post-ASCT was significantly lower as compared to pre-ASCT SBP and DBP. There was a significantly higher mean GFR at day of ASCT and 30 days post-ASCT and significantly lower mean GFR at 180 days post-ASCT as compared to pre-ASCT. White patients had similar patterns to the total group for SBP, DBP, and GFR except for SBP which was still significantly lower and GFR which was not significantly different at 180 days. African-American patients showed no significant reductions in the mean values of SBP and DBP and no significant increases for GFR in follow-up after day of ASCT. Furthermore, the mean value of GFR was significantly lower at 180 days post-ASCT. ASCT in MM patients had a positive impact on SBP and DBP and GFR but the impact was minimal for African-American patients. We recommend that clinicians consider closer follow-up of BP and kidney function and more intense therapy in African-Americans with MM. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring

PubMed Central

Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D.; Godfrey, Keith M.; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An

2015-01-01

Abstract Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother–offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00–0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01–0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (−0.03 to 0.13; P = 0.21), 0.03 (−0.04 to 0.10; P = 0

Pressure Points in Reading Comprehension: A Quantile Multiple Regression Analysis

ERIC Educational Resources Information Center

Logan, Jessica

2017-01-01

The goal of this study was to examine how selected pressure points or areas of vulnerability are related to individual differences in reading comprehension and whether the importance of these pressure points varies as a function of the level of children's reading comprehension. A sample of 245 third-grade children were given an assessment battery…

Mitogen-activated protein kinase pathway mediates DBP-maf-induced apoptosis in RAW 264.7 macrophages.

PubMed

Gumireddy, Kiranmai; Reddy, C Damodar; Swamy, Narasimha

2003-09-01

Vitamin D-binding protein-macrophage-activating factor (DBP-maf) is derived from serum vitamin D binding protein (DBP) by selective deglycosylation during inflammation. In the present study, we investigated the effect of DBP-maf on RAW 264.7 macrophages and the underlying intracellular signal transduction pathways. DBP-maf increased proapoptotic caspase-3, -8, and -9 activities and induced apoptosis in RAW 264.7 cells. However, DBP, the precursor to DBP-maf did not induce apoptosis in these cells. Cell cycle analysis of DBP-maf-treated RAW 264.7 cells revealed growth arrest with accumulation of cells in sub-G(0)/G(1) phase. We also investigated the role of mitogen-activated protein kinase (MAPK) pathways in the DBP-maf-induced apoptosis of RAW264.7 cells. DBP-maf increased the phosphorylation of p38 and JNK1/2, while it decreased the ERK1/2 phosphorylation. Treatment with the p38 MAPK inhibitor, SB202190, attenuated DBP-maf-induced apoptosis. PD98059, a MEK specific inhibitor, did not show a significant inhibition of apoptosis induced by DBP-maf. Taken together, these results suggest that the p38 MAPK pathway plays a crucial role in DBP-maf-mediated apoptosis of macrophages. Our studies indicate that, during inflammation DBP-maf may function positively by causing death of the macrophages when activated macrophages are no longer needed at the site of inflammation. In summary, we report for the first time that DBP-maf induces apoptosis in macrophages via p38 and JNK1/2 pathway. Copyright 2003 Wiley-Liss, Inc.

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure

PubMed Central

Wain, Louise V; Verwoert, Germaine C; O’Reilly, Paul F; Shi, Gang; Johnson, Toby; Johnson, Andrew D; Bochud, Murielle; Rice, Kenneth M; Henneman, Peter; Smith, Albert V; Ehret, Georg B; Amin, Najaf; Larson, Martin G; Mooser, Vincent; Hadley, David; Dörr, Marcus; Bis, Joshua C; Aspelund, Thor; Esko, Tõnu; Janssens, A Cecile JW; Zhao, Jing Hua; Heath, Simon; Laan, Maris; Fu, Jingyuan; Pistis, Giorgio; Luan, Jian’an; Arora, Pankaj; Lucas, Gavin; Pirastu, Nicola; Pichler, Irene; Jackson, Anne U; Webster, Rebecca J; Zhang, Feng; Peden, John F; Schmidt, Helena; Tanaka, Toshiko; Campbell, Harry; Igl, Wilmar; Milaneschi, Yuri; Hotteng, Jouke-Jan; Vitart, Veronique; Chasman, Daniel I; Trompet, Stella; Bragg-Gresham, Jennifer L; Alizadeh, Behrooz Z; Chambers, John C; Guo, Xiuqing; Lehtimäki, Terho; Kühnel, Brigitte; Lopez, Lorna M; Polašek, Ozren; Boban, Mladen; Nelson, Christopher P; Morrison, Alanna C; Pihur, Vasyl; Ganesh, Santhi K; Hofman, Albert; Kundu, Suman; Mattace-Raso, Francesco US; Rivadeneira, Fernando; Sijbrands, Eric JG; Uitterlinden, Andre G; Hwang, Shih-Jen; Vasan, Ramachandran S; Wang, Thomas J; Bergmann, Sven; Vollenweider, Peter; Waeber, Gérard; Laitinen, Jaana; Pouta, Anneli; Zitting, Paavo; McArdle, Wendy L; Kroemer, Heyo K; Völker, Uwe; Völzke, Henry; Glazer, Nicole L; Taylor, Kent D; Harris, Tamara B; Alavere, Helene; Haller, Toomas; Keis, Aime; Tammesoo, Mari-Liis; Aulchenko, Yurii; Barroso, Inês; Khaw, Kay-Tee; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Eyheramendy, Susana; Org, Elin; Sõber, Siim; Lu, Xiaowen; Nolte, Ilja M; Penninx, Brenda W; Corre, Tanguy; Masciullo, Corrado; Sala, Cinzia; Groop, Leif; Voight, Benjamin F; Melander, Olle; O’Donnell, Christopher J; Salomaa, Veikko; d’Adamo, Adamo Pio; Fabretto, Antonella; Faletra, Flavio; Ulivi, Sheila; Del Greco, M Fabiola; Facheris, Maurizio; Collins, Francis S; Bergman, Richard N; Beilby, John P; Hung, Joseph; Musk, A William; Mangino, Massimo; Shin, So-Youn; Soranzo, Nicole; Watkins, Hugh; Goel, Anuj; Hamsten, Anders; Gider, Pierre; Loitfelder, Marisa; Zeginigg, Marion; Hernandez, Dena; Najjar, Samer S; Navarro, Pau; Wild, Sarah H; Corsi, Anna Maria; Singleton, Andrew; de Geus, Eco JC; Willemsen, Gonneke; Parker, Alex N; Rose, Lynda M; Buckley, Brendan; Stott, David; Orru, Marco; Uda, Manuela; van der Klauw, Melanie M; Zhang, Weihua; Li, Xinzhong; Scott, James; Chen, Yii-Der Ida; Burke, Gregory L; Kähönen, Mika; Viikari, Jorma; Döring, Angela; Meitinger, Thomas; Davies, Gail; Starr, John M; Emilsson, Valur; Plump, Andrew; Lindeman, Jan H; ’t Hoen, Peter AC; König, Inke R; Felix, Janine F; Clarke, Robert; Hopewell, Jemma C; Ongen, Halit; Breteler, Monique; Debette, Stéphanie; DeStefano, Anita L; Fornage, Myriam; Mitchell, Gary F; Smith, Nicholas L; Holm, Hilma; Stefansson, Kari; Thorleifsson, Gudmar; Thorsteinsdottir, Unnur; Samani, Nilesh J; Preuss, Michael; Rudan, Igor; Hayward, Caroline; Deary, Ian J; Wichmann, H-Erich; Raitakari, Olli T; Palmas, Walter; Kooner, Jaspal S; Stolk, Ronald P; Jukema, J Wouter; Wright, Alan F; Boomsma, Dorret I; Bandinelli, Stefania; Gyllensten, Ulf B; Wilson, James F; Ferrucci, Luigi; Schmidt, Reinhold; Farrall, Martin; Spector, Tim D; Palmer, Lyle J; Tuomilehto, Jaakko; Pfeufer, Arne; Gasparini, Paolo; Siscovick, David; Altshuler, David; Loos, Ruth JF; Toniolo, Daniela; Snieder, Harold; Gieger, Christian; Meneton, Pierre; Wareham, Nicholas J; Oostra, Ben A; Metspalu, Andres; Launer, Lenore; Rettig, Rainer; Strachan, David P; Beckmann, Jacques S; Witteman, Jacqueline CM; Erdmann, Jeanette; van Dijk, Ko Willems; Boerwinkle, Eric; Boehnke, Michael; Ridker, Paul M; Jarvelin, Marjo-Riitta; Chakravarti, Aravinda; Abecasis, Goncalo R; Gudnason, Vilmundur; Newton-Cheh, Christopher; Levy, Daniel; Munroe, Patricia B; Psaty, Bruce M; Caulfield, Mark J; Rao, Dabeeru C

2012-01-01

Numerous genetic loci influence systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans 1-3. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N=74,064) and follow-up studies (N=48,607), we identified at genome-wide significance (P= 2.7×10-8 to P=2.3×10-13) four novel PP loci (at 4q12 near CHIC2/PDGFRAI, 7q22.3 near PIK3CG, 8q24.12 in NOV, 11q24.3 near ADAMTS-8), two novel MAP loci (3p21.31 in MAP4, 10q25.3 near ADRB1) and one locus associated with both traits (2q24.3 near FIGN) which has recently been associated with SBP in east Asians. For three of the novel PP signals, the estimated effect for SBP was opposite to that for DBP, in contrast to the majority of common SBP- and DBP-associated variants which show concordant effects on both traits. These findings indicate novel genetic mechanisms underlying blood pressure variation, including pathways that may differentially influence SBP and DBP. PMID:21909110

The Relationship Between Preoperative and Primary Care Blood Pressure Among Veterans Presenting from Home for Surgery. Is There Evidence for Anesthesiologist-Initiated Blood Pressure Referral?

PubMed Central

Schonberger, Robert B.; Burg, Matthew M.; Holt, Natalie; Lukens, Carrie L.; Dai, Feng; Brandt, Cynthia

2011-01-01

SBP≥146mmHg had 95.9% estimated specificity (95% CI 94.4 to 97.0) for identifying subsequent primary care SBP≥140mmHg and estimated sensitivity of 26.8% (95% CI 22.0 to 32.0). A similarly high specificity using a single DOS SBP required a threshold SBP≥160mmHg, for which estimated specificity was 95.2% (95% CI 94.2 to 96.1). For DBP, a presenting DOS DBP≥92mmHg had 95.7% specificity (95% CI 94.8 to 96.4) for subsequent primary care DBP≥90mmHg with a sensitivity of 18.8% (95% CI 14.4 to 24.0). Conclusion A small bias toward higher DOS blood pressures relative to subsequent primary care measurements was observed. DOS factors predicted only a small proportion of the observed variation. Accounting for the observed bias, a two-stage SBP threshold and a single-reading DBP threshold were highly specific though insensitive for identifying subsequent primary care blood pressure elevation. PMID:22075017

Validation of the TONOPORT VI ambulatory blood pressure monitor in adults according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Abou-Dakn, M; Döhmen, C; Wenzel, S

2017-02-01

The present study aims to examine the performance of the TONOPORT VI ambulatory blood pressure (BP) monitor in the inflation and deflation measurement methods, according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP 2010). Systolic and diastolic blood pressures (SBP and DBP, respectively) of 33 subjects (23 female, 10 male) were sequentially measured and compared with reference measurements obtained by two observers using a standard mercury sphygmomanometer. The subjects were selected according to the recruitment instructions of the ESH-IP 2010. Three comparative readings were performed per subject. Among the 99 readings in the inflation measurement method were 92/94 (SBP/DBP) with differences ⩽5, 97/99 ⩽10 and 98/99 ⩽15 mm Hg. All of the 33 subjects had at least 2 out of 3 comparative readings with differences ⩽5 mm Hg and 0/0 of the subjects had no reading ⩽15 mm Hg. The validation of the deflation measurement method resulted in differences where 93/91 were ⩽5, 98/98 were ⩽10, and 99/99 were ⩽15 mm Hg. Thirty-two of the 33 subjects had at least 2 out of 3 comparative readings ⩽5 mm Hg and 0/0 of the subjects had no reading ⩽15 mm Hg. In conclusion, the TONOPORT VI, respectively, in the inflation and deflation measurement methods met all requirements of Part 1 and 2 of the ESH-IP 2010. Based on the study results, the TONOPORT VI can be recommended for BP measurements in adults.

Blood pressure reactivity in the evaluation of resting blood pressure and mood responses to pindolol and propranolol in hypertensive patients.

PubMed

Potempa, K M; Fogg, L F; Fish, A F; Kravitz, H M

1993-01-01

The purpose of this exploratory study was to evaluate the relationship of blood pressure reactivity during exercise to treatment responsiveness to two commonly used beta-adrenergic blocking agents, propranolol and pindolol. Prospective, placebo-controlled, balanced, cross-over clinical trial. University-affiliated medical center. A convenience sample of 19 white male subjects with mild to moderate essential hypertension were studied. The mean age was 63.4 years (SD = 5.2). The mean resting systolic blood pressure (SBP) was 158.6 mm Hg (SD = 12.3) and mean resting diastolic blood pressure (DBP) was 96.4 mm Hg (SD = 8.6). They had no clinical evidence of secondary hypertension, diabetes, heart, liver, pulmonary, or renal disease. Resting blood pressure; blood pressure reactivity to exercise; self-report measures of depressive symptoms, and mood disturbances. Antihypertensive medication was tapered off and subjects were free of all prescription drugs for 2 weeks. Subjects were randomly assigned to propranolol-pindolol or pindolol-propranolol group. Each 4- to 6-week treatment phase was preceded by a 2-week placebo phase. At the end of the initial placebo phase and each active drug treatment phase, subjects were assessed for depression and mood disturbances by use of standardized measures and were given a graded exercise test on a cycle ergometer. Resting blood pressure was assessed weekly and before each exercise test. Significant relationships between DBP reactivity to exercise during the placebo phase and the degree of blood pressure and mood responsiveness to pindolol and propranolol treatment were observed. Subjects demonstrating high DBP reactivity required high doses of beta-blocker for resting DBP reduction, and these subjects showed the least change in mood at high doses. Similar patterns were found for the relationship of SBP reactivity and blood pressure and mood responsiveness to drug treatment, but these relationships were not statistically significant

Isolation and characterization of the DNA-binding protein (DBP) of the Autographa californica multiple nucleopolyhedrovirus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mikhailov, Victor S.; N. K. Koltzov Institute of Developmental Biology, Russian Academy of Sciences, Moscow 117808; Vanarsdall, Adam L.

2008-01-20

DNA-binding protein (DBP) of Autographa californica multiple nucleopolyhedrovirus (AcMNPV) was expressed as an N-terminal His{sub 6}-tag fusion using a recombinant baculovirus and purified to near homogeneity. Purified DBP formed oligomers that were crosslinked by redox reagents resulting in predominantly protein dimers and tetramers. In gel retardation assays, DBP showed a high affinity for single-stranded oligonucleotides and was able to compete with another baculovirus SSB protein, LEF-3, for binding sites. DBP binding protected ssDNA against hydrolysis by a baculovirus alkaline nuclease AN/LEF-3 complex. Partial proteolysis by trypsin revealed a domain structure of DBP that is required for interaction with DNA andmore » that can be disrupted by thermal treatment. Binding to ssDNA, but not to dsDNA, changed the pattern of proteolytic fragments of DBP indicating adjustments in protein structure upon interaction with ssDNA. DBP was capable of unwinding short DNA duplexes and also promoted the renaturation of long complementary strands of ssDNA into duplexes. The unwinding and renaturation activities of DBP, as well as the DNA binding activity, were sensitive to sulfhydryl reagents and were inhibited by oxidation of thiol groups with diamide or by alkylation with N-ethylmaleimide. A high affinity of DBP for ssDNA and its unwinding and renaturation activities confirmed identification of DBP as a member of the SSB/recombinase family. These activities and a tight association with subnuclear structures suggests that DBP is a component of the virogenic stroma that is involved in the processing of replicative intermediates.« less

Biodegradability of DBP precursors after drinking water ozonation.

PubMed

de Vera, Glen Andrew; Keller, Jurg; Gernjak, Wolfgang; Weinberg, Howard; Farré, Maria José

2016-12-01

Ozonation is known to generate biodegradable organic matter, which is typically reduced by biological filtration to avoid bacterial regrowth in distribution systems. Post-chlorination generates halogenated disinfection byproducts (DBPs) but little is known about the biodegradability of their precursors. This study determined the effect of ozonation and biofiltration conditions, specifically ozone exposure and empty bed contact time (EBCT), on the control of DBP formation potentials in drinking water. Ozone exposure was varied through addition of H 2 O 2 during ozonation at 1 mgO 3 /mgDOC followed by biological filtration using either activated carbon (BAC) or anthracite. Ozonation led to a 10% decrease in dissolved organic carbon (DOC), without further improvement from H 2 O 2 addition. Raising H 2 O 2 concentrations from 0 to 2 mmol/mmolO 3 resulted in increased DBP formation potentials during post-chlorination of the ozonated water (target Cl 2 residual after 24 h = 1-2 mg/L) as follows: 4 trihalomethanes (THM4, 37%), 8 haloacetic acids (HAA8, 44%), chloral hydrate (CH, 107%), 2 haloketones (HK2, 97%), 4 haloacetonitriles (HAN4, 33%), trichloroacetamide (TCAM, 43%), and adsorbable organic halogen (AOX, 27%), but a decrease in the concentrations of 2 trihalonitromethanes (THNM2, 43%). Coupling ozonation with biofiltration prior to chlorination effectively lowered the formation potentials of all DBPs including CH, HK2, and THNM2, all of which increased after ozonation. The dynamics of DBP formation potentials during BAC filtration at different EBCTs followed first-order reaction kinetics. Minimum steady-state concentrations were attained at an EBCT of about 10-20 min, depending on the DBP species. The rate of reduction in DBP formation potentials varied among individual species before reaching their minimum concentrations. CH, HK2, and THNM2 had the highest rate constants of between 0.5 and 0.6 min -1 followed by HAN4 (0.4 min -1 ), THM4 (0.3 min -1 ), HAA8 (0

Removal efficiency and enzymatic mechanism of dibutyl phthalate (DBP) by constructed wetlands.

PubMed

Qi, Xin; Li, Tiancui; Wang, Feihua; Dai, Yanran; Liang, Wei

2018-06-01

Four vertical-flow constructed wetland systems were set up in the field in order to study the removal efficiency and possible enzymatic mechanism of the constructed wetlands in treating sewage containing different concentrations of dibutyl phthalate (DBP). Under DBP spiked concentrations of 0.5, 1.0, and 2.0 mg/L, good DBP removal rates of 62.08, 82.17, and 84.17% were achieved, respectively. Meanwhile, certain removal effects of general water quality parameters were observed in all four constructed wetlands: with high average removal rates of nitrate nitrogen (NO 3 - -N) and chemical oxygen demand (COD) of 91.10~93.89 and 82.83~89.17%, respectively, with moderate removal efficiencies of total nitrogen (TN), total phosphorus (TP), ammonia nitrogen (NH 4 + -N) of 44.59~49.67, 30.58~37.18, and 28.52~37.45%, respectively. Compared to the control, an increase of enzyme activities of urease, phosphatase, dehydrogenase, and nitrate reductase was observed in the treatments with DBP addition. In the presence of 0.5 mg/L of DBP concentration, the urease, phosphatase, and dehydrogenase activities reached the highest levels, with an increase of 350.02, 36.57, and 417.88% compared with the control, respectively. It appeared that the low concentration of DBP might better stimulate the release of enzymes.

Using RSSCTs to predict field-scale GAC control of DBP formation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cummings, L.; Summers, R.S.

1994-06-01

The primary objective of this study was to evaluate the use of the rapid small-scale column test (RSSCT) for predicting the control of disinfection by-product (DBP) formation by granular activated carbon (GAC). DBP formation was assessed by using a simulated distribution system (SDS) test and measuring trihalomethanes and total organic halide in the influent and effluent of the laboratory- and field-scale columns. It was observed that for the water studied, the RSSCTs effectively predicted the nonabsorbable fraction, time to 50 percent breakthrough, and the shape of the breakthrough curve for DBP formation. The advantage of RSSCTs is that conclusions aboutmore » the amenability of a GAC for DBP control can be reached in a short time period instead of at the end of a long-term pilot study. The authors recommend that similar studies be conducted with a range of source waters because the effectiveness of GAC is site-specific.« less

Influence of geomagnetic activity and atmospheric pressure on human arterial pressure during the solar cycle 24

NASA Astrophysics Data System (ADS)

Azcárate, T.; Mendoza, B.; Levi, J. R.

2016-11-01

We performed a study of the systolic (SBP) and diastolic (DBP) arterial blood pressure behavior under natural variables such as the atmospheric pressure (AtmP) and the horizontal geomagnetic field component (H). We worked with a sample of 304 healthy normotense volunteers, 152 men and 152 women, with ages between 18 and 84 years in Mexico City during the period 2008-2014, corresponding to the minimum, ascending and maximum phases of the solar cycle 24. The data was divided by gender, age and day/night cycle. We studied the time series using three methods: Correlations, bivariate and superposed epochs (within a window of three days around the day of occurrence of a geomagnetic storm) analysis, between the SBP and DBP and the natural variables (AtmP and H). The correlation analysis indicated correlation between the SBP and DBP and AtmP and H, being the largest during the night. Furthermore, the correlation and bivariate analysis showed that the largest correlations are between the SBP and DBP and the AtmP. The superposed epoch analysis found that the largest number of significant SBP and DBP changes occurred for women. Finally, the blood pressure changes are larger during the solar minimum and ascending solar cycle phases than during the solar maximum; the storms of the minimum were more intense than those of the maximum and this could be the reason of behavior of the blood pressure changes along the solar cycle.

Blood pressure and pain sensitivity in children and adolescents.

PubMed

Drouin, Sammantha; McGrath, Jennifer J

2013-06-01

Elevated blood pressure is associated with diminished pain sensitivity. While this finding is well established in adults, it is less clear when the relation between blood pressure and pain sensitivity emerges across the life course. Evidence suggests this phenomenon may exist during childhood. Children (N = 309; 56% boys) aged 10-15 years and their parents participated. Blood pressure readings were taken during a resting baseline. Maximum pain intensity was rated using a visual analogue scale (rated 0-10) in response to a finger prick pain induction. Parent-measured resting blood pressure was inversely associated with boys' pain ratings only. Cross-sectionally, lower pain ratings were related to higher SBP, univariately. Longitudinally, pain ratings predicted higher DBP, even after controlling for covariates. Determining when and how the relation between blood pressure and pain sensitivity emerges may elucidate the pathophysiology of hypertension. Copyright © 2013 Society for Psychophysiological Research.

Simultaneous validation of the SunTech CT40 automated blood pressure measurement device by the 1993 British Hypertension Society protocol and the Association for the Advancement of Medical Instrumentation/International Organization for Standardization 81060-2: 2013 standard.

PubMed

Polo Friz, Hernan; Punzi, Veronica; Petri, Francesco; Orlandi, Riccardo; Maggiolini, Daniele; Polo Friz, Melisa; Primitz, Laura; Vighi, Giuseppe

2017-10-01

This study aimed to perform a simultaneous, third-party, independent validation of the oscillometric SunTech CT40 device for blood pressure (BP) measurement, according to the 1993 protocol of the British Hypertension Society and the standard of the Association for the Advancement of Medical Instrumentation (AAMI)/the International Organization for Standardization (ISO) 81060-2:2013. Patient recruitment, study procedures, and data analysis followed the recommendations stated by the protocols. The study was approved by the institutional review board. A total of 94 participants were included, 52 (55.3%) women, mean±SD age: 63.1±18.0 years, mean±SD arm circumference: 35.0±9.0 cm. The average of observers' entry BPs was 146.9±37.2 mmHg for systolic blood pressure (SBP) and 82.2±22.1 mmHg for diastolic blood pressure (DBP). Differences between the standard measurement and the test device within 5, 10, and 15 mmHg, for the better observer, were 79.4, 96.5, and 100.0% for SBP and 82.6, 97.5, and 100.0% for DBP, respectively. The mean±SD differences between the readings obtained using the test device and those obtained by the observers (AAMI/ISO 81060-2:2013 standard criterion 1) were 0.3±5.0 mmHg (SBP) and -0.8±4.3 mmHg (DBP), and the mean±SD differences between average of reference readings and average of test device readings in each patient (criterion 2) were 0.3±3.9 and -0.8±3.5 mmHg for SBP and DBP, respectively. The CT40 BP device achieved A/A grade of the British Hypertension Society protocol and fulfilled the requirements (criteria 1 and 2) of the AAMI/ISO standard. CT40 can be recommended for BP measurement in adults.

Regulation of glucose-dependent gene expression by the RNA helicase Dbp2 in Saccharomyces cerevisiae.

PubMed

Beck, Zachary T; Cloutier, Sara C; Schipma, Matthew J; Petell, Christopher J; Ma, Wai Kit; Tran, Elizabeth J

2014-11-01

Cellular homeostasis requires a fine balance between energy uptake, utilization, and growth. Dbp2 is a member of the DEAD-box protein family in Saccharomyces cerevisiae with characterized ATPase and helicase activity in vitro. DEAD-box RNA helicases are a class of enzymes that utilize ATP hydrolysis to remodel RNA and/or RNA-protein (RNP) composition. Dbp2 has been proposed to utilize its helicase activity in vivo to promote RNA-protein complex assembly of both messenger (m)RNAs and long noncoding (lnc)RNAs. Previous work from our laboratory demonstrated that loss of DBP2 enhances the lncRNA-dependent transcriptional induction of the GAL genes by abolishing glucose-dependent repression. Herein, we report that either a carbon source switch or glucose deprivation results in rapid export of Dbp2 to the cytoplasm. Genome-wide RNA sequencing identified a new class of antisense hexose transporter transcripts that are specifically upregulated upon loss of DBP2. Further investigation revealed that both sense and antisense hexose transporter (HXT) transcripts are aberrantly expressed in DBP2-deficient cells and that this expression pathway can be partially mimicked in wild-type cells by glucose depletion. We also find that Dbp2 promotes ribosome biogenesis and represses alternative ATP-producing pathways, as loss of DBP2 alters the transcript levels of ribosome biosynthesis (snoRNAs and associated proteins) and respiration gene products. This suggests that Dbp2 is a key integrator of nutritional status and gene expression programs required for energy homeostasis. Copyright © 2014 by the Genetics Society of America.

Inhibition of angiogenesis by vitamin D-binding protein: characterization of anti-endothelial activity of DBP-maf.

PubMed

Kalkunte, Satyan; Brard, Laurent; Granai, Cornelius O; Swamy, Narasimha

2005-01-01

Angiogenesis is a complex process involving coordinated steps of endothelial cell activation, proliferation, migration, tube formation and capillary sprouting with participation of intracellular signaling pathways. Regulation of angiogenesis carries tremendous potential for cancer therapy. Our earlier studies showed that vitamin D-binding protein-macrophage activating factor (DBP-maf) acts as a potent anti-angiogenic factor and inhibits tumor growth in vivo. The goal of this investigation was to understand the effect of DBP-maf on human endothelial cell (HEC) and the mechanism of angiogenesis inhibition. DBP-maf inhibited human endothelial cell (HEC) proliferation by inhibiting DNA synthesis (IC(50) = 7.8 +/- 0.15 microg/ml). DBP-maf significantly induced S- and G0/G1-phase arrest in HEC in 72 h. DBP-maf potently blocked VEGF-induced migration, tube-formation of HEC in a dose dependent manner. In addition, DBP-maf inhibited growth factor-induced microvessel sprouting in rat aortic ring assay. Moreover, DBP-maf inhibited VEGF signaling by decreasing VEGF-mediated phosphorylation of VEGFR-2 and ERK1/2, a downstream target of VEGF signaling cascade. However, Akt activation was not affected. These studies collectively demonstrate that DBP-maf inhibits angiogenesis by blocking critical steps such as HEC proliferation, migration, tube formation and microvessel sprouting. DBP-maf exerts its effect by inhibiting VEGR-2 and ERK1/2 signaling cascades. Understanding the cellular and molecular mechanisms of anti-endothelial activity of DBP-maf will allow us to develop it as an angiogenesis targeting novel drug for tumor therapy.

A novel wearable device for continuous, non-invasion blood pressure measurement.

PubMed

Xin, Qin; Wu, Jianping

2017-08-01

In this paper, we have developed a wearable cuffless device for daily blood pressure (BP) measurement. We incorporated the light based sensor and other hard wares in a small volume for BP detection. With optimized algorithm, the real-time BP reading could be achieved, the data could be presented in the screen and be transmitted by internet of things (IoT) for history data comparison and multi-terminal viewing. Thus, further analysis provides the probability for diet or sports suggestion and alarm. We have measured BP from more than 60 subjects, compare to traditional mercury blood pressure meter, no obvious error in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) are detected. Such device can be used for continues non-invasion BP detection, and further data docking and health analysis could be achieved. Copyright © 2017. Published by Elsevier Ltd.

Vitamin D binding protein-macrophage activating factor (DBP-maf) inhibits angiogenesis and tumor growth in mice.

PubMed

Kisker, Oliver; Onizuka, Shinya; Becker, Christian M; Fannon, Michael; Flynn, Evelyn; D'Amato, Robert; Zetter, Bruce; Folkman, Judah; Ray, Rahul; Swamy, Narasimha; Pirie-Shepherd, Steven

2003-01-01

We have isolated a selectively deglycosylated form of vitamin D binding protein (DBP-maf) generated from systemically available DBP by a human pancreatic cancer cell line. DBP-maf is antiproliferative for endothelial cells and antiangiogenic in the chorioallantoic membrane assay. DBP-maf administered daily was able to potently inhibit the growth of human pancreatic cancer in immune compromised mice (T/C=0.09). At higher doses, DBP-maf caused tumor regression. Histological examination revealed that treated tumors had a higher number of infiltrating macrophages as well as reduced microvessel density, and increased levels of apoptosis relative to untreated tumors. Taken together, these data suggest that DBP-maf is an antiangiogenic molecule that can act directly on endothelium as well as stimulate macrophages to attack both the endothelial and tumor cell compartment of a growing malignancy.

Real-Time Detection of Dust Devils from Pressure Readings

NASA Technical Reports Server (NTRS)

Wagstaff, Kiri

2009-01-01

A method for real-time detection of dust devils at a given location is based on identifying the abrupt, temporary decreases in atmospheric pressure that are characteristic of dust devils as they travel through that location. The method was conceived for use in a study of dust devils on the Martian surface, where bandwidth limitations encourage the transmission of only those blocks of data that are most likely to contain information about features of interest, such as dust devils. The method, which is a form of intelligent data compression, could readily be adapted to use for the same purpose in scientific investigation of dust devils on Earth. In this method, the readings of an atmospheric- pressure sensor are repeatedly digitized, recorded, and processed by an algorithm that looks for extreme deviations from a continually updated model of the current pressure environment. The question in formulating the algorithm is how to model current normal observations and what minimum magnitude deviation can be considered sufficiently anomalous as to indicate the presence of a dust devil. There is no single, simple answer to this question: any answer necessarily entails a compromise between false detections and misses. For the original Mars application, the answer was sought through analysis of sliding time windows of digitized pressure readings. Windows of 5-, 10-, and 15-minute durations were considered. The windows were advanced in increments of 30 seconds. Increments of other sizes can also be used, but computational cost increases as the increment decreases and analysis is performed more frequently. Pressure models were defined using a polynomial fit to the data within the windows. For example, the figure depicts pressure readings from a 10-minute window wherein the model was defined by a third-degree polynomial fit to the readings and dust devils were identified as negative deviations larger than both 3 standard deviations (from the mean) and 0.05 mbar in magnitude. An

Arabidopsis Protein Phosphatase DBP1 Nucleates a Protein Network with a Role in Regulating Plant Defense

PubMed Central

Naumann, Kai; Lassowskat, Ines; Navarrete-Gómez, Marisa; Scheel, Dierk; Vera, Pablo

2014-01-01

Arabidopsis thaliana DBP1 belongs to the plant-specific family of DNA-binding protein phosphatases. Although recently identified as a novel host factor mediating susceptibility to potyvirus, little is known about DBP1 targets and partners and the molecular mechanisms underlying its function. Analyzing changes in the phosphoproteome of a loss-of-function dbp1 mutant enabled the identification of 14-3-3λ isoform (GRF6), a previously reported DBP1 interactor, and MAP kinase (MAPK) MPK11 as components of a small protein network nucleated by DBP1, in which GRF6 stability is modulated by MPK11 through phosphorylation, while DBP1 in turn negatively regulates MPK11 activity. Interestingly, grf6 and mpk11 loss-of-function mutants showed altered response to infection by the potyvirus Plum pox virus (PPV), and the described molecular mechanism controlling GRF6 stability was recapitulated upon PPV infection. These results not only contribute to a better knowledge of the biology of DBP factors, but also of MAPK signalling in plants, with the identification of GRF6 as a likely MPK11 substrate and of DBP1 as a protein phosphatase regulating MPK11 activity, and unveils the implication of this protein module in the response to PPV infection in Arabidopsis. PMID:24595057

Effect of di-n-butyl phthalate (DBP) on the fruit quality of cucumber and the health risk.

PubMed

Wang, Lei; Sun, Xin; Chang, Qin; Tao, Yue; Wang, Lihua; Dong, Junwei; Lin, Yulong; Zhang, Ying

2016-12-01

Di-n-butyl phthalate (DBP) widely used as plastic films' plasticizer, can cause agricultural pollution which is of increasing concern because of the food safety issues. Cucumber ( Cucumis sativus Linn.), commonly cultured in greenhouse, was exposed to DBP stress to gain more information about the ecological risk of DBP in this study. Changes of DBP residues and fruit quality of cucumber at different DBP concentrations (0, 5, 10, 20, 40 mg/kg of dry soil) were investigated in pot experiments using an agricultural soil under greenhouse condition, respectively. DBP residue in cucumber fruits ranged from 0.5326 to 1.8938 mg/kg, and the quality of cucumber fruits (organic acids, vitamin C, soluble protein, and soluble sugar) were influenced by DBP stress. Moreover, the health risk assessment was evaluated by estimate daily intakes (EDI) and the target hazard quotient (THQ) was analyzed. Under 40 mg/kg DBP condition, the highest value of EDI was 2.49 μg/kg bw/day and the THQ ranged from 0.000700 to 0.0249. Although the risk of DBP in cucumber fruits was lower than the threshold limit value of risk, the potential health risk was not a negligible issue.

Unfair treatment and trait anger in relation to nighttime ambulatory blood pressure in African American and white adolescents.

PubMed

Beatty, Danielle L; Matthews, Karen A

2009-10-01

To determine if ambulatory blood pressure (ABP) at night relative to day ABP among adolescents is influenced by unfair treatment and trait anger, and whether these associations are stronger in African Americans and adolescents from lower socioeconomic status (SES) families and neighborhoods. A total of 189 healthy white and African American adolescents (ages = 14-16 years, standard deviation = 0.62, 50% female) completed 2 days and 1 night of ABP monitoring and unfair treatment and trait anger questionnaires. SES was measured using 1) parental education and 2) a composite neighborhood SES score based on U.S. Census tract data for neighborhood poverty and education. The night/day ABP ratio was calculated by dividing the night ABP mean (readings from the self-reported bedtime of each participant through 5 AM) by the day ABP mean (8:30 AM until self-reported bedtime). Higher trait anger was associated with a higher night/day diastolic blood pressure (DBP) ratio in the full sample, B = 0.003, SE = 0.001, t = 2.20, p = .03. A significant interaction effect for Race x Unfair Treatment on the night/day DBP ratio, B = 0.01, SE = 0.003, t = 3.17, p = .002, followed by post hoc tests indicated that greater unfair treatment was associated with a higher night/day DBP ratio among African Americans, B = 0.006, SE = 0.002, t = 2.56, p = .01. Further, among African American adolescents living in lower SES neighborhoods, greater unfair treatment predicted a higher night/day DBP ratio, B = 0.008, SE = 0.003, t = 3.15, p = .002, and higher trait anger scores predicted a higher night/day DBP ratio, B = 0.008, SE = 0.002, t = 3.19, p = .002. Trait anger may be a factor leading to elevated nighttime DBP in both African Americans and whites. Unfair treatment and trait anger are important predictors of elevated night/day ABP ratios among African American adolescents living in lower SES neighborhoods. These factors may contribute to the onset of hypertension in African Americans at a

Diastolic blood pressure-estimated left ventricular dp/dt.

PubMed

Yilmaz, Hüseyin; Minareci, Kenan; Kabukçu, Mehmet; Sancaktar, Oktay

2002-02-01

Peak dp/dt is one of the best isovolumic phase indexes of the myocardial contractile state requiring invasive procedures or presence of mitral regurgitation severe enough to measure in clinical practice by Doppler echocardiography. In this study, we sought the correlation between two noninvasive methods of measurements for left ventricular dp/dt-diastolic blood pressure- (DBP) estimated and continuous-wave Doppler-derived dp/dt-min electrocardiographic/echocardiographic study to emphasize the clinical feasibility of the DBP-estimated method. Thirty-six randomized patients (27 male, 9 female; 58 +/- 8 years) with mild mitral regurgitation were enrolled in this study. DBP-estimated dp/dt was calculated from DBP minus the left ventricular end-diastolic pressure (LVEDP) over the isovolumetric contraction time (IVCT). LVEDP was assumed to be 10 mmHg for all patients. Doppler-determined left ventricular dp/dt was derived from the continuous-wave Doppler spectrum of mitral regurgitation jet by dividing the magnitude of the left ventricular atrial pressure gradient rise between 1 mm/sec-3 mm/sec of mitral regurgitant velocity signal by the time taken for this change. Left ventricular dp/dt by Doppler was 1122 +/- 303 mmHg/sec and blood pressure-estimated dp/dt was 1063 +/- 294 mmHg/sec. There was a high correlation (r = 0.97, P < 0.001) of dp/dt between the two techniques. DBP and IVCT can generate left ventricular dp/dt without invasive procedures, even in the absence of mitral regurgitation in clinical practice.

Does the Position or Contact Pressure of the Stethoscope Make Any Difference to Clinical Blood Pressure Measurements

PubMed Central

Pan, Fan; Zheng, Dingchang; He, Peiyu; Murray, Alan

2014-01-01

Abstract This study aimed to investigate the effect of stethoscope position and contact pressure on auscultatory blood pressure (BP) measurement. Thirty healthy subjects were studied. Two identical stethoscopes (one under the cuff, the other outside the cuff) were used to simultaneously and digitally record 2 channels of Korotkoff sounds during linear cuff pressure deflation. For each subject, 3 measurements with different contact pressures (0, 50, and 100 mm Hg) on the stethoscope outside the cuff were each recorded at 3 repeat sessions. The Korotkoff sounds were replayed twice on separate days to each of 2 experienced listeners to determine systolic and diastolic BPs (SBP and DBP). Variance analysis was performed to study the measurement repeatability and the effect of stethoscope position and contact pressure on BPs. There was no significant BP difference between the 3 repeat sessions, between the 2 determinations from each listener, between the 2 listeners and between the 3 stethoscope contact pressures (all P > 0.06). There was no significant SBP difference between the 2 stethoscope positions at the 2 lower stethoscope pressures (P = 0.23 and 0.45), but there was a small (0.4 mm Hg, clinically unimportant) significant difference (P = 0.005) at the highest stethoscope pressure. The key result was that, DBP from the stethoscope under the cuff was significantly lower than that from outside the cuff by 2.8 mm Hg (P < 0.001, 95% confidence interval −3.5 to −2.1 mm Hg). Since it is known that the traditional Korotkoff sound method, with the stethoscope outside the cuff, tends to give a higher DBP than the true intra-arterial pressure, this study could suggest that the stethoscope position under the cuff, and closer to the arterial occlusion, might yield measurements closer to the actual invasive DBP. PMID:25546675

Blood pressure response to renal denervation is correlated with baseline blood pressure variability: a patient-level meta-analysis.

PubMed

Persu, Alexandre; Gordin, Daniel; Jacobs, Lotte; Thijs, Lutgarde; Bots, Michiel L; Spiering, Wilko; Miroslawska, Atena; Spaak, Jonas; Rosa, Ján; de Jong, Mark R; Berra, Elena; Fadl Elmula, Fadl Elmula M; Wuerzner, Gregoire; Taylor, Alison H M; Olszanecka, Agnieszka; Czarnecka, Danuta; Mark, Patrick B; Burnier, Michel; Renkin, Jean; Kjeldsen, Sverre E; Widimský, Jiří; Elvan, Arif; Kahan, Thomas; Steigen, Terje K; Blankestijn, Peter J; Tikkanen, Ilkka; Staessen, Jan A

2018-02-01

Sympathetic tone is one of the main determinants of blood pressure (BP) variability and treatment-resistant hypertension. The aim of our study was to assess changes in BP variability after renal denervation (RDN). In addition, on an exploratory basis, we investigated whether baseline BP variability predicted the BP changes after RDN. We analyzed 24-h BP recordings obtained at baseline and 6 months after RDN in 167 treatment-resistant hypertension patients (40% women; age, 56.7 years; mean 24-h BP, 152/90 mmHg) recruited at 11 expert centers. BP variability was assessed by weighted SD [SD over time weighted for the time interval between consecutive readings (SDiw)], average real variability (ARV), coefficient of variation, and variability independent of the mean (VIM). Mean office and 24-h BP fell by 15.4/6.6 and 5.5/3.7 mmHg, respectively (P < 0.001). In multivariable-adjusted analyses, systolic/diastolic SDiw and VIM for 24-h SBP/DBP decreased by 1.18/0.63 mmHg (P ≤ 0.01) and 0.86/0.42 mmHg (P ≤ 0.05), respectively, whereas no significant changes in ARV or coefficient of variation occurred. Furthermore, baseline SDiw (P = 0.0006), ARV (P = 0.01), and VIM (P = 0.04) predicted the decrease in 24-h DBP but not 24-h SBP after RDN. RDN was associated with a decrease in BP variability independent of the BP level, suggesting that responders may derive benefits from the reduction in BP variability as well. Furthermore, baseline DBP variability estimates significantly correlated with mean DBP decrease after RDN. If confirmed in younger patients with less arterial damage, in the absence of the confounding effect of drugs and drug adherence, baseline BP variability may prove a good predictor of BP response to RDN.

The toothless osteopetrotic rat has a normal vitamin D-binding protein-macrophage activating factor (DBP-MAF) cascade and chondrodysplasia resistant to treatments with colony stimulating factor-1 (CSF-1) and/or DBP-MAF.

PubMed

Odgren, P R; Popoff, S N; Safadi, F F; MacKay, C A; Mason-Savas, A; Seifert, M F; Marks, S C

1999-08-01

The osteopetrotic rat mutation toothless (tl) is characterized by little or no bone resorption, few osteoclasts and macrophages, and chondrodysplasia at the growth plates. Short-term treatment of tl rats with colony-stimulating factor-1 (CSF-1) has been shown to increase the number of osteoclasts and macrophages, producing dramatic resolution of skeletal sclerosis at some, but not all, sites. Defects in production of vitamin D-binding protein-macrophage activating factor (DBP-MAF) have been identified in two other independent osteopetrotic mutations of the rat (op and ia), and two in the mouse (op and mi), in which macrophages and osteoclasts can be activated by the administration of exogenous DBP-MAF. The present studies were undertaken to examine the histology and residual growth defects in tl rats following longer CSF-1 treatments, to investigate the possibility that exogenous DBP-MAF might act synergistically with CSF-1 to improve the tl phenotype, and to assess the integrity of the endogenous DBP-MAF pathway in this mutation. CSF-1 treatment-with or without DBP-MAF-induced resorption of metaphyseal bone to the growth plate on the marrow side, improved slightly but did not normalize long bone growth, and caused no improvement in the abnormal histology of the growth plate. Injections of lysophosphatidylcholine (lyso-Pc) to prime macrophage activation via the DBP-MAF pathway raised superoxide production to similar levels in peritoneal macrophages from both normal and mutant animals, indicating no defect in the DBP-MAF pathway in tl rats. Interestingly, pretreatments with CSF-1 alone also increased superoxide production, although the mechanism for this remains unknown. In summary, we find that, unlike other osteopetrotic mutations investigated to date, the DBP-MAF pathway does not appear to be defective in the tl rat; that additional DBP-MAF does not augment the beneficial skeletal effects seen with CSF-1 alone; and that the growth plate chondrodystrophy seen in

DEAD-box RNA helicase Dbp4 is required for small-subunit processome formation and function.

PubMed

Soltanieh, Sahar; Osheim, Yvonne N; Spasov, Krasimir; Trahan, Christian; Beyer, Ann L; Dragon, François

2015-03-01

DEAD-box RNA helicase Dbp4 is required for 18S rRNA synthesis: cellular depletion of Dbp4 impairs the early cleavage reactions of the pre-rRNA and causes U14 small nucleolar RNA (snoRNA) to remain associated with pre-rRNA. Immunoprecipitation experiments (IPs) carried out with whole-cell extracts (WCEs) revealed that hemagglutinin (HA)-tagged Dbp4 is associated with U3 snoRNA but not with U14 snoRNA. IPs with WCEs also showed association with the U3-specific protein Mpp10, which suggests that Dbp4 interacts with the functionally active U3 RNP; this particle, called the small-subunit (SSU) processome, can be observed at the 5' end of nascent pre-rRNA. Electron microscopy analyses indicated that depletion of Dbp4 compromised SSU processome formation and cotranscriptional cleavage of the pre-rRNA. Sucrose density gradient analyses revealed that depletion of U3 snoRNA or the Mpp10 protein inhibited the release of U14 snoRNA from pre-rRNA, just as was seen with Dbp4-depleted cells, indicating that alteration of SSU processome components has significant consequences for U14 snoRNA dynamics. We also found that the C-terminal extension flanking the catalytic core of Dbp4 plays an important role in the release of U14 snoRNA from pre-rRNA. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

DEAD-Box RNA Helicase Dbp4 Is Required for Small-Subunit Processome Formation and Function

PubMed Central

Soltanieh, Sahar; Osheim, Yvonne N.; Spasov, Krasimir; Trahan, Christian; Beyer, Ann L.

2014-01-01

DEAD-box RNA helicase Dbp4 is required for 18S rRNA synthesis: cellular depletion of Dbp4 impairs the early cleavage reactions of the pre-rRNA and causes U14 small nucleolar RNA (snoRNA) to remain associated with pre-rRNA. Immunoprecipitation experiments (IPs) carried out with whole-cell extracts (WCEs) revealed that hemagglutinin (HA)-tagged Dbp4 is associated with U3 snoRNA but not with U14 snoRNA. IPs with WCEs also showed association with the U3-specific protein Mpp10, which suggests that Dbp4 interacts with the functionally active U3 RNP; this particle, called the small-subunit (SSU) processome, can be observed at the 5′ end of nascent pre-rRNA. Electron microscopy analyses indicated that depletion of Dbp4 compromised SSU processome formation and cotranscriptional cleavage of the pre-rRNA. Sucrose density gradient analyses revealed that depletion of U3 snoRNA or the Mpp10 protein inhibited the release of U14 snoRNA from pre-rRNA, just as was seen with Dbp4-depleted cells, indicating that alteration of SSU processome components has significant consequences for U14 snoRNA dynamics. We also found that the C-terminal extension flanking the catalytic core of Dbp4 plays an important role in the release of U14 snoRNA from pre-rRNA. PMID:25535329

Vitamin D Binding Protein-Macrophage Activating Factor (DBP-maf) Inhibits Angiogenesis and Tumor Growth in Mice1

PubMed Central

Kisker, Oliver; Onizuka, Shinya; Becker, Christian M; Fannon, Michael; Flynn, Evelyn; D'Amato, Robert; Zetter, Bruce; Folkman, Judah; Ray, Rahul; Swamy, Narasimha; Pirie-Shepherd, Steven

2003-01-01

Abstract We have isolated a selectively deglycosylated form of vitamin D binding protein (DBP-maf) generated from systemically available DBP by a human pancreatic cancer cell line. DBP-maf is antiproliferative for endothelial cells and antiangiogenic in the chorioallantoic membrane assay. DBP-maf administered daily was able to potently inhibit the growth of human pancreatic cancer in immune compromised mice (T/C=0.09). At higher doses, DBP-maf caused tumor regression. Histological examination revealed that treated tumors had a higher number of infiltrating macrophages as well as reduced microvessel density, and increased levels of apoptosis relative to untreated tumors. Taken together, these data suggest that DBP-maf is an antiangiogenic molecule that can act directly on endothelium as well as stimulate macrophages to attack both the endothelial and tumor cell compartment of a growing malignancy. PMID:12659668

A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly.

PubMed

Lv, Yue-Bin; Zhu, Peng-Fei; Yin, Zhao-Xue; Kraus, Virginia Byers; Threapleton, Diane; Chei, Choy-Lye; Brasher, Melanie Sereny; Zhang, Juan; Qian, Han-Zhu; Mao, Chen; Matchar, David Bruce; Luo, Jie-Si; Zeng, Yi; Shi, Xiao-Ming

2017-02-01

Higher or lower blood pressure may relate to cognitive impairment, whereas the relationship between blood pressure and cognitive impairment among the elderly is not well-studied. The study objective was to determine whether blood pressure is associated with cognitive impairment in the elderly, and, if so, to accurately describe the association. Cross-sectional data from the sixth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2011. Community-based setting in longevity areas in China. A total of 7144 Chinese elderly aged 65 years and older were included in the sample. Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured, pulse pressure (PP) was calculated as (SBP) - (DBP) and mean arterial pressures (MAP) was calculated as 1/3(SBP) + 2/3(DBP). Cognitive function was assessed via a validated Mini-Mental State Examination (MMSE). Based on the results of generalized additive models (GAMs), U-shaped associations were identified between cognitive impairment and SBP, DBP, PP, and MAP. The cutpoints at which risk for cognitive impairment (MMSE <24) was minimized were determined by quadratic models as 141 mm Hg, 85 mm Hg, 62 mm Hg, and 103 mm Hg, respectively. In the logistic models, U-shaped associations remained for SBP, DBP, and MAP but not PP. Below the identified cutpoints, each 1-mm Hg decrease in blood pressure corresponded to 0.7%, 1.1%, and 1.1% greater risk in the risk of cognitive impairment, respectively. Above the cutpoints, each 1-mm Hg increase in blood pressure corresponded to 1.2%, 1.8%, and 2.1% greater risk of cognitive impairment for SBP, DBP, and MAP, respectively. A U-shaped association between blood pressure and cognitive function in an elderly Chinese population was found. Recognition of these instances is important in identifying the high-risk population for cognitive impairment and to individualize blood pressure management for cognitive impairment prevention. Copyright © 2016

A U-shaped Association between Blood Pressure and Cognitive Impairment in Chinese Elderly

PubMed Central

Lv, Yue-Bin; Zhu, Peng-Fei; Yin, Zhao-Xue; Kraus, Virginia Byers; Threapleton, Diane; Chei, Choy-Lye; Brasher, Melanie Sereny; Zhang, Juan; Qian, Han-Zhu; Mao, Chen; Matchar, David Bruce; Luo, Jie-Si; Zeng, Yi; Shi, Xiao-Ming

2017-01-01

Objectives Higher or lower blood pressure may relate to cognitive impairment, while the relationship between blood pressure and cognitive impairment among the elderly is not well-studied. The study objective was to determine whether blood pressure is associated with cognitive impairment in the elderly, and, if so, to accurately describe the association. Design Cross-sectional data from the sixth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2011 Setting Community-based setting in longevity areas in China Participants 7,144 Chinese elderly aged 65 years and older were included in the sample Measures Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured, pulse pressure (PP) was calculated as (SBP)-(DBP) and mean arterial pressures (MAP) was calculated as 1/3(SBP) + 2/3(DBP). Cognitive function was assessed via a validated Mini-Mental State Examination (MMSE). Results Based on the results of generalized additive models (GAMs), U-shaped associations were identified between cognitive impairment and SBP, DBP, PP and MAP. The cut-points at which risk for cognitive impairment (MMSE<24) was minimized were determined by quadratic models as 141 mmHg, 85 mmHg, 62 mmHg and 103 mmHg, respectively. In the logistic models, U-shaped associations remained for SBP, DBP, and MAP but not PP. Below the identified cut-points, each 1mmHg decrease in blood pressure corresponded to 0.7%, 1.1%, and 1.1% greater risk in the risk of cognitive impairment, respectively. Above the cut-points, each 1mmHg increase in blood pressure corresponded to 1.2%, 1.8%, and 2.1% greater risk of cognitive impairment for SBP, DBP and MAP, respectively. Conclusion A U-shaped association between blood pressure and cognitive function in an elderly Chinese population was found. Recognition of these instances is important identifying the high-risk population for cognitive impairment and to individualize blood pressure management for cognitive impairment

Validation of the ROSSMAX blood pressure measuring monitor according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults.

PubMed

O'Brien, Eoin; Atkins, Neil; Murphy, Anne; Lyons, Simon

2003-12-01

It is now accepted that blood pressure measuring devices should be subjected to an independent evaluation of their accuracy before they are marketed for clinical use. The results of validation of the ROSSMAX Blood Pressure Measuring Monitor for self-measurement according to the European Society of Hypertension International Protocol for Validation of Blood Pressure Measuring Devices in Adults are presented in this paper. Thirty-three subjects were recruited from among staff and patients at Beaumont Hospital, Dublin, Ireland. The ROSSMAX monitor was connected to the Sphygmocorder, an audiovisual system for validation, which records blood pressure on tape and video for later analysis. Nine sequential same-arm measurements between the device and a standard mercury sphygmomanometer were recorded using the Sphygmocorder. In phase 1, the ROSSMAX monitor produced 21 measurements within 5 mmHg, 31 within 10 mmHg and 38 within 15 mmHg for systolic blood pressure (SBP), and 36 within 5 mmHg, 43 within 10 mmHg and 45 within 15 mmHg for diastolic blood pressure (DBP). The mean differences were -5.6 (10.2) [mean (SD)] mmHg for SBP and -0.5 (4.5) mmHg for DBP. The ROSSMAX monitor failed to meet any of the criteria for SBP but comfortably passed all of the criteria for DBP. In phase 2.1, the ROSSMAX monitor had 51 measurements within 5 mmHg, 73 within 10 mmHg and 86 within 15 mmHg for SBP, and 71 measurements within 5 mmHg, 93 within 10 mmHg and 98 within 15 mmHg for DBP. The mean differences were -4.5. (9.5) mmHg for SBP and -1.8 (5.0) mmHg for DBP. The ROSSMAX monitor failed to meet any of the criteria for SBP but comfortably passed all of the criteria for DBP. In phase 2.2, 16 subjects had at least two of the differences lying within 5 mmHg and 10 subjects had no differences within 5 mmHg for SBP; 26 subjects had at least two of the differences falling within 5 mmHg and three subjects no differences within 5 mmHg for DBP. The ROSSMAX monitor failed to meet the criteria for SBP

Models for predicting disinfection byproduct (DBP) formation in drinking waters: a chronological review.

PubMed

Chowdhury, Shakhawat; Champagne, Pascale; McLellan, P James

2009-07-01

Disinfection for the supply of safe drinking water forms a variety of known and unknown byproducts through reactions between the disinfectants and natural organic matter. Chronic exposure to disinfection byproducts through the ingestion of drinking water, inhalation and dermal contact during regular indoor activities (e.g., showering, bathing, cooking) may pose cancer and non-cancer risks to human health. Since their discovery in drinking water in 1974, numerous studies have presented models to predict DBP formation in drinking water. To date, more than 48 scientific publications have reported 118 models to predict DBP formation in drinking waters. These models were developed through laboratory and field-scale experiments using raw, pretreated and synthetic waters. This paper aims to review DBP predictive models, analyze the model variables, assess the model advantages and limitations, and to determine their applicability to different water supply systems. The paper identifies the current challenges and future research needs to better control DBP formation. Finally, important directions for future research are recommended to protect human health and to follow the best management practices.

DBP CONTROL IN DRINKING WATER: COST AND PERFORMANCE

EPA Science Inventory

The U.S. Environmental Protection Agency (U.S. EPA) is currently attempting to balance the complex trade-offs in chemical and microbial risks associated with controlling disinfection and disinfection byproducts (D/DBP) in drinking water. In attempting to achieve this balance, the...

Does the position or contact pressure of the stethoscope make any difference to clinical blood pressure measurements: an observational study.

PubMed

Pan, Fan; Zheng, Dingchang; He, Peiyu; Murray, Alan

2014-12-01

This study aimed to investigate the effect of stethoscope position and contact pressure on auscultatory blood pressure (BP) measurement. Thirty healthy subjects were studied. Two identical stethoscopes (one under the cuff, the other outside the cuff) were used to simultaneously and digitally record 2 channels of Korotkoff sounds during linear cuff pressure deflation. For each subject, 3 measurements with different contact pressures (0, 50, and 100 mm Hg) on the stethoscope outside the cuff were each recorded at 3 repeat sessions. The Korotkoff sounds were replayed twice on separate days to each of 2 experienced listeners to determine systolic and diastolic BPs (SBP and DBP). Variance analysis was performed to study the measurement repeatability and the effect of stethoscope position and contact pressure on BPs. There was no significant BP difference between the 3 repeat sessions, between the 2 determinations from each listener, between the 2 listeners and between the 3 stethoscope contact pressures (all P > 0.06). There was no significant SBP difference between the 2 stethoscope positions at the 2 lower stethoscope pressures (P = 0.23 and 0.45), but there was a small (0.4 mm Hg, clinically unimportant) significant difference (P = 0.005) at the highest stethoscope pressure. The key result was that, DBP from the stethoscope under the cuff was significantly lower than that from outside the cuff by 2.8 mm Hg (P < 0.001, 95% confidence interval -3.5 to -2.1 mm Hg). Since it is known that the traditional Korotkoff sound method, with the stethoscope outside the cuff, tends to give a higher DBP than the true intra-arterial pressure, this study could suggest that the stethoscope position under the cuff, and closer to the arterial occlusion, might yield measurements closer to the actual invasive DBP.

Plasma apelin levels, blood pressure and cardiovascular risk factors in a coastal Chinese population.

PubMed

Zhu, Pengli; Huang, Feng; Lin, Fan; Yuan, Yin; Chen, Falin; Li, Qiaowei

2013-11-01

To describe the relationship of plasma apelin levels with blood pressure in a coastal Chinese population. This cross-sectional study included a total of 1031 subjects from the coastal areas of China. One-way analysis of variance (ANOVA) and linear trend test, Pearson's correlation analysis, as well as multivariate linear regression analysis were used to evaluate the association between plasma apelin levels and blood pressure. Plasma apelin levels dropped with increasing quartiles of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MABP) (all P<0.001). SBP, DBP, and MABP values decreased as the apelin levels increased within the quartiles. After adjusting for age and gender, the significant differences in SBP, DBP, and MABP between the groups within the apelin quartiles remained (all P<0.05). A significant negative correlation between SBP, DBP, as well as MABP and apelin levels was observed (all P<0.01); even after adjusting for cardiovascular confounding factors, this negative correlation remained (all P<0.001). A negative correlation between plasma apelin levels and blood pressure was found in this 1000-population-based epidemiological study. Apelin may become a potential therapeutic target of anti-hypertensive treatment.

NTP-CERHR Monograph on the Potential Human Reproductive and Developmental Effects of Di-n-Butyl Phthalate (DBP).

PubMed

2003-04-01

TThe National Toxicology Program (NTP) Center for the Evaluation of Risks to Human Reproduction (CERHR) conducted an evaluation of the potential for di-n-butyl phthalate (DBP) to cause adverse effects on reproduction and development in humans. DBP is one of 7 phthalate chemicals evaluated by the NTP CERHR Phthalates Expert Panel. These phthalates were selected for evaluation because of high production volume, extent of human exposures, use in children's products, and/or published evidence of reproductive or developmental toxicity. Unlike many phthalates, DBP is not currently used as a plasticizer in polyvinyl chloride plastics. DBP is a component of latex adhesives and is used in cosmetics and other personal care products, as a plasticizer in cellulose plastics, and as a solvent for dyes. The results of this evaluation on DBP are published in a NTP-CERHR monograph which includes: 1) the NTP Brief, 2) the Expert Panel Report on the Reproductive and Developmental Toxicity of Di-n-Butyl Phthalate, and 3) public comments received on the Expert Panel Report. As stated in the NTP Brief, the NTP reached the following conclusions regarding the possible effects of exposure to DBP on human development and reproduction. First, although DBP could possibly affect human reproduction and development if exposures are sufficiently high, the NTP concludes that there is negligible concern for reproductive toxicity in exposed adults. Second, the NTP concludes that there is minimal concern for developmental effects when pregnant women are exposed to DBP levels estimated by the panel (2-10 mug/kg body weight/day). There is no direct evidence that exposure of people to DBP adversely affects reproduction or development, but studies reviewed by the expert panel show that oral exposure to high doses of DBP (>/=100 mg/kg body weight/day) may adversely affect the prenatal and early postnatal development in rodents. Finally, based on exposure estimates in women of reproductive age, the NTP

Relationship between somatotype and blood pressure in a group of institutionalized Venezuelan elders.

PubMed

Herrera, H; Rebato, E; Hernández, R; Hernández-Valera, Y; Alfonso-Sánchez, M A

2004-01-01

Somatotype, as an indirect measure of estimating body composition, provides an easy and comprehensive picture of body shape. Multiple investigations have shown the existence of an association between somatotype components and cardiovascular disease. The aim of the present study was to examine the association of somatotype with blood pressure during ageing. The Heath-Carter anthropometric somatotype and both systolic (SBP) and diastolic (DBP) blood pressures were recorded. The sample included 809 healthy institutionalized elders (370 males and 439 females) from geriatric units in Caracas, Venezuela. Ages ranged from 60 to 102 years. Product-moment correlation coefficients between somatotype components and both blood pressure readings were calculated. Principal component analysis and homogeneity analysis by means of alternative least squares tests were also performed. Females were more endomorphic and mesomorphic than males. Males were more ectomorphic than females. SBP showed a downward tendency with age in males, while in females the tendency was for the SBP to increase. Correlations among variables were from low to moderate and ranged from -0.37 to +0.34 in males, and from -0.18 to +0.32 in females. Correlations tended to be stronger in the younger age group and differences between sexes were found. A negative tendency in the correlation between ectomorphy and both SBP and DBP was found, except for the oldest age group, for which the correlation was positive. Endomorphy and mesomorphy showed a stable correlation pattern with blood pressure in males, while in females this pattern was more irregular and less consistent. Individuals with high levels of SBP and DBP had mean somatotypes, which were similar to those of other male groups characterized by myocardial infarct, coronary heart disease and the risk of hypertension, indicating that these somatotypes may be associated with cardiovascular risk factors. In particular, our results indicate that individuals who

Romantic Relationship Satisfaction and Ambulatory Blood Pressure During Social Interactions: Specificity or Spillover Effects?

PubMed

Cornelius, Talea; Birk, Jeffrey L; Edmondson, Donald; Schwartz, Joseph E

2018-05-08

People in high-quality romantic relationships tend to have lower blood pressure (BP). People may experience lower BP specifically when interacting with romantic partners. This study parsed the effects of different types of social interactions on ambulatory BP (ABP) and tested whether romantic relationship satisfaction moderated these effects during interactions with partners in particular (specificity) or with others (spillover; e.g., friends, co-workers). Partnered participants (N = 594) were drawn from a larger study on BP and cardiovascular health (age = 46.5 ± 9.3; 57.4% female). Participants reported on romantic relationship satisfaction and completed 24-hr ABP monitoring. At each reading, participants reported whether they had a social interaction and with whom. Multilevel models accounted for nesting of data over time. Romantic relationship satisfaction significantly modified the effects of some social interactions on systolic and diastolic BP (SBP, DBP). Participants with high (+1 SD) relationship satisfaction had significantly lower SBP (-0.77 mmHg, p = .02) during partner interactions compared with no social interaction; low-satisfaction (-1 SD) participants had a nonsignificant 0.59 mmHg increase (p = .14). A similar pattern emerged for DBP. Relationship satisfaction also modified SBP response during friend interactions (elevated SBP for low-satisfaction participants) and DBP response during "other" interactions (elevated DBP for high-satisfaction participants). Participants with high levels of romantic relationship satisfaction experienced significantly lower BP during social interactions with their partner compared with situations without social interaction. Although there was some evidence for spillover to other types of relationships, effects were largely restricted to partner interactions.

Impact of calibration on estimates of central blood pressures.

PubMed

Soender, T K; Van Bortel, L M; Møller, J E; Lambrechtsen, J; Hangaard, J; Egstrup, K

2012-12-01

Using the Sphygmocor device it is recommended that the radial pressure wave is calibrated for brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP). However it has been suggested that brachial-to-radial pressure amplification causes underestimation of central blood pressures (BPs) using this calibration. In the present study we examined if different calibrations had an impact on estimates of central BPs and on the clinical interpretation of our results. On the basis of ambulatory BP measurements, patients were categorized into patients with controlled, uncontrolled or resistant hypertension. We first calibrated the radial pressure wave as recommended and afterwards recalibrated the same pressure wave using brachial DBP and calculated mean arterial pressure. Recalibration of the pressure wave generated significantly higher estimates of central SBP (P=0.0003 and P<0.0001 at baseline and P=0.0001 and P=0.0002 after 6 months). Using recommended calibration we found a significant change in central SBP in both treatment groups (P=0.05 and P=0.01), however, after recalibrating significance was lost in patients with resistant hypertension (P=0.15). We conclude that calibration with DBP and mean arterial pressure produces higher estimates of central BPs than recommended calibration. The present study also shows that this difference between the two calibration methods can produce more than a systematic error and has an impact on interpretation of clinical results.

Professional Identity of a Reading Teacher: Responding to High-Stakes Testing Pressures

ERIC Educational Resources Information Center

Assaf, Lori Czop

2008-01-01

This case study explores the professional identity of one reading specialist, Marsha, who struggled with testing pressures at her urban elementary school in the U.S. It offers an in-depth look at how Marsha's instructional decisions and practices in a pull-out reading program aimed at helping English Language Learners (ELL) shifted when she was…

RIVERBANK FILTRATION: FATE OF DBP PRECURSORS AND SELECTED MICROORGANISMS

EPA Science Inventory

The fate of disinfection by-product (DBP) precursors and selected microorganisms during riverbank filtration (RBF) was monitored at three different mid-Western drinking water utilities. At all three sites, filtration (RBF) was monitored at three different mid-Western drinking wa...

Chromosomal localization and cDNA cloning of the human DBP and TEF genes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khatib, Z.A.; Inaba, T.; Valentine, M.

1994-09-15

The authors have isolated cDNA and genomic clones and determined the human chromosome positions of two genes encoding transcription factors expressed in the liver and the pituitary gland: albumin D-site-binding protein (DBP) and thyrotroph embryonic factor (TEF). Both proteins have been identified as members of the PAR (proline and acidic amino acid-rich) subfamily of bZIP transcription factors in the rat, but human homologues have not been characterized. Using a fluorescence in situ hybridization technique, the DBP locus was assigned to chromosome 19q13, and TEF to chromosome 22q13. Each assignment was confirmed by means of human chromosome segregation in somatic cellmore » hybrids. Coding sequences of DBP and TEF, extending beyond the bZIP domain to the PAR region, were highly conserved in both human-human and interspecies comparisons. Conservation of the exon-intron boundaries of each bZIP domain-encoding exon suggested derivation from a common ancestral gene. DBP and TEF mRNAs were expressed in all tissues and cell lines examined, including brain, lung, liver, spleen, and kidney. Knowledge of the human chromosome locations of these PAR proteins will facilitate studies to assess their involvement in carcinogenesis and other fundamental biological processes. 37 refs., 5 figs., 1 tab.« less

Nuclear Export of Pre-Ribosomal Subunits Requires Dbp5, but Not as an RNA-Helicase as for mRNA Export

PubMed Central

Neumann, Bettina; Wu, Haijia; Hackmann, Alexandra; Krebber, Heike

2016-01-01

The DEAD-box RNA-helicase Dbp5/Rat8 is known for its function in nuclear mRNA export, where it displaces the export receptor Mex67 from the mRNA at the cytoplasmic side of the nuclear pore complex (NPC). Here we show that Dbp5 is also required for the nuclear export of both pre-ribosomal subunits. Yeast temperature-sensitive dbp5 mutants accumulate both ribosomal particles in their nuclei. Furthermore, Dbp5 genetically and physically interacts with known ribosomal transport factors such as Nmd3. Similar to mRNA export we show that also for ribosomal transport Dbp5 is required at the cytoplasmic side of the NPC. However, unlike its role in mRNA export, Dbp5 does not seem to undergo its ATPase cycle for this function, as ATPase-deficient dbp5 mutants that selectively inhibit mRNA export do not affect ribosomal transport. Furthermore, mutants of GLE1, the ATPase stimulating factor of Dbp5, show no major ribosomal export defects. Consequently, while Dbp5 uses its ATPase cycle to displace the export receptor Mex67 from the translocated mRNAs, Mex67 remains bound to ribosomal subunits upon transit to the cytoplasm, where it is detectable on translating ribosomes. Therefore, we propose a model, in which Dbp5 supports ribosomal transport by capturing ribosomal subunits upon their cytoplasmic appearance at the NPC, possibly by binding export factors such as Mex67. Thus, our findings reveal that although different ribonucleoparticles, mRNAs and pre-ribosomal subunits, use shared export factors, they utilize different transport mechanisms. PMID:26872259

Nuclear Export of Pre-Ribosomal Subunits Requires Dbp5, but Not as an RNA-Helicase as for mRNA Export.

PubMed

Neumann, Bettina; Wu, Haijia; Hackmann, Alexandra; Krebber, Heike

2016-01-01

The DEAD-box RNA-helicase Dbp5/Rat8 is known for its function in nuclear mRNA export, where it displaces the export receptor Mex67 from the mRNA at the cytoplasmic side of the nuclear pore complex (NPC). Here we show that Dbp5 is also required for the nuclear export of both pre-ribosomal subunits. Yeast temperature-sensitive dbp5 mutants accumulate both ribosomal particles in their nuclei. Furthermore, Dbp5 genetically and physically interacts with known ribosomal transport factors such as Nmd3. Similar to mRNA export we show that also for ribosomal transport Dbp5 is required at the cytoplasmic side of the NPC. However, unlike its role in mRNA export, Dbp5 does not seem to undergo its ATPase cycle for this function, as ATPase-deficient dbp5 mutants that selectively inhibit mRNA export do not affect ribosomal transport. Furthermore, mutants of GLE1, the ATPase stimulating factor of Dbp5, show no major ribosomal export defects. Consequently, while Dbp5 uses its ATPase cycle to displace the export receptor Mex67 from the translocated mRNAs, Mex67 remains bound to ribosomal subunits upon transit to the cytoplasm, where it is detectable on translating ribosomes. Therefore, we propose a model, in which Dbp5 supports ribosomal transport by capturing ribosomal subunits upon their cytoplasmic appearance at the NPC, possibly by binding export factors such as Mex67. Thus, our findings reveal that although different ribonucleoparticles, mRNAs and pre-ribosomal subunits, use shared export factors, they utilize different transport mechanisms.

2014 CRL Blood Pressure Study of Life Insurance Applicants.

PubMed

Fulks, Michael; Dolan, Vera F; Stout, Robert L

2015-01-01

Objective .- Define the relative mortality risk by systolic (SBP) and diastolic blood pressure (DBP) in a relatively healthy cohort split by age and sex with adjustment for smoking status, other findings and admitted heart disease history. Method .- Blood pressure (BP in mm Hg), build, laboratory studies and limited medical history are collected when people apply for individual life insurance. Information on 2,472,706 applicants tested by Clinical Reference Laboratory from 1993 to 2007 was utilized with follow-up for vital status using the September 2011 Social Security Death Master File identifying 31,033 deaths. Data was analyzed by SBP and DBP split by age and sex accounting for smoking and for BMI, urine protein/creatinine ratio and history of heart disease in a Cox multivariate survival analysis. Separate analysis by admitted hypertension history was also conducted. Results are presented by SBP and DBP for 4 age-sex groups with and without added covariates beyond age and smoking status. Results .- Relative mortality progressively increased by SBP level from the 90 to 119 band (down to 80 in younger women) upward with little additional impact by DBP. Addition of covariates beyond age and smoking resulted in a 5% to 10% reduction in relative risk. Although high DBP had limited impact, a pulse pressure/SBP ratio >½ identified 1% of applicants at high mortality risk, with little difference in risk for ratios ≤½. Hypertension history with current BP control was associated with a 10% to 25% increase in relative mortality risk as compared to those with similar BP but no such history. Conclusion .- Increasing SBP is closely associated with increasing relative mortality, starting from the lowest SBP. Increasing DBP has little additional impact, but a pulse pressure/SBP ratio >½ is a potent marker of increased risk as well. Accounting for build and other laboratory findings reduces risk modestly. A history of hypertension with current control increases risk.

Low diastolic blood pressure and adverse outcomes in heart failure with preserved ejection fraction.

PubMed

Tsujimoto, Tetsuro; Kajio, Hiroshi

2018-07-15

It remains unknown whether a low diastolic blood pressure (DBP) increases the risks of cardiovascular events and death in patients with heart failure with preserved ejection fraction (HFpEF). We used data from the TOPCAT trial. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure. Hazard ratios (HRs) were analyzed for DBPs of <60, 60-69, 70-79, and ≥90 mm Hg in comparison with a DBP of 80-89 mm Hg using multivariable Cox proportional hazard models. This study included 3417 patients with HFpEF who had a controlled blood pressure. In the mean follow-up period of 3.0 years, 881 patients experienced at least one confirmed primary outcome event. Compared with patients with a DBP of 80-89 mm Hg, the adjusted HRs for primary outcome events were significantly higher in those with DBPs of <60 mm Hg (HR: 2.19 [95% confidence interval,1.72-2.78]) and 60-69 mm Hg (HR: 1.52 [1.23-1.87]). Similarly, the adjusted HRs for all-cause death, major cardiovascular events, and hospitalization for heart failure, but not stroke, were significantly higher in patients with a DBP of <70 mm Hg. A relationship between a low DBP and adverse outcomes was found in HFpEF patients with a systolic blood pressure of ≥120 mm Hg; however, a low systolic blood pressure with a DBP of ≥70 mm Hg was not associated with these event risks. A low DBP increased the risks of adverse outcomes in patients with HFpEF. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

The Relationship between Self-Efficacy and Resting Blood Pressure in Spousal Alzheimer’s Caregivers

PubMed Central

Harmell, Alexandrea L.; Mausbach, Brent T; Roepke, Susan K.; Moore, Raeanne; von Känel, Roland; Patterson, Thomas L; Dimsdale, Joel E; Mills, Paul J; Ziegler, Michael G.; Allison, Matthew A.; Ancoli-Israel, Sonia; Grant, Igor

2011-01-01

OBJECTIVE To examine whether increased self-efficacy for using problem-focused coping was significantly related to several resting blood pressure measures in spousal Alzheimer’s disease caregivers. METHODS Participants included 100 older caregivers (mean age= 73.8 ± 8.14 years) providing in home care for a spouse with Alzheimer’s disease (AD). All participants completed a 13 item short form of the coping self-efficacy scale and underwent an in-home assessment where a visiting nurse took the average of three serial blood pressure readings. Multiple regression was used to examine the relationship between self-efficacy and mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) after controlling for age, gender, smoking history, body mass index, the care recipient’s clinical dementia rating (CDR), diabetes, alcohol use, and the use of anti-hypertensive medications. RESULTS Overall, increased self-efficacy (as measured by the Coping Self-efficacy scale) was significantly related to lower resting MAP (β = −.26, t(90) = −2.47, p = .016) and SBP (β=−.28, t(90)= −2.74, p= .007) . Self-efficacy was marginally associated with resting DBP, but not significant (β = −.20, t(90) = −1.91, p= .06). Lastly, self-efficacy was significantly related to pulse pressure (β = −.21, t(90) = −2.31 p= .023). In addition, 1 standard deviation increase in self-efficacy was associated with a decrease of approximately 4 mmHg in SBP. CONCLUSIONS These results suggest an association between high self-efficacy on resting blood pressure. Because psychosocial interventions for Alzheimer’s caregivers have potential to increase self-efficacy, it appears possible that these interventions could have a beneficial impact on caregivers’ cardiovascular function. PMID:21489059

Continuous positive airway pressure reduces blood pressure in patients with obstructive sleep apnea; a systematic review and meta-analysis with 1000 patients.

PubMed

Schein, Andressa S O; Kerkhoff, Alessandra C; Coronel, Christian C; Plentz, Rodrigo D M; Sbruzzi, Graciele

2014-09-01

Obstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure. The objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA. The search was conducted in the following databases, from their beginning until February 2013: MEDLINE, Embase, Cochrane CENTRAL, Lilacs and PEDro. In addition, a manual search was performed on references of published studies. Randomized clinical trials (RCTs) that used CPAP compared with placebo CPAP or subtherapeutic CPAP for treatment of patients with OSA and that evaluated office SBP and DBP and 24-h ambulatory blood pressure were selected. Sixteen RCTs were included among 3409 publications, totaling 1166 patients. The use of CPAP resulted in reductions in office SBP [-3.20  mmHg; 95% confidence interval (CI) -4.67 to -1.72] and DBP (-2.87  mmHg; 95% CI -5.18 to -0.55); in night-time SBP (-4.92  mmHg; 95% CI -8.70 to -1.14); in mean 24-h blood pressure (-3.56  mmHg; 95% CI -6.79 to -0.33), mean night-time blood pressure (-2.56  mmHg; 95% CI -4.43 to -0.68) and 24-h DBP (-3.46  mmHg; 95% CI -6.75 to -0.17). However, no significant change was observed in daytime SBP (-0.74  mmHg; 95% CI -3.90 to 2.41) and daytime DBP (-1.86  mmHg; 95% CI -4.55 to 0.83). Treatment with CPAP promoted significantly but small reductions in blood pressure in individuals with OSA. Further studies should be performed to evaluate the effects of long-term CPAP and the impact on cardiovascular risk.

Diastolic blood pressure, aortic atheroma, and prognosis in hypertension: new insights into a complex association.

PubMed

Courand, Pierre-Yves; Milon, Hugues; Bricca, Giampiero; Khettab, Fouad; Lantelme, Pierre

2014-03-01

Our study aimed at determining the interaction between the prognostic value of diastolic blood pressure (DBP) and aortic atherosclerosis (ATS). With aging, equal systolic blood pressures (SBPs) become associated with low DBPs; i.e., high pulse pressures (PPs) become associated with a high risk of cardiovascular death. This association is usually ascribed to aortic stiffening with age but the precise impact of low DBP per se is yet uncertain. 938 hypertensive patients recruited in the seventies had an aortic ATS score at pretreatment aortography. All-cause and cardiovascular deaths were assessed 20 years later. The prognostic values of DBP and SBP were assessed by a multivariate Cox regression model and their interactions with ATS examined. In the presence of ATS, an increase of 10 mmHg in DBP was associated with a protective effect: hazard ratios 0.84 [0.72-0.99] for cardiovascular death and 0.88 [0.78-1.00] for all-cause death. However, in the absence of ATS, DBP had no prognostic value: hazard ratios 1.05 [0.89-1.23] for cardiovascular death and 0.99 [0.88-1.11] for all-cause death (p for interaction: 0.061 and 0.087, respectively). No interaction was found between SBP and ATS (p for interaction > 0.40). The prognostic values of DBP and aortic atheroma are not superimposable; yet, they are tightly connected: a low DBP is disadvantageous only in the presence of a pathologic aorta. Aortic atherosclerosis may explain, at least partly, in some high risk populations, the J-shape of the already reported DBP-outcome relationship. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The impact of arm circumference on noninvasive oscillometric blood pressure referenced with intra-aortic blood pressure.

PubMed

Shangguan, Qing; Wu, Yanqing; Xu, Jinsong; Su, Hai; Li, Juxiang; Hong, Kui; Cheng, Xiaoshu

2015-12-01

To investigate the influence of arm circumference (AC) on the brachial blood pressure (BP) measured with an adult cuff. This study included 208 patients (150 men, 61.0±8.0 years) for coronary angiography. Intra-aortic BP and noninvasive right brachial oscillometric BP (noninvasive BP) were measured simultaneously before coronary angiography. The noninvasive BP was measured using an electronic oscillometric device with an adult cuff (12×22 cm). The mid-ACs were measured. Thus, proper cuff-arm (≤26 cm) and small cuff (>26 cm) groups were created. The difference in intra-aortic and noninvasive BP was calculated as BPi-n. The correlation coefficients (r) between noninvasive and invasive systolic blood pressure (SBP), mean artery pressure, and diastolic blood pressure (DBP) were 0.88, 0.76, and 0.58, respectively. The SBPi-n was higher (7.9±1.6 vs. 5.2±1.1 mmHg), but the DBPi-n (3.9±1.4 vs. 6.1±1.0 mmHg, P<0.05) was lower in the group ≤26 cm than in the group >26 cm. Among the four subgroups divided by 20-23, 24-26, 27-30, and 31-37 cm of AC, as the AC increased, the SBPi-n increased, but DBP decreased, resulting in noninvasive SBP 4.6 mmHg higher and noninvasive DBP 4.6 mmHg lower in the 31-37 cm group in comparison with the 20-23 cm group. When an adult cuff was used, the noninvasive oscillometric SBP was overestimated, but DBP was underestimated in the individuals with large arms against the intra-aortic BP.

Racial differences in the impact of social support on nocturnal blood pressure.

PubMed

Cooper, Denise C; Ziegler, Michael G; Nelesen, Richard A; Dimsdale, Joel E

2009-06-01

To investigate whether black and white adults benefit similarly from perceived social support in relation to blood pressure (BP) dipping during sleep. The Interpersonal Support Evaluation List (ISEL, 12-item version), which measures the perceived availability of several types of functional social support, was examined for interactive effects with race on dipping of mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) derived from 24-hour ambulatory blood pressure monitoring (ABPM). The sample consisted of 156 young to middle-aged adults (61 blacks, 95 whites; mean age = 35.7 years). Mean ISEL scores did not differ between racial groups. Controlling for age, body mass index (BMI), resting BP, and socioeconomic status (SES), the interaction of social support by race yielded associations with nighttime dipping in MAP and DBP (p < .001) as well as SBP (p < .01). As ISEL scores increased among white participants, the extent of dipping increased in MAP, SBP, and DBP (p < .01), explaining 10%, 10%, and 8% of the variance, respectively. Conversely, black participants exhibited associations between increasing ISEL scores and decreasing levels of dipping in MAP, SBP, and DBP (p < .05), accounting for 9%, 8%, and 8% of the variance, respectively. As perceived social support increased, white adults received cardiovascular benefits as suggested by enhanced nocturnal dipping of BP, but black adults accrued risks as evidenced by blunted declines in BP during sleep.

Exaggerated blood pressure response to exercise--a new portent of masked hypertension.

PubMed

Kayrak, Mehmet; Bacaksiz, Ahmet; Vatankulu, Mehmet Akif; Ayhan, Selim S; Kaya, Zeynettin; Ari, Hatem; Sonmez, Osman; Gok, Hasan

2010-01-01

Masked hypertension (MHT) is a popular entity with increased risk of developing sustained hypertension, heart attack, stroke, and death. Subjects have normal blood pressure (BP) at office but elevated values at night so it is difficult to diagnose. Exaggerated blood pressure response to exercise (EBPR) is also a predictor of future hypertension. To investigate the relationship between these two entities, we evaluated 61 normotensive subjects with EBPR. The subjects underwent 24-h ambulatory blood pressure monitoring (ABPM). The prevalence of masked hypertension among subjects with EBPR was 41%. Body mass index (BMI), non-high density lipoprotein (HDL) cholesterol, diastolic blood pressure (DBP) at peak exercise and recovery, nondipping DBP pattern, and elevated early morning average BPs were associated with masked hypertension. In multivariate logistic regression analysis, the DBP measured at peak exercise was detected as an independent predictor of MHT in subjects with EBPR. Subjects with abnormally elevated BP during exercise are prone to MHT, necessitate medical assessment and close follow-up for hypertension.

Allelic variation of the Lyme disease spirochete adhesin DbpA influences spirochetal binding to decorin, dermatan sulfate, and mammalian cells.

PubMed

Benoit, Vivian M; Fischer, Joshua R; Lin, Yi-Pin; Parveen, Nikhat; Leong, John M

2011-09-01

After transmission by an infected tick, the Lyme disease spirochete, Borrelia burgdorferi sensu lato, colonizes the mammalian skin and may disseminate systemically. The three major species of Lyme disease spirochete--B. burgdorferi sensu stricto, B. garinii, and B. afzelii--are associated with different chronic disease manifestations. Colonization is likely promoted by the ability to bind to target tissues, and Lyme disease spirochetes utilize multiple adhesive molecules to interact with diverse mammalian components. The allelic variable surface lipoprotein decorin binding protein A (DbpA) promotes bacterial binding to the proteoglycan decorin and to the glycosaminoglycan (GAG) dermatan sulfate. To assess allelic variation of DbpA in GAG-, decorin-, and cell-binding activities, we expressed dbpA alleles derived from diverse Lyme disease spirochetes in B. burgdorferi strain B314, a noninfectious and nonadherent strain that lacks dbpA. Each DbpA allele conferred upon B. burgdorferi strain B314 the ability to bind to cultured kidney epithelial (but not glial or endothelial) cells, as well as to purified decorin and dermatan sulfate. Nevertheless, allelic variation of DbpA was associated with dramatic differences in substrate binding activity. In most cases, decorin and dermatan sulfate binding correlated well, but DbpA of B. afzelii strain VS461 promoted differential binding to decorin and dermatan sulfate, indicating that the two activities are separable. DbpA from a clone of B. burgdorferi strain N40 that can cause disseminated infection in mice displayed relatively low adhesive activity, indicating that robust DbpA-mediated adhesive activity is not required for spread in the mammalian host.

Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans.

PubMed

Song, Bo Mi; Kim, Hyeon Chang; Shim, Jee-Seon; Lee, Myung Ha; Choi, Dong Phil

2016-05-01

We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.

Reliability of laser Doppler flowmetry curve reading for measurement of toe and ankle pressures: intra- and inter-observer variation.

PubMed

Høyer, C; Paludan, J P D; Pavar, S; Biurrun Manresa, J A; Petersen, L J

2014-03-01

To assess the intra- and inter-observer variation in laser Doppler flowmetry curve reading for measurement of toe and ankle pressures. A prospective single blinded diagnostic accuracy study was conducted on 200 patients with known or suspected peripheral arterial disease (PAD), with a total of 760 curve sets produced. The first curve reading for this study was performed by laboratory technologists blinded to clinical clues and previous readings at least 3 months after the primary data sampling. The pressure curves were later reassessed following another period of at least 3 months. Observer agreement in diagnostic classification according to TASC-II criteria was quantified using Cohen's kappa. Reliability was quantified using intra-class correlation coefficients, coefficients of variance, and Bland-Altman analysis. The overall agreement in diagnostic classification (PAD/not PAD) was 173/200 (87%) for intra-observer (κ = .858) and 175/200 (88%) for inter-observer data (κ = .787). Reliability analysis confirmed excellent correlation for both intra- and inter-observer data (ICC all ≥.931). The coefficients of variance ranged from 2.27% to 6.44% for intra-observer and 2.39% to 8.42% for inter-observer data. Subgroup analysis showed lower observer-variation for reading of toe pressures in patients with diabetes and/or chronic kidney disease than patients not diagnosed with these conditions. Bland-Altman plots showed higher variation in toe pressure readings than ankle pressure readings. This study shows substantial intra- and inter-observer agreement in diagnostic classification and reading of absolute pressures when using laboratory technologists as observers. The study emphasises that observer variation for curve reading is an important factor concerning the overall reproducibility of the method. Our data suggest diabetes and chronic kidney disease have an influence on toe pressure reproducibility. Copyright © 2013 European Society for Vascular Surgery. Published

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings.

PubMed

Andreadis, Emmanuel A; Geladari, Charalampia V; Angelopoulos, Epameinondas T; Savva, Florentia S; Georgantoni, Anna I; Papademetriou, Vasilios

2018-04-07

Automated office blood pressure (AOBP) measurement is superior to conventional office blood pressure (OBP) because it eliminates the "white coat effect" and shows a strong association with ambulatory blood pressure. We conducted a cross-sectional study in 146 participants with office hypertension, and we compared AOBP readings, taken with or without the presence of study personnel, before and after the conventional office readings to determine whether their variation in blood pressure showed a difference in blood pressure values. We also compared AOBP measurements with daytime ambulatory blood pressure monitoring and conventional office readings. The mean age of the studied population was 56±12 years, and 53.4% of participants were male. Bland-Altman analysis revealed a bias (ie, mean of the differences) of 0.6±6 mm Hg systolic for attended AOBP compared with unattended and 1.4±6 and 0.1±6 mm Hg bias for attended compared with unattended systolic AOBP when measurements were performed before and after conventional readings, respectively. A small bias was observed when unattended and attended systolic AOBP measurements were compared with daytime ambulatory blood pressure monitoring (1.3±13 and 0.6±13 mm Hg, respectively). Biases were higher for conventional OBP readings compared with unattended AOBP (-5.6±15 mm Hg for unattended AOBP and oscillometric OBP measured by a physician, -6.8±14 mm Hg for unattended AOBP and oscillometric OBP measured by a nurse, and -2.1±12 mm Hg for unattended AOBP and auscultatory OBP measured by a second physician). Our findings showed that independent of the presence or absence of medical staff, AOBP readings revealed similar values that were closer to daytime ambulatory blood pressure monitoring than conventional office readings, further supporting the use of AOBP in the clinical setting. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

[Effect of maximum blood pressure fluctuation on prognosis of patients with acute ischemic stroke within 24 hours after hospital admission].

PubMed

Wang, H; Tang, Y; Zhang, Y; Xu, K; Zhao, J B

2018-05-10

Objective: To investigate the relationship between the maximum blood pressure fluctuation within 24 hours after admission and the prognosis at discharge. Methods: The patients with ischemic stroke admitted in Department of Neurology of the First Affiliated Hospital of Harbin Medical University within 24 hours after onset were consecutively selected from April 2016 to March 2017. The patients were grouped according to the diagnostic criteria of hypertension. Ambulatory blood pressure of the patients within 24 hours after admission were measured with bedside monitors and baseline data were collected. The patients were scored by NIHSS at discharge. The relationships between the maximum values of systolic blood pressure (SBP) or diastolic blood pressure (DBP) and the prognosis at discharge were analyzed. Results: A total of 521 patients with acute ischemic stroke were enrolled. They were divided into normal blood pressure group (82 cases) and hypertension group(439 cases). In normal blood pressure group, the maximum values of SBP and DBP were all in normal distribution ( P >0.05). The maximum value of SBP fluctuation was set at 146.6 mmHg. After adjustment for potential confounders, the OR for poor prognosis at discharge in patients with SBP fluctuation ≥146.6 mmHg was 2.669 (95 %CI : 0.594-11.992) compared with those with SBP fluctuation <146.6 mmHg. The maximum value of DBP fluctuation was set at 90.0 mmHg, and the adjusted OR for poor prognosis at discharge in patients with DBP fluctuation ≥90.0 mmHg was 0.416 (95 %CI : 0.087-1.992) compared with those with DBP fluctuation <90.0 mmHg. In hypertension group, the maximum values of SBP and DBP were not in normal distribution ( P <0.05). The maximum value of SBP fluctuation was set at median 171.0 mmHg. After adjustment for the confounders, the greater the maximum of SBP, the greater the risk of poor prognosis at discharge was, the OR was 1.636 (95 %CI : 1.014-2.641). The maximum value of DBP fluctuation was set at

IRIS Toxicological Review of Dibutyl Phthalate (Dbp) (Preliminary Assessment Materials)

EPA Science Inventory

In January 2015, EPA released the draft literature searches and associated search strategies, evidence tables, and exposure response arrays for DBP to obtain input from stakeholders and the public prior to developing the draft IRIS assessment. Specifically, EPA was interested in ...

DBP formation and disinfection under current and future climates - slides

EPA Science Inventory

How to predict and monitoring DBP formation under current and future climate is a challenge and important to water plant operations and water supply security. This presentation summarizes a system approach being developed at the EPA Water Resources Adaptation Program (WRAP).

Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans

PubMed Central

Song, Bo Mi; Shim, Jee-Seon; Lee, Myung Ha; Choi, Dong Phil

2016-01-01

Background and Objectives We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. Subjects and Methods A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. Results The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Conclusion Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure. PMID:27275174

The DEAD-box Protein Dbp2 Functions with the RNA-binding Protein Yra1 to Promote mRNP Assembly

PubMed Central

Ma, Wai Kit; Cloutier, Sara C.; Tran, Elizabeth J.

2013-01-01

Eukaryotic gene expression involves numerous biochemical steps that are dependent on RNA structure and ribonucleoprotein (RNP) complex formation. The DEAD-box class of RNA helicases plays fundamental roles in formation of RNA and RNP structure in every aspect of RNA metabolism. In an effort to explore the diversity of biological roles for DEAD-box proteins, our laboratory recently demonstrated that the DEAD-box protein Dbp2 associates with actively transcribing genes and is required for normal gene expression in Saccharomyces cerevisiae. We now provide evidence that Dbp2 interacts genetically and physically with the mRNA export factor Yra1. In addition, we find that Dbp2 is required for in vivo assembly of mRNA-binding proteins Yra1, Nab2 and Mex67 onto poly(A)+ RNA. Strikingly, we also show that Dbp2 is an efficient RNA helicase in vitro and that Yra1 decreases the efficiency of ATP-dependent duplex unwinding. We provide a model whereby mRNP assembly requires Dbp2 unwinding activity and once the mRNP is properly assembled, inhibition by Yra1 prevents further rearrangements. Both Yra1 and Dbp2 are conserved in multicellular eukaryotes suggesting that this constitutes a broadly conserved mechanism for stepwise assembly of mature mRNPs in the nucleus. PMID:23721653

The DBP Phenotype Gc-1f/Gc-1f Is Associated with Reduced Risk of Cancer. The Tromsø Study

PubMed Central

Jorde, Rolf; Schirmer, Henrik; Wilsgaard, Tom; Bøgeberg Mathiesen, Ellisiv; Njølstad, Inger; Løchen, Maja-Lisa; Joakimsen, Ragnar Martin; Grimnes, Guri

2015-01-01

Background and Objective In addition to its role as a transport protein, the vitamin D binding protein (DBP) may also affect lipid metabolism, inflammation and carcinogenesis. There are three common variants of the DBP, Gc1s (1s), Gc1f (1f), Gc2 (2) that result in six common phenotypes (1s/1s, 1s/1f, 1s/2, 1f/1f, 1f/2, and 2/2). These phenotypes can be identified by genotyping for the two single nucleotide polymorphisms rs7041 and rs4588 in the GC gene. The DBP variants have different binding coefficients for the vitamin D metabolites, and accordingly there may be important relations between DBP phenotypes and health. Methods DNA was prepared from subjects who participated in the fourth survey of the Tromsø Study in 1994-1995 and who were registered with the endpoints myocardial infarction (MI), type 2 diabetes (T2DM), cancer or death as well as a randomly selected control group. The endpoint registers were complete up to 2010- 2013. Genotyping was performed for rs7041 and rs4588 and serum 25-hydroxyvitamin D (25(OH)D) was measured. Results Genotyping for rs7041 and rs4588 was performed successfully in 11 704 subjects. Among these, 1660 were registered with incident MI, 958 with T2DM, 2410 with cancer and 4318 had died. Subjects with the DBP phenotype 1f/1f had 23 – 26 % reduced risk of incident cancer compared to the 1s/1s and 2/2 phenotypes (P < 0.02, Cox regression with gender as covariate). Differences in serum 25(OH)D levels could not explain the apparent cancer protective effect of the DBP variant 1f. In addition to cancer and 25(OH)D, there were significant associations between DBP phenotype and body height, hip circumference and serum calcium. Conclusion There are important biological differences between the common DBP phenotypes. If the relation between the DBP variant 1f and cancer is confirmed in other studies, determination of DBP phenotype may have clinical importance. PMID:25993554

Noise in pressure transducer readings produced by variations in solar radiation

USGS Publications Warehouse

Cain, S. F.; Davis, G.A.; Loheide, Steven P.; Butler, J.J.

2004-01-01

Variations in solar radiation can produce noise in readings from gauge pressure transducers when the transducer cable is exposed to direct sunlight. This noise is a result of insolation-induced heating and cooling of the air column in the vent tube of the transducer cable. A controlled experiment was performed to assess the impact of variations in solar radiation on transducer readings. This experiment demonstrated that insolation-induced fluctuations in apparent pressure head can be as large as 0.03 m. The magnitude of these fluctuations is dependent on cable color, the diameter of the vent tube, and the length of the transducer cable. The most effective means of minimizing insolation-induced noise is to use integrated transducer-data logger units that fit within a well. Failure to address this source of noise can introduce considerable uncertainty into analyses of hydraulic tests when the head change is relatively small, as is often the case for tests in highly permeable aquifers or for tests using distant observation wells.

Noise in pressure transducer readings produced by variations in solar radiation.

PubMed

Cain, Samuel F; Davis, Gregory A; Loheide, Steven P; Butler, James J

2004-01-01

Variations in solar radiation can produce noise in readings from gauge pressure transducers when the transducer cable is exposed to direct sunlight. This noise is a result of insolation-induced heating and cooling of the air column in the vent tube of the transducer cable. A controlled experiment was performed to assess the impact of variations in solar radiation on transducer readings. This experiment demonstrated that insolation-induced fluctuations in apparent pressure head can be as large as 0.03 m. The magnitude of these fluctuations is dependent on cable color, the diameter of the vent tube, and the length of the transducer cable. The most effective means of minimizing insolation-induced noise is to use integrated transducer-data logger units that fit within a well. Failure to address this source of noise can introduce considerable uncertainty into analyses of hydraulic tests when the head change is relatively small, as is often the case for tests in highly permeable aquifers or for tests using distant observation wells.

Impact of diastolic and systolic blood pressure on mortality: implications for the definition of "normal".

PubMed

Taylor, Brent C; Wilt, Timothy J; Welch, H Gilbert

2011-07-01

The National Heart, Lung and Blood Institute currently defines a blood pressure under 120/80 as "normal." To examine the independent effects of diastolic (DBP) and systolic blood pressure (SBP) on mortality and to estimate the number of Americans affected by accounting for these effects in the definition of "normal." DESIGN, PARTICIPANTS AND MEASURES: Data on adults (age 25-75) collected in the early 1970s in the first National Health and Nutrition Examination Survey were linked to vital status data through 1992 (N = 13,792) to model the relationship between blood pressure and mortality rate adjusting for age, sex, race, smoking status, BMI, cholesterol, education and income. To estimate the number of Americans in each blood pressure category, nationally representative data collected in the early 1960s (as a proxy for the underlying distribution of untreated blood pressure) were combined with 2008 population estimates from the US Census. The mortality rate for individuals over age 50 began to increase in a stepwise fashion with increasing DBP levels of over 90. However, adjusting for SBP made the relationship disappear. For individuals over 50, the mortality rate began to significantly increase at a SBP ≥ 140 independent of DBP. In individuals ≤ 50 years of age, the situation was reversed; DBP was the more important predictor of mortality. Using these data to redefine a normal blood pressure as one that does not confer an increased mortality risk would reduce the number of American adults currently labeled as abnormal by about 100 million. DBP provides relatively little independent mortality risk information in adults over 50, but is an important predictor of mortality in younger adults. Conversely, SBP is more important in older adults than in younger adults. Accounting for these relationships in the definition of normal would avoid unnecessarily labeling millions of Americans as abnormal.

Extent of, and variables associated with, blood pressure variability among older subjects.

PubMed

Morano, Arianna; Ravera, Agnese; Agosta, Luca; Sappa, Matteo; Falcone, Yolanda; Fonte, Gianfranco; Isaia, Gianluca; Isaia, Giovanni Carlo; Bo, Mario

2018-02-23

Blood pressure variability (BPV) may have prognostic implications for cardiovascular risk and cognitive decline; however, BPV has yet to be studied in old and very old people. Aim of the present study was to evaluate the extent of BPV and to identify variables associated with BPV among older subjects. A retrospective study of patients aged ≥ 65 years who underwent 24-h ambulatory blood pressure monitoring (ABPM) was carried out. Three different BPV indexes were calculated for systolic and diastolic blood pressure (SBP and DBP): standard deviation (SD), coefficient of variation (CV), and average real variability (ARV). Demographic variables and use of antihypertensive medications were considered. The study included 738 patients. Mean age was 74.8 ± 6.8 years. Mean SBP and DBP SD were 20.5 ± 4.4 and 14.6 ± 3.4 mmHg. Mean SBP and DBP CV were 16 ± 3 and 20 ± 5%. Mean SBP and DBP ARV were 15.7 ± 3.9 and 11.8 ± 3.6 mmHg. At multivariate analysis older age, female sex and uncontrolled mean blood pressure were associated with both systolic and diastolic BPV indexes. The use of calcium channel blockers and alpha-adrenergic antagonists was associated with lower systolic and diastolic BPV indexes, respectively. Among elderly subjects undergoing 24-h ABPM, we observed remarkably high indexes of BPV, which were associated with older age, female sex, and uncontrolled blood pressure values.

Baculovirus-expressed vitamin D-binding protein-macrophage activating factor (DBP-maf) activates osteoclasts and binding of 25-hydroxyvitamin D(3) does not influence this activity.

PubMed

Swamy, N; Ghosh, S; Schneider, G B; Ray, R

2001-01-01

Vitamin D-binding protein (DBP) is a multi-functional serum protein that is converted to vitamin D-binding protein-macrophage activating factor (DBP-maf) by post-translational modification. DBP-maf is a new cytokine that mediates bone resorption by activating osteoclasts, which are responsible for resorption of bone. Defective osteoclast activation leads to disorders like osteopetrosis, characterized by excessive accumulation of bone mass. Previous studies demonstrated that two nonallelic mutations in the rat with osteopetrosis have independent defects in the cascade involved in the conversion of DBP to DBP-maf. The skeletal defects associated with osteopetrosis are corrected in these mutants with in vivo DBP-maf treatment. This study evaluates the effects of various forms of DBP-maf (native, recombinant, and 25-hydroxyvitamin D(3) bound) on osteoclast function in vitro in order to determine some of the structural requirements of this protein that relate to bone resorbing activities. Osteoclast activity was determined by evaluating pit formation using osteoclasts, isolated from the long bones of newborn rats, incubated on calcium phosphate coated, thin film, Ostologic MultiTest Slides. Incubation of osteoclasts with ex vivo generated native DBP-maf resulted in a dose dependent, statistically significant, activation of the osteoclasts. The activation was similar whether or not the vitamin D binding site of the DBP-maf was occupied. The level of activity in response to DBP-maf was greater than that elicited by optimal doses of other known stimulators (PTH and 1,25(OH(2)D(3)) of osteoclast function. Furthermore, another potent macrophage activating factor, interferon--gamma, had no effect on osteoclast activity. The activated form of a full length recombinant DBP, expressed in E. coli showed no activity in the in vitro assay. Contrary to this finding, baculovirus-expressed recombinant DBP-maf demonstrated significant osteoclast activating activity. The normal

Effects of Di-butyl Phthalate (DBP) on Developing Medaka Embryos

ERIC Educational Resources Information Center

Tang, Sherry

2012-01-01

Plasticizers are chemical additives that enhance plastic flexibility. They are ubiquitous environmental contaminants and are commonly found in river and lake waters (Fromme et al 2002). The present study aimed to investigate the effects of a water-soluble plasticizer, dibutyl phthalate (DBP) on developing Medaka ("Oryzias latipes") embryos. Three…

Associations of blood pressure with self-report measures of anger and hostility among black and white men and women.

PubMed

Durel, L A; Carver, C S; Spitzer, S B; Llabre, M M; Weintraub, J K; Saab, P G; Schneiderman, N

1989-01-01

This study examined associations between blood pressure (BP) and dispositional variables pertaining to anger and hostility. Black and White 25- to 44-year old male and female normotensives and unmedicated mild to moderate hypertensives completed four reliable self-report scales--the Cook-Medley Hostility (Ho) Scale, the Trait Anger subscale of the State-Trait Anger Scale (STAS-T), and the Cognitive Anger and Somatic Anger subscales of the Cognitive-Somatic Anger Scale--plus the Framingham Anger Scale and the Harburg Anger Scale. They also engaged in three laboratory tasks--Type A Structured Interview (SI), a video game, and a cold pressor task--that elicit cardiovascular reactivity. Ambulatory BP readings at home and at work were also obtained from most subjects. Blacks had significantly higher Ho and lower STAS-T scores than did Whites. Women reported higher levels of somatic anger than did men. White women showed significant positive correlations between STAS-T and systolic BP (SBP) and diastolic BP (DBP) both at rest in the laboratory and during the SI. Black women revealed significant positive relationships between STAS-T and SBP and DBP at rest in the laboratory and at work as well as with DBP during the cold pressor test. For Black men, cognitive anger and DBP at rest were positively related. In contrast, White men revealed significant negative correlations between Ho scores and SBP at rest and during the video game; these men also showed significant negative relationships between somatic anger and SBP and DBP reactivity during the cold pressor test. Women, but not men, showed significant positive relationships between all four anger measures and ambulatory BP at work. Whereas main effects relating anger and cardiovascular measures were not apparent as a function of race, Blacks demonstrated significantly greater SBP and DBP reactivity than Whites during the cold pressor test, with the converse occurring during the SI. Men demonstrated significantly greater

Nucleolar proteins Bfr2 and Enp2 interact with DEAD-box RNA helicase Dbp4 in two different complexes

PubMed Central

Soltanieh, Sahar; Lapensée, Martin; Dragon, François

2014-01-01

Different pre-ribosomal complexes are formed during ribosome biogenesis, and the composition of these complexes is highly dynamic. Dbp4, a conserved DEAD-box RNA helicase implicated in ribosome biogenesis, interacts with nucleolar proteins Bfr2 and Enp2. We show that, like Dbp4, Bfr2 and Enp2 are required for the early processing steps leading to the production of 18S ribosomal RNA. We also found that Bfr2 and Enp2 associate with the U3 small nucleolar RNA (snoRNA), the U3-specific protein Mpp10 and various pre-18S ribosomal RNA species. Thus, we propose that Bfr2, Dbp4 and Enp2 are components of the small subunit (SSU) processome, a large complex of ∼80S. Sucrose gradient sedimentation analyses indicated that Dbp4, Bfr2 and Enp2 sediment in a peak of ∼50S and in a peak of ∼80S. Bfr2, Dbp4 and Enp2 associate together in the 50S complex, which does not include the U3 snoRNA; however, they associate with U3 snoRNA in the 80S complex (SSU processome). Immunoprecipitation experiments revealed that U14 snoRNA associates with Dbp4 in the 50S complex, but not with Bfr2 or Enp2. The assembly factor Tsr1 is not part of the ‘50S’ complex, indicating this complex is not a pre-40S ribosome. A combination of experiments leads us to propose that Bfr2, Enp2 and Dbp4 are recruited at late steps during assembly of the SSU processome. PMID:24357410

Blood pressure change and antihypertensive treatment in old and very old people: evidence of age, sex and cohort effects.

PubMed

Molander, L; Lövheim, H

2013-03-01

The epidemiology of blood pressure in very old age has not been thoroughly studied. The objective of this study was to study blood pressure changes throughout old age and changes in blood pressure and antihypertensive drug use from 1981 to 2005. The study includes 1133 blood pressure measurements from two studies carried out in Umeå, Sweden. The U70 study (1981-1990) included individuals aged 70-88 and the Umeå 85+/GERDA study (2000-2005) covered people aged 85, 90 or ≥95 years. The impact of age, sex and year of investigation on blood pressure was investigated using linear regression. Mean diastolic blood pressure (DBP) decreased by 0.35 mm Hg (P<0.001) for each year of age. An inverted U-shaped relation was found between age and systolic blood pressure (SBP), with SBP reaching its maximum at 74.5 years. Mean SBP and DBP also decreased over time (SBP by 0.44 mm Hg per year, P<0.001 and DBP by 0.34 mm Hg per year, P<0.001). The proportion of participants on antihypertensive drugs increased from 39.0% in 1981 to 69.4% in 2005. In this study of people aged ≥70 years, mean SBP and DBP decreased with higher age and later investigation year. Antihypertensive drug use increased with time, which might partly explain the observed cohort effect.

Ovo-vegetarian diet is associated with lower systemic blood pressure in Taiwanese women.

PubMed

Ho, C P; Yu, J H; Lee, T J F

2017-12-01

This study was designed to investigate blood pressure (BP) profiles among Taiwanese women with different dietary patterns. Cross-sectional study. A total of 269 non-hypertensive Taiwanese women, 40 years of age or older, were surveyed using structured questionnaires, and measurements of BP and physiological parameters were made. To assess differences among vegans, ovo-vegetarians, and meat eaters in terms of BP, demographic, and health behavior data, the chi-squared and Fisher's exact tests were employed for categorical variables, and analysis of variance and independent t-tests were performed for continuous variables. Multiple regression analysis was used to examine the relationship between BP and dietary patterns while controlling for potential confounding factors. A significant difference was found among the three test groups in terms of age, education, employment, stress, and waist-hip ratio. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly differed among the three groups. After controlling for age, body weight, waist circumference, and hip circumference, the three groups were observed to be a significant risk factor of the SBP and DBP. The SBP and DBP of the ovo-vegetarian group were significantly lower than those of the meat-eater group. No significant differences were found between the vegan and meat-eater groups in terms of SBP and DBP. Dietary pattern is a likely risk factor for SBP and DBP outcomes in Taiwanese women. In particular, the SBP and DBP of ovo-vegetarians are the lowest among the values observed for all dietary patterns. This finding suggests that an ovo-vegetarian diet is beneficial for long-term BP control and prevention of hypertension in females. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Different components of blood pressure are associated with increased risk of atherosclerotic cardiovascular disease versus heart failure in advanced chronic kidney disease

PubMed Central

Bansal, Nisha; McCulloch, Charles E.; Lin, Feng; Robinson-Cohen, Cassianne; Rahman, Mahboob; Kusek, John W.; Anderson, Amanda H.; Xie, Dawei; Townsend, Raymond R.; Lora, Claudia M.; Wright, Jackson; Go, Alan S.; Ojo, Akinlolu; Alper, Arnold; Lustigova, Eva; Cuevas, Magda; Kallem, Radhakrishna; Hsu, Chi-yuan

2016-01-01

Blood pressure is a modifiable risk for cardiovascular disease (CVD). Among hemodialysis patients, there is a U-shaped association between blood pressure and risk of death. However, few studies have examined the association between blood pressure and CVD in patients with stage 4 and 5 chronic kidney disease. Here we studied 1,795 Chronic Renal Insufficiency Cohort (CRIC) Study participants with estimated glomerular filtration rate under 30 ml/min/1.73 m2 and not on dialysis. The association of systolic (SBP), diastolic (DBP) and pulse pressure with risk of physician-adjudicated atherosclerotic CVD (stroke, myocardial infarction or peripheral arterial disease) and heart failure were tested using Cox regression adjusted for demographics, comorbidity and medications. There was a significant association with higher SBP (adjusted hazard ratio 2.04 [95% confidence interval: 1.46, 2.84]) for SBP over 140 vs under 120 mmHg, higher DBP (2.52 [1.54, 4.11]) for DBP over 90 vs under 80 mmHg and higher pulse pressure (2.67 [1.82, 3.92]) for pulse pressure over 68 vs under 51 mmHg with atherosclerotic CVD. For heart failure, there was a significant association with higher pulse pressure only (1.42 [1.05, 1.92]) for pulse pressure over 68 vs under 51 mmHg, but not for SBP or DBP. Thus, among participants with stage 4 and 5 chronic kidney disease, there was an independent association between higher SBP, DBP and pulse pressure with risk of atherosclerotic CVD, while only higher pulse pressure was independently associated with greater risk of heart failure. Further trials are needed to determine whether aggressive reduction of blood pressure reduces the risk of CVD events in patients with stage 4 and 5 chronic kidney disease. PMID:27717485

Short-term neonatal/prepubertal exposure of dibutyl phthalate (DBP) advanced pubertal timing and affected hypothalamic kisspeptin/GPR54 expression differently in female rats.

PubMed

Hu, Jialei; Du, Guizhen; Zhang, Wei; Huang, Hongyu; Chen, Danni; Wu, Di; Wang, Xinru

2013-12-06

Dibutyl phthalate (DBP) had been widely used and its exposure in children has been thought to be one of the reasons causing a trend of advanced pubertal timing in girls. Puberty starts from hypothalamic gonadotropin-releasing hormone release which is controlled by many factors including neurotransmitter kisspeptin and its receptor GPR54. These neural organization or reorganization happens in hypothalamus during neonatal or prepubertal period which may be two target windows of DBP exposure. The present study was designed to determine: (1) the difference between the effects of neonatal and prepubertal DBP exposure on female pubertal timing; (2) whether kisspeptin/GPR54 expression in hypothalamus would respond to neonatal and prepubertal DBP exposure differently. Female Sprague-Dawley rats were exposed by subcutaneous injection of 0.5, 5 and 50mg/kg DBP during Postnatal day (P)1-5 (neonatal) or P26-30 (prepubertal). Physiological data demonstrated that both neonatal and prepubertal DBP exposure could advance pubertal timing significantly accompanied by irregular estrous cycles but only a little gonadal impairment. Exposure-period-related difference was found significant with prepubertal exposure groups having longer estrous cycle duration, heavier at vaginal opening and having higher serum estradiol level compared with neonatal exposure groups. Molecular data showed an up-regulated trend in kisspeptin mRNA and immunoreactivity levels of hypothalamic area arcuate but a down-regulation in GPR54 mRNA expression after P1-5 DBP treatment. In P26-30 groups, kisspeptin mRNA and immunoreactivity levels tended to be lower after DBP treatment. These results demonstrated small dose of DBP could induce earlier pubertal timing in females and both neonatal and prepubertal periods were critical windows for DBP exposure. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Determinants of day-night difference in blood pressure, a comparison with determinants of daytime and night-time blood pressure.

PubMed

Musameh, M D; Nelson, C P; Gracey, J; Tobin, M; Tomaszewski, M; Samani, N J

2017-01-01

Blunted day-night difference in blood pressure (BP) is an independent cardiovascular risk factor, although there is limited information on determinants of diurnal variation in BP. We investigated determinants of day-night difference in systolic (SBP) and diastolic (DBP) BP and how these compared with determinants of daytime and night-time SBP and DBP. We analysed the association of mean daytime, mean night-time and mean day-night difference (defined as (mean daytime-mean night-time)/mean daytime) in SBP and DBP with clinical, lifestyle and biochemical parameters from 1562 adult individuals (mean age 38.6) from 509 nuclear families recruited in the GRAPHIC Study. We estimated the heritability of the various BP phenotypes. In multivariate analysis, there were significant associations of age, sex, markers of adiposity (body mass index and waist-hip ratio), plasma lipids (total and low-density lipoprotein cholesterol and triglycerides), serum uric acid, alcohol intake and current smoking status on daytime or night-time SBP and/or DBP. Of these, only age (P=4.7 × 10 -5 ), total cholesterol (P=0.002), plasma triglycerides (P=0.006) and current smoking (P=3.8 × 10 -9 ) associated with day-night difference in SBP, and age (P=0.001), plasma triglyceride (P=2.2 × 10 -5 ) and current smoking (3.8 × 10 -4 ) associated with day-night difference in DBP. 24-h, daytime and night-time SBP and DBP showed substantial heritability (ranging from 18-43%). In contrast day-night difference in SBP showed a lower heritability (13%) while heritability of day-night difference in DBP was not significant. These data suggest that specific clinical, lifestyle and biochemical factors contribute to inter-individual variation in daytime, night-time and day-night differences in SBP and DBP. Variation in day-night differences in BP is largely non-genetic.

Determinants of day–night difference in blood pressure, a comparison with determinants of daytime and night-time blood pressure

PubMed Central

Musameh, M D; Nelson, C P; Gracey, J; Tobin, M; Tomaszewski, M; Samani, N J

2017-01-01

Blunted day–night difference in blood pressure (BP) is an independent cardiovascular risk factor, although there is limited information on determinants of diurnal variation in BP. We investigated determinants of day–night difference in systolic (SBP) and diastolic (DBP) BP and how these compared with determinants of daytime and night-time SBP and DBP. We analysed the association of mean daytime, mean night-time and mean day–night difference (defined as (mean daytime−mean night-time)/mean daytime) in SBP and DBP with clinical, lifestyle and biochemical parameters from 1562 adult individuals (mean age 38.6) from 509 nuclear families recruited in the GRAPHIC Study. We estimated the heritability of the various BP phenotypes. In multivariate analysis, there were significant associations of age, sex, markers of adiposity (body mass index and waist–hip ratio), plasma lipids (total and low-density lipoprotein cholesterol and triglycerides), serum uric acid, alcohol intake and current smoking status on daytime or night-time SBP and/or DBP. Of these, only age (P=4.7 × 10−5), total cholesterol (P=0.002), plasma triglycerides (P=0.006) and current smoking (P=3.8 × 10−9) associated with day–night difference in SBP, and age (P=0.001), plasma triglyceride (P=2.2 × 10−5) and current smoking (3.8 × 10−4) associated with day–night difference in DBP. 24-h, daytime and night-time SBP and DBP showed substantial heritability (ranging from 18–43%). In contrast day–night difference in SBP showed a lower heritability (13%) while heritability of day–night difference in DBP was not significant. These data suggest that specific clinical, lifestyle and biochemical factors contribute to inter-individual variation in daytime, night-time and day–night differences in SBP and DBP. Variation in day–night differences in BP is largely non-genetic. PMID:26984683

The Effect of Compressibility on the Pressure Reading of a Prandtl Pitot Tube at Subsonic Flow Velocity

NASA Technical Reports Server (NTRS)

Walchner, O

1939-01-01

Errors arising from yawed flow were also determined up to 20 degrees angle of attack. In axial flow, the Prandtl pitot tube begins at w/a approx. = 0.8 to give an incorrect static pressure reading, while it records the tank pressure correctly, as anticipated, up to sonic velocity. Owing to the compressibility of the air, the Prandtl pitot tube manifests compression shocks when the air speed approaches velocity of sound. This affects the pressure reading of the instrument. Because of the increasing importance of high speed in aviation, this compressibility effect is investigated in detail.

Does chocolate reduce blood pressure? A meta-analysis.

PubMed

Ried, Karin; Sullivan, Thomas; Fakler, Peter; Frank, Oliver R; Stocks, Nigel P

2010-06-28

Dark chocolate and flavanol-rich cocoa products have attracted interest as an alternative treatment option for hypertension, a known risk factor for cardiovascular disease. Previous meta-analyses concluded that cocoa-rich foods may reduce blood pressure. Recently, several additional trials have been conducted with conflicting results. Our study summarises current evidence on the effect of flavanol-rich cocoa products on blood pressure in hypertensive and normotensive individuals. We searched Medline, Cochrane and international trial registries between 1955 and 2009 for randomised controlled trials investigating the effect of cocoa as food or drink compared with placebo on systolic and diastolic blood pressure (SBP/DBP) for a minimum duration of 2 weeks. We conducted random effects meta-analysis of all studies fitting the inclusion criteria, as well as subgroup analysis by baseline blood pressure (hypertensive/normotensive). Meta-regression analysis explored the association between type of treatment, dosage, duration or baseline blood pressure and blood pressure outcome. Statistical significance was set at P < 0.05. Fifteen trial arms of 13 assessed studies met the inclusion criteria. Pooled meta-analysis of all trials revealed a significant blood pressure-reducing effect of cocoa-chocolate compared with control (mean BP change +/- SE: SBP: -3.2 +/- 1.9 mmHg, P = 0.001; DBP: -2.0 +/- 1.3 mmHg, P = 0.003). However, subgroup meta-analysis was significant only for the hypertensive or prehypertensive subgroups (SBP: -5.0 +/- 3.0 mmHg; P = 0.0009; DBP: -2.7 +/- 2.2 mm Hg, P = 0.01), while BP was not significantly reduced in the normotensive subgroups (SBP: -1.6 +/- 2.3 mmHg, P = 0.17; DBP: -1.3 +/- 1.6 mmHg, P = 0.12). Nine trials used chocolate containing 50% to 70% cocoa compared with white chocolate or other cocoa-free controls, while six trials compared high- with low-flavanol cocoa products. Daily flavanol dosages ranged from 30 mg to 1000 mg in the active treatment

Relationship between dietary caffeine intake and blood pressure in adults.

PubMed

Köksal, Eda; Yardımcı, Hülya; Kocaadam, Betül; Deniz Güneş, Burcu; Yılmaz, Birsen; Karabudak, Efsun

2017-03-01

The aim of this study was to determine the consumption frequency of caffeinated foods and beverages and daily caffeine consumption amounts, and examine relation between caffeine and blood pressure (BP). A cross sectional door-to-door interview was conducted with 1329 volunteers between the ages of 20 and 60 (mean ages 29.9 ± 10.8 years) and based in Ankara/Turkey. The rate of individuals whose BPs were above 140/90 mmHg was 13.5%. The median caffeine consumption was 150.0 ± 122.06 mg. Although no significant correlation was found between total caffeine intake and diastolic blood pressure (DBP) of individuals, a positive correlation was observed between daily total caffeine and systolic blood pressure (SBP) (p < .05). Also, when analyzed factors that could be associated with DBP and SBP, BMI had effect in the model formed for both types of BP (p < .05). While smoking status associated with SBP (p = .002), gender and waist circumference related to DBP (p < .05) As a result relationship between caffeine intake and BP was affected other factors.

Orthostatic changes in blood pressure and mortality in a nursing home population.

PubMed

Hartog, Laura C; Hendriks, Steven H; Cimzar-Sweelssen, Mateja; Knipscheer, Astrid; Groenier, Klaas H; Kleefstra, Nanne; Bilo, Henk J G; van Hateren, Kornelis J J

2016-06-01

Hypertension, orthostatic hypotension and orthostatic hypertension (OHT) are highly prevalent in old age. The associations in the very elderly and frail patients between blood pressure, and especially orthostatic changes in blood pressure, and mortality are unclear. We aimed to investigate the relationships between orthostatic changes in blood pressure, blood pressure and mortality in nursing home residents. A prospective observational cohort study. Cox proportional hazard modelling was used to investigate the relation between orthostatic hypotension, OHT, the various blood pressure variables and mortality with adjustment for confounders. In the case of significant associations in the models, risk prediction capabilities were assessed with Harrell's C statistics and the proportion of explained variance (R). Two hundred and ninety patients with a mean age of 80.8 (SD 9.9) years participated in this study. The overall mortality risk increased by 17% [95% confidence interval (CI): 2-34%] for every 10-mmHg increase in DBP. Adding DBP did not change Harrell's C values and increased R with 0.03 or less. Only in patients at the psychogeriatric department, orthostatic hypotension was associated with an increased all-cause mortality risk [hazard ratio (HR) 1.71 (95% CI: 1.08-2.71%)]. The HR of OHT in this patient group was 0.61 (95% CI: 0.32-1.19%). DBP was related to all-cause mortality in a nursing home population. Orthostatic hypotension was related to all-cause mortality in the most frail group of nursing home patients. The predictive capabilities of both DBP and orthostatic hypotension are rather small with respect to mortality. A beneficial effect of OHT could not be excluded on the basis of the width of the CI.

Correlates of blood pressure in young insulin-dependent diabetics and their families.

PubMed

Tarn, A C; Thomas, J M; Drury, P L

1990-09-01

We compared the correlates of blood pressure in 163 young patients with insulin-dependent diabetes and in 232 of their non-diabetic siblings. A single observer recorded blood pressure in all subjects, plus all their available parents, using a standardized technique. Other variables recorded included age, weight, height, presence of diabetes and urinary albumin. The major factors accounting for over 50% of the variance of systolic blood pressure (SBP) in both groups were age, weight, paternal SBP and sex. In addition, in the diabetic group the logarithm of the random urinary albumin concentration was a significant explanatory variable. For diastolic blood pressure (DBP) approximately 16% of the variance was explained by age, weight and maternal DBP. Parental blood pressure was an important determinant of blood pressure in both the diabetic and non-diabetic sibling groups. The similarity of the correlates of blood pressure in the two groups suggests that the determinants of blood pressure in young insulin-dependent diabetic patients and in the general population are similar.

Age, arterial stiffness, and components of blood pressure in Chinese adults.

PubMed

Zheng, Meili; Xu, Xiping; Wang, Xiaobin; Huo, Yong; Xu, Xin; Qin, Xianhui; Tang, Genfu; Xing, Houxun; Fan, Fangfang; Cui, Wei; Yang, Xinchun

2014-12-01

Blood pressure (BP) changes with age. We conducted a cross-sectional study in rural Chinese adults to investigate: (1) what is the relationship between age, arterial stiffness, and BP in Chinese men and women; and (2) to what degree can the age-BP relationship be explained by arterial stiffness, controlling for other covariables. These analyses included a total of 1688 subjects (males/females: 623/1065), aged 40 to 88 years. Among them, 353 (20.9%) had hypertension (defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg). Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV). baPWV appeared to be more strongly correlated with BP (including SBP, DBP, mean arterial pressure [MAP], pulse pressure [PP]) than age (P < 0.001 for comparisons between Spearman correlation coefficients). Furthermore, baPWV was associated with BP (including SBP, DBP, MAP, and PP) and risk of hypertension in a dose-response fashion, independent of age; in contrast, the age-BP associations were either attenuated or became negative after adjusting for baPWV. Arterial stiffness appears to be an independent contributor to hypertension, even after adjusting for age and other covariables. In contrast, age-BP associations became attenuated or negative after adjusting for baPWV. The utility of baPWV as a diagnostic, prognostic, and therapeutic indicator for hypertension warrants further investigation.

Blood pressure and the global burden of cardiovascular disease.

PubMed

Rodgers, A; MacMahon, S

1999-01-01

Cardiovascular disease is responsible for a large and increasing proportion of death and disability worldwide. Half of this burden occurs in Asia. This study assessed the possible effects of population-wide (2% lower DBP for all) and targeted (7% lower DBP for those with usual DBP > or = 95 mmHg) BP interventions in Asia, using data from surveys of blood pressure levels, the Global Burden of Disease Project, Eastern Asian cohort studies and randomised trials of blood pressure lowering. Overall each of the two interventions would be expected to avert about one million deaths per year throughout Asia in 2020. These benefits would be approximately additive. About half a million deaths might be averted annually by each intervention in China alone, with about four-fifths of this benefit due to averted stroke. The relative benefits of these two strategies are similar to estimates made for US and UK populations. However, the absolute benefits are many times greater due to the size of the predicted CVD burden in Asia.

The J-curve between Diastolic Blood Pressure and Risk of All-cause and Cardiovascular Death.

PubMed

Kimm, Heejin; Mok, Yejin; Lee, Sun Ju; Lee, Sunmi; Back, Joung Hwan; Jee, Sun Ha

2018-01-01

The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population. We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30-95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models. A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP <60 mmHg compared to 70-79 mmHg were 1.23 (95% confidence interval [CI], 1.16-1.30) and 1.37 (95% CI, 1.20-1.57), respectively, after adjustment for multivariable including systolic blood pressure. Increased risks of all-cause death in the lowest DBP category group were maintained in men or women, 30-59 or ≥60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60-69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30-59 years and DM group, and risk for IHD death in most subgroups except for elderly (≥60 years) decreased. A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg. Copyright © 2018. The Korean Society of Cardiology

Validation of Transtek blood pressure monitor TMB-1491 for self-measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Tian, Huiyong; Zeng, Sijian; Zhong, Xiaoyan; Gong, Wei; Liu, Wenjun

2015-10-01

Transtek blood pressure monitor TMB-1491 is an automatic upper arm device designed for self/home measurement in adult populations. This study aimed to evaluate its accuracy according to the European Society of Hypertension International Protocol revision 2010. The protocol requirements were followed precisely with the recruitment of 33 adult individuals on whom same-left-arm sequential systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. According to the validation protocol, 99 pairs of test device and reference blood pressure measurements were obtained in this study (three pairs for each of the 33 participants). The device produced 74, 95 and 99 measurements within 5, 10, and 15 mmHg for SBP and 85, 97, and 99 for DBP, respectively. The mean±SD device-observer difference was -0.6±4.4 mmHg for SBP and -0.6±3.4 mmHg for DBP. The number of participants with two or three device-observer difference within 5 mmHg was 24 for SBP and 29 for DBP. In addition, none of the participants had a device-observer difference within 5 mmHg for SBP, and three of the participants had the same for DBP. Transtek TMB-1491 has passed all phases of European Society of Hypertension International Protocol revision 2010 and can be recommended for self/home measurement in adult populations.

Lyophilization, Reconstitution, and DBP Formation in Reverse-Osmosis Concentrated Natural Organic Matter

EPA Science Inventory

Drinking water treatment and disinfection byproduct (DBP) research can be complicated by natural organic matter (NOM) temporal variability. NOM preservation by lyophilization (freeze-drying) has been long practiced to address this issue; however, its applicability for drinking w...

Epidemiology of high blood pressure among the Kaingang people on the Xapecó Indigenous Land in Santa Catarina State, Brazil, 2013.

PubMed

Bresan, Deise; Bastos, João Luiz; Leite, Maurício Soares

2015-02-01

This cross-sectional study describes the prevalence of high blood pressure (HBP; measured at one setting, and suggestive of a clinical diagnosis of arterial hypertension) and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and their associations with socio-demographic and anthropometric variables among 355 Kaingang adults (≥ 20 years) on the Xapecó Indigenous Land in Brazil. Weight, height, waist circumference (WC), SBP, and DBP were measured and socio-demographic data were collected. Prevalence of HBP was 53.2% (95%CI: 45.3; 61.1) in men and 40.7% (95%CI: 33.8; 47.6) in women. In women, age and WC were directly associated with HBP; age was associated with SBP and schooling with DBP. In men, HBP was statistically associated with high body mass index (BMI) and tile floor in the home (as a socioeconomic proxy); BMI and WC were associated with SBP; BMI and WC were associated with DBP. The study highlights the need for measures to control risk factors for HBP, especially due to its relevance for cardiovascular diseases and their consequences.

Cuff-less PPG based continuous blood pressure monitoring: a smartphone based approach.

PubMed

Gaurav, Aman; Maheedhar, Maram; Tiwari, Vijay N; Narayanan, Rangavittal

2016-08-01

Cuff-less estimation of systolic (SBP) and diastolic (DBP) blood pressure is an efficient approach for non-invasive and continuous monitoring of an individual's vitals. Although pulse transit time (PTT) based approaches have been successful in estimating the systolic and diastolic blood pressures to a reasonable degree of accuracy, there is still scope for improvement in terms of accuracies. Moreover, PTT approach requires data from sensors placed at two different locations along with individual calibration of physiological parameters for deriving correct estimation of systolic and diastolic blood pressure (BP) and hence is not suitable for smartphone deployment. Heart Rate Variability is one of the extensively used non-invasive parameters to assess cardiovascular autonomic nervous system and is known to be associated with SBP and DBP indirectly. In this work, we propose a novel method to extract a comprehensive set of features by combining PPG signal based and Heart Rate Variability (HRV) related features using a single PPG sensor. Further, these features are fed into a DBP feedback based combinatorial neural network model to arrive at a common weighted average output of DBP and subsequently SBP. Our results show that using this current approach, an accuracy of ±6.8 mmHg for SBP and ±4.7 mmHg for DBP is achievable on 1,750,000 pulses extracted from a public database (comprising 3000 people). Since most of the smartphones are now equipped with PPG sensor, a mobile based cuff-less BP estimation will enable the user to monitor their BP as a vital parameter on demand. This will open new avenues towards development of pervasive and continuous BP monitoring systems leading to an early detection and prevention of cardiovascular diseases.

Randomized Controlled Ethanol Cookstove Intervention and Blood Pressure in Pregnant Nigerian Women.

PubMed

Alexander, Donee; Northcross, Amanda; Wilson, Nathaniel; Dutta, Anindita; Pandya, Rishi; Ibigbami, Tope; Adu, Damilola; Olamijulo, John; Morhason-Bello, Oludare; Karrison, Theodore; Ojengbede, Oladosu; Olopade, Christopher O

2017-06-15

Hypertension during pregnancy is a leading cause of maternal mortality. Exposure to household air pollution elevates blood pressure (BP). To investigate the ability of a clean cookstove intervention to lower BP during pregnancy. We conducted a randomized controlled trial in Nigeria. Pregnant women cooking with kerosene or firewood were randomly assigned to an ethanol arm (n = 162) or a control arm (n = 162). BP measurements were taken during six antenatal visits. In the primary analysis, we compared ethanol users with control subjects. In subgroup analyses, we compared baseline kerosene users assigned to the intervention with kerosene control subjects and compared baseline firewood users assigned to ethanol with firewood control subjects. The change in diastolic blood pressure (DBP) over time was significantly different between ethanol users and control subjects (P = 0.040); systolic blood pressure (SBP) did not differ (P = 0.86). In subgroup analyses, there was no significant intervention effect for SBP; a significant difference for DBP (P = 0.031) existed among preintervention kerosene users. At the last visit, mean DBP was 2.8 mm Hg higher in control subjects than in ethanol users (3.6 mm Hg greater in control subjects than in ethanol users among preintervention kerosene users), and 6.4% of control subjects were hypertensive (SBP ≥140 and/or DBP ≥90 mm Hg) versus 1.9% of ethanol users (P = 0.051). Among preintervention kerosene users, 8.8% of control subjects were hypertensive compared with 1.8% of ethanol users (P = 0.029). To our knowledge, this is the first cookstove randomized controlled trial examining prenatal BP. Ethanol cookstoves have potential to reduce DBP and hypertension during pregnancy. Accordingly, clean cooking fuels may reduce adverse health impacts associated with household air pollution. Clinical trial registered with www.clinicaltrials.gov (NCT02394574).

Characterization of the mammalian DEAD-box protein DDX5 reveals functional conservation with S. cerevisiae ortholog Dbp2 in transcriptional control and glucose metabolism.

PubMed

Xing, Zheng; Wang, Siwen; Tran, Elizabeth J

2017-07-01

DEAD-box proteins are a class of nonprocessive RNA helicases that dynamically modulate the structure of RNA and ribonucleoprotein complexes (RNPs). However, the precise roles of individual members are not well understood. Work from our laboratory revealed that the DEAD-box protein Dbp2 in Saccharomyces cerevisiae is an active RNA helicase in vitro that functions in transcription by promoting mRNP assembly, repressing cryptic transcription initiation, and regulating long noncoding RNA activity. Interestingly, Dbp2 is also linked to glucose sensing and hexose transporter gene expression. DDX5 is the mammalian ortholog of Dbp2 that has been implicated in cancer and metabolic syndrome, suggesting that the role of Dbp2 and DDX5 in glucose metabolic regulation is conserved. Herein, we present a refined biochemical and biological comparison of yeast Dbp2 and human DDX5 enzymes. We find that human DDX5 possesses a 10-fold higher unwinding activity than Dbp2, which is partially due to the presence of a mammalian/avian specific C-terminal extension. Interestingly, ectopic expression of DDX5 rescues the cold sensitivity, cryptic initiation defects, and impaired glucose import in dbp2 Δ cells, suggesting functional conservation. Consistently, we show that DDX5 promotes glucose uptake and glycolysis in mouse AML12 hepatocyte cells, suggesting that mammalian DDX5 and S. cerevisiae Dbp2 share conserved roles in cellular metabolism. © 2017 Xing et al.; Published by Cold Spring Harbor Laboratory Press for the RNA Society.

Validation of the iHealth BP7 wrist blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Wang, Qing; Zhao, Huadong; Chen, Wan; Li, Ni; Wan, Yi

2014-02-01

The aim of this study was to validate the iHealth BP7 wireless wrist blood pressure monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. A total of 99 pairs of test device and reference blood pressure measurements (three pairs for each of the 33 participants) were obtained for validation. The ESH-IP revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. The device produced 66, 87, and 97 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 72, 93, and 99 mmHg for diastolic blood pressure (DBP), respectively. The mean±SD device-observer difference was -0.7±6.9 mmHg for SBP and -1.0±5.1 mmHg for DBP. The number of participants with two or three device-observer differences within 5 mmHg was 25 for SBP and 26 for DBP; furthermore, there were three participants for SBP and one participant for DBP, with none of the device-observer differences within 5 mmHg. On the basis of the validation results, the iHealth BP7 wireless wrist blood pressure monitor can be recommended for self-measurement in an adult population.

The Effect of Anthocyanins on Blood Pressure

PubMed Central

Zhu, Yongjian; Bo, Yacong; Wang, Xi; Lu, Wenjie; Wang, Xule; Han, Zhanying; Qiu, Chunguang

2016-01-01

Abstract The findings of clinical studies concerning the association between anthocyanins supplementation and blood pressure (BP) are inconsistent. In order to provide a more precise estimate of the overall effect of anthocyanins on systolic blood pressure (SBP) and diastolic blood pressure (DBP), we conducted a meta-analysis of clinical trials about anthocyanins supplementation and BP. PubMed, Web of Science, Wanfang Database, and China National Knowledge Infrastructure (CNKI) (until October 2015) were searched to identify potential studies with information on anthocyanins extract supplementation and arterial BP. The weighted mean difference (WMD) and 95% confidence interval (CI) were used as a summary statistic. Net changes in SBP and DBP between anthocyanins supplementation and placebo groups were calculated by subtracting the values at end of follow-up from those at baseline. Meta regression was used to explore the potential moderators of effect size. The publication bias was assessed using Begger's Funnel plots and Egger's tests; P < 0.05 was considered to be statistically significant. Finally, 6 clinical studies with 472 participants for the effect of anthocyanins consumption on BP were included in the present meta-analysis. There is no significant effect on either SBP (WMD: 1.15 mm Hg, 95% CI: −3.17 to 5.47, I2 = 56%) or DBP (WMD: 1.06 mm Hg, 95% CI: −0.71 to 2.83, I2 = 0%) following supplementation with anthocyanins. In summary, results from this meta-analysis do not favor any clinical efficacy of supplementation with anthocyanins in improving blood pressure. Further well-designed large randomized controlled trials (RCTs) with long follow-up period are needed to verify the association of anthocyanins supplementation and blood pressure. PMID:27082604

Clock-controlled output gene Dbp is a regulator of Arnt/Hif-1β gene expression in pancreatic islet β-cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakabayashi, Hiroko; Ohta, Yasuharu, E-mail: yohta@yamaguchi-u.ac.jp; Yamamoto, Masayoshi

2013-05-03

Highlights: •Arnt mRNA expressed in a circadian manner in mouse pancreatic islets. •Expressions of Dbp and Arnt damped in the islets of a diabetic model mouse. •DBP and E4BP4 regulate Arnt promoter activity by direct binding. •Arnt may have a role in connecting circadian rhythm and metabolism. -- Abstract: Aryl hydrocarbon receptor nuclear translocator (ARNT)/hypoxia inducible factor-1β (HIF-1β) has emerged as a potential determinant of pancreatic β-cell dysfunction and type 2 diabetes in humans. An 82% reduction in Arnt expression was observed in islets from type 2 diabetic donors as compared to non-diabetic donors. However, few regulators of Arnt expressionmore » have been identified. Meanwhile, disruption of the clock components CLOCK and BMAL1 is known to result in hypoinsulinemia and diabetes, but the molecular details remain unclear. In this study, we identified a novel molecular connection between Arnt and two clock-controlled output genes, albumin D-element binding protein (Dbp) and E4 binding protein 4 (E4bp4). By conducting gene expression studies using the islets of Wfs1{sup −/−} A{sup y}/a mice that develop severe diabetes due to β-cell apoptosis, we demonstrated clock-related gene expressions to be altered in the diabetic mice. Dbp mRNA decreased by 50%, E4bp4 mRNA increased by 50%, and Arnt mRNA decreased by 30% at Zeitgever Time (ZT) 12. Mouse pancreatic islets exhibited oscillations of clock gene expressions. E4BP4, a D-box negative regulator, oscillated anti-phase to DBP, a D-box positive regulator. We also found low-amplitude circadian expression of Arnt mRNA, which peaked at ZT4. Over-expression of DBP raised both mRNA and protein levels of ARNT in HEK293 and MIN6 cell lines. Arnt promoter-driven luciferase reporter assay in MIN6 cells revealed that DBP increased Arnt promoter activity by 2.5-fold and that E4BP4 competitively inhibited its activation. In addition, on ChIP assay, DBP and E4BP4 directly bound to D-box elements

Association between blood lead and blood pressure: a population-based study in Brazilian adults.

PubMed

Almeida Lopes, Ana Carolina Bertin de; Silbergeld, Ellen Kovner; Navas-Acien, Ana; Zamoiski, Rachel; Martins, Airton da Cunha; Camargo, Alissana Ester Iakmiu; Urbano, Mariana Ragassi; Mesas, Arthur Eumann; Paoliello, Monica Maria Bastos

2017-03-14

Environmental lead exposure among adults may increase blood pressure and elevate the risk of hypertension. The availability of data on blood lead levels (BLL) in adult Brazilian population is scarce and population-based studies are important for screening the population exposure and also to evaluate associations with adverse health effects. The goal of this study was to examine the association of BLL with blood pressure and hypertension in a population-based study in a city in Southern Brazil. A total of 948 adults, aged 40 years or older, were randomly selected. Information on socioeconomic, dietary, lifestyle and occupational background was obtained by orally administered household interviews. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured according to the guidelines VI Brazilian Guidelines on Hypertension. BLL were measured by inductively coupled plasma mass spectrometry technique. Multiple linear and logistic regression models were performed to evaluate associations of BLL with SBP and DBP, and with the chance of hypertension and of elevated SBP and DBP. The geometric mean of BLL was 1.97 μg/dL (95%CI:1.90-2.04 μg/dL). After multivariable adjustment, participants in the quartile 4 of blood lead presented 0.06 mm/Hg (95%CI, 0.04-0.09) average difference in DBP comparing with those in quartile 1. Participants in the 90th percentile of blood lead distribution had 0.07 mmHg (95% CI, 0.03 to 0.11) higher DBP compared with those participants in the 10th percentile of blood lead. The adjusted OR for hypertension was 2.54 (95% CI, 1.17-5.53), comparing the highest to the lowest blood lead quartiles. Compared with participants in the 10th percentile of blood lead, participants in the 90th percentile presented higher OR for hypertension (OR: 2.77; 95% CI, 1.41 to 5.46). At low concentrations, BLL were positively associated with DBP and with the odds for hypertension in adults aged 40 or older. It is important to enforce lead

One arm exercise induces significant interarm diastolic blood pressure difference.

PubMed

Hong, Dezhi; Wang, Jiwei; Su, Hai; Xu, Jingsong; Liu, Yanna; Peng, Qiang; Wang, Lijuan

2011-06-01

This study is designed to investigate the inducing effect of one arm exercise on interarm difference (IAD) in the blood pressure (BP). Fifty healthy young participants were included in the study. Three-minute exercises of the right arm elbow flexion and extension were performed. The bilateral brachial BP was simultaneously measured with two automatic BP measurement devices before (basic) and immediately 0, 5, 10, 15, 20, and 30 min after exercise. The absolute difference in the systolic BP (SBP) and diastolic BP (DBP) between the left and right BP of at least 10 mmHg was recognized as sIAD and dIAD. The baseline data of the SBP and DBP in left and right arms revealed no significant difference (SBP: 110 ± 10 vs. 111 ± 11 mmHg; DBP: 66 ± 8 vs. 66 ± 9 mmHg, both not significant). The prevalence of dIAD was 2% at the baseline. However, this prevalence increased to 80% at 0 min, as right arm exercise induced the right DBP decrease and left DBP increase, and then the prevalence decreased gradually within a 30-min recovery period. The prevalence of sIAD was zero at the baseline and the maximal prevalence was 8% during the 20-min postexercise period. One arm exercise can lead to a significant IAD in DBP. Any arm exercise should be avoided before BP measurement.

The relationships of body mass index, waist-to-height ratio, and body fat percentage with blood pressure and its hemodynamic determinants in Korean adolescents: a school-based study.

PubMed

Kim, Na Young; Hong, Young Mi; Jung, Jo Won; Kim, Nam Su; Noh, Chung Il; Song, Young-Hwan

2013-12-01

Obesity is an important risk factor for hypertension in adolescents. We investigated the relationship of obesity-related indices (body mass index [BMI], waist-to-height ratio [WHR], and body fat percentage [%BF]) with blood pressure and the hemodynamic determinants of blood pressure in Korean adolescents. In 2008, 565 adolescents, aged 12-16 years, were examined. The %BF of the participants was measured by bioelectrical impedance analysis. Echocardiography and brachial artery pulse tracing were used to estimate the stroke volume (SV), cardiac output (CO), total vascular resistance (TVR), and total arterial compliance (TAC). We noted that BMI, WHR, and %BF were positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The positive correlation between BMI and blood pressure (SBP and DBP) persisted after adjustment for WHR and %BF. However, after adjustment for BMI, the positive associations between blood pressure (SBP and DBP) and WHR as well as %BF, were not noted. With regard to the hemodynamic factors, BMI, but not WHR and %BF, was an independent positive factor correlated with SV and CO. TVR had an independent negative association with BMI; however, it was not associated with WHR or %BF. Moreover, we noted that BMI, WHR, and %BF did not affect TAC. In Korean adolescents, BMI had an independent positive correlation with SBP and DBP, possibly because of its effects on SV, CO, and TVR. WHR and %BF are believed to indirectly affect SBP and DBP through changes in BMI.

Components of height and blood pressure in childhood

PubMed Central

Regnault, Nolwenn; Kleinman, Ken P; Rifas-Shiman, Sheryl L; Langenberg, Claudia; Lipshultz, Steven E; Gillman, Matthew W

2014-01-01

Background In children being taller is associated with higher blood pressure (BP), but few studies have divided height into its components: trunk and leg length. We examined the associations of total height, trunk length and leg length with systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) at early childhood and mid-childhood visits, as well as change between the two visits. Methods We obtained five measures of SBP and DBP at the early childhood visit (N = 1153, follow-up rate = 54%) and at the mid-childhood visit (N = 1086, follow-up rate = 51%) respectively, in Project Viva, a US cohort study. We measured total height and sitting height (a measure of trunk length that includes head and neck) and calculated leg length as the difference between the two. Using mixed models, we adjusted the cross-sectional analyses for leg length when trunk length was the exposure of interest, and vice versa. We also adjusted for maternal race/ethnicity, child age, sex, overall adiposity and BP measurement conditions. Results At the mid-childhood visit, total height was positively associated with SBP [0.34 (0.24; 0.45) mmHg/cm] but not with DBP [0.07 (−0.003; 0.15)]. In models examining trunk and leg length separately, each was positively associated with SBP [0.72 (0.52; 0.92) and 0.33 (0.16; 0.49) respectively]. In a fully adjusted model with both leg and trunk length, only trunk length remained associated with BP. For a given leg length, a 1-cm increment in trunk length was associated with a 0.63-mmHg (0.42; 0.83) higher SBP and a 0.17-mmHg (0.02; 0.31) higher DBP. For a given trunk length, however, the associations of leg length with SBP [0.13 (−0.03; 0.30)] and with DBP [0.002 (−0.11; 0.12)] were null. These patterns were similar at the early childhood visit. Conclusions Children with greater trunk lengths have higher BPs, perhaps because of the additional pressure needed to overcome gravity to perfuse the brain. PMID:24413933

Long-term changes in blood pressure following orlistat and sibutramine treatment: a meta-analysis.

PubMed

Johansson, K; Sundström, J; Neovius, K; Rössner, S; Neovius, M

2010-11-01

Previous meta-analyses investigating blood pressure effects of anti-obesity drugs have included studies using non-licensed doses, but not data from head-to-head studies. Furthermore, although diabetes is an important comorbidity in obesity, variation in blood pressure effects across diabetes status has not been investigated. The objective of this study was to estimate the effects on systolic (SBP) and diastolic blood pressure (DBP) of orlistat and sibutramine. Medline, EMBASE, the Cochrane controlled trials register and reference lists of identified articles from 1990 to February 2009 were searched. All placebo-controlled randomized controlled trials of 12-month duration or randomized head-to-head studies of any duration on adults using standard doses were included. Studies/study arms were excluded if they only evaluated weight maintenance after weight loss. Randomized controlled trials were identified, subjected to inclusion and exclusion criteria, and reviewed. Random effects models were used for assessment of weighted mean differences. Eighteen placebo-controlled (12 orlistat, 5540 patients; 6 sibutramine, 1495 patients) and four head-to-head trials (348 patients) met the inclusion criteria. Three orlistat and three sibutramine studies examined overweight subjects with type 2 diabetes (T2DM), as did two head-to-head trials. Mean baseline SBP ranged from 119 to 153 mmHg, and mean DBP from 69 to 98 mmHg. Overall, the placebo-controlled SBP change was -1.9 (95% CI; -2.7, -1.1) mmHg for orlistat, and 0.5 (-1.1, 2.1) mmHg for sibutramine. The corresponding values for DBP were -1.5 (-2.2, -0.8) and 1.7 (0.7, 2.6). Compared with patients without diabetes, diabetic patients treated with orlistat experienced smaller and non-significant reductions of SBP (-0.9; -2.6, 0.7 vs. -2.2; -3.0, -1.3) and DBP (-1.0; -2.4, 0.3 vs. -1.6; -2.4, -0.8). For sibutramine, higher on-treatment elevations in SBP (1.6; -1.3, 4.5 vs. 0.1; -1.8, 2.0) and DBP (2.4; 0.6, 4.1 vs. 1.4; 0.3, 2

Concomitant administration of nitrous oxide and remifentanil reduces oral tissue blood flow without decreasing blood pressure during sevoflurane anesthesia in rabbits.

PubMed

Kasahara, Masataka; Ichinohe, Tatsuya; Okamoto, Sota; Okada, Reina; Kanbe, Hiroaki; Matsuura, Nobuyuki

2015-06-01

To determine whether continuous administration of nitrous oxide and remifentanil—either alone or together—alters blood flow in oral tissues during sevoflurane anesthesia. Eight male tracheotomized Japanese white rabbits were anesthetized with sevoflurane under mechanical ventilation. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), common carotid arterial blood flow (CCBF), tongue mucosal blood flow (TMBF), mandibular bone marrow blood flow (BBF), masseter muscle blood flow (MBF), upper alveolar tissue blood flow (UBF), and lower alveolar tissue blood flow (LBF) were recorded in the absence of all test agents and after administration of the test agents (50 % nitrous oxide, 0.4 μg/kg/min remifentanil, and their combination) for 20 min. Nitrous oxide increased SBP, DBP, MAP, CCBF, BBF, MBF, UBF, and LBF relative to baseline values but did not affect HR or TMBF. Remifentanil decreased all hemodynamic variables except DBP. Combined administration of nitrous oxide and remifentanil recovered SBP, DBP, MAP, and CCBF to baseline levels, but HR and oral tissue blood flow remained lower than control values. Our findings suggest that concomitant administration of nitrous oxide and remifentanil reduces blood flow in oral tissues without decreasing blood pressure during sevoflurane anesthesia in rabbits.

Elevation of Morning Blood Pressure in Sodium Resistant Subjects by High Sodium Diet

PubMed Central

Lim, Chi-Yeon; Shin, Sung-Joon; Oh, Sang-Woo; Park, Yong-Soon; Kim, Jong-Wook; Park, Hye-Kyoung; Kim, Cho-il; Park, Cheol-Young; Kim, Sun-Woong

2013-01-01

The present study evaluated the response of blood pressure (BP) by dietary sodium in sodium resistant (SR) subjects. One hundred one subjects (mean age, 46.0 yr; 31 hypertensives) were admitted and given low sodium-dietary approaches to stop hypertension (DASH) diet (LSD, 100 mM NaCl/day) for 7 days and high sodium-DASH diet (HSD, 300 mM NaCl/day) for the following 7 days. On the last day of each diet, 24 hr ambulatory BP was measured. Morning systolic BP (SBP) and diastolic BP (DBP) were elevated after HSD in all subjects (P < 0.01), but daytime SBP and DBP were not changed (P > 0.05). In hypertensive subjects, morning DBP elevation was greater than daytime DBP elevation (P = 0.036), although both DBPs were significantly elevated after HSD. The augmented elevation of morning DBP in hypertensive subjects was contributed by the absolute elevation of morning DBP (P = 0.032) and relative elevation to daytime DBP (P = 0.005) in sodium resistant (SR) subjects, but not by sodium sensitive subjects. Although there was no absolute elevation, SR subjects with normotension showed a relative elevation of morning SBP compared to daytime SBP change after HSD (P = 0.009). The present study demonstrates an absolute and relative elevation of morning BP in SR subjects by HSD. PMID:23580363

An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes.

PubMed

Kengne, Andre Pascal; Libend, Christelle Nong; Dzudie, Anastase; Menanga, Alain; Dehayem, Mesmin Yefou; Kingue, Samuel; Sobngwi, Eugene

2014-01-01

Ambulatory blood pressure (BP) measurements (ABPM) predict health outcomes better than office BP, and are recommended for assessing BP control, particularly in high-risk patients. We assessed the performance of office BP in predicting optimal ambulatory BP control in sub-Saharan Africans with type 2 diabetes (T2DM). Participants were a random sample of 51 T2DM patients (25 men) drug-treated for hypertension, receiving care in a referral diabetes clinic in Yaounde, Cameroon. A quality control group included 46 non-diabetic individuals with hypertension. Targets for BP control were systolic (and diastolic) BP. Mean age of diabetic participants was 60 years (standard deviation: 10) and median duration of diabetes was 6 years (min-max: 0-29). Correlation coefficients between each office-based variable and the 24-h ABPM equivalent (diabetic vs. non-diabetic participants) were 0.571 and 0.601 for systolic (SBP), 0.520 and 0.539 for diastolic (DBP), 0.631 and 0.549 for pulse pressure (PP), and 0.522 and 0.583 for mean arterial pressure (MAP). The c-statistic for the prediction of optimal ambulatory control from office-BP in diabetic participants was 0.717 for SBP, 0.494 for DBP, 0.712 for PP, 0.582 for MAP, and 0.721 for either SBP + DBP or PP + MAP. Equivalents in diabetes-free participants were 0.805, 0.763, 0.695, 0.801 and 0.813. Office DBP was ineffective in discriminating optimal ambulatory BP control in diabetic patients, and did not improve predictions based on office SBP alone. Targeting ABPM to those T2DM patients who are already at optimal office-based SBP would likely be more cost effective in this setting.

Blood Pressure Associated with Arsenic Methylation and Arsenic Metabolism Caused by Chronic Exposure to Arsenic in Tube Well Water.

PubMed

Wei, Bing Gan; Ye, Bi Xiong; Yu, Jiang Ping; Yang, Lin Sheng; Li, Hai Rong; Xia, Ya Juan; Wu, Ke Gong

2017-05-01

The effects of arsenic exposure from drinking water, arsenic metabolism, and arsenic methylation on blood pressure (BP) were observed in this study. The BP and arsenic species of 560 participants were determined. Logistic regression analysis was applied to estimate the odds ratios of BP associated with arsenic metabolites and arsenic methylation capability. BP was positively associated with cumulative arsenic exposure (CAE). Subjects with abnormal diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) usually had higher urinary iAs (inorganic arsenic), MMA (monomethylated arsenic), DMA (dimethylated arsenic), and TAs (total arsenic) than subjects with normal DBP, SBP, and PP. The iAs%, MMA%, and DMA% differed slightly between subjects with abnormal BP and those with normal BP. The PMI and SMI were slightly higher in subjects with abnormal PP than in those with normal PP. Our findings suggest that higher CAE may elevate BP. Males may have a higher risk of abnormal DBP, whereas females have a higher risk of abnormal SBP and PP. Higher urinary iAs may increase the risk of abnormal BP. Lower PMI may elevate the BP. However, higher SMI may increase the DBP and SBP, and lower SMI may elevate the PP. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

[Comparison analysis of blood pressure, obesity, and cardio-respiratory fitness in schoolchildren].

PubMed

Burgos, Miria Suzana; Reuter, Cézane Priscila; Burgos, Leandro Tibiriçá; Pohl, Hildegard Hedwig; Pauli, Liane Teresinha Schuh; Horta, Jorge André; Reckziegel, Miriam Beatris; Franke, Silvia Isabel Rech; Prá, Daniel; Camargo, Marcelo

2010-06-01

During childhood and adolescence, physical inactivity, excess weight, and poor nutrition are risk factors for chronic diseases, especially obesity, hypertension, and diabetes mellitus. Early intervention can prevent the development of these complications. To determine the presence of cardiovascular risk (obesity and hypertension) in schoolchildren and its potential interactions with cardio-respiratory fitness. This was a cross-sectional study conducted in a stratified cluster sample of 1,666 schoolchildren, aged between 7 and 17 years, 873 (52.4%) of them male and 793 (47.6%) of them female. The following variables were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), body fat percentage (BF %), and cardio-respiratory fitness. SBP and DBP were correlated with waist circumference (WC), waist-hip ratio (WHR), sum of skin folds (SigmaSF), and cardio-respiratory fitness. A BMI assessment of the students showed that 26.7% of them were overweight or obese, and 35.9% had body fat percentage over moderately high. As to blood pressure, we found that 13.9% and 12.1% of the students were borderline or hypertensive, for SBP and DBP, respectively. There was an association among hypertension, obesity, and cardio-respiratory fitness. There was a significant correlation of SBP and DBP with all variables, and also a weak to moderate correlation with age, weight, height, BMI, and waist circumference. The presence of hypertension associated with obesity and its effects on cardio-respiratory fitness stress the importance of recommending, since childhood, a more active and healthy lifestyle.

Metabolic Adaptation to Nutrients Involves Coregulation of Gene Expression by the RNA Helicase Dbp2 and the Cyc8 Corepressor in Saccharomyces cerevisiae.

PubMed

Wang, Siwen; Xing, Zheng; Pascuzzi, Pete E; Tran, Elizabeth J

2017-07-05

Cells fine-tune their metabolic programs according to nutrient availability in order to maintain homeostasis. This is achieved largely through integrating signaling pathways and the gene expression program, allowing cells to adapt to nutritional change. Dbp2, a member of the DEAD-box RNA helicase family in Saccharomyces cerevisiae , has been proposed to integrate gene expression with cellular metabolism. Prior work from our laboratory has reported the necessity of DBP2 in proper gene expression, particularly for genes involved in glucose-dependent regulation. Here, by comparing differentially expressed genes in dbp2 ∆ to those of 700 other deletion strains from other studies, we find that CYC8 and TUP1 , which form a complex and inhibit transcription of numerous genes, corepress a common set of genes with DBP2 Gene ontology (GO) annotations reveal that these corepressed genes are related to cellular metabolism, including respiration, gluconeogenesis, and alternative carbon-source utilization genes. Consistent with a direct role in metabolic gene regulation, loss of either DBP2 or CYC8 results in increased cellular respiration rates. Furthermore, we find that corepressed genes have a propensity to be associated with overlapping long noncoding RNAs and that upregulation of these genes in the absence of DBP2 correlates with decreased binding of Cyc8 to these gene promoters. Taken together, this suggests that Dbp2 integrates nutrient availability with energy homeostasis by maintaining repression of glucose-repressed, Cyc8-targeted genes across the genome. Copyright © 2017 Wang et al.

Variation of the Korotkoff Stethoscope Sounds During Blood Pressure Measurement: Analysis Using a Convolutional Neural Network.

PubMed

Pan, Fan; He, Peiyu; Liu, Chengyu; Li, Taiyong; Murray, Alan; Zheng, Dingchang

2017-11-01

Korotkoff sounds are known to change their characteristics during blood pressure (BP) measurement, resulting in some uncertainties for systolic and diastolic pressure (SBP and DBP) determinations. The aim of this study was to assess the variation of Korotkoff sounds during BP measurement by examining all stethoscope sounds associated with each heartbeat from above systole to below diastole during linear cuff deflation. Three repeat BP measurements were taken from 140 healthy subjects (age 21 to 73 years; 62 female and 78 male) by a trained observer, giving 420 measurements. During the BP measurements, the cuff pressure and stethoscope signals were simultaneously recorded digitally to a computer for subsequent analysis. Heartbeats were identified from the oscillometric cuff pressure pulses. The presence of each beat was used to create a time window (1 s, 2000 samples) centered on the oscillometric pulse peak for extracting beat-by-beat stethoscope sounds. A time-frequency two-dimensional matrix was obtained for the stethoscope sounds associated with each beat, and all beats between the manually determined SBPs and DBPs were labeled as "Korotkoff." A convolutional neural network was then used to analyze consistency in sound patterns that were associated with Korotkoff sounds. A 10-fold cross-validation strategy was applied to the stethoscope sounds from all 140 subjects, with the data from ten groups of 14 subjects being analyzed separately, allowing consistency to be evaluated between groups. Next, within-subject variation of the Korotkoff sounds analyzed from the three repeats was quantified, separately for each stethoscope sound beat. There was consistency between folds with no significant differences between groups of 14 subjects (P = 0.09 to P = 0.62). Our results showed that 80.7% beats at SBP and 69.5% at DBP were analyzed as Korotkoff sounds, with significant differences between adjacent beats at systole (13.1%, P = 0.001) and diastole (17.4%, P < 0

Lack of association between systolic blood pressure and blood viscosity in normotensive healthy subjects.

PubMed

Irace, Concetta; Carallo, Claudio; Scavelli, Faustina; Loprete, Antonio; Merante, Valentina; Gnasso, Agostino

2012-01-01

A direct relationship between blood pressure and viscosity has frequently been reported, although clear data are not available. To better understand the relationship between these two variables, we evaluated blood viscosity and blood pressure in a group of healthy subjects without cardiovascular risk factors. Healthy subjects were selected from participants in a campaign of prevention of cardiovascular disease (n = 103). They underwent blood sampling for measurement of plasma and blood viscosity, haematocrit, blood lipids and glucose. The quantity and distribution of body fat was assessed by body mass index and waist/hip ratio, respectively. Systolic blood pressure (SBP) correlated significantly with age (r = 0.222) and waist/hip ratio (r = 0.374). Diastolic blood pressure (DBP) correlated significantly with waist/hip ratio (r = 0.216), haematocrit (r = 0.333) and blood viscosity (r = 0.258). Multiple linear regression analyses demonstrated that the only variable significantly associated with SBP was age, while haematocrit was the only variable significantly associated with DBP. Blood viscosity was closely related to waist/hip ratio. These findings show that SBP, in healthy subjects, is not influenced by haematocrit and blood viscosity. In contrast, DBP is related to the values of haematocrit. Among classical cardiovascular risk factors, waist/hip ratio is closely related to blood viscosity.

Mozart, but not the Beatles, reduces systolic blood pressure in patients with myocardial infarction.

PubMed

Gruhlke, Luiza Carolina; Patrício, Marcelo Coelho; Moreira, Daniel Medeiros

2015-12-01

Music reduces systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) in various clinical situations, but it is unclear whether these changes occur in post-infarction patients. The aim is to evaluate the effects of music on patients with acute myocardial infarction (MI). We evaluated patients with MI and we measured SBP, DBP, HR and double product (DP) two times before the intervention and one time every fifteen minutes with an ambulatory blood pressure monitor. We divided the patients into 3 groups: a group listening to music by Mozart; another listening to a Beatles collection and a third one listening to the radio news. Outcomes were the change in mean SBP, DBP, HR and DP with intervention. We enrolled 60 patients (20 in each group). SBP was significantly reduced in the Mozart group (variation of –7.2 ± 8.5 mmHg) compared to the Beatles group (–1.3 ± 6.2 mmHg) (P = 0.021) and the radio news group (0.6 ± 8.7 mmHg) (P = 0.003). DP was significantly reduced in the Mozart group compared with the News group (–668.5 ± 773.2 vs 31.6 ± 722.1 mmHg) (P = 0.006). There were no differences in DBP and HR. Patients with MI who listened Mozart had a reduction in SBP and DP compared to those who listened to the Beatles or the news.

Effect of short-term administration of cinnamon on blood pressure in patients with prediabetes and type 2 diabetes.

PubMed

Akilen, Rajadurai; Pimlott, Zeller; Tsiami, Amalia; Robinson, Nicola

2013-10-01

The aim of this study was to systematically review and evaluate the effect of short-term administration of cinnamon on blood pressure regulation in patients with prediabetes and type 2 diabetes by performing a meta-analysis of randomized, placebo-controlled clinical trials. Medical literature for randomized controlled trials (RCTs) of the effect of cinnamon on blood pressure was systematically searched; three original articles published between January 2000 and September 2012 were identified from the MEDLINE database and a hand search of the reference lists of the articles obtained through MEDLINE. The search terms included cinnamon or blood pressure or systolic blood pressure (SBP) or diastolic blood pressure (DBP) or diabetes. A random effects model was used to calculate weighted mean difference and 95% confidence intervals (CI). The pooled estimate of the effect of cinnamon intake on SBP and DBP demonstrated that the use of cinnamon significantly decreased SBP and DBP by 5.39 mm Hg (95% CI, -6.89 to -3.89) and 2.6 mm Hg (95% CI, -4.53 to -0.66) respectively. Consumption of cinnamon (short term) is associated with a notable reduction in SBP and DBP. Although cinnamon shows hopeful effects on BP-lowering potential, it would be premature to recommend cinnamon for BP control because of the limited number of studies available. Thus, undoubtedly a long-term, adequately powered RCT involving a larger number of patients is needed to appraise the clinical potential of cinnamon on BP control among patients with type 2 diabetes mellitus. Copyright © 2013 Elsevier Inc. All rights reserved.

UK Renal Registry 16th annual report: chapter 11 blood pressure profile of prevalent patients receiving renal replacement therapy in 2012: national and centre-specific analyses.

PubMed

Rao, Anirudh; Pitcher, David; Farrington, Ken

2013-01-01

There continues to be uncertainty in the literature about which blood pressure (BP) recordings in which time period associate best with long-term patient outcomes and therefore optimal target ranges. Patients receiving renal replacement therapy (RRT) on 31st December 2012 with a BP reading in either the fourth or third quarter of 2012 were included. Summary statistics were calculated for each renal centre and country. Data completeness for BP measurements submitted to the UK Renal Registry (UKRR) for all modalities were improved from previous years: it was better for haemodialysis (HD) patients (75% for pre-HD measurements) than for peritoneal dialysis (PD) patients (51%) or transplant recipients (41%). In 2012, the median pre- and post-HD systolic blood pressures (SBPs) were 140 mmHg and 128 mmHg respectively. The median SBP of patients on PD was 137 mmHg. Transplant recipients had a median SBP of 134 mmHg. Median diastolic blood pressures (DBPs) were 71 mmHg (pre-HD), 67 mmHg (post-HD), 78 mmHg (PD) and 79 mmHg (transplant). Only 26% of PD patients achieved the Renal Association guideline of SBP <130 mmHg and DBP <80 mmHg. Amongst transplant patients, 27% achieved the Renal Association guideline of SBP <130 mmHg and DBP <80 mmHg. In 2012 there continued to be significant variation in the achievement of BP standards between UK renal centres. © 2014 S. Karger AG, Basel.

RESULTS OF THE NATIONWIDE DBP OCCURRENCE STUDY: IDENTIFICATION OF NEW AND INTERESTING DBPS

EPA Science Inventory

Drinking water disinfection by-products (DBPs) are formed when disinfectants, such as chlorine, react with natural organic matter and bromide present in the water. Chloroform was the first DBP identified in drinking water (in 1974), and was subsequently shown (along with other t...

Inter-arm Differences in Simultaneous Blood Pressure Measurements in Ambulatory Patients without Cardiovascular Diseases.

PubMed

Kim, Kyoung Bog; Oh, Mi Kyeong; Kim, Haa Gyoung; Ki, Ji Hoon; Lee, Soo Hee; Kim, Su Min

2013-03-01

It has traditionally been known that there is normally a difference in blood pressure (BP) between the two arms; there is at least 20 mm Hg difference in the systolic blood pressure (SBP) and 10 mm Hg difference in the diastolic blood pressure (DBP). However, recent epidemiologic studies have shown that there are between-arm differences of < 5 mm Hg in simultaneous BP measurements. The purposes of this study is to examine whether there are between-arm differences in simultaneous BP measurements obtained from ambulatory patients without cardiovascular diseases and to identify the factors associated these differences. We examined 464 patients who visited the outpatient clinic of Gangneung Asan Hospital clinical department. For the current analysis, we excluded patients with ischemic heart disease, stroke, arrhythmia, congestive heart failure, or hyperthyroidism. Simultaneous BP measurements were obtained using the Omron MX3 BP monitor in both arms. The inter-arm difference (IAD) in BP was expressed as the relative difference (right-arm BP [R] minus left-arm BP [L]: R - L) and the absolute difference (|R - L|). The mean absolute IAD in SBP and DBP were 3.19 ± 2.38 and 2.41 ± 1.59 mm Hg, respectively, in men and 2.61 ± 2.18 and 2.25 ± 2.01 mm Hg, respectively, in women. In men, there were 83.8% of patients with the IAD in SBP of ≤ 6 mm Hg, 98.1% with the IAD in SBP of ≤ 10 mm Hg, 96.5% with the IAD in DBP of ≤ 6 mm Hg and 0% with the IAD in DBP of > 10 mm Hg. In women, 89.6% of patients had IAD in SBP of ≤ 6 mm Hg, 92.1% with IAD in DBP of ≤ 6 mm Hg, and 0% with IAD in SBP of > 10 mm Hg or IAD in DBP of > 10 mm Hg. Gangneung Asan Hospital clinical series of patients showed that the absolute IAD in SBP had a significant correlation with cardiovascular risk factors such as the 10-year Framingham cardiac risk scores and higher BP in men and higher BP in women. However, the absolute IAD in SBP and DBP had no significant correlation with the age, obesity

Inter-arm Differences in Simultaneous Blood Pressure Measurements in Ambulatory Patients without Cardiovascular Diseases

PubMed Central

Kim, Kyoung Bog; Kim, Haa Gyoung; Ki, Ji Hoon; Lee, Soo Hee; Kim, Su Min

2013-01-01

Background It has traditionally been known that there is normally a difference in blood pressure (BP) between the two arms; there is at least 20 mm Hg difference in the systolic blood pressure (SBP) and 10 mm Hg difference in the diastolic blood pressure (DBP). However, recent epidemiologic studies have shown that there are between-arm differences of < 5 mm Hg in simultaneous BP measurements. The purposes of this study is to examine whether there are between-arm differences in simultaneous BP measurements obtained from ambulatory patients without cardiovascular diseases and to identify the factors associated these differences. Methods We examined 464 patients who visited the outpatient clinic of Gangneung Asan Hospital clinical department. For the current analysis, we excluded patients with ischemic heart disease, stroke, arrhythmia, congestive heart failure, or hyperthyroidism. Simultaneous BP measurements were obtained using the Omron MX3 BP monitor in both arms. The inter-arm difference (IAD) in BP was expressed as the relative difference (right-arm BP [R] minus left-arm BP [L]: R - L) and the absolute difference (|R - L|). Results The mean absolute IAD in SBP and DBP were 3.19 ± 2.38 and 2.41 ± 1.59 mm Hg, respectively, in men and 2.61 ± 2.18 and 2.25 ± 2.01 mm Hg, respectively, in women. In men, there were 83.8% of patients with the IAD in SBP of ≤ 6 mm Hg, 98.1% with the IAD in SBP of ≤ 10 mm Hg, 96.5% with the IAD in DBP of ≤ 6 mm Hg and 0% with the IAD in DBP of > 10 mm Hg. In women, 89.6% of patients had IAD in SBP of ≤ 6 mm Hg, 92.1% with IAD in DBP of ≤ 6 mm Hg, and 0% with IAD in SBP of > 10 mm Hg or IAD in DBP of > 10 mm Hg. Gangneung Asan Hospital clinical series of patients showed that the absolute IAD in SBP had a significant correlation with cardiovascular risk factors such as the 10-year Framingham cardiac risk scores and higher BP in men and higher BP in women. However, the absolute IAD in SBP and DBP had no significant correlation

Validation of the Grandway MD2301 digital automatic blood pressure monitor according to the European Society of Hypertension International Protocol.

PubMed

Chen, Wan; Zeng, Zhao-Lin; Bing, Sen; Li, Lin-Yi; Wang, Rui; Wan, Yi

2016-08-01

The aim of the present study was to validate the Grandway MD2301 digital automatic blood pressure monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. The ESH-IP revision 2010 for the validation of blood pressure-measuring devices in adults was followed precisely. Systolic and diastolic blood pressure (SBP and DBP, respectively) were measured sequentially in 33 adult patients and compared with a standard mercury sphygmomanometer (two observers). A total of 99 comparison pairs were obtained. The device produced 78, 95 and 99 measurements within 5, 10, and 15 mmHg for SBP and 83, 96, and 99 for DBP, respectively. The average device-observer difference was -1.81±4.22 mmHg for SBP and -0.15±3.93 mmHg for DBP. All of the data were within the standards requirements to pass the testing. The Grandway MD2301 digital automatic blood pressure monitor meets the standards of the ESH-IP revision 2010 and can be recommended for self/home measurement in the general population.

DBP formation of aquatic humic substances

USGS Publications Warehouse

Pomes, M.L.; Green, W.R.; Thurman, E.M.; Orem, W.H.; Lerch, H.E.

1999-01-01

Aquatic humic substances (AHSs) in water generate potentially harmful disinfection by-products (DBPs) such as haloacetic acids (HAAs) and trihalomethanes (THMs) during chlorination. AHSs from two Arkansas reservoirs were characterized to define source, identify meta-dihydroxybenzene (m-DHB) structures as probable DBP precursors, and evaluate predicted HAA and THM formation potentials. Elemental nitrogen content 0.5 ??eq/mg, ??13C values of -27???, and low yields of syringyl phenols found by cupric oxide (CuO) oxidation suggest a pine tree source for the AHSs found in the Maumelle and Winona reservoirs in Little Rock, Ark. CuO oxidation yielded fewer m-DHB structures in Maumelle AHSs than in Winona AHSs. A higher 3,5-dihydroxybenzoic acid (3,5-DHBA) content correlated with increased HAA and THM formation potential. The 3,5-DHBA concentration in Winona AHSs was similar to the range found in AHSs extracted from deciduous leaf litter, twigs, and grass leachates.

Aging attenuates the interarm diastolic blood pressure difference induced by one-arm exercise.

PubMed

Hu, Wei-tong; Li, Ju-xiang; Wang, Ji-wei; Xu, Jin-song; Yang, Qing; Geng, Yong-Jian; Su, Hai; Cheng, Xiao-shu

2013-04-01

It is known that one-arm exercise increases the interarm diastolic blood pressure difference (dIAD) in young individuals, but no research has been carried out in middle-aged and more senior populations. This study aimed to determine whether aging impacts the exercise-induced dIAD in healthy individuals. Normotensive adults (n=120) were recruited and divided into the young (22.5±1.5 years), middle-aged (42.8±4.6 years), and senior (61.0±7.0 years) groups. The right arm exercise involved performing cycling movements at 60 times/min for 3 min. Bilateral brachial blood pressures (BPs) were simultaneously measured using two automatic BP measurement devices before (baseline), immediately (0), 5, 10, and 15 min after the exercise. The difference in bilateral diastolic BPs was calculated as BP l-r and its absolute value of at least 10 mmHg was considered as IAD. At baseline, the systolic blood pressure (SBP) l-r and diastolic blood pressure (DBP) l-r were similar in three age groups. One-arm exercise induced a marked decrease in DBP in the exercised arm, and then increased the prevalence of DBP l-r and dIAD in the three age groups in an age-dependent manner. The prevalence of dIAD increased from the baseline of zero to 85% at 0 min in young, 37% in middle-aged, and 30% in senior groups. One-arm exercise did not significantly alter the prevalence of SBP l-r and systolic IAD in the three groups. A reverse correlation was found between the DBP l-r 0 and ages (r=-0.359, P<0.05), but there was no correlation between aging and SBP l-r 0. Aging attenuates the levels and duration of the dIAD induced by one-arm exercise in healthy adults.

Biodegradation of di-n-butyl phthalate (DBP) by a novel endophytic Bacillus megaterium strain YJB3.

PubMed

Feng, Nai-Xian; Yu, Jiao; Mo, Ce-Hui; Zhao, Hai-Ming; Li, Yan-Wen; Wu, Bing-Xiao; Cai, Quan-Ying; Li, Hui; Zhou, Dong-Mei; Wong, Ming-Hung

2018-03-01

Phthalic acid esters (PAEs) are a group of recalcitrant and hazardous organic compounds that pose a great threat to both ecosystem and human beings. A novel endophytic strain YJB3 that could utilize a wide range of PAEs as the sole carbon and energy sources for cell growth was isolated from Canna indica root tissue. It was identified as Bacillus megaterium based on morphological characteristics and 16S rDNA sequence homology analysis. The degradation capability of the strain YJB3 was investigated by incubation in mineral salt medium containing di-n-butyl-phthalate (DBP), one of important PAEs under different environmental conditions, showing 82.5% of the DBP removal in 5days of incubation under the optimum conditions (acetate 1.2g·L -1 , inocula 1.8%, and temperature 34.2°C) achieved by two-step sequential optimization technologies. The DBP metabolites including mono-butyl phthalate (MBP), phthalic acid (PA), protocatechuic acid (PCA), etc. were determined by GC-MS. The PCA catabolic genes responsible for the aromatic ring cleavage of PCA in the strain YJB3 were excavated by whole-genome sequencing. Thus, a degradation pathway of DBP by the strain YJB3 was proposed that MBP was formed, followed by PA, and then the intermediates were further utilized till complete degradation. To our knowledge, this is the first study to show the biodegradation of PAEs using endophyte. The results in the present study suggest that the strain YJB3 is greatly promising to act as a competent inoculum in removal of PAEs in both soils and crops. Copyright © 2017 Elsevier B.V. All rights reserved.

Blood pressure and antihypertensive medication profile in a multiethnic Asian population of stable chronic kidney disease patients.

PubMed

Teo, Boon Wee; Chua, Horng Ruey; Wong, Weng Kin; Haroon, Sabrina; Subramanian, Srinivas; Loh, Ping Tyug; Sethi, Sunil; Lau, Titus

2016-05-01

Clinical practice guidelines recommend different blood pressure (BP) goals for chronic kidney disease (CKD) patients. Usage of antihypertensive medication and attainment of BP targets in Asian CKD patients remain unclear. This study describes the profile of antihypertensive agents used and BP components in a multiethnic Asian population with stable CKD. Stable CKD outpatients with variability of serum creatinine levels < 20%, taken > 3 months apart, were recruited. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated manometers, according to practice guidelines. Serum creatinine was assayed and the estimated glomerular filtration rate (GFR) calculated using the CKD Epidemiology Collaboration equation. BP and antihypertensive medication profile was examined using univariate analyses. 613 patients (55.1% male; 74.7% Chinese, 6.4% Indian, 11.4% Malay; 35.7% diabetes mellitus) with a mean age of 57.8 ± 14.5 years were recruited. Mean SBP was 139 ± 20 mmHg, DBP was 74 ± 11 mmHg, serum creatinine was 166 ± 115 µmol/L and GFR was 53 ± 32 mL/min/1.73 m(2). At a lower GFR, SBP increased (p < 0.001), whereas DBP decreased (p = 0.0052). Mean SBP increased in tandem with the number of antihypertensive agents used (p < 0.001), while mean DBP decreased when ≥ 3 antihypertensive agents were used (p = 0.0020). Different targets are recommended for each BP component in CKD patients. A majority of patients cannot attain SBP targets and/or exceed DBP targets. Research into monitoring and treatment methods is required to better define BP targets in CKD patients. Copyright: © Singapore Medical Association.

Effects of vitamin D binding protein-macrophage activating factor (DBP-MAF) infusion on bone resorption in two osteopetrotic mutations.

PubMed

Schneider, G B; Benis, K A; Flay, N W; Ireland, R A; Popoff, S N

1995-06-01

Osteopetrosis is a heterogeneous group of bone diseases characterized by an excess accumulation of bone and a variety of immune defects. Osteopetrosis (op) and incisors absent (ia) are two nonallelic mutations in the rat which demonstrated these skeletal defects as a result of reduced bone resorption. Osteopetrotic (op) rats have severe sclerosis as a result of reduced numbers of osteoclasts which are structurally abnormal. The sclerosis in ia rats is not as severe as in op mutants; they have elevated numbers of osteoclasts, but they are also morphologically abnormal, lacking a ruffled border. Both of these mutations have defects in the inflammation-primed activation of macrophages. They demonstrate independent defects in the cascade involved in the conversion of vitamin D binding protein (DBP) to a potent macrophage activating factor (DBP-MAF). Because this factor may also play a role in the pathogenesis of osteoclastic dysfunction, the effects of ex vivo-generated DBP-MAF were evaluated on the skeletal system of these two mutations. Newborn ia and op rats and normal littermate controls were injected with DBP-MAF or vehicle once every 4 days from birth until 2 weeks of age, at which time bone samples were collected to evaluate a number of skeletal parameters. DBP-MAF treated op rats had an increased number of osteoclasts and the majority of them exhibited normal structure. There was also reduced bone volume in the treated op animals and an associated increased cellularity of the marrow spaces. The skeletal sclerosis was also corrected in the ia rats; the bone marrow cavity size was significantly enlarged and the majority of the osteoclasts appeared normal with extensive ruffled borders.

Integrated Disinfection Byproducts (DBPs) Mixtures Research: DBP Concentration via Reverse Osmosis Membrane Techniques

EPA Science Inventory

With the completion of the 4-lab project, the NOM concentration aspect of 4-lab is being continued with renewed focus on creating drinking water relevant freeze-dried NOM isolates that can be used for many drinking water research efforts from DBP investigations to water reuse inv...

A new automatic blood pressure kit auscultates for accurate reading with a smartphone

PubMed Central

Wu, Hongjun; Wang, Bingjian; Zhu, Xinpu; Chu, Guang; Zhang, Zhi

2016-01-01

Abstract The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and −0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989–0.995) and diastolic (ICC = 0.987, 95% CI: 0.979–0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland–Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service. PMID:27512876

The protective role of racial identity and Africentric worldview in the association between racial discrimination and blood pressure.

PubMed

Neblett, Enrique W; Carter, Sierra E

2012-06-01

To examine the protective effects of racial identity and Africentric worldview on the association between racial discrimination and blood pressure (BP). Two hundred ten African American young adults completed questionnaires assessing demographic characteristics, prior racial discrimination experiences, racial identity, and Africentric worldview. Resting BP was assessed before and after completion of the study measures. Racial discrimination was unrelated to BP in the overall sample (systolic BP, p = .444; diastolic BP [DBP], p = .915; mean arterial pressure, p = .774). However, racial identity and Africentric worldview moderated the association between racial discrimination and BP. Racial discrimination was negatively related to DBP for participants who felt that others viewed African Americans less favorably and who endorsed the uniqueness of the African American experience (B = -2.59, standard error [SE] = 1.29, p = .046). These individuals also had the lowest DBP at high levels of racial discrimination. Racial discrimination was positively associated with DBP for individuals with low levels of Africentric orientation (B = 1.43, SE = 0.72, p = .048) but was unrelated to DBP at moderate (B = 0.24, SE = 0.65, p = .718) and high (B = -0.96, SE = 1.01, p = .341) levels of Africentric worldview. Racial and cultural personal characteristics such as racial identity and Africentric orientation may serve an important protective function for BP in African American young adults.

Does the accuracy of blood pressure measurement correlate with hearing loss of the observer?

PubMed

Song, Soohwa; Lee, Jongshill; Chee, Youngjoon; Jang, Dong Pyo; Kim, In Young

2014-02-01

The auscultatory method is influenced by the hearing level of the observers. If the observer has hearing loss, it is possible to measure blood pressure inaccurately by misreading the Korotkoff sounds at systolic blood pressure (SBP) and diastolic blood pressure (DBP). Because of the potential clinical problems this discrepancy may cause, we used a hearing loss simulator to determine how hearing level affects the accuracy of blood pressure measurements. Two data sets (data set A, 32 Korotkoff sound video clips recorded by the British Hypertension Society; data set B, 28 Korotkoff sound data acquired from the Korotkoff sound recording system developed by Hanyang University) were used and all the data were attenuated to simulate a hearing loss of 5, 10, 15, 20, and 25 dB using the hearing loss simulator. Five observers with normal hearing assessed the blood pressures from these data sets and the differences between the values measured from the original recordings (no attenuation) and the attenuated versions were analyzed. Greater attenuation of the Korotkoff sounds, or greater hearing loss, resulted in larger blood pressure measurement differences when compared with the original data. When measuring blood pressure with hearing loss, the SBP tended to be underestimated and the DBP was overestimated. The mean differences between the original data and the 25 dB hearing loss data for the two data sets combined were 1.55±2.71 and -4.32±4.21 mmHg for SBP and DBP, respectively. This experiment showed that the accuracy of blood pressure measurements using the auscultatory method is affected by observer hearing level. Therefore, to reduce possible error using the auscultatory method, observers' hearing should be tested.

Impact of the Absolute Difference in Diastolic Blood Pressure Between Arms in Patients With Coronary Artery Disease

PubMed Central

Hitaka, Yuka; Miura, Shin-ichiro; Koyoshi, Rie; Shiga, Yuhei; Miyase, Yuiko; Norimatsu, Kenji; Nakamura, Ayumi; Adachi, Sen; Kuwano, Takashi; Sugihara, Makoto; Ike, Amane; Nishikawa, Hiroaki; Saku, Keijiro

2015-01-01

Background We investigated the relationship between the severity and presence of coronary artery disease (CAD) and a difference in systolic and diastolic blood pressure (SBP and DBP) between arms or between lower limbs. Methods We enrolled 277 patients who underwent coronary angiography. We calculated the absolute (|right BP (rt. BP) - left BP (lt. BP)|) and relative (rt. BP - lt. BP) differences in SBP or DBP between arms or between lower limbs, and assessed the severity of CAD in terms of the Gensini score. Results The absolute difference in DBP between arms in the CAD group was significantly lower than that in the non-CAD group, whereas the absolute difference in DBP between lower limbs in the CAD group was significantly higher. There were no differences in the absolute or relative difference in SBP between arms or lower limbs between the groups. The absolute difference in DBP between arms decreased as the Gensini score increased. In a logistic regression analysis, the presence of CAD was independently associated with the absolute difference in DBP between arms, in addition to male, family history, dyslipidemia, diabetes mellitus and hypertension. Conclusion The absolute difference in DBP between arms in addition to traditional factors may be a critical risk factor for the presence of CAD. PMID:26491500

Impact of the Absolute Difference in Diastolic Blood Pressure Between Arms in Patients With Coronary Artery Disease.

PubMed

Hitaka, Yuka; Miura, Shin-Ichiro; Koyoshi, Rie; Shiga, Yuhei; Miyase, Yuiko; Norimatsu, Kenji; Nakamura, Ayumi; Adachi, Sen; Kuwano, Takashi; Sugihara, Makoto; Ike, Amane; Nishikawa, Hiroaki; Saku, Keijiro

2015-11-01

We investigated the relationship between the severity and presence of coronary artery disease (CAD) and a difference in systolic and diastolic blood pressure (SBP and DBP) between arms or between lower limbs. We enrolled 277 patients who underwent coronary angiography. We calculated the absolute (|right BP (rt. BP) - left BP (lt. BP)|) and relative (rt. BP - lt. BP) differences in SBP or DBP between arms or between lower limbs, and assessed the severity of CAD in terms of the Gensini score. The absolute difference in DBP between arms in the CAD group was significantly lower than that in the non-CAD group, whereas the absolute difference in DBP between lower limbs in the CAD group was significantly higher. There were no differences in the absolute or relative difference in SBP between arms or lower limbs between the groups. The absolute difference in DBP between arms decreased as the Gensini score increased. In a logistic regression analysis, the presence of CAD was independently associated with the absolute difference in DBP between arms, in addition to male, family history, dyslipidemia, diabetes mellitus and hypertension. The absolute difference in DBP between arms in addition to traditional factors may be a critical risk factor for the presence of CAD.

The dependence of chlorine decay and DBP formation kinetics on pipe flow properties in drinking water distribution.

PubMed

Zhao, Yingying; Yang, Y Jeffrey; Shao, Yu; Neal, Jill; Zhang, Tuqiao

2018-04-27

Simultaneous chlorine decay and disinfection byproduct (DBP) formation have been discussed extensively because of their regulatory and operational significance. This study further examines chemical reaction variability in the water quality changes under various hydrodynamic conditions in drinking water distribution. The variations of kinetic constant for overall chlorine decay (k E ) and trihalomethane (THM) formation were determined under stagnant to turbulent flows using three devices of different wall demand and two types of natural organic matters (NOM) in water. The results from the comparative experiments and modeling analyses show the relative importance of wall demand (k w ), DBP-forming chlorine decay (k D ), and other bulk demand (k b ' ) for pipe flows of Re = 0-52500. It is found that chlorine reactivity of virgin NOM is the overriding factor. Secondly, for tap water NOM of lower reactivity, pipe flow properties (Re or u) can significantly affect k E , the THM yield (T), formation potential (Y), and the time to reach the maximum THM concentration (t max ) through their influence on kinetic ratio k D (k b ' +k w ). These observations, corroborating with turbidity variations during experiments, cannot be explained alone by chlorine dispersion to and from the pipe wall. Mass exchanges through deposition and scale detachment, most likely being flow-dependent, may have contributed to the overall chlorine decay and DBP formation rates. Thus for the simultaneous occurrence of chlorine decay and DBP formation, model considerations of NOM reactivity, pipe types (wall demand), flow hydraulics, and their interactions are essential. Copyright © 2018 Elsevier Ltd. All rights reserved.

Blood pressure differences between office and home settings among Japanese normotensive subjects and hypertensive patients.

PubMed

Mori, Hisao; Ukai, Hiroshi; Yamamoto, Hareaki; Yuasa, Shouhei; Suzuki, Yoshiro; Chin, Keiichi; Katsumata, Takuma; Umemura, Satoshi

2017-03-01

This study attempted to clarify the differences in blood pressure (BP) between the office (clinic) and home settings in patients with controlled, sustained, masked or white-coat hypertension. The following formula was used: office mean systolic BP (omSBP)-mean morning home SBP (mmhSBP)/office mean diastolic BP (omDBP)-mean morning home DBP (mmhDBP). The paired t-test was used for statistical analysis. The omSBP-mmhSBP/omDBP-mmhDBP calculation yielded the following results: among normotensive subjects, -1.1±11.2/-1.7±8.5 mm Hg (mean SBP and mean DBP were higher at home than in the office; n=451, P=0.038 in SBP, P=0.000 in DBP); in controlled hypertensive patients, -0.42±10.9/-2.2±8.2 mm Hg (n=1362, P=0.160 in SBP, P=0.000 in DBP); among sustained hypertensive patients, 5.6±14.7/0.048±9.9 mm Hg (n=1370, P=0.000 in SBP, P=0.857 in DBP); in masked hypertensive patients, -15.3±12.9/-9.3±9.5 mm Hg (n=1308, both P=0.000); and among white-coat hypertensive patients, 23.7±13.2/8.2±9.1 mm Hg (n=580, both P=0.000). Our results showed a difference of 5 mm Hg in SBP among sustained hypertensive patients, as recommended by the Japanese Society of Hypertension Guidelines for the Management of Hypertension; however, in other hypertensive patient types, the differences in SBP and DBP between office and home measurements differed by >5 mm Hg. Office and home BP measurements should be interpreted cautiously, keeping in mind the clinical setting.

Effects of garlic on blood pressure in patients with and without systolic hypertension: a meta-analysis.

PubMed

Reinhart, Kurt M; Coleman, Craig I; Teevan, Colleen; Vachhani, Payal; White, C Michael

2008-12-01

Garlic has been suggested to lower blood pressure; however, studies evaluating this parameter have provided conflicting results. To examine the effect of garlic on blood pressure in patients with and without elevated systolic blood pressure (SPB) through meta-analyses of randomized controlled trials. A systematic search of MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials was conducted to identify randomized controlled trials in humans evaluating garlic's effect on blood pressure. All databases were searched from their inception through June 26, 2008, using the key words garlic, Allium sativum, and allicin. A manual search of published literature was used to identify additional relevant studies. To be included in the analysis, studies must have been written in English or German and reported endpoints of SBP or diastolic blood pressure (DBP). Studies whose population had a mean baseline SBP greater than 140 mm Hg were evaluated separately from those whose population had lower baseline blood pressures. Garlic's effect on SBP and DBP was treated as a continuous variable and weighted mean differences were calculated using a random-effects model. Ten trials were included in the analysis; 3 of these had patients with elevated SBP. Garlic reduced SBP by 16.3 mm Hg (95% CI 6.2 to 26.5) and DBP by 9.3 mm Hg (95% CI 5.3 to 13.3) compared with placebo in patients with elevated SBP. However, the use of garlic did not reduce SBP or DBP in patients without elevated SBP. There was only a minor degree of heterogeneity in the analyses and publication bias did not appear to influence the results. This meta-analysis suggests that garlic is associated with blood pressure reductions in patients with an elevated SBP although not in those without elevated SBP. Future research should focus on the impact of garlic on clinical events and the assessment of the long-term risk of harm.

Clinical significance of blood pressure ratios in hypertensive crisis in children.

PubMed

Wu, Han-Ping; Yang, Wen-Chieh; Wu, Yung-Kang; Zhao, Lu-Lu; Chen, Chun-Yu; Fu, Yun-Ching

2012-03-01

Hypertensive crisis is categorised into hypertensive urgency and hypertensive emergency. The present work aimed to determine the effect of different gradings of blood pressure (BP) ratios in predicting the severity of paediatric hypertensive crisis. This was a retrospective case series, based in the paediatric emergency departments of the Changhua Christian Hospital and the Tzu-Chi General Hospital, Taiwan. From 1995 to 2010, the correlation between the severity of hypertension (HTN) and the difference in elevated systolic BP and 99th percentile plus 5 mm Hg (dSBP), the difference in elevated diastolic BP and 99th percentile plus 5 mm Hg (dDBP), dSBP ratio (dSBP/99th percentile plus 5 mm Hg) and dDBP ratio were analysed. A total of 110 children with a first attack of hypertensive crisis were recruited. Patients with hypertensive crisis caused by essential HTN had lower dDBP ratios than the other causes (p=0.033), while those with an oncological aetiology had the highest dSBP and dDBP ratios among all the aetiologies. For clinical presentations, patients with nausea/vomiting and visual impairment presented with higher dSBP ratios than those without the symptoms (both p<0.05), but patients with altered consciousness had higher dSBP and dDBP ratios than those who had clear consciousness (p<0.05). Children with hypertensive urgency had lower dSBP and dDBP ratios than those with hypertensive emergency (both p<0.05). dDBP and dSBP ratios may serve as BP parameters in predicting the severity of paediatric hypertensive crisis. A dSBP ratio greater than 20% may indicate a critical point for severe hypertensive crisis in children.

Validation of the Andon KD-5917 automatic upper arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Guo, Wan-Gang; Li, Bing-Ling; He, Yong; Xue, Yu-Sheng; Wang, Hai-Yan; Zheng, Qiang-Sun; Xiang, Ding-Cheng

2014-08-01

To validate the Andon KD-5917 automatic upper arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Sequential same-left-arm measurements of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were obtained in 33 participants using the mercury sphygmomanometer and the test device. According to the validation protocol, 99 pairs of test device and reference blood pressure measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 73, 98, and 99 measurements within 5, 10, and 15 mmHg for SBP and 86, 98, and 99 for DBP, respectively. The mean ± SD device-observer difference was 3.07 ± 3.68 mmHg for SBP and -0.89 ± 3.72 mmHg for DBP. The number of patients with two or three of the device-observer difference within 5 mmHg was 26 for SBP and 29 for DBP, and no patient had a device-observer difference within 5 mmHg. The Andon KD-5917 automatic upper arm blood pressure monitor can be recommended for clinical use and self-measurement in an adult population on the basis of the European Society of Hypertension International Protocol revision 2010.

Suppression of grp78 core promoter element-mediated stress induction by the dbpA and dbpB (YB-1) cold shock domain proteins.

PubMed Central

Li, W W; Hsiung, Y; Wong, V; Galvin, K; Zhou, Y; Shi, Y; Lee, A S

1997-01-01

The highly conserved grp78 core promoter element plays an important role in the induction of grp78 under diverse stress signals. Previous studies have established a functional region in the 3' half of the core (stress-inducible change region [SICR]) which exhibits stress-inducible changes in stressed nuclei. The human transcription factor YY1 is shown to bind the SICR and transactivate the core element under stress conditions. Here we report that expression library screening with the core element has identified two new core binding proteins, YB-1 and dbpA. Both proteins belong to the Y-box family of proteins characterized by an evolutionarily conserved DNA binding motif, the cold shock domain (CSD). In contrast to YY1, which binds only double-stranded SICR, the Y-box/CSD proteins much prefer the lower strand of the SICR. The Y-box proteins can repress the inducibility of the grp78 core element mediated by treatment of cells with A23187, thapsigargin, and tunicamycin. In gel shift assays, YY1 binding to the core element is inhibited by either YB-1 or dbpA. A yeast interaction trap screen using LexA-YY1 as a bait and a HeLa cell cDNA-acid patch fusion library identified YB-1 as a YY1-interacting protein. In cotransfection experiments, the Y-box proteins antagonize the YY1-mediated enhancement of transcription directed by the grp78 core in stressed cells. Thus, the CSD proteins may be part of the stress signal transduction mechanism in the mammalian system. PMID:8972186

The effect of viscous soluble fiber on blood pressure: A systematic review and meta-analysis of randomized controlled trials.

PubMed

Khan, K; Jovanovski, E; Ho, H V T; Marques, A C R; Zurbau, A; Mejia, S B; Sievenpiper, J L; Vuksan, V

2018-01-01

Dietary fiber intake, especially viscous soluble fiber, has been established as a means to reduce cardiometabolic risk factors. Whether this is true for blood pressure remains controversial. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate the effects of viscous soluble fiber supplementation on blood pressure and quantify the effect of individual fibers. MEDLINE, Embase, and Cochrane databases were searched. We included RCTs of ≥4-weeks in duration assessing viscous fiber supplementation from five types: β-glucan from oats and barley, guar gum, konjac, pectin and psyllium, on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Study data were pooled using the generic inverse variance method with random effects models and expressed as mean differences (MD) with 95% confidence intervals (CIs). Twenty-two (N = 1430) and twenty-one RCTs (N = 1343) were included in the final analysis for SBP and DBP, respectively. Viscous fiber reduced SBP (MD = -1.59 mmHg [95% CI: -2.72,-0.46]) and DBP (MD = -0.39 mmHg [95% CI: -0.76,-0.01]) at a median dose of 8.7 g/day (1.45-30 g/day) over a median follow-up of 7-weeks. Substantial heterogeneity in SBP (I 2  = 72%, P < 0.01) and DBP (I 2  = 67%, P < 0.01) analysis occurred. Within the five fiber types, SBP reductions were observed only for supplementation using psyllium fiber (MD = -2.39 mmHg [95% CI: -4.62,-0.17]). Viscous soluble fiber has an overall lowering effect on SBP and DBP. Inclusion of viscous fiber to habitual diets may have additional value in reducing CVD risk via improvement in blood pressure. ClinicalTrials.gov identifier-NCT02670967. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Low job control is associated with higher diastolic blood pressure in men with mildly elevated blood pressure: the Rosai Karoshi study.

PubMed

Hattori, Tomomi; Munakata, Masanori

2015-01-01

Job strain is a risk factor for hypertension, but it is not fully understood if components of job strain, or job demand or job control per se could be related to blood pressure (BP), and if so, whether the relationship differs between normotension and mildly elevated BP. We examined resting BP, and job stress components in 113 Japanese male hospital clerks (38.1 ± 4.4 yr). Subjects were classified into normotensive (NT) (<130/85 mmHg, n=83) and mildly elevated BP (ME) (≥130/85 mmHg) groups. Diastolic BP (DBP) showed a significant interaction between group and job control level (p=0.013). Subjects with low job control demonstrated higher DBP than those with high job control (89.1 ± 2.1 vs. 82.3 ± 2.3 mmHg, p=0.042) in ME group even after adjustments for covariates while DBP did not differ between low and high job control subjects in NT group. Systolic BP (SBP) did not differ between high and low job control subjects in both groups. Neither SBP nor DBP differed between high and low demand groups in either group. Among job strain components, job control may be independently related to BP in Japanese male workers with mildly elevated BP.

Low job control is associated with higher diastolic blood pressure in men with mildly elevated blood pressure: the Rosai Karoshi study

PubMed Central

HATTORI, Tomomi; MUNAKATA, Masanori

2015-01-01

Job strain is a risk factor for hypertension, but it is not fully understood if components of job strain, or job demand or job control per se could be related to blood pressure (BP), and if so, whether the relationship differs between normotension and mildly elevated BP. We examined resting BP, and job stress components in 113 Japanese male hospital clerks (38.1 ± 4.4 yr). Subjects were classified into normotensive (NT) (<130/85 mmHg, n=83) and mildly elevated BP (ME) (≥130/85 mmHg) groups. Diastolic BP (DBP) showed a significant interaction between group and job control level (p=0.013). Subjects with low job control demonstrated higher DBP than those with high job control (89.1 ± 2.1 vs. 82.3 ± 2.3 mmHg, p=0.042) in ME group even after adjustments for covariates while DBP did not differ between low and high job control subjects in NT group. Systolic BP (SBP) did not differ between high and low job control subjects in both groups. Neither SBP nor DBP differed between high and low demand groups in either group. Among job strain components, job control may be independently related to BP in Japanese male workers with mildly elevated BP. PMID:25914072

The effect of dairy consumption on blood pressure in mid-childhood: CAPS cohort study.

PubMed

Rangan, A M; Flood, V L; Denyer, G; Ayer, J G; Webb, K L; Marks, G B; Celermajer, D S; Gill, T P

2012-06-01

It has been postulated that a higher dairy consumption may affect blood pressure regulation. The aim of this study was to examine the association between dairy consumption and blood pressure in mid-childhood. Subjects (n = 335) were participants of a birth cohort at high risk of asthma with information on diet at 18 months and blood pressure at 8 years. Multivariate analyses were used to assess the association of dairy consumption (serves) and micronutrient intakes (mg). In a subgroup of children (n = 201), dietary intake was also measured at approximately 9 years. Children in the highest quintile of dairy consumption at 18 months had lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 8 years (2.5 mm Hg, P=0.046 and 1.9 mm Hg, P = 0.047, respectively) than those in the lowest quintiles. SBP was lowest among children in the highest quintiles of calcium, magnesium and potassium intakes. Significant negative linear trends were observed between SBP and intakes of dairy serves, calcium, magnesium and potassium. Furthermore, SBP and DBP were lowest in the group of children that consumed at least two dairy serves at both 18 months and the follow-up dietary data collection at 9 years, compared with all other children (SBP 98.7 vs 101.0 mm Hg, P = 0.07; and DBP 56.5 vs 59.3 mm Hg, P = 0.006, respectively). These results are consistent with a protective effect of dairy consumption in childhood on blood pressure at age 8 years.

Older Women with Controlled Isolated Systolic Hypertension: Exercise and Blood Pressure.

PubMed

Ubolsakka-Jones, Chulee; Sangthong, Benjarat; Aueyingsak, Sahachat; Jones, David A

2016-06-01

Exercise is generally regarded as beneficial for health, but the consequent increases in blood pressure might pose a risk for hypertensive subjects. The purpose of this study was to determine blood pressure responses to dynamic exercise and sustained handgrip in patients with isolated systolic hypertension (ISH) who were stable on medication. Nineteen female ISH patients (66 ± 5 yr) and 19 age-matched normotensive (NT) female controls undertook a 5-min cycle exercise (60% heart rate reserve [HRR]) and a 2-min handgrip exercise (30% maximum voluntary contraction). Blood pressure responses were measured using an oscillometric cuff, together with heart rate and resting brachial pulse transit times. Systolic blood pressure (SBP) levels after cycle exercise were 194 ± 18 and 153 ± 19 mm Hg for ISH and NT, respectively, with the increase above resting being greater for ISH (P < 0.001), and only small changes were found in diastolic blood pressure (DBP). During handgrip exercise, SBP rose to 168 ± 19 and 140 ± 8 mm Hg for ISH and NT, respectively. The increases above baseline were greater for ISH both during the exercise and postexercise circulatory occlusion (P = 0.017). The increase in DBP levels during exercise and postexercise occlusion were similar in ISH and NT, suggesting little difference in metaboreflex sensitivity. Pulse transit time was shorter for ISH compared with NT (166 ± 6 ms and 242 ± 24 ms, respectively, P < 0.001), indicating stiffer arteries, which would increase SBP but not DBP. Despite being well controlled and normotensive control subjects at rest, ISH patients had high SBP responses to both dynamic and static exercises, which may constitute a risk for cardiovascular incidents.

Association between Macronutrients Intake, Visceral Obesity and Blood Pressure in a Sample of Obese Egyptian Women.

PubMed

Hassan, Nayera E; El Shebini, Salwa M; Ahmed, Nihad H; Selim Mostafa, Mohamed

2015-03-15

Study the association between the total caloric intake, protein, lipid, and some classes of fatty acids of the diet, and their effects on blood pressure in a sample of Egyptian obese women with and without visceral obesity. Five hundred forty-nine obese women were included in the study with mean age of 38.1 ± 11.56 years and mean Body mass index [BMI] of 36.17 ± 7.23. They enrolled in a program for losing weight. Visceral fat was determined using ultrasound. Blood pressure was measured 3 times and the mean was recorded. Twenty four hours dietary recall was reported. Thirty point four percentages of samples has visceral obesity ≥ 7cm; they were the older, showed higher values of BMI, visceral obesity and blood pressure. Significant difference was found between groups regarding mean value of BMI, visceral obesity, both systolic blood pressure SBP and diastolic blood pressure DBP and most of the daily macronutrients intake. In groups (2&3) positive significant correlation was recorded between (SBP) & (DBP) and total daily intake of total calories, carbohydrate, total fat, saturated fatty acids and cholesterol, and negative significant correlation with total daily intake of total protein, animal and vegetable protein, linolenic and linoleic fatty acids, while oleic fatty acid showed negative correlation with SBP&DBP in all groups. This study emphasizes the hypothesis that the macronutrients composition of diet influences blood pressure in different ways, in obese patients with visceral obesity.

Association between Macronutrients Intake, Visceral Obesity and Blood Pressure in a Sample of Obese Egyptian Women

PubMed Central

Hassan, Nayera E.; El Shebini, Salwa M.; Ahmed, Nihad H.; Selim Mostafa, Mohamed

2015-01-01

AIM: Study the association between the total caloric intake, protein, lipid, and some classes of fatty acids of the diet, and their effects on blood pressure in a sample of Egyptian obese women with and without visceral obesity. METHODS: Five hundred forty-nine obese women were included in the study with mean age of 38.1 ± 11.56 years and mean Body mass index [BMI] of 36.17 ± 7.23. They enrolled in a program for losing weight. Visceral fat was determined using ultrasound. Blood pressure was measured 3 times and the mean was recorded. Twenty four hours dietary recall was reported. RESULTS: Thirty point four percentages of samples has visceral obesity ≥ 7cm; they were the older, showed higher values of BMI, visceral obesity and blood pressure. Significant difference was found between groups regarding mean value of BMI, visceral obesity, both systolic blood pressure SBP and diastolic blood pressure DBP and most of the daily macronutrients intake. In groups (2&3) positive significant correlation was recorded between (SBP) & (DBP) and total daily intake of total calories, carbohydrate, total fat, saturated fatty acids and cholesterol, and negative significant correlation with total daily intake of total protein, animal and vegetable protein, linolenic and linoleic fatty acids, while oleic fatty acid showed negative correlation with SBP&DBP in all groups. CONCLUSION: This study emphasizes the hypothesis that the macronutrients composition of diet influences blood pressure in different ways, in obese patients with visceral obesity. PMID:27275219

Interarm blood pressure difference and target organ damage in the general population.

PubMed

Johansson, Jouni K; Puukka, Pauli J; Jula, Antti M

2014-02-01

The objective of the study was to investigate interarm differences of blood pressure (BP) and its determinants, and to clarify whether both arms are equally good in assessing BP and target organ damage in the general population. We studied a representative sample of Finnish adult population with 484 study participants, ages 25-74 years. BP was measured twice by an oscillometric monitor simultaneously on both arms. Study participants underwent a clinical examination including measurements of serum lipids, glucose and indicators of target organ damage. BP was 2.3/0.2 mmHg higher on right than on left arm (P < 0.001/P = 0.15 for SBP/DBP differences). SBP and DBP measured on right and left arms correlated equally with left ventricular mass index (LVMI), interventricular septal thickness (IVST), posterior wall thickness (PWT), pulse wave velocity (PWV) and albuminuria. Higher SBP level was an independent determinant of both greater systolic and diastolic interarm BP difference. Exaggerated absolute diastolic interarm BP difference (>5 mmHg) was associated with higher BMI, arm circumference, LVMI, IVST and PWT, whereas exaggerated absolute systolic interarm BP difference (>10 mmHg) was not associated with any clinical variables. There was only a small difference in BP between arms in a healthy general population. Both arms are equally good determinants of target organ damage. BP should be measured at least once on both arms and prefer the arm with higher BP readings in the future BP measurements.

DNA sequence-specific dimeric bisbenzimidazoles DBP(n) and DBPA(n) as inhibitors of H-NS silencing in bacterial cells.

PubMed

Melkina, Olga E; Koval, Vasilii S; Ivanov, Alexander A; Zhuze, Alexei L; Zavilgelsky, Gennadii B

2018-03-01

DNA sequence-specific fluorescent dimeric bisbenzimidazoles DBP(n) and DBPA(n), noncovalently interacting with A-T pairs in the minor groove of double-stranded DNA were used for studying and monitoring the expression of histone-like H-NS-dependent promoters. Histone-like H-NS selectively binds to AT-rich segments of DNA and silences a large number of genes in bacterial chromosomes. The H-NS-dependent promoters of Quorum Sensing (QS)-regulated lux operons of the marine bacteria mesophilic Aliivibrio fischeri, psychrophilic Aliivibrio logei were used. Escherichia coli lux biosensors were constructed by cloning fragments bearing QS-regulated promoters into the vector, thereby placing each fragment upstream of the promoterless Photorhabdus luminescens luxCDABE genes. It was shown that the dimeric bisbenzimidazoles DBP(n) and DBPA(n) counteract the H-NS silencing activity. Thus, the presence of DBP(n) or DBPA(n) in the medium leads to an approximately 10-100-fold increase in the level of transcription of QS promoters in E. coli hns + . The largest decrease in the level of H-NS repression was observed using ligands containing a linker with a length of ca. 18Å, such as DBP(2) and DBPA(2). Ligands containing linkers with n=1 and 3 are an order of magnitude less active; ligands with n=4 are inactive. DBPA(2) exhibits activity starting with a concentration of 0.5μM; the minimum concentration of DBP(2) is 5-7 times higher. It is suggested that A-T pairs located at five nucleotide pair intervals, which correspond to the linker length in highly active ligands with n=2, play a key role in the structure of H-NS-binding sites in QS-regulated promoters. Copyright © 2017 Elsevier GmbH. All rights reserved.

Children's blood pressure and its association with road traffic noise exposure - A systematic review with meta-analysis.

PubMed

Dzhambov, Angel M; Dimitrova, Donka D

2017-01-01

Primary and synthetic research on road traffic noise (RTN) and blood pressure (BP) is more common for adults than it is for children and adolescents. Given the conflicting evidence from primary studies, this study aimed to conduct an up-to-date systematic review with meta-analysis of the association between RTN and children's BP, by using advanced statistical techniques, to take into account the heterogeneity in primary studies. MEDLINE (PubMed), EMBASE (ScienceDirect with filters), and the Internet (Google) were searched (last update: July 21, 2016) in English, Spanish, and Russian. Thirteen articles (total n=8 770) were included in the systematic review and 37 effect size estimates were pooled in different meta-analyses under the quality effects model. Results showed 0.48mmHg (95% CI: -0.87, 1.83) increase in systolic blood pressure (SBP) and 0.22mmHg (95% CI: -0.64, 1.07) in diastolic blood pressure (DBP) per 5dB increase in RTN at school/kindergarten; and 0.20mmHg (95% CI: -0.30, 0.71) increase in SBP and 0.03mmHg (95% CI: -0.18, 0.25) in DBP per 5dB increase in RTN at home. There was high heterogeneity in the first three models and evidence of publication bias in the first. The following categorical and linear factors were significant effect modifiers in different exposure - outcome scenarios: country where the study was conducted, the mode of noise assessment, the mode of BP measurement, the type of reported effect size estimate, the overall quality score of the estimate, the minimum number of BP readings, and children's mean age. All evidence considered, the observed association between RTN and BP is weak and further flattened by methodological issues of primary studies, but its long-term consequences should not be ignored. Copyright © 2016 Elsevier Inc. All rights reserved.

[Assessment of resistant hypertension with home blood pressure monitoring].

PubMed

Marui, Fabiane Rosa Rezende H; Bombig, Maria Teresa Nogueira; Francisco, Yoná Afonso; Thalenberg, José Marcos; Fonseca, Francisco Antonio Helfenstein; Souza, Dilma de; Costa, Francisco de Assis; Izar, Maria Cristina; Carvalho, Antonio Carlos de Camargo; Póvoa, Rui

2010-10-01

ambulatory blood pressure monitoring (ABPM) is considered the gold standard for the diagnostic confirmation of resistant hypertension (RH). However, home blood pressure monitoring (HBPM) has been considered an option, because of its lower cost and greater comfort. to compare the values obtained by HBPM with those obtained by ABPM in the identification of patients with resistant hypertension. a total of 51 consecutive patients with resistant hypertension were selected. All were adults of both genders and were undergoing treatment in an outpatient referral clinic from January 2007 to September 2009. Casual office blood pressure (BP), 24-hour ABPM, and HBPM were performed according to current guidelines, with a maximum two-week interval between the methods. the comparison of ABPM (mean daytime) with HBPM showed a good correlation between them, both for systolic blood pressure (SBP) and for diastolic blood pressure (DBP): SBP r = 0.70, CI = 0.51-0.82, DBP r = 0.69, CI = 0.52-0.81. RH was confirmed by ABPM in 33 patients and by HBPM in 37, with no significant difference between the methods. according to the results obtained, we conclude that HBPM is a method that can be used as an alternative to ABPM for the diagnostic confirmation of RH.

Transient but not sustained blood pressure increments by occupational noise. An ambulatory blood pressure measurement study.

PubMed

Fogari, R; Zoppi, A; Corradi, L; Marasi, G; Vanasia, A; Zanchetti, A

2001-06-01

Studies on the effects of chronic exposure to industrial noise on clinic blood pressure (BP) at rest have yielded inconsistent results. The aim of this study was to evaluate the effect of occupational noise exposure on ambulatory blood pressure (ABP) in normotensive subjects. We studied 476 normotensive workers, aged 20-50 years (systolic blood pressure (SBP) < 140, diastolic blood pressure (DBP) < 90), at a metallurgical factory; 238 were exposed to high levels of noise (> 85 dB), while 238 were not exposed (< 80 dB). Clinical evaluation included measurements of casual BP (by standard mercury sphygmomanometer, Korotkoff sound phase I and V) and heart rate (HR) (by pulse palpation), body height and weight. All subjects underwent a 24 h non-invasive ABP monitoring (by SpaceLabs 90207 recorder; SpaceLabs, Redmond, Washington, USA) twice within 14 days: one during a normal working day and one during a non-working day. Measurements were performed every 15 min. Computed analysis of individual recordings provided average SBP, DBP and HR values for 24 h, daytime working hours (0800-1700 h), daytime non-working hours (1700-2300 h) and night-time (2300-0800 h). No significant difference in clinic SBP, DBP and HR was observed between exposed and non-exposed subjects. Results obtained by ABP monitoring showed in the exposed workers: (a) a higher SBP (by a mean of 6 mmHg, P < 0.0001 versus controls) and DBP (by a mean of 3 mmHg, P < 0.0001) during the time of exposure and the following 2 or 3 h, whereas no difference between the two groups was found during the non-working day; (b) an increase in HR, which was present not only during the time of exposure to noise (+3.7 beats-per-minute (bpm), P < 0.0001 versus controls), but also during the non-working hours (+2.8 bpm, P < 0.001) and during the day-time hours of the non-working day (+2.8 bpm, P < 0.003); (c) a significant increase in BP variability throughout the working day. These findings suggest that in normotensive subjects

The relationship of dietary sodium, potassium, fruits, and vegetables intake with blood pressure among Korean adults aged 40 and older.

PubMed

Kim, Mi Kyung; Kim, Kirang; Shin, Min-Ho; Shin, Dong Hoon; Lee, Young-Hoon; Chun, Byung-Yeol; Choi, Bo Youl

2014-08-01

The inverse relationships of combined fruits and vegetables intake with blood pressure have been reported. However, whether there are such relationships with salty vegetables has rarely been investigated in epidemiologic studies. We evaluated the relation of combined and separate intake of fruits, vegetable intakes, and salty vegetables, as well as sodium and potassium, with blood pressure among the middle-aged and elderly populations. The present cross-sectional analysis of a prospective cohort baseline survey was performed with 6,283 subjects (2,443 men and 3,840 women) and free of hypertension, diabetes, cardiovascular diseases, and cancer. Dietary data were collected by trained interviewers using food frequency questionnaire. The significantly inverse linear trend of diastolic blood pressure (DBP) was found in fruits and non-pickled vegetables (81.2 mmHg in the lowest quintile vs 79.0 mmHg in the highest quintile, P for trend = 0.0040) and fruits only (80.9 mmHg in the lowest quintile vs 79.4 mmHg in the highest quintile, P for trend = 0.0430) among men. In contrast, sodium and sodium to potassium ratio were positively related with blood pressure among men (DBP, 78.8 mmHg in the lowest quintile vs 80.6 mmHg in the highest quintile, P for trend = 0.0079 for sodium; DBP, 79.0 mmHg in the lowest quintile vs 80.7 mmHg in the highest quintile, P for trend = 0.0199 and SBP, 123.8 mmHg in the lowest quintile vs 125.9 mmHg in the highest quintile for sodium/potassium). Kimchies consumption was positively related to DBP for men (78.2 mmHg in the lowest quintile vs 80.9 mmHg in the highest quintile for DBP, P for trend = 0.0003). Among women, these relations were not found. Fruits and/or non-pickled vegetables may be inversely, but sodium, sodium to potassium, and Kimchies may be positively related to blood pressure among men.

Significance of an Increase in Diastolic Blood Pressure during a Stress Test in Terms of Comorbidities and Long-term Total and CV Mortality.

PubMed

Sydó, Nóra; Sydó, Tibor; Gonzalez Carta, Karina A; Hussain, Nasir; Merkely, Béla; Murphy, Joseph G; Squires, Ray W; Lopez-Jimenez, Francisco; Allison, Thomas G

2018-05-15

A decrease in diastolic blood pressure (DBP) with exercise is considered normal, but the significance of an increase in DBP has not been validated. Our aim was to determine the relationship of DBP increasing on a stress test regarding comorbidities and mortality. Our database was reviewed from 1993-2010 using the first stress test of a patient. Non-Minnesota residence, baseline CV disease, rest DBP <60 or >100 mmHg, and age <30 or ≥80 were exclusion criteria. DBP response was classified Normal if peak DBP-rest DBP <0, Borderline 0-9, Abnormal ≥10mmHg. Mortality was determined from Mayo Clinic records and Minnesota Death Index. Logistic regression was used to determine the relationship of DBP response to presence of comorbidities. Cox regression was used to determine total and CV mortality risk by DBP response. All analyses were adjusted for age, sex and resting DBP. 20760 patients were included (51±11 years, female n=7314). Rest/peak averaged DBP 82±8/69 ±15 mmHg in normal vs 79±9/82±9 mmHg in borderline vs 76±9/92±11 mmHg in abnormal DBP response. There were 1582 deaths (8%) with 557 (3%) CV deaths over 12±5 years of follow-up. In patients with borderline and abnormal DBP response, odds ratios for obesity, hypertension, diabetes and current smoking were significant, while hazard ratios for total and CV death were not significant compared to patients with normal DBP response. DBP response to exercise is significantly associated with important comorbidities at the time of the stress test but does not add to the prognostic yield of stress test.

Emotional dampening in persons with elevated blood pressure: affect dysregulation and risk for hypertension.

PubMed

McCubbin, James A; Loveless, James P; Graham, Jack G; Hall, Gabrielle A; Bart, Ryan M; Moore, DeWayne D; Merritt, Marcellus M; Lane, Richard D; Thayer, Julian F

2014-02-01

Persons with higher blood pressure have emotional dampening in some contexts. This may reflect interactive changes in central nervous system control of affect and autonomic function in the early stages of hypertension development. The purpose of this study is to determine the independence of cardiovascular emotional dampening from alexithymia to better understand the role of affect dysregulation in blood pressure elevations. Ninety-six normotensives were assessed for resting systolic and diastolic (DBP) blood pressure, recognition of emotions in faces and sentences using the Perception of Affect Task (PAT), alexithymia, anxiety, and defensiveness. Resting DBP significantly predicted PAT emotion recognition accuracy in men after adjustment for age, self-reported affect, and alexithymia. Cardiovascular emotional dampening is independent of alexithymia and affect in men. Dampened emotion recognition could potentially influence interpersonal communication and psychosocial distress, thereby further contributing to BP dysregulation and increased cardiovascular risk.

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants.

PubMed

2018-03-19

Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Change in mean blood pressure is the main driver of the worldwide change in

Dark chocolate and blood pressure: a novel study from Jordan.

PubMed

Al-Safi, Saafan A; Ayoub, Nehad M; Al-Doghim, Imad; Aboul-Enein, Faisal H

2011-11-01

The goal of this study was to assess the effect of dark chocolate intake on cardiovascular parameters like blood pressure and heart rate values in a normotensive population. This is a randomized cross-sectional study involving a total of 14,310 adults that were selected from various regions of Jordan. Well-trained pharmacy students interviewed participants in the outpatient settings. Participants reported their weekly intake of dark chocolate that has been further classified into mild (1-2 bars/week), moderate (3-4 bars/week), and high intake ( > 4 bars/week). For each participant, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured three times with (10-15) minute intervals in the sitting position and the resting state. The arterial blood pressure (ABP) was calculated from the measured SBP and DBP values. All measured blood pressure values were significantly decreased for participants who reported higher dark chocolate consumption. Our results showed that heart rate values were not affected by variable intake of dark chocolate. In addition, increasing dark chocolate intake was associated with a significant decrease of blood pressure values in participants irrespective of the family history of hypertension or the age of the individual. However, heart rate values were unaffected. Higher intake of dark chocolate can be associated with lower values of blood pressure, while its effect on heart rate values was not consistent.

Effects of Roselle on arterial pulse pressure and left ventricular hypertrophy in hypertensive patients.

PubMed

Al-Shafei, Ahmad I; El-Gendy, Ola A

2013-12-01

To characterize the effects of regular Roselle ingestion on blood pressure and left ventricular hypertrophy (LVH) in patients with established moderate essential hypertension. This non-randomized quasi-experimental study was conducted in Kafr El-Shaikh, Egypt, for 8 weeks, from September 2012 to November 2012. The effects of a 4-week period of regular Roselle ingestion followed by a 4-week recovery period on systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and heart rates (HR) was studied in 2 equal, gender- and age-matched groups (n=50 each; average age - 50+/-5 years) of normotensive subjects, and patients with moderate essential hypertension. Electrocardiographic assessments of LVH were also made prior to, and at the end of both treatment and recovery periods. Pulse pressure (PP) significantly fell from baseline values by 10.9% (normotensive group [NG]), 21.2% (hypertensive group [HG]); SBP by 10% (NG), 19.6% (HG); DBP by 9.5% (NG), 18.7% (HG), and HR by 14.6% (NG), 17.1% (HG) by the end of week 4 of treatment. Following treatment cessation, SBP, DBP, PP, and HR returned to pretreatment levels over 4 weeks. Before intervention, none of the normotensive subjects, but 14 hypertensive patients showed LVH. However, Roselle treatment was associated with regression of LVH in 10 patients with only 4 patients showing LVH after 4 weeks of treatment. This became 10 patients 4 weeks after ceasing treatment. These findings empirically suggest favorable cardiovascular effects of Roselle in patients with established moderate essential hypertension.

The variability of ankle-arm blood pressure difference and ankle-brachial index in treated hypertensive patients.

PubMed

Cao, Kaiwu; Xu, Jinsong; Sun, Hanjun; Li, Ping; Li, Juxiang; Cheng, Xiaoshu; Su, Hai

2014-10-01

The purpose of this study was to investigate whether ankle-arm blood pressure (BP) difference (An-a) and ankle-brachial index (ABI) are consistent in treated hypertensive patients with obvious BP variation. This study enrolled 414 hypertensive patients (200 males; mean age, 61.3 ± 13.3 years) admitted to our hospital. BP of four limbs was simultaneously measured using four automatic BP measurement devices on the day of admission, and three and six day after admission. The An-a differences on systolic BP (SBP), diastolic BP (DBP), mean artery pressure (MAP), and pulse pressure (PP) in both sides were calculated, respectively. The relative decrease amplitude (RDA) of BP was calculated using the formula: RDA = (BP1 - BPn)/BP1. The ABI of the right side was calculated. From the first to the third measurement, arm SBP and DBP levels of both arms significantly decreased (right arm: SBP: 163.7 ± 18.4, 147.7 ± 15.3 vs. 135.4 ± 11.7 mm Hg; P < .05; DBP: 86.6 ± 13.4, 79.9 ± 11.6 vs. 74.5 ± 9.6 mm Hg; P < .05); at the same time, the ankle SBP (right ankle: 182.1 ± 22.1, 147.7 ± 15.3 vs. 153.4 ± 16.6 mm Hg; P < .05) and DBP (84.8 ± 13.4, 79.9 ± 11.6 vs. 75.8 ± 9.8 mm Hg; P < .05) of both sides also significantly decreased. The mean An-a of three measurements of both sides was consistent at the levels of about 20 mm Hg on SBP and PP, 7 mm Hg on MAP, and 0 mm Hg on DBP. However, sABI gradually increased from the first to the third measurement.In treated hypertensive patients, the An-a differences on SBP, DBP, PP, and MAP are generally consistent, but sABI is associated with underlying SBP levels.

Sibling composition during childhood and adult blood pressure among native Amazonians in Bolivia.

PubMed

Zeng, Wu; Undurraga, Eduardo A; Nyberg, Colleen; Eisenberg, Dan T A; Parida, Sabita; Zycherman, Ariela; Magvanjav, Oyunbileg; Reyes-García, Victoria; Tanner, Susan; Godoy, Ricardo

2013-07-01

Sibling configuration, including birth order, or the number, age, and sex of siblings is associated with parental resource allocation between children and is thus associated with a person's well-being. Little is known about the association between specific types of siblings and adult health outcomes. Here we test several hypotheses about sibling composition (number of older brothers, older sisters, younger sisters, younger brothers) and adult blood pressure in a foraging-farming society of native Amazonians in Bolivia (Tsimane'). We collected data in 2007 from 374 adults (16-60years of age) from 196 households in 13 villages. Household random-effects multiple regressions were run using systolic (SBP) or diastolic blood pressure (DBP) as outcomes; covariates included the four sibling categories and control variables (e.g., sex, age, education, body mass index [BMI]). Mean SBP and DBP were 114 (SD=14) and 66 (SD=11)mmHg. The prevalence of hypertension was 5.08%. Having an additional younger brother bore a small (3.3-5.9%) positive association with both SBP and DBP, with the effect weakening as people aged. Having an additional younger sister was associated with a small (3.8%) increase in SBP among women, with the magnitude shrinking as people aged. In a large family, the number of younger brothers may exert an impact on an individual's blood pressure. Copyright © 2012 Elsevier B.V. All rights reserved.

Possible monitoring requirements for the disinfectants and disinfection by-products (D/DBP) regulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-01-01

The monitoring requirements presented in the report were developed by EPA before a negotiated Disinfectants and Disinfection By-Products (D/DBP) rule was considered. The framework described herein may be substantially changed as a result of the negotiated rulemaking process. The document is useful to consider in developing various monitoring options during the negotiated rulemaking process.

Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods

EPA Science Inventory

Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...

Validation of the blood pressure measurement device Erkameter 125 PRO according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Beime, Beate; Deutsch, Cornelia; Krüger, Ralf; Zimmermann, Erik; Bramlage, Peter

2016-12-01

The aim of the present study was to validate the blood pressure (BP) measurement device Erkameter 125 PRO according to the International Protocol revision 2010 of the European Society of Hypertension (ESH-IP2). In 33 patients aged 32-79 years, BP measurements were performed alternately using the Erkameter 125 PRO and the reference mercury sphygmomanometer according to ESH-IP revision 2010. For the analysis, a total of 99 comparisons were included. All absolute differences between the test device and the reference were within 10 mmHg for systolic blood pressure (SBP), and all except one for diastolic blood pressure (DBP). A total of 93 out of 99 comparisons for SBP showed an absolute difference within 5 mmHg and 92 out of 99 for DBP. The mean±SD difference between the Erkameter 125 PRO and the standard reference was -0.5±3.5 mmHg for SBP and 0.5±3.5 mmHg for DBP. As to part 2 of ESH-IP 2010, all patients had a minimum of two out of three measurements within 5 mmHg difference for SBP and 31 out of 33 patients for DBP. The Erkameter 125 PRO fulfilled the requirements of parts 1 and 2 of the ESH-IP revision 2010 and can be recommended for office BP measurements in adults.

Structurally characterized 1,1,3,3-tetramethylguanidine solvated magnesium aryloxide complexes: [Mg(mu-OEt)(DBP)(H-TMG)]2, [Mg(mu-OBc)(DBP)(H-TMG)]2, [Mg(mu-TMBA)(DBP)(H-TMG)]2, [Mg(mu-DPP)(DBP)(H-TMG)]2, [Mg(BMP)2(H-TMG)2], [Mg(O-2,6-Ph2C6H3)2 (H-TMG)2].

PubMed

Monegan, Jessie D; Bunge, Scott D

2009-04-06

The synthesis and structural characterization of several 1,1,3,3-tetramethylguanidine (H-TMG) solvated magnesium aryloxide complexes are reported. Bu(2)Mg was successfully reacted with H-TMG, HOC(6)H(3)(CMe(3))(2)-2,6 (H-DBP), and either ethanol, a carboxylic acid, or diphenyl phosphate in a 1:1 ratio to yield the corresponding [Mg(mu-L)(DBP)(H-TMG)](2) where L = OCH(2)CH(3) (OEt, 1), O(2)CC(CH(3))(3) (OBc, 2), O(2)C(C(6)H(2)-2,4,6-(CH(3))(3)) (TMBA, 3), or O(2)P(OC(6)H(5))(2) (DPP, 4). Bu(2)Mg was also reacted with two equivalents of H-TMG and HOC(6)H(3)(CMe(3))-2-(CH(3))-6 (BMP) or HO-2,6-Ph(2)C(6)H(3) to yield [Mg(BMP)(2)(H-TMG)(2)] (5) and [Mg(O-2,6-Ph(2)C(6)H(3))(2)(H-TMG)(2)] (6). Compounds 1-6 were characterized by single-crystal X-ray diffraction. Polymerization of l- and rac-lactide with 1 was found to generate polylactide (PLA). A discussion concerning the relevance of compounds 2 - 4 to the structure of Mg-activated phosphatase enzymes is also provided. The bulk powders for all complexes were found to be in agreement with the crystal structures based on elemental analyses, FT-IR spectroscopy, and (1)H, (13)C and (31)P NMR studies.

Examining the utility of thresholds for aerobic fitness related to resting blood pressure and BMI in Portuguese children.

PubMed

Duncan, Michael J; Martins, Clarice; Silva, Gustavo; Ribeiro, José Carlos; Oliveira, José; Pizarro, Andreia; Mota, Jorge; Aires, Luisa

2015-01-01

This study examined the utility of the Ruiz et al. cut-points when examining body mass index (BMI) and resting blood pressure in young people. Two hundred fifty-six children (154 girls and 102 boys) aged 7-16 years underwent assessment of BMI, physical maturation, resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) and cardiorespiratory fitness using breath by breath gas analysis during treadmill testing to exhaustion. Results from a series of 2 (fit vs. unfit) × 2 (gender) ways analysis of covariance, controlling for maturation indicated higher SBP in the unfit group compared to the fit group (P = 0.001), higher DBP in the unfit group compared to the fit group (P = 0.04) and higher BMI (in unfit) than fit children (P = 0.0001). Males had significantly higher BMI than females (P = 0.04). Maturation as a covariate was significantly and positively associated with SBP (P = 0.003), DBP (P = 0.004), and BMI (P = 0.001). This study suggests that the Ruiz et al. cut-points are valid in distinguishing between children with higher and lower BMI and resting BP values. © 2014 Wiley Periodicals, Inc.

Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study

PubMed Central

Fox, Ervin R.; Young, J. Hunter; Li, Yali; Dreisbach, Albert W.; Keating, Brendan J.; Musani, Solomon K.; Liu, Kiang; Morrison, Alanna C.; Ganesh, Santhi; Kutlar, Abdullah; Ramachandran, Vasan S.; Polak, Josef F.; Fabsitz, Richard R.; Dries, Daniel L.; Farlow, Deborah N.; Redline, Susan; Adeyemo, Adebowale; Hirschorn, Joel N.; Sun, Yan V.; Wyatt, Sharon B.; Penman, Alan D.; Palmas, Walter; Rotter, Jerome I.; Townsend, Raymond R.; Doumatey, Ayo P.; Tayo, Bamidele O.; Mosley, Thomas H.; Lyon, Helen N.; Kang, Sun J.; Rotimi, Charles N.; Cooper, Richard S.; Franceschini, Nora; Curb, J. David; Martin, Lisa W.; Eaton, Charles B.; Kardia, Sharon L.R.; Taylor, Herman A.; Caulfield, Mark J.; Ehret, Georg B.; Johnson, Toby; Chakravarti, Aravinda; Zhu, Xiaofeng; Levy, Daniel; Munroe, Patricia B.; Rice, Kenneth M.; Bochud, Murielle; Johnson, Andrew D.; Chasman, Daniel I.; Smith, Albert V.; Tobin, Martin D.; Verwoert, Germaine C.; Hwang, Shih-Jen; Pihur, Vasyl; Vollenweider, Peter; O'Reilly, Paul F.; Amin, Najaf; Bragg-Gresham, Jennifer L.; Teumer, Alexander; Glazer, Nicole L.; Launer, Lenore; Zhao, Jing Hua; Aulchenko, Yurii; Heath, Simon; Sõber, Siim; Parsa, Afshin; Luan, Jian'an; Arora, Pankaj; Dehghan, Abbas; Zhang, Feng; Lucas, Gavin; Hicks, Andrew A.; Jackson, Anne U.; Peden, John F.; Tanaka, Toshiko; Wild, Sarah H.; Rudan, Igor; Igl, Wilmar; Milaneschi, Yuri; Parker, Alex N.; Fava, Cristiano; Chambers, John C.; Kumari, Meena; JinGo, Min; van der Harst, Pim; Kao, Wen Hong Linda; Sjögren, Marketa; Vinay, D.G.; Alexander, Myriam; Tabara, Yasuharu; Shaw-Hawkins, Sue; Whincup, Peter H.; Liu, Yongmei; Shi, Gang; Kuusisto, Johanna; Seielstad, Mark; Sim, Xueling; Nguyen, Khanh-Dung Hoang; Lehtimäki, Terho; Matullo, Giuseppe; Wu, Ying; Gaunt, Tom R.; Charlotte Onland-Moret, N.; Cooper, Matthew N.; Platou, Carl G.P.; Org, Elin; Hardy, Rebecca; Dahgam, Santosh; Palmen, Jutta; Vitart, Veronique; Braund, Peter S.; Kuznetsova, Tatiana; Uiterwaal, Cuno S.P.M.; Campbell, Harry; Ludwig, Barbara; Tomaszewski, Maciej; Tzoulaki, Ioanna; Palmer, Nicholette D.; Aspelund, Thor; Garcia, Melissa; Chang, Yen-Pei C.; O'Connell, Jeffrey R.; Steinle, Nanette I.; Grobbee, Diederick E.; Arking, Dan E.; Hernandez, Dena; Najjar, Samer; McArdle, Wendy L.; Hadley, David; Brown, Morris J.; Connell, John M.; Hingorani, Aroon D.; Day, Ian N.M.; Lawlor, Debbie A.; Beilby, John P.; Lawrence, Robert W.; Clarke, Robert; Collins, Rory; Hopewell, Jemma C.; Ongen, Halit; Bis, Joshua C.; Kähönen, Mika; Viikari, Jorma; Adair, Linda S.; Lee, Nanette R.; Chen, Ming-Huei; Olden, Matthias; Pattaro, Cristian; Hoffman Bolton, Judith A.; Köttgen, Anna; Bergmann, Sven; Mooser, Vincent; Chaturvedi, Nish; Frayling, Timothy M.; Islam, Muhammad; Jafar, Tazeen H.; Erdmann, Jeanette; Kulkarni, Smita R.; Bornstein, Stefan R.; Grässler, Jürgen; Groop, Leif; Voight, Benjamin F.; Kettunen, Johannes; Howard, Philip; Taylor, Andrew; Guarrera, Simonetta; Ricceri, Fulvio; Emilsson, Valur; Plump, Andrew; Barroso, Inês; Khaw, Kay-Tee; Weder, Alan B.; Hunt, Steven C.; Bergman, Richard N.; Collins, Francis S.; Bonnycastle, Lori L.; Scott, Laura J.; Stringham, Heather M.; Peltonen, Leena; Perola, Markus; Vartiainen, Erkki; Brand, Stefan-Martin; Staessen, Jan A.; Wang, Thomas J.; Burton, Paul R.; SolerArtigas, Maria; Dong, Yanbin; Snieder, Harold; Wang, Xiaoling; Zhu, Haidong; Lohman, Kurt K.; Rudock, Megan E.; Heckbert, Susan R.; Smith, Nicholas L.; Wiggins, Kerri L.; Shriner, Daniel; Veldre, Gudrun; Viigimaa, Margus; Kinra, Sanjay; Prabhakaran, Dorairajan; Tripathy, Vikal; Langefeld, Carl D.; Rosengren, Annika; Thelle, Dag S.; MariaCorsi, Anna; Singleton, Andrew; Forrester, Terrence; Hilton, Gina; McKenzie, Colin A.; Salako, Tunde; Iwai, Naoharu; Kita, Yoshikuni; Ogihara, Toshio; Ohkubo, Takayoshi; Okamura, Tomonori; Ueshima, Hirotsugu; Umemura, Satoshi; Eyheramendy, Susana; Meitinger, Thomas; Wichmann, H.-Erich; Cho, Yoon Shin; Kim, Hyung-Lae; Lee, Jong-Young; Scott, James; Sehmi, Joban S.; Zhang, Weihua; Hedblad, Bo; Nilsson, Peter; Smith, George Davey; Wong, Andrew; Narisu, Narisu; Stančáková, Alena; Raffel, Leslie J.; Yao, Jie; Kathiresan, Sekar; O'Donnell, Chris; Schwartz, Steven M.; Arfan Ikram, M.; Longstreth, Will T.; Seshadri, Sudha; Shrine, Nick R.G.; Wain, Louise V.; Morken, Mario A.; Swift, Amy J.; Laitinen, Jaana; Prokopenko, Inga; Zitting, Paavo; Cooper, Jackie A.; Humphries, Steve E.; Danesh, John; Rasheed, Asif; Goel, Anuj; Hamsten, Anders; Watkins, Hugh; Bakker, Stephan J.L.; van Gilst, Wiek H.; Janipalli, Charles S.; Radha Mani, K.; Yajnik, Chittaranjan S.; Hofman, Albert; Mattace-Raso, Francesco U.S.; Oostra, Ben A.; Demirkan, Ayse; Isaacs, Aaron; Rivadeneira, Fernando; Lakatta, Edward G.; Orru, Marco; Scuteri, Angelo; Ala-Korpela, Mika; Kangas, Antti J.; Lyytikäinen, Leo-Pekka; Soininen, Pasi; Tukiainen, Taru; Würz, Peter; Twee-Hee Ong, Rick; Dörr, Marcus; Kroemer, Heyo K.; Völker, Uwe; Völzke, Henry; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Zelenika, Diana; Deloukas, Panos; Mangino, Massimo; Spector, Tim D.; Zhai, Guangju; Meschia, James F.; Nalls, Michael A.; Sharma, Pankaj; Terzic, Janos; Kranthi Kumar, M.J.; Denniff, Matthew; Zukowska-Szczechowska, Ewa; Wagenknecht, Lynne E.; Fowkes, Gerald R.; Charchar, Fadi J.; Schwarz, Peter E.H.; Hayward, Caroline; Guo, Xiuqing; Bots, Michiel L.; Brand, Eva; Samani, Nilesh J.; Polasek, Ozren; Talmud, Philippa J.; Nyberg, Fredrik; Kuh, Diana; Laan, Maris; Hveem, Kristian; Palmer, Lyle J.; van der Schouw, Yvonne T.; Casas, Juan P.; Mohlke, Karen L.; Vineis, Paolo; Raitakari, Olli; Wong, Tien Y.; Shyong Tai, E.; Laakso, Markku; Rao, Dabeeru C.; Harris, Tamara B.; Morris, Richard W.; Dominiczak, Anna F.; Kivimaki, Mika; Marmot, Michael G.; Miki, Tetsuro; Saleheen, Danish; Chandak, Giriraj R.; Coresh, Josef; Navis, Gerjan; Salomaa, Veikko; Han, Bok-Ghee; Kooner, Jaspal S.; Melander, Olle; Ridker, Paul M.; Bandinelli, Stefania; Gyllensten, Ulf B.; Wright, Alan F.; Wilson, James F.; Ferrucci, Luigi; Farrall, Martin; Tuomilehto, Jaakko; Pramstaller, Peter P.; Elosua, Roberto; Soranzo, Nicole; Sijbrands, Eric J.G.; Altshuler, David; Loos, Ruth J.F.; Shuldiner, Alan R.; Gieger, Christian; Meneton, Pierre; Uitterlinden, Andre G.; Wareham, Nicholas J.; Gudnason, Vilmundur; Rettig, Rainer; Uda, Manuela; Strachan, David P.; Witteman, Jacqueline C.M.; Hartikainen, Anna-Liisa; Beckmann, Jacques S.; Boerwinkle, Eric; Boehnke, Michael; Larson, Martin G.; Järvelin, Marjo-Riitta; Psaty, Bruce M.; Abecasis, Gonçalo R.; Elliott, Paul; van Duijn , Cornelia M.; Newton-Cheh, Christopher

2011-01-01

The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10−8) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10−8). The top IBC association for SBP was rs2012318 (P= 6.4 × 10−6) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10−6) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexity. PMID:21378095

Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study.

PubMed

Fox, Ervin R; Young, J Hunter; Li, Yali; Dreisbach, Albert W; Keating, Brendan J; Musani, Solomon K; Liu, Kiang; Morrison, Alanna C; Ganesh, Santhi; Kutlar, Abdullah; Ramachandran, Vasan S; Polak, Josef F; Fabsitz, Richard R; Dries, Daniel L; Farlow, Deborah N; Redline, Susan; Adeyemo, Adebowale; Hirschorn, Joel N; Sun, Yan V; Wyatt, Sharon B; Penman, Alan D; Palmas, Walter; Rotter, Jerome I; Townsend, Raymond R; Doumatey, Ayo P; Tayo, Bamidele O; Mosley, Thomas H; Lyon, Helen N; Kang, Sun J; Rotimi, Charles N; Cooper, Richard S; Franceschini, Nora; Curb, J David; Martin, Lisa W; Eaton, Charles B; Kardia, Sharon L R; Taylor, Herman A; Caulfield, Mark J; Ehret, Georg B; Johnson, Toby; Chakravarti, Aravinda; Zhu, Xiaofeng; Levy, Daniel

2011-06-01

The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10(-8)) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10(-8)). The top IBC association for SBP was rs2012318 (P= 6.4 × 10(-6)) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10(-6)) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexity.

Relationship between dietary sodium, potassium, and calcium, anthropometric indexes, and blood pressure in young and middle aged Korean adults.

PubMed

Park, Juyeon; Lee, Jung-Sug; Kim, Jeongseon

2010-04-01

Epidemiological evidence of the effects of dietary sodium, calcium, and potassium, and anthropometric indexes on blood pressure is still inconsistent. To investigate the relationship between dietary factors or anthropometric indexes and hypertension risk, we examined the association of systolic and diastolic blood pressure (SBP and DBP) with sodium, calcium, and potassium intakes and anthropometric indexes in 19~49-year-olds using data from Korean National Health and Nutrition Examination Survey (KNHANES) III. Total of 2,761 young and middle aged adults (574 aged 19~29 years and 2,187 aged 30~49 years) were selected from KNHANES III. General information, nutritional status, and anthropometric data were compared between two age groups (19~29 years old and 30~49 years old). The relevance of blood pressure and risk factors such as age, sex, body mass index (BMI), weight, waist circumference, and the intakes of sodium, potassium, and calcium was determined by multiple regression analysis. Multiple regression models showed that waist circumference, weight, and BMI were positively associated with SBP and DBP in both age groups. Sodium and potassium intakes were not associated with either SBP or DBP. Among 30~49-year-olds, calcium was inversely associated with both SBP and DBP (P = 0.012 and 0.010, respectively). Our findings suggest that encouraging calcium consumption and weight control may play an important role in the primary prevention and management of hypertension in early adulthood.

A randomized 9-month study of blood pressure and body fat responses to aerobic training versus combined aerobic and resistance training in older men.

PubMed

Sousa, Nelson; Mendes, Romeu; Abrantes, Catarina; Sampaio, Jaime; Oliveira, José

2013-08-01

This randomized study evaluated the impact of different exercise training modalities on blood pressure and body fat responses in apparently healthy older men. Forty-eight elderly men (aged 65-75 years) were randomly assigned to an aerobic training group (ATG, n=15), a combined aerobic and resistance training group (CTG, n=16), or a control group (n=17). Both exercise training programs were moderate-to-vigorous intensity, three days/week for 9-months. Strength, aerobic endurance, body fat and blood pressure were measured on five different occasions. The data were analyzed using a mixed-model ANOVA, and the independence between systolic blood pressure (SBP), diastolic blood pressure (DBP) and group was tested. A significant main effect of group (p<0.001) was observed in strength and aerobic endurance, with higher performance observed in the CTG. A significant main effect of group (p<0.001) and time (p=0.029) was observed in body fat percentage, with a 2.3% decrease in CTG. A significant main effect of time was observed in SBP (p=0.005) and in DBP (p=0.011) for both ATG and CTG. Mean decreases in SBP and DBP, respectively, were 15 and 6 mmHg for ATG and 24 and 12 mmHg for CTG. There was a significant association for SBP (p=0.008) and DBP (p=0.005) in the CTG, with significant individual BP profile modifications. Both exercise-training programs reduce resting blood pressure. However, only the combined exercise training was effective at reducing body fat percentage; consequently, there were larger changes in blood pressure, which result in a significant reduction in hypertensive subjects. Copyright © 2013 Elsevier Inc. All rights reserved.

Impact of DBP on histology and expression of HSP 70 in gill and liver tissue of Cyprinus carpio.

PubMed

Agus, Hizlan H; Erkmen, Belda; Sümer, Sibel; Sepici-Dinçel, Aylin; Erkoç, Figen

2015-09-01

Di-n-butyl phthalate (DBP) widely used plasticizer in the plastic industry, affects regulation of the endocrine system and causes toxicity in animals. In the present study, the aim was to study the toxic effects/damages of DBP exposure using Hsp70 levels and histopathological changes in Carp liver and gill. Hsp70 expression levels were assessed as specific biomarker of in vivo ecotoxicological stress. Carp (Cyprinus carpio) were exposed to sub-lethal concentration of DBP (di-n-butyl phthalate, 1 mg/L) for 4, 24 and 96 h. Gill and liver tissues were evaluated histopathologically and RNA quantifications for Hsp70 expression levels were carried out using a two-step real-time RT-PCR. In liver, a rapid but non-significant increase in mRNA levels in the first 4 h was observed. mRNA levels significantly increased up to 2-3 fold after 24 and 96 h (p < 0.05). However, irregular mRNA level changes were also recorded: Gill specific and time-dependent regulation of Hsp70 expression were 4-5 fold inhibition after 4 and 24 h (p < 0.05), then increased up to 4 fold after 96 h (p < 0.05). Histopathological findings support altered transcription results as: Epithelial lifting, hyperplasia, fusion of secondary lamellae, telangiectasis, passive hyperemia and hydropic degeneration. Significant alterations of Hsp70 levels were likely due to a tissue specific response against chemical stress, cellular damage and lesions due to DBP. Carp was found to be a suitable experimental model for toxicology, and Hsp70 mRNA levels are reliable, specific biomarkers.

[Effect of physical activity and t-786C polymorphism in blood pressure and blood flow in the elderly].

PubMed

Zago, Anderson Saranz; Kokubun, Eduardo; Fenty-Stewart, Nicola; Park, Joon-Young; Attipoe, Selasi; Hagberg, James; Brown, Michael

2010-10-01

the T-786C polymorphism of the gene for endothelial nitric oxide synthase (eNOS) and superoxide anion production may reduce production and bioavailability of nitric oxide, affecting the degree of vasodilation. This effect can be reversed by exercise. to investigate the influence of aerobic training and T-786C polymorphism in the concentrations of nitric oxide metabolites (NOx) in blood flow (BF) and blood pressure (BP). thirty-two elderly pre-hypertensive women (59 ± 6 years old) were divided into two groups according to the T-786C polymorphism (TT and TC + CC). We analyzed the concentrations of NOx (plasma) and blood flow by venous occlusion plethysmography at rest, 1, 2 and 3 minutes post-occlusion (BF-0, BF-1 BF-2 BF-3, respectively). Evaluations were performed before and after 6 months of a program of aerobic exercise. In the pre-training evaluations, NOx levels were lower in TC + CC group than in TT group. The TT group showed correlations between NOx and BF-0 (r = 0.6) and diastolic blood pressure (DBP) and BF-0 (r = -0.7), but no correlation was found in TC + CC group. In the post-training evaluations, there were correlations between NOx and BF-0 (r = 0.6) and the changes in NOx and DBP (r = -0.6) in TT group. There were also correlations between DBP and BF-1 (r = -0.8), DBP, and BF-2 (r = -0.6), DBP, and BF-3 (r = -0.6), in the changes between NOx and BF-1 (r = 0.8) and changes in NOx and DBP (r = -0.7) in TC + CC group. it was concluded that 6 months of aerobic exercise can increase the relationship between NO, BP and BF in elderly of allele C carriers.

Exposure to DBP and High Iodine Aggravates Autoimmune Thyroid Disease Through Increasing the Levels of IL-17 and Thyroid-Binding Globulin in Wistar Rats.

PubMed

Duan, Jiufei; Kang, Jun; Deng, Ting; Yang, Xu; Chen, Mingqing

2018-05-01

Autoimmune thyroid disease (AITD) is the most common autoimmune disease that causes hypothyroidism. High iodine is a well-known factor that can induce thyroid disorders, including Hashimoto's thyroiditis, one of the main types of AITD. Recent epidemiological studies have indicated that phthalates, especially di-n-butyl phthalate (DBP) may induce thyroid disease. In this study, we aim to determine the effects and underlying mechanisms of high iodine and/or DBP exposure on AITD. Female Wistar rats were modeled with thyroglobulin and exposed to high iodine and/or DBP. We investigated histopathological changes in the thyroid and measured thyroid hormone levels in serum to assess thyroid function. In the thyroid and liver, we detected oxidative stress, proinflammatory factors (IL-1β, IL-6, and IL-17) and the activation of activator protein 1 (AP-1), a transcription factor that is related to the synthesis of the thyroxine-binding globulin (TBG) and the activation of Th17. After blocking AP-1 with SP600125, we detected TBG and the Th17 related cytokines (IL-6 and IL-17). The data showed that thyroid damage and the alteration of thyroid hormones were greater when the rats were exposed to both high iodine and DBP. Coexposure to DBP and high iodine enhanced the activation of AP-1 in the liver and thyroid, and induced an increase in the levels of TBG in serum and IL-17 in the thyroid. Blocking AP-1 activation prevented the increase of TBG and IL-17. The results indicate that high iodine and/or DBP exposure exacerbated AITD through altering TBG levels in serum and aggravating IL-17 in the thyroid.

Visit-to-visit and 24-h blood pressure variability: association with endothelial and smooth muscle function in African Americans.

PubMed

Diaz, K M; Veerabhadrappa, P; Kashem, M A; Thakkar, S R; Feairheller, D L; Sturgeon, K M; Ling, C; Williamson, S T; Kretzschmar, J; Lee, H; Grimm, H; Babbitt, D M; Vin, C; Fan, X; Crabbe, D L; Brown, M D

2013-11-01

The purpose of this study was to investigate the association of visit-to-visit and 24-h blood pressure (BP) variability with markers of endothelial injury and vascular function. We recruited 72 African Americans who were non-diabetic, non-smoking and free of cardiovascular (CV) and renal disease. Office BP was measured at three visits and 24-h ambulatory BP monitoring was conducted to measure visit-to-visit and 24-h BP variability, respectively. The 5-min time-course of brachial artery flow-mediated dilation and nitroglycerin-mediated dilation were assessed as measures of endothelial and smooth muscle function. Fasted blood samples were analyzed for circulating endothelial microparticles (EMPs). Significantly lower CD31+CD42- EMPs were found in participants with high visit-to-visit systolic blood pressure (SBP) variability or high 24-h diastolic blood pressure (DBP) variability. Participants with high visit-to-visit DBP variability had significantly lower flow-mediated dilation and higher nitroglycerin-mediated dilation at multiple time-points. When analyzed as continuous variables, 24-h mean arterial pressure variability was inversely associated with CD62+ EMPs; visit-to-visit DBP variability was inversely associated with flow-mediated dilation normalized by smooth muscle function and was positively associated with nitroglycerin-mediated dilation; and 24-h DBP variability was positively associated with nitroglycerin-mediated dilation. All associations were independent of age, gender, body mass index and mean BP. In conclusion, in this cohort of African Americans visit-to-visit and 24-h BP variability were associated with measures of endothelial injury, endothelial function and smooth muscle function. These results suggest that BP variability may influence the pathogenesis of CV disease, in part, through influences on vascular health.

Impact of age on the importance of systolic and diastolic blood pressures for stroke risk: the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project.

PubMed

Vishram, Julie K K; Borglykke, Anders; Andreasen, Anne H; Jeppesen, Jørgen; Ibsen, Hans; Jørgensen, Torben; Broda, Grazyna; Palmieri, Luigi; Giampaoli, Simona; Donfrancesco, Chiara; Kee, Frank; Mancia, Giuseppe; Cesana, Giancarlo; Kuulasmaa, Kari; Sans, Susana; Olsen, Michael H

2012-11-01

This study investigates age-related shifts in the relative importance of systolic (SBP) and diastolic (DBP) blood pressures as predictors of stroke and whether these relations are influenced by other cardiovascular risk factors. Using 34 European cohorts from the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project with baseline between 1982 and 1997, 68 551 subjects aged 19 to 78 years, without cardiovascular disease and not receiving antihypertensive treatment, were included. During a mean of 13.2 years of follow-up, stroke incidence was 2.8%. Stroke risk was analyzed using hazard ratios per 10-mm Hg/5-mm Hg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, DBP was analyzed separately for DBP ≥ 71 mm Hg and DBP <71 mm Hg. Stroke risk was associated positively with SBP and DBP ≥ 71 mm Hg (SBP/DBP ≥ 71 mm Hg; hazard ratios: 1.15/1.06 [95% CI: 1.12-1.18/1.03-1.09]) and negatively with DBP <71 mm Hg (0.88[0.79-0.98]). The hazard ratio for DBP decreased with age (P<0.001) and was not influenced by other cardiovascular risk factors. Taking into account the age × DBP interaction, both SBP and DBP ≥ 71 mm Hg were significantly associated with stroke risk until age 62 years, but in subjects older than 46 years the superiority of SBP for stroke risk exceeded that of DBP ≥ 71 mm Hg and remained significant until age 78 years. DBP <71 mm Hg became significant at age 50 years with an inverse relation to stroke risk. In Europeans, stroke risk should be assessed by both SBP and DBP until age 62 years with increased focus on SBP from age 47 years. From age 62 years, emphasis should be on SBP without neglecting the potential harm of very low DBP.

Improved Measurement of Blood Pressure by Extraction of Characteristic Features from the Cuff Oscillometric Waveform

PubMed Central

Lim, Pooi Khoon; Ng, Siew-Cheok; Jassim, Wissam A.; Redmond, Stephen J.; Zilany, Mohammad; Avolio, Alberto; Lim, Einly; Tan, Maw Pin; Lovell, Nigel H.

2015-01-01

We present a novel approach to improve the estimation of systolic (SBP) and diastolic blood pressure (DBP) from oscillometric waveform data using variable characteristic ratios between SBP and DBP with mean arterial pressure (MAP). This was verified in 25 healthy subjects, aged 28 ± 5 years. The multiple linear regression (MLR) and support vector regression (SVR) models were used to examine the relationship between the SBP and the DBP ratio with ten features extracted from the oscillometric waveform envelope (OWE). An automatic algorithm based on relative changes in the cuff pressure and neighbouring oscillometric pulses was proposed to remove outlier points caused by movement artifacts. Substantial reduction in the mean and standard deviation of the blood pressure estimation errors were obtained upon artifact removal. Using the sequential forward floating selection (SFFS) approach, we were able to achieve a significant reduction in the mean and standard deviation of differences between the estimated SBP values and the reference scoring (MLR: mean ± SD = −0.3 ± 5.8 mmHg; SVR and −0.6 ± 5.4 mmHg) with only two features, i.e., Ratio2 and Area3, as compared to the conventional maximum amplitude algorithm (MAA) method (mean ± SD = −1.6 ± 8.6 mmHg). Comparing the performance of both MLR and SVR models, our results showed that the MLR model was able to achieve comparable performance to that of the SVR model despite its simplicity. PMID:26087370

Accuracy of Blood Pressure-to-Height Ratio to Define Elevated Blood Pressure in Children and Adolescents: The CASPIAN-IV Study.

PubMed

Kelishadi, Roya; Bahreynian, Maryam; Heshmat, Ramin; Motlagh, Mohammad Esmail; Djalalinia, Shirin; Naji, Fatemeh; Ardalan, Gelayol; Asayesh, Hamid; Qorbani, Mostafa

2016-02-01

The aim of this study was to propose a simple practical diagnostic criterion for pre-hypertension (pre-HTN) and hypertension (HTN) in the pediatric age group. This study was conducted on a nationally representative sample of 14,880 students, aged 6-18 years. HTN and pre-HTN were defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95 and 90-95th percentile for age, gender, and height, respectively. By using the area under the curve (AUC) of the receiver operator characteristic curves, we estimated the diagnostic accuracy of two indexes of SBP-to-height ratio (SBPHR) and DBP-to-height (DBPHR) to define pre-HTN and HTN. Overall, SBPHR performed relatively well in classifying subjects to HTN (AUC 0.80-0.85) and pre-HTN (AUC 0.84-0.90). Likewise, DBPHR performed relatively well in classifying subjects to HTN (AUC 0.90-0.97) and pre-HTN (AUC 0.70-0.83). Two indexes of SBPHR and DBPHR are considered as valid, simple, inexpensive, and accurate tools to diagnose pre-HTN and HTN in pediatric age group.

Evidence-based proposal for the number of ambulatory readings required for assessing blood pressure level in research settings: an analysis of the IDACO database.

PubMed

Yang, Wen-Yi; Thijs, Lutgarde; Zhang, Zhen-Yu; Asayama, Kei; Boggia, José; Hansen, Tine W; Ohkubo, Takayoshi; Jeppesen, Jørgen; Stolarz-Skrzypek, Katarzyna; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Li, Yan; Wang, Ji-Guang; Imai, Yutaka; Kawecka-Jaszcz, Kalina; O'Brien, Eoin; Staessen, Jan A

2018-06-17

Guidelines on the required number of ambulatory blood pressure (ABP) readings focus on individual patients. Clinical researchers often face the dilemma of applying recommendations and discarding potentially valuable information or accepting fewer readings. Starting from ABP recordings with ≥30/≥10 awake/asleep readings in 4277 participants enrolled in eight population studies in the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes (IDACO), we randomly selected a certain number of readings (from 30 to 1 awake and 10 to 1 asleep readings) at a time over 1000 bootstraps at each step. We evaluated: (i) concordance of the ABP level; (ii) consistency of the cross-classification based on office blood pressure and ABP; and (iii) accuracy in predicting cardiovascular complications. For each criterion, we fitted a regression line joining data points relating outcome to the number of readings covering the ranges of 30-20/10-7 for awake/asleep readings. Reducing readings widened the SD of the systolic/diastolic differences between full (reference) and selected recordings from 1.7/1.2 (30 readings) to 14.3/10.3 mm Hg (single reading) during wakefulness, and from 1.9/1.4 to 10.3/7.7 mm Hg during sleep; lowered the κ statistic from 0.94 to 0.63, and decreased the hazard ratio associated with 10/5 mm Hg increments in systolic/diastolic ABP from 1.21/1.14 to 1.06/1.04 during wakefulness and from 1.26/1.17 to 1.14/1.08 during sleep. The first data points falling off these regression lines during wakefulness/sleep corresponded to 8/3 and 8/4 readings for criteria (i) and (iii) and to 5 awake readings for criterion (ii). 24-h ambulatory recordings with ≥8/≥4 awake/asleep readings yielded ABP levels similar to recordings including the guideline-recommended ≥20/≥7 readings. These criteria save valuable data in a research setting, but are not applicable to clinical practice.

Parental and offspring contribution of genetic markers of adult blood pressure in early life: The FAMILY study.

PubMed

Robiou-du-Pont, Sébastien; Anand, Sonia S; Morrison, Katherine M; McDonald, Sarah D; Atkinson, Stephanie A; Teo, Koon K; Meyre, David

2017-01-01

Previous genome wide association studies (GWAS) identified associations of multiple common variants with diastolic and systolic blood pressure traits in adults. However, the contribution of these loci to variations of blood pressure in early life is unclear. We assessed the child and parental contributions of 33 GWAS single-nucleotide polymorphisms (SNPs) for blood pressure in 1,525 participants (515 children, 406 mothers and 237 fathers) of the Family Atherosclerosis Monitoring In early life (FAMILY) study followed-up for 5 years. Two genotype scores for systolic (29 SNPs) and diastolic (24 SNPs) blood pressure were built. Linear mixed-effect regressions showed significant association between rs1378942 in CSK and systolic blood pressure (β = 0.98±0.46, P = 3.4×10-2). The child genotype scores for diastolic and systolic blood pressure were not associated in children. Nominally significant parental genetic effects were found between the SNPs rs11191548 (CYP17A1) (paternal, β = 2.78±1.49, P = 6.1×10-2 for SBP and β = 3.60±1.24, P = 3.7×10-3 for DBP), rs17367504 (MTHFR) (paternal, β = 2.42±0.93, P = 9.3×10-3 for SBP and β = 1.89±0.80, P = 1.8×10-2 for DBP and maternal, β = -1.32±0.60, P = 2.9×10-2 and β = -1.97±0.77, P = 1.0×10-2, for SBP and DBP respectively) and child blood pressure. Our study supports the view that adult GWAS loci have a limited impact on blood pressure during the five first years of life. The parental genetic effects observed on blood pressure in children may suggest epigenetic mechanisms in the transmission of the risk of hypertension. Further replication is needed to confirm our results.

The anabolic effects of vitamin D-binding protein-macrophage activating factor (DBP-MAF) and a novel small peptide on bone.

PubMed

Schneider, Gary B; Grecco, Kristina J; Safadi, Fayez F; Popoff, Steven N

2003-01-01

Vitamin D-binding protein-macrophage activating factor (DBP-MAF) has previously been shown to stimulate bone resorption and correct the skeletal defects associated with osteopetrosis in two nonallelic mutations in rats. This same protein and a small fragment of the protein have now been shown to demonstrate an anabolic effect on the skeleton of both newborn and young adult, intact rats. The novel peptide fragment was synthetically produced based on the human amino acid sequence at the site of glycosylation in the third domain of the native protein (DBP). The peptide tested is 14 amino acids in length and demonstrates no homologies other than to that region of DBP. Newborn rats were injected i.p. with saline, peptide (0.4 ng/g body wt.) or DBP-MAF (2 ng/g body wt.) every other day from birth to 14 days of age. On day 16 the rats were euthanized and the long bones collected for bone densitometry by pQCT. After 2 weeks of treatment with either the whole protein (DBP-MAF) or the small peptide, bone density was significantly increased in the treated animals compared to the saline controls. Young adult female rats (180 grams) were given s.c. injections of saline or peptide (0.4 ng/g body wt. or 5 ng/g body wt.) every other day for 2 weeks; 2 days after the final injections, the rats were euthanized and the femurs and tibias collected for bone densitometry. Both doses of the peptide resulted in significant increases in bone density as determined by pQCT. Young adult rats were injected locally with a single dose of the peptide (1 microg) or saline into the marrow cavity of the distal femur. One week after the single injection, the bones were collected for radiographic and histological evaluation. The saline controls showed no evidence of new bone formation, whereas the peptide-treated animals demonstrated osteoinduction in the marrow cavity and osteogenesis of surrounding cortical and metaphyseal bone. These data suggest that DBP-MAF and the synthetic peptide represent

Systolic and Diastolic Blood Pressure, Incident Cardiovascular Events and Death in Elderly Persons: The Role of Functional Limitation in the Cardiovascular Health Study

PubMed Central

Peralta, Carmen A.; Katz, Ronit; Newman, Anne B.; Psaty, Bruce M.; Odden, Michelle C.

2014-01-01

Whether limitation in ability to perform activities of daily living (ADL) or gait speed can identify elders in whom the association of systolic (SBP) and diastolic (DBP) blood pressure with cardiovascular events (CVD) and death differs is unclear. We evaluated whether limitation in ADL or gait speed modify the association of SBP or DBP with incident CVD (N= 2,358) and death (N=3,547) in the Cardiovascular Health Study. Mean age was 78 ± 5 and 21% reported limitation in ≥1 ADL. There were 778 CV events and 1,289 deaths over 9 years. Among persons without and with ADL limitation, SBP was associated with incident CVD: HR (per 10 mmHg increase) 1.08 (95% CI 1.03, 1.13) and 1.06 (0.97, 1.17), respectively. ADL modified the association of DBP with incident CVD. Among those without ADL limitation, DBP was weakly associated with incident CVD, HR 1.04 (0.79, 1.37) for DBP > 80, compared with <65 mmHg. Among those with ADL limitation, DBP was inversely associated with CVD: HR 0.65 (0.44, 0.96) for DBP 66–80 mmHg and HR 0.49 (0.25, 0.94) for DBP > 80, compared to DBP ≤ 65. Among persons with ADL limitation, a DBP 66–80 had the lowest risk for death, HR 0.72 (0.57, 0.91), compared with DBP ≤ 65. Associations did not vary by 15 feet walking speed ADL can identify elders in whom diastolic hypotension is associated with higher CV risk and death. Functional status, rather than chronologic age alone, should inform design of hypertension trials in elders. PMID:24935945

The association between smoking and blood pressure in men: a cross-sectional study.

PubMed

Li, Guoju; Wang, Hailing; Wang, Ke; Wang, Wenrui; Dong, Fen; Qian, Yonggang; Gong, Haiying; Hui, Chunxia; Xu, Guodong; Li, Yanlong; Pan, Li; Zhang, Biao; Shan, Guangliang

2017-10-10

Cigarette smoking is a known risk factor for cardiovascular disease (CVD), but the association between smoking and blood pressure is unclear. Thus, the current study examined the association between cigarette smoking and blood pressure in men. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) were examined using digital blood pressure measuring device, and smoking status was determined with China National Health Survey. The ANCOVA showed that the adjusted DBP and MAP were lower in current smokers versus nonsmokers and the adjusted SBP was lower in current smokers versus former smokers (P < 0.05). Additionally, the adjusted PP tend to be decreased steadily as the pack·years increased in current smokers. In a fully adjusted logistic regression model, former smokers had increased ORs (95% CI) of 1.48 (1.01, 2.18) of hypertension and current smokers had not increased ORs (95% CI) of 0.83 (0.61, 1.12), compared with never smokers. The findings revealed that the adjusted blood pressure were lower in current smokers versus nonsmokers and former smokers. No significant dose-dependent effect of current smoking on blood pressure indices except PP was observed. Smoking cessation was significantly associated with an increased risk of hypertension. However, current smoking was not a risk factor of hypertension.

Association between serum osteocalcin level and blood pressure in a Chinese population.

PubMed

Xu, Yiting; Ma, Xiaojing; Xiong, Qin; Hu, Xiang; Zhang, Xueli; Yuan, Yeqing; Bao, Yuqian

2018-04-01

This observational study investigated the association between serum osteocalcin level and blood pressure in a Chinese population. A total of 2241 subjects (909 men and 1,332 women; age, 24-78 years) from Shanghai communities were recruited. Subjects were divided into non-hypertensive and hypertensive groups according to diagnosis of hypertension based on the 1999 World Health Organization-International Society of Hypertension Guidelines. Serum osteocalcin levels were measured using an electrochemiluminescence immunoassay. Men in the hypertensive group showed lower serum osteocalcin level compared with those in the non-hypertensive group, [16.37 (13.34-20.11) ng/mL versus 17.01 (14.23-20.79) ng/mL, p = .039]. No difference in serum osteocalcin level was found between the two groups of women (p = .675). An inverse association was observed between serum osteocalcin level and systolic blood pressure (SBP) in men (p = .004), but serum osteocalcin level was not associated with diastolic blood pressure (DBP) in men (p = .472). No associations were detected between serum osteocalcin level and SBP or DBP in women (SBP: p = .108; DBP: p = .575). A multiple stepwise regression analysis showed an inverse association between serum osteocalcin level and SBP in men after adjusting for age, smoking status, family history of hypertension, and lipid and C-reactive protein levels (standardized β = -0.074, p = .023), but the association disappeared after adjustment for body mass index, waist circumference, blood glucose, and homeostasis model assessment of insulin resistance (p = .327). Serum osteocalcin level was not independently associated with blood pressure in a Chinese population.

Association between blood lead and blood pressure: Results from the Canadian Health Measures Survey (2007 to 2011).

PubMed

Bushnik, Tracey; Levallois, Patrick; D'Amour, Monique; Anderson, Todd J; McAlister, Finlay A

2014-07-01

Hypertension is the leading risk factor for cardiovascular disease, but its cause is not always known. Interest is increasing in the potential role of environmental chemicals, including lead. Data are from the first two cycles of the Canadian Health Measures Survey. Lead in whole blood (PbB), and systolic (SBP) and diastolic (DBP) blood pressure were measured and hypertension status was derived for 4,550 respondents aged 40 to 79. Linear regression estimated associations between PbB and SBP and DBP. Logistic regression estimated associations between PbB and hypertension. Adjusted least squares geometric means of PbB were estimated for hypertensive versus non-hypertensive individuals. Compared with non-hypertensive individuals, those with hypertension had higher average PbB levels, were older, more likely to be male, and more likely to have other hypertension risk factors (diabetes, family history of high blood pressure). In adjusted regression models, a modest association emerged between PbB levels and SBP among 40- to 54-year-olds, and between PbB levels and DBP for the overall population. No association emerged between PbB levels and hypertension prevalence. A modest association was observed between blood lead levels and blood pressure, but not with hypertension, in Canadian adults aged 40 to 79.

Mean Blood Pressure Difference among Adolescents Based on Dyssomnia Types.

PubMed

Sembiring, Krisnarta; Ramayani, Oke Rina; Lubis, Munar

2018-02-15

Dyssomnia is the most frequent sleep disturbance and associated with increased blood pressure. There has been no study determining the difference in mean blood pressure based on dyssomnia types among adolescents. To determine the difference in mean blood pressure among adolescents based on dyssomnia types. Cross-sectional study was conducted in SMP Negeri 1 Muara Batang Gadis in April 2016. Samples were students having sleep disturbance based on Sleep Disturbance Scale for Children (SDSC) questionnaire. Stature and blood pressure data were collected along with demographic data and sleep disorder questionnaire. Analyses were done with Kruskal-Wallis test and logistic regression. P - value < 0.05 was considered significant. Seventy-six samples were obtained with mean age 13.9 (SD 1.14) years - old. Dyssomnia proportion and hypertension were 72/76 and 20/76 respectively. Mean systolic (SBP) and diastolic blood pressure (DBP) was 111.1 (SD 16.46) mmHg and 70.3 (SD 11.98) mmHg respectively. Mean SDSC score was 49.7 (SD 8.96), and the most frequent dyssomnia type was disorders of initiating and maintaining sleep. Age and sex were not the risk factors of hypertension in dyssomnia. There was a significant difference in mean SBP (P = 0.006) and DBP (P = 0.022) based on dyssomnia types. Combination dyssomnia type had the highest mean blood pressure among dyssomnia types. There is a significant difference in mean blood pressure among adolescents based on dyssomnia types.

Habitual energy expenditure modifies the association between NOS3 gene polymorphisms and blood pressure.

PubMed

Vimaleswaran, Karani S; Franks, Paul W; Barroso, Inês; Brage, Soren; Ekelund, Ulf; Wareham, Nicholas J; Loos, Ruth J F

2008-03-01

The endothelial nitric-oxide synthase (NOS3) gene encodes the enzyme (eNOS) that synthesizes the molecule nitric oxide, which facilitates endothelium-dependent vasodilation in response to physical activity. Thus, energy expenditure may modify the association between the genetic variation at NOS3 and blood pressure. To test this hypothesis, we genotyped 11 NOS3 polymorphisms, capturing all common variations, in 726 men and women from the Medical Research Council (MRC) Ely Study (age (mean +/- s.d.): 55 +/- 10 years, body mass index: 26.4 +/- 4.1 kg/m(2)). Habitual/non-resting energy expenditure (NREE) was assessed via individually calibrated heart rate monitoring over 4 days. The intronic variant, IVS25+15 [G-->A], was significantly associated with blood pressure; GG homozygotes had significantly lower levels of diastolic blood pressure (DBP) (-2.8 mm Hg; P = 0.016) and systolic blood pressure (SBP) (-1.9 mm Hg; P = 0.018) than A-allele carriers. The interaction between NREE and IVS25+15 was also significant for both DBP (P = 0.006) and SBP (P = 0.026), in such a way that the effect of the GG-genotype on blood pressure was stronger in individuals with higher NREE (DBP: -4.9 mm Hg, P = 0.02. SBP: -3.8 mm Hg, P= 0.03 for the third tertile). Similar results were observed when the outcome was dichotomously defined as hypertension. In summary, the NOS3 IVS25+15 is directly associated with blood pressure and hypertension in white Europeans. However, the associations are most evident in the individuals with the highest NREE. These results need further replication and have to be ideally tested in a trial before being informative for targeted disease prevention. Eventually, the selection of individuals for lifestyle intervention programs could be guided by knowledge of genotype.

Towards reducing DBP formation potential of drinking water by favouring direct ozone over hydroxyl radical reactions during ozonation.

PubMed

De Vera, Glen Andrew; Stalter, Daniel; Gernjak, Wolfgang; Weinberg, Howard S; Keller, Jurg; Farré, Maria José

2015-12-15

When ozonation is employed in advanced water treatment plants to produce drinking water, dissolved organic matter reacts with ozone (O3) and/or hydroxyl radicals (OH) affecting disinfection byproduct (DBP) formation with subsequently used chlorine-based disinfectants. This study presents the effects of varying exposures of O3 and •OH on DBP concentrations and their associated toxicity generated after subsequent chlorination. DBP formation potential tests and in vitro bioassays were conducted after batch ozonation experiments of coagulated surface water with and without addition of tertiary butanol (t-BuOH, 10 mM) and hydrogen peroxide (H2O2, 1 mg/mg O3), and at different pH (6-8) and transferred ozone doses (0-1 mg/mg TOC). Although ozonation led to a 24-37% decrease in formation of total trihalomethanes, haloacetic acids, haloacetonitriles, and trihaloacetamides, an increase in formation of total trihalonitromethanes, chloral hydrate, and haloketones was observed. This effect however was less pronounced for samples ozonated at conditions favoring molecular ozone (e.g., pH 6 and in the presence of t-BuOH) over •OH reactions (e.g., pH 8 and in the presence of H2O2). Compared to ozonation only, addition of H2O2 consistently enhanced formation of all DBP groups (20-61%) except trihalonitromethanes. This proves that •OH-transformed organic matter is more susceptible to halogen incorporation. Analogously, adsorbable organic halogen (AOX) concentrations increased under conditions that favor •OH reactions. The ratio of unknown to known AOX, however, was greater at conditions that promote direct O3 reactions. Although significant correlation was found between AOX and genotoxicity with the p53 bioassay, toxicity tests using 4 in vitro bioassays showed relatively low absolute differences between various ozonation conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of Chemical Composition of Complex Disinfection Byproduct (DBP) Mixtures Produced by Different Treatment Methods - slides

EPA Science Inventory

Analyses of the chemical composition of complex DBP mixtures, produced by different drinking water treatment processes, are essential to generate toxicity data required for assessing their risks to humans. For mixture risk assessments, whole mixture toxicology studies generally a...

Quantitative model for the blood pressure-lowering interaction of valsartan and amlodipine.

PubMed

Heo, Young-A; Holford, Nick; Kim, Yukyung; Son, Mijeong; Park, Kyungsoo

2016-12-01

The objective of this study was to develop a population pharmacokinetic (PK) and pharmacodynamic (PD) model to quantitatively describe the antihypertensive effect of combined therapy with amlodipine and valsartan. PK modelling was used with data collected from 48 healthy volunteers receiving a single dose of combined formulation of 10 mg amlodipine and 160 mg valsartan. Systolic (SBP) and diastolic blood pressure (DBP) were recorded during combined administration. SBP and DBP data for each drug alone were gathered from the literature. PKPD models of each drug and for combined administration were built with NONMEM 7.3. A two-compartment model with zero order absorption best described the PK data of both drugs. Amlodipine and valsartan monotherapy effects on SBP and DBP were best described by an I max model with an effect compartment delay. Combined therapy was described using a proportional interaction term as follows: (D 1  + D 2 ) +ALPHA×(D 1 × D 2 ). D 1 and D 2 are the predicted drug effects of amlodipine and valsartan monotherapy respectively. ALPHA is the interaction term for combined therapy. Quantitative estimates of ALPHA were -0.171 (95% CI: -0.218, -0.143) for SBP and -0.0312 (95% CI: -0.07739, -0.00283) for DBP. These infra-additive interaction terms for both SBP and DBP were consistent with literature results for combined administration of drugs in these classes. PKPD models for SBP and DBP successfully described the time course of the antihypertensive effects of amlodipine and valsartan. An infra-additive interaction between amlodipine and valsartan when used in combined administration was confirmed and quantified. © 2016 The British Pharmacological Society.

Association of single nucleotide polymorphisms in VDR and DBP genes with HBV-related hepatocellular carcinoma risk in a Chinese population.

PubMed

Peng, Qiliu; Yang, Shi; Lao, Xianjun; Li, Ruolin; Chen, Zhiping; Wang, Jian; Qin, Xue; Li, Shan

2014-01-01

Polymorphisms of genes encoding components of the vitamin D pathway including vitamin D receptor (VDR) and vitamin D binding protein (DBP) have been widely investigated because of the complex role played by vitamin D in cancer tumorogenesis. In this study, we investigated the association between VDR and DBP gene polymorphisms and HBV-related HCC risk in a Chinese population. Study subjects were divided into three groups: 184 HBV patients with HCC, 296 HBV patients without HCC, and 180 healthy controls. The VDR rs2228570, and rs3782905 and the DBP rs7041 polymorphisms were genotyped using PCR-RFLP and the VDR rs11568820 polymorphism was genotyped by PCR-SSP, respectively. DNA sequencing was performed to validate the genotype results. We found that there were significant differences in the genotype and allele frequencies of the VDR rs2228570 and DBP rs7041 polymorphisms between HBV patients with HCC and healthy controls. The rs2228570 T allele was associated with a significant increased HBV-related HCC risk as compared with the C allele. The rs2228570 TT and TT/TC genotypes were correlated with a significant increased HBV-related HCC risk when compared with the wild-type CC homozygote. Similarly, the rs7041 G allele was associated with a significant increased HBV-related HCC risk as compared with the T allele. The rs7041 GG and GG/TG genotypes were correlated with a significant increased HBV-related HCC risk when compared with the wild-type TT homozygote. However, we did not observe any significant effect of VDR rs11568820, and rs3782905 polymorphisms on HBV-related HCC risk in this population. In haplotype analysis, we also did not find any significant differences in haplotype frequencies of the VDR gene between HBV patients with HCC and the healthy controls. We conclude that the VDR rs2228570 and DBP rs7041 polymorphisms may contribute to increased susceptibility to HBV-related HCC in the Chinese population. Due to the marginal significance, further large and well

A Quantitative Comparison of Physiologic Indicators of Cardiopulmonary Resuscitation Quality: Diastolic Blood Pressure Versus End-Tidal Carbon Dioxide

PubMed Central

Morgan, Ryan W.; French, Benjamin; Kilbaugh, Todd J.; Naim, Maryam Y.; Wolfe, Heather; Bratinov, George; Shoap, Wesley; Hsieh, Ting-Chang; Nadkarni, Vinay M.; Berg, Robert A.; Sutton, Robert M.

2016-01-01

Aim The American Heart Association (AHA) recommends monitoring invasive arterial diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) when available. In intensive care unit patients, both may be available to the rescuer. The objective of this study was to compare DBP versus ETCO2 during CPR as predictors of cardiac arrest survival. Methods In two models of cardiac arrest (primary ventricular fibrillation [VF] and asphyxia-associated VF), 3-month old swine received either standard AHA guideline-based CPR or patient-centric, BP-guided CPR. Mean values of DBP and ETCO2 in the final two minutes before the first defibrillation attempt were compared using receiver operating characteristic curves (area under curve [AUC] analysis). The optimal DBP cut point to predict survival was derived and subsequently validated in two independent, randomly generated cohorts. Results Of 60 animals, 37 (61.7%) survived to 45 minutes. DBP was higher in survivors than in non-survivors (40.6±1.8mmHg vs. 25.9±2.4mmHg; p<0.001), while ETCO2 was not different (30.0±1.5mmHg vs. 32.5±1.8mmHg; p=0.30). By AUC analysis, DBP was superior to ETCO2 (0.82 vs. 0.60; p=0.025) in discriminating survivors from non-survivors. The optimal DBP cut point in the derivation cohort was 34.1mmHg. In the validation cohort, this cut point demonstrated a sensitivity of 0.78, specificity of 0.81, positive predictive value of 0.64, and negative predictive value of 0.89 for survival. Conclusions In both primary and asphyxia-associated VF porcine models of cardiac arrest, DBP discriminates survivors from non-survivors better than ETCO2. Failure to attain a DBP >34mmHg during CPR is highly predictive of non-survival. PMID:27107688

[Association between polymorphism of rs10185316 in insulin-induced gene 2 and blood pressure among children and adolescents].

PubMed

Yang, Y D; Song, J Y; Liu, F H; Shang, X R; Wang, H J; Ma, J

2017-10-06

Objective: To examine the association between polymorphism of rs10185316 in insulin-induced gene 2 (INSIG2) and blood pressure among children and adolescents. Methods: 9 junior middle schools in Dongcheng District of Beijing and 5 schools (3 primary junior middle schools, 2 primary schools) in Haidian District of Beijing were chosen in 2005 and 2007, respectively. According to the Chinese BMI percentile criteria for screening overweight and obesity in school children, we recruited 1 425 overweight or obese children and 605 normal weight children. A total of 2 018 students with complete data of blood pressure and genotype data were included in this study. According to the blood pressure criterion of children and adolescents, 702 participants were categorized into high blood pressure group and 1 316 into normal blood pressure group. Participants' information of gender, age, height, weight and blood pressure were collected by questionnaire and physical examination. Genomic DNA was extracted from peripheral blood sample for genotyping of INSIG2 rs10185316 polymorphism. Multiple linear regression was conducted to analyze the associations between rs10185316 polymorphism in INSIG2 and SBP, DBP, mean arterial pressure (MAP) and pulse pressure. Results: The age, BMI, SBP and DBP of the high blood pressure group were separately (14.3±1.4) years old, (27.3±4.2) kg/m(2), (130.5±10.9) and (76.7±13.3) mmHg (1 mmHg=0.133 kPa), all higher than that of the normal blood pressure group, which were (12.2±2.9) years old, (22.0±4.0) kg/m(2), (104.4±10.9) and(54.6±15.2) mmHg, respectively (all P values<0.001). After age, sex, district and BMI adjusted, compared with the participants carrying INSIG2 rs10185316 CC genotype, CG/GG genotype carriers had lower DBP (β(95 %CI ):-1.67(-2.84--0.50), P= 0.005), higher PP(β(95 %CI ): 1.91(0.61-3.20), P= 0.004), and lower MAP(β(95 %CI ):=-1.03(-2.01--0.05), P= 0.039). Conclusion: INSIG2 rs10185316 polymorphism was associated with DBP, PP

What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

PubMed

Eguchi, Kazuo; Kuruvilla, Sujith; Ogedegbe, Gbenga; Gerin, William; Schwartz, Joseph E; Pickering, Thomas G

2009-06-01

To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. We enrolled 56 patients from a hypertension clinic (mean age: 60 +/- 14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. The analyses were performed using the second-third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 +/- 15.8/77.5 +/- 9.5 and 133.2 +/- 15.5/76.9 +/- 9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 +/- 14/79 +/- 10 mmHg) than the 10-s interval readings. There was no significant difference in patients' compliance in taking adequate numbers of readings at the different time intervals. The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval.

Pathway modeling of microarray data: A case study of pathway activity changes in the testis following in utero exposure to dibutyl phthalate (DBP)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ovacik, Meric A.; Sen, Banalata; Euling, Susan Y.

Pathway activity level analysis, the approach pursued in this study, focuses on all genes that are known to be members of metabolic and signaling pathways as defined by the KEGG database. The pathway activity level analysis entails singular value decomposition (SVD) of the expression data of the genes constituting a given pathway. We explore an extension of the pathway activity methodology for application to time-course microarray data. We show that pathway analysis enhances our ability to detect biologically relevant changes in pathway activity using synthetic data. As a case study, we apply the pathway activity level formulation coupled with significancemore » analysis to microarray data from two different rat testes exposed in utero to Dibutyl Phthalate (DBP). In utero DBP exposure in the rat results in developmental toxicity of a number of male reproductive organs, including the testes. One well-characterized mode of action for DBP and the male reproductive developmental effects is the repression of expression of genes involved in cholesterol transport, steroid biosynthesis and testosterone synthesis that lead to a decreased fetal testicular testosterone. Previous analyses of DBP testes microarray data focused on either individual gene expression changes or changes in the expression of specific genes that are hypothesized, or known, to be important in testicular development and testosterone synthesis. However, a pathway analysis may inform whether there are additional affected pathways that could inform additional modes of action linked to DBP developmental toxicity. We show that Pathway activity analysis may be considered for a more comprehensive analysis of microarray data.« less

Effect of Childhood Obesity Prevention Programs on Blood Pressure: A Systematic Review and Meta-Analysis

PubMed Central

Cai, Li; Wu, Yang; Wilson, Renee F.; Segal, Jodi B.; Kim, Miyong T.; Wang, Youfa

2015-01-01

Background Childhood overweight and obesity are associated with elevated blood pressure (BP). However, little is known about how childhood obesity lifestyle prevention programs affect BP. We assessed the effects of childhood obesity prevention programs on BP in children in developed countries. Methods and Results We searched databases up to April 22, 2013 for relevant randomized controlled trials, quasi-experimental studies, and natural experiments. Studies were included if they applied a diet and/or physical activity intervention(s) and were followed for ≥1 year (or ≥ 6 months for school-based intervention studies); they were excluded if they targeted only overweight/obese subjects or those with a medical condition. In our meta-analysis, intervention effects were calculated for systolic blood pressure (SBP) and diastolic blood pressure (DBP) using weighted random effects models. Of the 23 included intervention studies (involving 18,925 participants), 21 involved a school setting. Our meta-analysis included 19 studies reporting on SBP and 18 on DBP. The pooled intervention effect was −1.64 mmHg (95% CI: -2.56, −0.71; P=0.001) for SBP and -1.44 mmHg (95% CI: −2.28, −0.60; P=0.001) for DBP. The combined diet and physical activity interventions led to a significantly greater reduction in both SBP and DBP than the diet-only or physical activity-only intervention. Thirteen interventions (46%) had a similar effect on both adiposity-related outcomes and BP; while 11 interventions (39%) showed a significant desirable effect on BP, but not on adiposity-related outcomes. Conclusions Obesity prevention programs have a moderate effect on reducing BP and those targeting at both diet and physical activity seem to be more effective. PMID:24552832

Effects of room environment and nursing experience on clinical blood pressure measurement: an observational study.

PubMed

Zhang, Meng; Zhang, Xuemei; Chen, Fei; Dong, Birong; Chen, Aiqing; Zheng, Dingchang

2017-04-01

This study aimed to examine the effects of measurement room environment and nursing experience on the accuracy of manual auscultatory blood pressure (BP) measurement. A training database with 32 Korotkoff sounds recordings from the British Hypertension Society was played randomly to 20 observers who were divided into four groups according to the years of their nursing experience (i.e. ≥10 years, 1-9 years, nursing students with frequent training, and those without any medical background; five observers in each group). All the observers were asked to determine manual auscultatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) both in a quiet clinical assessment room and in a noisy nurse station area. This procedure was repeated on another day, yielding a total of four measurements from each observer (i.e. two room environments and two repeated determinations on 2 separate days) for each Korotkoff sound. The measurement error was then calculated against the reference answer, with the effects of room environment and nursing experience of the observer investigated. Our results showed that there was no statistically significant difference for BPs measured under both quiet and noisy environments (P>0.80 for both SBP and DBP). However, there was a significant effect on the measurement accuracy between the observer groups (P<0.001 for both SBP and DBP). The nursing students performed best with overall SBP and DBP errors of -0.8±2.4 and 0.1±1.8 mmHg, respectively. The SBP measurement error from the nursing students was significantly smaller than that for each of the other three groups (all P<0.001). Our results indicate that frequent nursing trainings are important for nurses to achieve accurate manual auscultatory BP measurement.

Effects of nattokinase on blood pressure: a randomized, controlled trial.

PubMed

Kim, Ji Young; Gum, Si Nae; Paik, Jean Kyung; Lim, Hyo Hee; Kim, Kyong-Chol; Ogasawara, Kazuya; Inoue, Kenichi; Park, Sungha; Jang, Yangsoo; Lee, Jong Ho

2008-08-01

The objective of this study was to examine the effects of nattokinase supplementation on blood pressure in subjects with pre-hypertension or stage 1 hypertension. In a randomized, double-blind, placebo-controlled trial, 86 participants ranging from 20 to 80 years of age with an initial untreated systolic blood pressure (SBP) of 130 to 159 mmHg received nattokinase (2,000 FU/capsule) or a placebo capsule for 8 weeks. Seventy-three subjects completed the protocol. Compared with the control group, the net changes in SBP and diastolic blood pressure (DBP) were -5.55 mmHg (95% confidence interval [CI], -10.5 to -0.57 mmHg; p<0.05) and -2.84 mmHg (CI, -5.33 to -0.33 mmHg; p<0.05), respectively, after the 8-week intervention. The corresponding net change in renin activity was -1.17 ng/mL/h for the nattokinase group compared with the control group (p<0.05). In conclusion, nattokinase supplementation resulted in a reduction in SBP and DBP. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.

Validation of the Beneware model ABP-021 ambulatory blood pressure monitor according to the revised 2010 European Society of hypertension international protocol.

PubMed

Pereira, Telmo; Guimarães, João

2018-06-11

This study aimed to evaluate the accuracy of the Beneware model ABP-021 oscillometric blood pressure monitor in the general population according to the European Society of Hypertension International Protocol (ESH-IP). The accuracy of the device was assessed in relation to various clinical variables, including age, sex, BMI, and arm circumference. Thirty-three individuals (18 men and 15 women), with a mean age of 36±14 years (age range: 20-68 years), were studied according to the recommendations of the ESH-IP. Sequential same-arm blood pressure measurements were performed, alternating between a mercury standard and the automatic device. The differences among the test-control measurements were assessed and divided into categorization zones of 5, 10, and 15 mmHg discrepancy. The device complied with the quality requirements of the ESH-IP. The device-observer disagreement was -1.2±4.7 mmHg for systolic blood pressure (SBP) and -1.7±4.3 mmHg for diastolic blood pressure (DBP). The device produced 77, 93, and 98 measurements, respectively, within the 5, 10, and 15 mmHg discrepancy limits for SBP. For DBP, 80, 97, and 99 measurements were observed within the 5, 10, and 15 mmHg discrepancy limits. The number of participants with two or three of the device-observer differences within 5 mmHg was 26 for SBP and 29 for DBP, whereas there were only two participants with no device-observer differences within 5 mmHg for DBP. These data show that the Beneware model ABP-021 monitor meets the requirements of the ESH-IP, in static conditions, indicating its suitability for measuring blood pressure in the general adult population.

Dibutyl Phthalate (DBP)-Induced Apoptosis and Neurotoxicity are Mediated via the Aryl Hydrocarbon Receptor (AhR) but not by Estrogen Receptor Alpha (ERα), Estrogen Receptor Beta (ERβ), or Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) in Mouse Cortical Neurons.

PubMed

Wójtowicz, Anna K; Szychowski, Konrad A; Wnuk, Agnieszka; Kajta, Małgorzata

2017-01-01

Dibutyl phthalate (di-n-butyl phthalate, DBP) is one of the most commonly used phthalate esters. DBP is widely used as a plasticizer in a variety of household industries and consumer products. Because phthalates are not chemically bound to products, they can easily leak out to enter the environment. DBP can pass through the placental and blood-brain barriers due to its chemical structure, but little is known about its mechanism of action in neuronal cells. This study demonstrated the toxic and apoptotic effects of DBP in mouse neocortical neurons in primary cultures. DBP stimulated caspase-3 and LDH activities as well as ROS formation in a concentration (10 nM-100 µM) and time-dependent (3-48 h) manner. DBP induced ROS formation at nanomolar concentrations, while it activated caspase-3 and LDH activities at micromolar concentrations. The biochemical effects of DBP were accompanied by decreased cell viability and induction of apoptotic bodies. Exposure to DBP reduced Erα and Pparγ mRNA expression levels, which were inversely correlated with protein expression of the receptors. Treatment with DBP enhanced Ahr mRNA expression, which was reflected by the increased AhR protein level observed at 3 h after exposure. ERα, ERβ, and PPARγ antagonists stimulated DBP-induced caspase-3 and LDH activities. AhR silencing demonstrated that DBP-induced apoptosis and neurotoxicity are mediated by AhR, which is consistent with the results from DBP-induced enhancement of AhR mRNA and protein expression. Our study showed that AhR is involved in DBP-induced apoptosis and neurotoxicity, while the ERs and PPARγ signaling pathways are impaired by the phthalate.

Effects of Massage on Blood Pressure in Patients With Hypertension and Prehypertension: A Meta-analysis of Randomized Controlled Trials.

PubMed

Liao, I-Chen; Chen, Shiah-Lian; Wang, Mei-Yeh; Tsai, Pei-Shan

2016-01-01

Massage may help reduce blood pressure; previous studies on the effect of massage on blood pressure have presented conflicting findings. In addition, no systematic review is available. The aim of this study was to evaluate the evidence concerning the effect of massage on blood pressure in patients with hypertension or prehypertension. A search was performed on electronic database records up to October 31, 2013, based on the following medical subject headings or keywords: hypertension, massage, chiropractic, manipulation, and blood pressure. The methodological quality of randomized controlled trials was assessed based on the Cochrane collaboration tool. A meta-analysis was performed to evaluate the effect of massage on hypertension. The study selection, data extraction, and validation were performed independently by 2 reviewers. Nine randomized controlled trials met our inclusion criteria. The results of this study show that massage contributes to significantly enhanced reduction in both systolic blood pressure (SBP) (mean difference, -7.39 mm Hg) and diastolic blood pressure (DBP) (mean difference, -5.04 mm Hg) as compared with control treatments in patients with hypertension and prehypertension. The effect size (Hedges g) for SBP and DBP was -0.728 (95% confidence interval, -1.182 to -0.274; P = .002) and -0.334 (95% confidence interval, -0.560 to -0.107; P = .004), respectively. This systematic review found a medium effect of massage on SBP and a small effect on DBP in patients with hypertension or prehypertension. High-quality randomized controlled trials are urgently required to confirm these results, although the findings of this study can be used to guide future research.

Circadian Misalignment Increases C-Reactive Protein and Blood Pressure in Chronic Shift Workers.

PubMed

Morris, Christopher J; Purvis, Taylor E; Mistretta, Joseph; Hu, Kun; Scheer, Frank A J L

2017-04-01

Shift work is a risk factor for inflammation, hypertension, and cardiovascular disease. This increased risk cannot be fully explained by classical risk factors. Shift workers' behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in shift workers, independent of differences in work stress, food quality, and other factors that are likely to differ between night and day shifts. Thus, our objectives were to determine the independent effect of circadian misalignment on 24-h high-sensitivity C-reactive protein (hs-CRP; a marker of systemic inflammation) and blood pressure levels-cardiovascular disease risk factors-in chronic shift workers. Chronic shift workers undertook two 3-day laboratory protocols that simulated night work, comprising 12-hour inverted behavioral and environmental cycles (circadian misalignment) or simulated day work (circadian alignment), using a randomized, crossover design. Circadian misalignment increased 24-h hs-CRP by 11% ( p < 0.0001). Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 1.4 mmHg and 0.8 mmHg, respectively (both p ≤ 0.038). The misalignment-mediated increase in 24-h SBP was primarily explained by an increase in SBP during the wake period (+1.7 mmHg; p = 0.017), whereas the misalignment-mediated increase in 24-h DBP was primarily explained by an increase in DBP during the sleep opportunity (+1.8 mmHg; p = 0.005). Circadian misalignment per se increases hs-CRP and blood pressure in shift workers. This may help explain the increased inflammation, hypertension, and cardiovascular disease risk in shift workers.

The evolution of systolic blood pressure as a strong predictor of cardiovascular risk and the effectiveness of fixed-dose ARB/CCB combinations in lowering levels of this preferential target

PubMed Central

Mourad, Jean-Jacques

2008-01-01

Elevated blood pressure is an important cardiovascular risk factor. Although targets for both diastolic blood pressure (DBP) and systolic blood pressure (SBP) are defined by current guidelines, DBP has historically taken precedence in hypertension management. However, there is strong evidence that SBP is superior to DBP as a predictor of cardiovascular events. Moreover, achieving control of SBP is assuming greater importance amongst an aging population. In spite of the growing recognition of the importance of SBP in reducing cardiovascular risk and the emphasis by current guidelines on SBP control, a substantial proportion of patients still fail to achieve SBP targets, and SBP control is achieved much less frequently than DBP control. Thus, new approaches to the management of hypertension are required in order to control SBP and minimize cardiovascular risk. Fixed-dose combination (FDC) therapy is an approach that offers the advantages of multiple drug administration and a reduction in regimen complexity that favors compliance. We have reviewed the latest evidence demonstrating the efficacy in targeting SBP of the most recent FDC products; combinations of the calcium channel blocker (CCB), amlodipine, with angiotensin receptor blockers (ARBs), valsartan or olmesartan. In addition, results from studies with new classes of agent are outlined. PMID:19337545

The Dependence of Chlorine Decay and DBP Formation Kinetics On Pipe Flow Properties in Drinking Water Distribution

EPA Science Inventory

Simultaneous chlorine decay and disinfection byproduct (DBP) formation has long been discussed because of its regulatory and operational significance. This study further examines the water quality changes under hydrodynamic settings during drinking water distribution. Comparative...

Azilsartan in Patients With Mild to Moderate Hypertension Using Clinic and Ambulatory Blood Pressure Measurements.

PubMed

Perez, Alfonso; Cao, Charlie

2017-01-01

This was a phase 2, multicenter, randomized, parallel-group, double-blind dose-ranging study. Hypertensive adults (n=555) received one of five doses of azilsartan (AZL; 2.5, 5, 10, 20, 40 mg), olmesartan medoxomil (OLM) 20 mg, or placebo once daily. The primary endpoint was change in trough clinic diastolic blood pressure (DBP) at week 8. Compared with placebo, all AZL doses (except 2.5 mg) provided statistically and clinically significant reductions in DBP and systolic blood pressure (SBP) based on both clinic blood pressure (BP) and 24-hour ambulatory BP monitoring (ABPM). AZL 40 mg was statistically superior vs OLM. Clinic BP was associated with a pronounced placebo effect (-6 mm Hg), whereas this was negligible with ABPM (±0.5 mm Hg). Adverse event frequency was similar in the AZL and placebo groups. Based on these and other findings, subsequent trials investigated the commercial AZL medoxomil tablet at doses 20 to 80 mg/d using 24-hour ABPM. ©2016 Wiley Periodicals, Inc.

Controlled aerobic exercise training reduces resting blood pressure in sedentary older adults.

PubMed

Huang, Guoyuan; Shi, Xiangrong; Gibson, Cheryl A; Huang, Sunny C; Coudret, Nadine A; Ehlman, Mary C

2013-12-01

The results of existing controlled clinical trials were synthesized to determine effects of aerobic exercise training on resting systolic (SBP) and diastolic blood pressure (DBP) among previously sedentary older adults, to quantify the magnitude of observed changes, and to examine the influence of the associated interventional variables on these changes. Studies were identified via a systematic computer database search, hand searching, and cross-referencing of previously located articles. All potentially eligible articles were carefully reviewed and examined with the established inclusion criteria. Twenty-three studies, representing a total of 1226 older subjects, were included in the final analysis. Robust statistically significant effects were found in terms of the pooled standardized effect size of - 0.33 ± 0.06 (p < 0.0001) in SBP and - 0.39 ± 0.09 (p < 0.0001) in DBP. When compared with the control group, net decreases in both SBP (- 5.39 ± 1.21 mmHg, p < 0.0001) and DBP (-3.68 ± 0.83 mmHg, p < 0.0001) were observed in older exercisers, representing a 3.9% and a 4.5% reduction, respectively. This meta-analytic study provides robust quantitative data to support the efficacy and effectiveness of controlled endurance exercise training in decreasing resting SBP and DBP among previously sedentary older adults.

What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

PubMed Central

Eguchi, Kazuo; Kuruvilla, Sujith; Ogedegbe, Gbenga; Gerin, William; Schwartz, Joseph E.; Pickering, Thomas G.

2010-01-01

Objectives To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance. Design We enrolled 56 patients from a hypertension clinic (mean age: 60 ±14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors. Results The analyses were performed using the second–third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 ±15.8/77.5 ±9.5 and 133.2 ±15.5/76.9 ±9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 ±14/79 ±10 mmHg) than the 10-s interval readings. There was no significant difference in patients’ compliance in taking adequate numbers of readings at the different time intervals. Conclusion The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval. PMID:19462492

A Systematic Assessment of the Association of Polysomnographic Indices with Blood Pressure: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Dean, Dennis A.; Wang, Rui; Jacobs, David R.; Duprez, Daniel; Punjabi, Naresh M.; Zee, Phyllis C.; Shea, Steven; Watson, Karol; Redline, Susan

2015-01-01

Study Objective: Blood pressure (BP) may be adversely affected by a variety of sleep disturbances, including sleep fragmentation, hypoxemia, respiratory disturbances, and periodic limb movements. We aim to identify which polysomnography indices are most strongly and consistently associated with systolic and diastolic blood pressure (SBP, DBP) levels in a population-based sample. Design: Cross-sectional analysis of data from 2,040 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent polysomnography at MESA Exam 5 in 2011–2013. Setting: Multisite cohort study. Participants: Participants were mean age 68 y (54% females; 28% African American, 24% Hispanic, 11% Chinese). Measurements: Thirty-two candidate polysomnography predictors were identified representing the domains of breathing disturbance frequency, hypoxemia, sleep architecture, and periodic limb movements. Cluster analysis was used for variable reduction. Statistical models, adjusted for potential confounders, were derived using stepwise regression. Final models were selected using cross-validation techniques. Results: The apnea-hypopnea index (AHI) defined using a 4% desaturation hypopnea criterion (AHI4P) was most consistently associated with SBP level. The AHI and periodic limb movement index (associated with arousals; PLMIA) were significantly associated with DBP. Estimated adjusted differences in SBP and DBP levels between an individual with no sleep apnea (AHI4P = 0) and one with moderately severe sleep apnea (AHI4P = 30) were 2.2 mm Hg and 1.1 mm Hg, respectively. Each 10-unit increase in the PLMIA was associated with an increase in DBP of 1.2 mm Hg. Conclusion: Our results support the use of a currently recommended apnea-hypopnea index definition as a marker of blood pressure risk and indicate that measurement of limb movements with arousals is also independently associated with diastolic blood pressure. Citation: Dean DA, Wang R, Jacobs DR, Duprez D, Punjabi NM, Zee PC

Validation of the iHealth BP5 wireless upper arm blood pressure monitor for self-measurement according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Shang, Fujun; Zhu, Yizheng; Zhu, Zhenlai; Liu, Lei; Wan, Yi

2013-10-01

The aim of this study was to validate the iHealth BP5 wireless upper arm blood pressure (BP) monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. The ESH-IP revision 2010 for validation of BP measuring devices in adults was followed precisely. A total of 99 pairs of test device and reference BP measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 71, 89, and 97 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 73, 90, and 99 mmHg for diastolic blood pressure (DBP), respectively. The mean ± SD device-observer difference was -1.21 ± 5.87 mmHg for SBP and -1.04 ± 5.28 mmHg for DBP. The number of participants with two or three device-observer differences within 5 mmHg was 25 for SBP and 28 for DBP. In addition, three participants had no device-observer difference within 5 mmHg for SBP and none of the participants had the same for DBP. According to the validation results on the basis of the ESH-IP revision 2010, the iHealth BP5 wireless upper arm BP monitor can be recommended for self/home measurement in an adult population.

Bromine incorporation into five DBP classes upon chlorination of water with extremely low SUVA values.

PubMed

Hong, Huachang; Yan, Xiaoqing; Song, Xuhui; Qin, Yanyan; Sun, Hongjie; Lin, Hongjun; Chen, Jianrong; Liang, Yan

2017-07-15

The main objective of this study was to assess the effects of disinfection conditions on bromine incorporation into disinfection by-products (DBPs) during chlorination of water with low specific UV absorbance (SUVA). Five classes of DBPs were included: trihalomethanes (THMs), dihaloacetic acids (di-HAAs), trihaloacetic acids (tri-HAAs), dihaloacetonitriles (DHANs) and trihalonitromethanes (THNMs). Results showed that the bromine utilization in DBPs formation was positive related with reaction time, pH and temperature. On the other hand, the bromine substitution factors (BSFs) of DBPs were generally increased with pH (except tri-HAAs) and bromide concentration, but decreased with the reaction time, temperature and chlorine dose. Moreover, the BSFs values varied with DBP classes with the ranking being as following: THNMs≫DHANs≫tri-HAAs>THM≈di-HAAs. These results were mostly similar with the references, yet the pH effect on BSFs as well as the rank of BSFs for different DBP classes may differ with the specific UV absorbance of organic matter. Copyright © 2017 Elsevier B.V. All rights reserved.

Associations between height and blood pressure in the United States population

PubMed Central

Bourgeois, Brianna; Watts, Krista; Thomas, Diana M.; Carmichael, Owen; Hu, Frank B.; Heo, Moonseong; Hall, John E.; Heymsfield, Steven B.

2017-01-01

Abstract The mechanisms linking short stature with an increase in cardiovascular and cerebrovascular disease risk remain elusive. This study tested the hypothesis that significant associations are present between height and blood pressure in a representative sample of the US adult population. Participants were 12,988 men and women from a multiethnic sample (age ≥ 18 years) evaluated in the 1999 to 2006 National Health and Nutrition Examination Survey who were not taking antihypertensive medications and who had complete height, weight, % body fat, and systolic and diastolic arterial blood pressure (SBP and DBP) measurements; mean arterial blood pressure and pulse pressure (MBP and PP) were calculated. Multiple regression models for men and women were developed with each blood pressure as dependent variable and height, age, race/ethnicity, body mass index, % body fat, socioeconomic status, activity level, and smoking history as potential independent variables. Greater height was associated with significantly lower SBP and PP, and higher DBP (all P < .001) in combined race/ethnic–sex group models beginning in the 4th decade. Predicted blood pressure differences between people who are short and tall increased thereafter with greater age except for MBP. Socioeconomic status, activity level, and smoking history did not consistently contribute to blood pressure prediction models. Height-associated blood pressure effects were present in US adults who appeared in the 4th decade and increased in magnitude with greater age thereafter. These observations, in the largest and most diverse population sample evaluated to date, provide support for postulated mechanisms linking adult stature with cardiovascular and cerebrovascular disease risk. PMID:29390353

Household responsibilities, income, and ambulatory blood pressure among working men and women

PubMed Central

Thurston, Rebecca C.; Sherwood, Andrew; Matthews, Karen A.; Blumenthal, James A.

2011-01-01

Objective To test the hypothesis that a greater perceived responsibility for household tasks and a greater number of hours spent doing these tasks would be associated with elevated ambulatory systolic (SBP) and diastolic blood pressure (DBP). The connection between job characteristics and cardiovascular outcomes has been widely studied. However, less is known about links between household work characteristics and cardiovascular health. Methods 113 employed unmedicated hypertensive men and women underwent one day of ambulatory blood pressure (ABP) monitoring. Participants provided information on 1) the number of hours spent doing and 2) their degree of responsibility for seven household tasks (child care, pet care, caring for ill/elderly, household chores, house/car repair, yardwork, finances). Associations between task hours and responsibility ratings in relation to SBP and DBP were estimated using generalized estimating equations, with covariates age, race, gender, body mass index, location, posture. Interactions with gender and socioeconomic position were assessed. Results A greater perceived responsibility for household tasks, but not the hours spent doing these tasks, was associated with higher ambulatory SBP (b(95% confidence interval (CI))=0.93(0.29–1.56), p=0.004) and DBP (b(95%CI)=0.30(0.10–0.51), p=0.003)). Significant interactions with income indicated that associations between household responsibilities and ABP were most pronounced among low income participants (SBP: b(95%CI)=1.40(0.58–2.21), p<0.001; DBP: b(95%CI)=0.48(0.18–0.78), p<0.01). The task most strongly associated with BP was household chores. No interactions with gender were observed. Conclusions Greater perceived responsibility for household tasks was associated with elevated ABP, particularly for lower income participants. Household obligations may have important implications for cardiovascular health, meriting further empirical attention. PMID:21217097

Validation of the Medipro MediCare 100f upper arm blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Yi, Jun; Wan, Yi; Pan, Feng; Yu, Xiaorong; Zhao, Huadong; Shang, Fujun; Xu, Yongyong

2011-08-01

The validation of sphygmomanometer is important in accurate blood pressure measurement. This study presents the validation results by the Medipro MediCare 100f upper arm blood pressure monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. The ESH-IP revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. A total of 99 couples of test device and reference blood pressure measurements were obtained during the study (three pairs for each of the 33 participants). The device produced 73, 93, and 98 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 79, 93, and 96 for diastolic blood pressure (DBP), respectively. The mean standard deviation device-observer difference was 1.4 ± 5.2 mmHg for SBP and 0.02±5.8 mmHg for DBP. The number of participants with two or three of the device-observer differences within 5 mmHg was 24 for SBP and 30 for DBP, whereas there was no participant with none of the device-observer differences within 5 mmHg. According to the results of the validation study based on the ESH-IP revision 2010, the Medipro MediCare 100f can be recommended for self-measurement in an adult population.

Validation of BP devices QardioArm® in the general population and Omron M6 Comfort® in type II diabetic patients according to the European Society of Hypertension International Protocol (ESH-IP).

PubMed

Chahine, Mirna N; Topouchian, Jirar; Zelveian, Parounak; Hakobyan, Zoya; Melkonyan, Arevik; Azaki, Alaa; Diab, Reem; Harb, Aya; Asmar, Roland

2018-01-01

Following the European Society of Hypertension International Protocol (ESH-IP) Revision 2010, QardioArm ® and Omron M6 Comfort IT ® oscillometric devices were evaluated in the general population and in patients with type II diabetes, respectively, for self-blood pressure (BP) measurement. Both devices, QardioArm ® and Omron M6 Comfort ® , measure BP at the brachial level. The ESH-IP Revision 2010 includes a total number of 33 subjects. For each measure, the difference between observer and device BP values was calculated. In all, 99 pairs of BP differences are classified into three categories (≤5, ≤10, and ≤15 mmHg). The protocol procedures were followed precisely. QardioArm ® and Omron M6 Comfort ® fulfilled the requirements of the ESH-IP and passed the validation process successfully. For QardioArm ® , a total of 69 out of 99 comparisons for systolic blood pressure (SBP) showed an absolute difference within 5 mmHg and 82 out of 99 for diastolic blood pressure (DBP). As for Omron M6 Comfort ® , a total of 83 out of 99 comparisons for SBP showed an absolute difference within 5 mmHg and 77 out of 99 for DBP. The mean differences between the device and mercury readings were 0.7±5.9 mmHg for SBP and 0.3±4.1 mmHg for DBP for QardioArm ® and -1.4±4.7 mmHg for SBP and -2.1±4.3 mmHg for DBP for Omron M6 Comfort ® . With regard to part 2 of ESH-IP 2010, 27 out of 33 subjects had a minimum of two out of three measurements within 5 mmHg difference for SBP and 31 out of 33 subjects for DBP for the QardioArm ® , and 29 out of 33 patients had a minimum of two out of three measurements within 5 mmHg difference for SBP and 26 out of 33 patients for DBP for Omron M6 Comfort ® . QardioArm ® and Omron M6 Comfort ® readings differing from the mercury standard by <5, 10, and 15 mmHg fulfill the ESH-IP Revision 2010 requirements. Consequently, these two devices are suitable for use in the general population and non-insulin-dependent type II diabetic patients

Validation of BP devices QardioArm® in the general population and Omron M6 Comfort® in type II diabetic patients according to the European Society of Hypertension International Protocol (ESH-IP)

PubMed Central

Chahine, Mirna N; Topouchian, Jirar; Zelveian, Parounak; Hakobyan, Zoya; Melkonyan, Arevik; Azaki, Alaa; Diab, Reem; Harb, Aya; Asmar, Roland

2018-01-01

Background Following the European Society of Hypertension International Protocol (ESH-IP) Revision 2010, QardioArm® and Omron M6 Comfort IT® oscillometric devices were evaluated in the general population and in patients with type II diabetes, respectively, for self-blood pressure (BP) measurement. Methods Both devices, QardioArm® and Omron M6 Comfort®, measure BP at the brachial level. The ESH-IP Revision 2010 includes a total number of 33 subjects. For each measure, the difference between observer and device BP values was calculated. In all, 99 pairs of BP differences are classified into three categories (≤5, ≤10, and ≤15 mmHg). The protocol procedures were followed precisely. Results: QardioArm® and Omron M6 Comfort® fulfilled the requirements of the ESH-IP and passed the validation process successfully. For QardioArm®, a total of 69 out of 99 comparisons for systolic blood pressure (SBP) showed an absolute difference within 5 mmHg and 82 out of 99 for diastolic blood pressure (DBP). As for Omron M6 Comfort®, a total of 83 out of 99 comparisons for SBP showed an absolute difference within 5 mmHg and 77 out of 99 for DBP. The mean differences between the device and mercury readings were 0.7±5.9 mmHg for SBP and 0.3±4.1 mmHg for DBP for QardioArm® and −1.4±4.7 mmHg for SBP and −2.1±4.3 mmHg for DBP for Omron M6 Comfort®. With regard to part 2 of ESH-IP 2010, 27 out of 33 subjects had a minimum of two out of three measurements within 5 mmHg difference for SBP and 31 out of 33 subjects for DBP for the QardioArm®, and 29 out of 33 patients had a minimum of two out of three measurements within 5 mmHg difference for SBP and 26 out of 33 patients for DBP for Omron M6 Comfort®. Conclusion: QardioArm® and Omron M6 Comfort® readings differing from the mercury standard by <5, 10, and 15 mmHg fulfill the ESH-IP Revision 2010 requirements. Consequently, these two devices are suitable for use in the general population and non-insulin-dependent type

Ambulatory hypertension subtypes and 24-hour systolic and diastolic blood pressure as distinct outcome predictors in 8341 untreated people recruited from 12 populations.

PubMed

Li, Yan; Wei, Fang-Fei; Thijs, Lutgarde; Boggia, José; Asayama, Kei; Hansen, Tine W; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Gu, Yu-Mei; Torp-Pedersen, Christian; Dolan, Eamon; Liu, Yan-Ping; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Mena, Luis; Maestre, Gladys E; Filipovský, Jan; Imai, Yutaka; O'Brien, Eoin; Wang, Ji-Guang; Staessen, Jan A

2014-08-05

Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24≥80 mm Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs≤1.54; P≥0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs≥1.75; P≤0.0054). Isolated systolic hypertension (SBP24≥130 mm Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P≤0.0012). Below age 50, DBP24 was the main driver of risk, reaching significance for total (HR for 1-SD increase, 2.05; P=0.0039) and cardiovascular mortality (HR, 4.07; P=0.0032) and for all cardiovascular end points combined (HR, 1.74; P=0.039) with a nonsignificant contribution of SBP24 (HR≤0.92; P≥0.068); above age 50, SBP24 predicted all end points (HR≥1.19; P≤0.0002) with a nonsignificant contribution of DBP24 (0.96≤HR≤1.14; P≥0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P≤0.043). The risks conferred by DBP24 and SBP24 are age dependent. DBP24 and isolated diastolic hypertension drive coronary complications below age 50, whereas above age 50 SBP24 and isolated systolic and mixed hypertension are the predominant risk factors. © 2014 American Heart Association, Inc.

Ambulatory Hypertension Subtypes and 24-Hour Systolic and Diastolic Blood Pressure as Distinct Outcome Predictors in 8341 Untreated People Recruited From 12 Populations

PubMed Central

Li, Yan; Wei, Fang-Fei; Thijs, Lutgarde; Boggia, José; Asayama, Kei; Hansen, Tine W.; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Gu, Yu-Mei; Torp-Pedersen, Christian; Dolan, Eamon; Liu, Yan-Ping; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Mena, Luis; Maestre, Gladys E.; Filipovský, Jan; Imai, Yutaka; O’Brien, Eoin; Wang, Ji-Guang; Staessen, Jan A.

2015-01-01

Background Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. Methods and Results We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24≥80 mm Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs≤1.54; P≥0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs≥1.75; P≤0.0054). Isolated systolic hypertension (SBP24≥130 mm Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P≤0.0012). Below age 50, DBP24 was the main driver of risk, reaching significance for total (HR for 1-SD increase, 2.05; P=0.0039) and cardiovascular mortality (HR, 4.07; P=0.0032) and for all cardiovascular end points combined (HR, 1.74; P=0.039) with a nonsignificant contribution of SBP24 (HR≤0.92; P≥0.068); above age 50, SBP24 predicted all end points (HR≥1.19; P≤0.0002) with a nonsignificant contribution of DBP24 (0.96≤HR≤1.14; P≥0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P≤0.043). Conclusions The risks conferred by DBP24 and SBP24 are age dependent. DBP24 and isolated diastolic hypertension drive coronary complications below age 50, whereas above age 50 SBP24 and isolated systolic and mixed hypertension are the predominant risk factors. PMID:24906822

Measuring Helicase Inhibition of the DEAD-box Protein Dbp2 by Yra1

PubMed Central

Ma, Wai Kit; Tran, Elizabeth J.

2016-01-01

Despite the highly conserved helicase core, individual DEAD-box proteins are specialized in diverse RNA metabolic processes. One mechanism that determines DEAD-box protein specificity is enzymatic regulation by other protein cofactors. In this chapter, we describe a protocol for purifying the Saccharomyces cerevisiae DEAD-box RNA helicase Dbp2 and RNA-binding protein Yra1 and subsequent analysis of helicase regulation. The experiments described here can be adapted to RNA helicase and purified co-factor. PMID:25579587

Association of Carbon Monoxide exposure with blood pressure among pregnant women in rural Ghana: Evidence from GRAPHS.

PubMed

Quinn, Ashlinn K; Ae-Ngibise, Kenneth Ayuurebobi; Jack, Darby W; Boamah, Ellen Abrafi; Enuameh, Yeetey; Mujtaba, Mohammed Nuhu; Chillrud, Steven N; Wylie, Blair J; Owusu-Agyei, Seth; Kinney, Patrick L; Asante, Kwaku Poku

2016-03-01

The Ghana Randomized Air Pollution and Health Study (GRAPHS) is a community-level randomized-controlled trial of cookstove interventions for pregnant women and their newborns in rural Ghana. Given that household air pollution from biomass burning may be implicated in adverse cardiovascular outcomes, we sought to determine whether exposure to carbon monoxide (CO) from woodsmoke was associated with blood pressure (BP) among 817 adult women. Multivariate linear regression models were used to evaluate the association between CO exposure, determined with 72 hour personal monitoring at study enrollment, and BP, also measured at study enrollment. At the time of these assessments, women were in the first or second trimester of pregnancy. A significant positive association was found between CO exposure and diastolic blood pressure (DBP): on average, each 1 ppm increase in exposure to CO was associated with 0.43 mmHg higher DBP [0.01, 0.86]. A non-significant positive trend was also observed for systolic blood pressure (SBP). This study is one of very few to have examined the relationship between household air pollution and blood pressure among pregnant women, who are at particular risk for hypertensive complications. The results of this cross-sectional study suggest that household air pollution from wood-burning fires is associated with higher blood pressure, particularly DBP, in pregnant women at early to mid-gestation. The clinical implications of the observed association toward the eventual development of chronic hypertension and/or hypertensive complications of pregnancy remain uncertain, as few of the women were overtly hypertensive at this point in their pregnancies. Copyright © 2015 Elsevier GmbH. All rights reserved.

A quantitative comparison of physiologic indicators of cardiopulmonary resuscitation quality: Diastolic blood pressure versus end-tidal carbon dioxide.

PubMed

Morgan, Ryan W; French, Benjamin; Kilbaugh, Todd J; Naim, Maryam Y; Wolfe, Heather; Bratinov, George; Shoap, Wesley; Hsieh, Ting-Chang; Nadkarni, Vinay M; Berg, Robert A; Sutton, Robert M

2016-07-01

The American Heart Association (AHA) recommends monitoring invasive arterial diastolic blood pressure (DBP) and end-tidal carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) when available. In intensive care unit patients, both may be available to the rescuer. The objective of this study was to compare DBP vs. ETCO2 during CPR as predictors of cardiac arrest survival. In two models of cardiac arrest (primary ventricular fibrillation [VF] and asphyxia-associated VF), 3-month old swine received either standard AHA guideline-based CPR or patient-centric, BP-guided CPR. Mean values of DBP and ETCO2 in the final 2min before the first defibrillation attempt were compared using receiver operating characteristic curves (area under curve [AUC] analysis). The optimal DBP cut point to predict survival was derived and subsequently validated in two independent, randomly generated cohorts. Of 60 animals, 37 (61.7%) survived to 45min. DBP was higher in survivors than in non-survivors (40.6±1.8mmHg vs. 25.9±2.4mmHg; p<0.001), while ETCO2 was not different (30.0±1.5mmHg vs. 32.5±1.8mmHg; p=0.30). By AUC analysis, DBP was superior to ETCO2 (0.82 vs. 0.60; p=0.025) in discriminating survivors from non-survivors. The optimal DBP cut point in the derivation cohort was 34.1mmHg. In the validation cohort, this cut point demonstrated a sensitivity of 0.78, specificity of 0.81, positive predictive value of 0.64, and negative predictive value of 0.89 for survival. In both primary and asphyxia-associated VF porcine models of cardiac arrest, DBP discriminates survivors from non-survivors better than ETCO2. Failure to attain a DBP >34mmHg during CPR is highly predictive of non-survival. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Associations of methylenetetrahydrofolate reductase C677T genotype with blood pressure levels in Chinese population with essential hypertension.

PubMed

Cheng, Jun; Tao, Fang; Liu, Yanhong; Venners, Scott A; Hsu, Yi-Hsiang; Jiang, Shanqun; Weinstock, Justin; Wang, Binyan; Tang, Genfu; Xu, Xiping

2018-01-01

To confirm the association between baseline blood pressure (BP) levels and the methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in patients with essential hypertension. A total of 347 patients were enrolled from the Dongzhi community in Anhui Province, China. The C677T polymorphism of the MTHFR gene was detected using high-throughput TaqMan allelic discrimination assay. Baseline BP was measured using a standardized mercury-gravity monometer. In the whole sample, the frequency of the MTHFR C677T genotypes CC, CT, and TT were 38.6%, 48.1%, and 13.3%, respectively. In a recessive model (CC+CT versus TT genotypes), baseline diastolic blood pressure (DBP) was significantly higher in patients with the TT genotype compared to those with the CT or CC genotypes (P= 0.013). We also divided all patients into three groups based on the tertiles of the baseline BP distribution. Compared to subjects in the lowest tertile of DBP, the adjusted odds of having the TT genotype among subjects in the highest tertile was 2.6 (95% CI: 1.1 to 6.2). However, no significant associations were observed between baseline systolic blood pressure (SBP) and the MTHFR C677T polymorphism. The MTHFR gene polymorphism could be an important genetic determinant of baseline DBP levels in Chinese essential hypertensive patients.

THE CARCINOGENIC RESPONSE TO A MIXTURE OF DRINKING WATER DISINFECTION BY-PRODUCTS (DBP) WAS LESS THAN ADDITIVE

EPA Science Inventory

THE CARCINOGENIC RESPONSE TO A MIXTURE OF DRINKING WATER DISINFECTION BY -PRODUCTS (DBP) W AS LESS THAN ADDITIVE.

Current default risk assessments for chemical mixtures assume additivity of carcinogenic effects but this may under or over represent the actual biological res...

RENAL CARCINOGENICITY OF INDIVIDUAL AND A MIXTURE OF DRINKING WATER DISINFECTION BY-PRODUCTS (DBP) IN EKER RATS

EPA Science Inventory

RENAL CARCINOGENICITY OF INDIVIDUAL AND A MIXTURE OF DRINKING / WATER DISINFECTION BY -PRODUCTS (DBP) IN EKER RATS.

Eker rats develop hereditary renal cell carcinoma secondary to a germline mutation in the tuberous sclerosis 2 tumor suppressor gene, and are highly suscepti...

Relationship Between 24-Hour Ambulatory Blood Pressure and Cognitive Function in Community-Living Older Adults: The UCSD Ambulatory Blood Pressure Study.

PubMed

Conway, Kyle S; Forbang, Nketi; Beben, Tomasz; Criqui, Michael H; Ix, Joachim H; Rifkin, Dena E

2015-12-01

Twenty-four-hour ambulatory blood pressure (BP) patterns have been associated with diminished cognitive function in hypertensive and very elderly populations. The relationship between ambulatory BP patterns and cognitive function in community-living older adults is unknown. We conducted a cross-sectional study in which 24-hour ambulatory BP, in-clinic BP, and cognitive function measures were obtained from 319 community-living older adults. The mean age was 72 years, 66% were female, and 13% were African-American. We performed linear regression with performance on the Montreal Cognitive Assessment (MoCA) as the primary outcome and 24-hour BP patterns as the independent variable, adjusting for age, sex, race/ethnicity, education, and comorbidities. Greater nighttime systolic dipping (P = 0.046) and higher 24-hour diastolic BP (DBP; P = 0.015) were both significantly associated with better cognitive function, whereas 24-hour systolic BP (SBP), average real variability, and ambulatory arterial stiffness were not. Higher 24-hour DBP and greater nighttime systolic dipping were significantly associated with improved cognitive function. Future studies should examine whether low 24-hour DBP and lack of nighttime systolic dipping predict future cognitive impairment. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study.

PubMed

Triantafyllidi, Helen; Arvaniti, Chrysa; Schoinas, Antonios; Benas, Dimitris; Vlachos, Stefanos; Palaiodimos, Leonidas; Pavlidis, George; Ikonomidis, Ignatios; Batistaki, Chrysanthi; Voumvourakis, Costas; Lekakis, John

2018-01-01

Sympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. We performed bilateral SPG block with lidocaine 2% in 33 hypertensive patients (mean age 48±12years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51±12years, 8 men). All patients have been subjected to 24h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24h SBP decrease ≥5mmHg. We found that 24h and daytime DBP (p=0.02) as well as daytime DBP load (p=0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36%) regarding: a. SBP and DBP during overall 24h and daytime (p<0.001) and night-time periods, b. pre-awake and early morning SBP and c. SBP (daytime and night-time) and DBP (daytime) load. No differences regarding BP were found in the sham operation group. SPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure. Copyright © 2017 Elsevier B.V. All rights reserved.

Why should I read? - A cross-cultural investigation into adolescents' reading socialisation and reading attitude

NASA Astrophysics Data System (ADS)

Broeder, Peter; Stokmans, Mia

2013-06-01

While reading behaviour of adolescents is a frequent object of research, most studies in this field are restricted to a single country. This study investigates reading as a leisure-time activity across social groups from three regions differing in reading tradition as well as in the facilities available for reading. The authors analyse the reading behaviour of a total of 2,173 adolescents in the Netherlands, in Beijing (China), and in Cape Town (South Africa). Taking Icek Ajzen's Theory of Planned Behaviour as a starting point, the authors adjusted it to model the three most important determinants of reading behaviour, namely (1) reading attitude; (2) subjective norms (implicit and explicit social pressure to read); and (3) perceived behavioural control, which includes reading proficiency and appropriateness of the available books (book supply). While they found the adjusted model to fit the Dutch and Beijing situation quite well, it appeared to be inappropriate for the Cape Town situation. Despite considerable cultural and situational differences between the Netherlands and Beijing, the results show a similar pattern for these two environments. The most important determinants turn out to be: the hedonic reading attitude, the implicit norm of family and friends, the attractiveness of the available choice of books, and the perceived reading proficiency.

Evaluation of riverbank infiltration as a process for removing particles and DBP precursors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, J.; Smith, J.; Dooley, L.

1996-11-01

Recent outbreaks of waterborne disease attributed to Cryptosporidium in drinking water have raised serious concerns over the effectiveness of conventional water treatment processes to produce safe drinking water supplies. Past studies have shown Cryptosporidium and Giardia to be prevalent in surface water supplies, particularly in urban-impacted surface waters such as the Ohio River which Louisville Water Company (LWC) treatment facilities utilize as their source water. Such indications of the widespread occurrence of these pathogens in source waters underscore the need for the water supply industry to evaluate alternative technologies to conventional water treatment to reduce the risk of waterborne diseasemore » occurrence. Public health concerns, shared by the water utility industry, drinking water regulators, and public water supply consumers alike, prompted the US Environmental Protection Agency (USEPA) to propose regulatory action aimed at balancing the risks of microbial disease occurrence and the health risks associated with exposure to potentially harmful compounds formed during drinking water disinfection. In pursuit of this objective, USEPA proposed the Enhanced Surface Water Treatment Rule (ESWTR) to improve public water supply treatment performance for microbial removal and proposed the Disinfectant/Disinfection Byproduct (D/DBP) Rule to reduce DBP exposure levels. As a consequence of these rules, many water utilities will be tasked with the challenge of developing treatment capabilities which improve microbial removal performance while minimizing the production of DBPs.« less

The association of birth order with later body mass index and blood pressure: a comparison between prospective cohort studies from the United Kingdom and Brazil.

PubMed

Howe, L D; Hallal, P C; Matijasevich, A; Wells, J C; Santos, I S; Barros, A J D; Lawlor, D A; Victora, C G; Smith, G D

2014-07-01

Previous studies have found greater adiposity and cardiovascular risk in first born children. The causality of this association is not clear. Examining the association in diverse populations may lead to improved insight. We examine the association between birth order and body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP) in the 2004 Pelotas cohort from southern Brazil and the Avon Longitudinal Study of Parents and Children (ALSPAC) from Bristol, south-west England, restricting analysis to families with two children in order to remove confounding by family size. No consistent differences in BMI, SBP or DBP were observed comparing first and second born children. Within the Pelotas 2004 cohort, first born females were thinner, with lower SBP and DBP; for example, mean difference in SBP comparing first with second born was -0.979 (95% confidence interval -2.901 to 0.943). In ALSPAC, first born females had higher BMI, SBP and DBP. In both cohorts, associations tended to be in the opposite direction in males, although no statistical evidence for gender interactions was found. The findings do not support an association between birth order and BMI or blood pressure. Differences to previous studies may be explained by differences in populations and/or confounding by family size in previous studies.

The Effect of Anthocyanins on Blood Pressure: A PRISMA-Compliant Meta-Analysis of Randomized Clinical Trials.

PubMed

Zhu, Yongjian; Bo, Yacong; Wang, Xi; Lu, Wenjie; Wang, Xule; Han, Zhanying; Qiu, Chunguang

2016-04-01

The findings of clinical studies concerning the association between anthocyanins supplementation and blood pressure (BP) are inconsistent. In order to provide a more precise estimate of the overall effect of anthocyanins on systolic blood pressure (SBP) and diastolic blood pressure (DBP), we conducted a meta-analysis of clinical trials about anthocyanins supplementation and BP. PubMed, Web of Science, Wanfang Database, and China National Knowledge Infrastructure (CNKI) (until October 2015) were searched to identify potential studies with information on anthocyanins extract supplementation and arterial BP. The weighted mean difference (WMD) and 95% confidence interval (CI) were used as a summary statistic. Net changes in SBP and DBP between anthocyanins supplementation and placebo groups were calculated by subtracting the values at end of follow-up from those at baseline. Meta regression was used to explore the potential moderators of effect size. The publication bias was assessed using Begger's Funnel plots and Egger's tests; P < 0.05 was considered to be statistically significant. Finally, 6 clinical studies with 472 participants for the effect of anthocyanins consumption on BP were included in the present meta-analysis. There is no significant effect on either SBP (WMD: 1.15 mm Hg, 95% CI: -3.17 to 5.47, I2 = 56%) or DBP (WMD: 1.06 mm Hg, 95% CI: -0.71 to 2.83, I2 = 0%) following supplementation with anthocyanins. In summary, results from this meta-analysis do not favor any clinical efficacy of supplementation with anthocyanins in improving blood pressure. Further well-designed large randomized controlled trials (RCTs) with long follow-up period are needed to verify the association of anthocyanins supplementation and blood pressure.

Loci influencing blood pressure identified using a cardiovascular gene-centric array.

PubMed

Ganesh, Santhi K; Tragante, Vinicius; Guo, Wei; Guo, Yiran; Lanktree, Matthew B; Smith, Erin N; Johnson, Toby; Castillo, Berta Almoguera; Barnard, John; Baumert, Jens; Chang, Yen-Pei Christy; Elbers, Clara C; Farrall, Martin; Fischer, Mary E; Franceschini, Nora; Gaunt, Tom R; Gho, Johannes M I H; Gieger, Christian; Gong, Yan; Isaacs, Aaron; Kleber, Marcus E; Mateo Leach, Irene; McDonough, Caitrin W; Meijs, Matthijs F L; Mellander, Olle; Molony, Cliona M; Nolte, Ilja M; Padmanabhan, Sandosh; Price, Tom S; Rajagopalan, Ramakrishnan; Shaffer, Jonathan; Shah, Sonia; Shen, Haiqing; Soranzo, Nicole; van der Most, Peter J; Van Iperen, Erik P A; Van Setten, Jessica; Van Setten, Jessic A; Vonk, Judith M; Zhang, Li; Beitelshees, Amber L; Berenson, Gerald S; Bhatt, Deepak L; Boer, Jolanda M A; Boerwinkle, Eric; Burkley, Ben; Burt, Amber; Chakravarti, Aravinda; Chen, Wei; Cooper-Dehoff, Rhonda M; Curtis, Sean P; Dreisbach, Albert; Duggan, David; Ehret, Georg B; Fabsitz, Richard R; Fornage, Myriam; Fox, Ervin; Furlong, Clement E; Gansevoort, Ron T; Hofker, Marten H; Hovingh, G Kees; Kirkland, Susan A; Kottke-Marchant, Kandice; Kutlar, Abdullah; Lacroix, Andrea Z; Langaee, Taimour Y; Li, Yun R; Lin, Honghuang; Liu, Kiang; Maiwald, Steffi; Malik, Rainer; Murugesan, Gurunathan; Newton-Cheh, Christopher; O'Connell, Jeffery R; Onland-Moret, N Charlotte; Ouwehand, Willem H; Palmas, Walter; Penninx, Brenda W; Pepine, Carl J; Pettinger, Mary; Polak, Joseph F; Ramachandran, Vasan S; Ranchalis, Jane; Redline, Susan; Ridker, Paul M; Rose, Lynda M; Scharnag, Hubert; Schork, Nicholas J; Shimbo, Daichi; Shuldiner, Alan R; Srinivasan, Sathanur R; Stolk, Ronald P; Taylor, Herman A; Thorand, Barbara; Trip, Mieke D; van Duijn, Cornelia M; Verschuren, W Monique; Wijmenga, Cisca; Winkelmann, Bernhard R; Wyatt, Sharon; Young, J Hunter; Boehm, Bernhard O; Caulfield, Mark J; Chasman, Daniel I; Davidson, Karina W; Doevendans, Pieter A; Fitzgerald, Garret A; Gums, John G; Hakonarson, Hakon; Hillege, Hans L; Illig, Thomas; Jarvik, Gail P; Johnson, Julie A; Kastelein, John J P; Koenig, Wolfgang; März, Winfried; Mitchell, Braxton D; Murray, Sarah S; Oldehinkel, Albertine J; Rader, Daniel J; Reilly, Muredach P; Reiner, Alex P; Schadt, Eric E; Silverstein, Roy L; Snieder, Harold; Stanton, Alice V; Uitterlinden, André G; van der Harst, Pim; van der Schouw, Yvonne T; Samani, Nilesh J; Johnson, Andrew D; Munroe, Patricia B; de Bakker, Paul I W; Zhu, Xiaofeng; Levy, Daniel; Keating, Brendan J; Asselbergs, Folkert W

2013-04-15

Blood pressure (BP) is a heritable determinant of risk for cardiovascular disease (CVD). To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), we genotyped ∼50 000 single-nucleotide polymorphisms (SNPs) that capture variation in ∼2100 candidate genes for cardiovascular phenotypes in 61 619 individuals of European ancestry from cohort studies in the USA and Europe. We identified novel associations between rs347591 and SBP (chromosome 3p25.3, in an intron of HRH1) and between rs2169137 and DBP (chromosome1q32.1 in an intron of MDM4) and between rs2014408 and SBP (chromosome 11p15 in an intron of SOX6), previously reported to be associated with MAP. We also confirmed 10 previously known loci associated with SBP, DBP, MAP or PP (ADRB1, ATP2B1, SH2B3/ATXN2, CSK, CYP17A1, FURIN, HFE, LSP1, MTHFR, SOX6) at array-wide significance (P < 2.4 × 10(-6)). We then replicated these associations in an independent set of 65 886 individuals of European ancestry. The findings from expression QTL (eQTL) analysis showed associations of SNPs in the MDM4 region with MDM4 expression. We did not find any evidence of association of the two novel SNPs in MDM4 and HRH1 with sequelae of high BP including coronary artery disease (CAD), left ventricular hypertrophy (LVH) or stroke. In summary, we identified two novel loci associated with BP and confirmed multiple previously reported associations. Our findings extend our understanding of genes involved in BP regulation, some of which may eventually provide new targets for therapeutic intervention.

Time Course of Change in Blood Pressure From Sodium Reduction and the DASH Diet.

PubMed

Juraschek, Stephen P; Woodward, Mark; Sacks, Frank M; Carey, Vincent J; Miller, Edgar R; Appel, Lawrence J

2017-11-01

Both sodium reduction and the Dietary Approaches to Stop Hypertension (DASH) diet lower blood pressure (BP); however, the patterns of their effects on BP over time are unknown. In the DASH-Sodium trial, adults with pre-/stage 1 hypertension, not using antihypertensive medications, were randomly assigned to either a typical American diet (control) or DASH. Within their assigned diet, participants randomly ate each of 3 sodium levels (50, 100, and 150 mmol/d, at 2100 kcal) over 4-week periods. BP was measured weekly for 12 weeks; 412 participants enrolled (57% women; 57% black; mean age, 48 years; mean systolic BP [SBP]/diastolic BP [DBP], 135/86 mm Hg). For those assigned control, there was no change in SBP/DBP between weeks 1 and 4 on the high-sodium diet (weekly change, -0.04/0.06 mm Hg/week) versus a progressive decline in BP on the low-sodium diet (-0.94/-0.70 mm Hg/week; P interactions between time and sodium <0.001 for SBP and DBP). For those assigned DASH, SBP/DBP changed -0.60/-0.16 mm Hg/week on the high- versus -0.42/-0.54 mm Hg/week on the low-sodium diet ( P interactions between time and sodium=0.56 for SBP and 0.10 for DBP). When comparing DASH to control, DASH changed SBP/DBP by -4.36/-1.07 mm Hg after 1 week, which accounted for most of the effect observed, with no significant difference in weekly rates of change for either SBP ( P interaction=0.97) or DBP ( P interaction=0.70). In the context of a typical American diet, a low-sodium diet reduced BP without plateau, suggesting that the full effects of sodium reduction are not completely achieved by 4 weeks. In contrast, compared with control, DASH lowers BP within a week without further effect thereafter. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000608. © 2017 American Heart Association, Inc.

Genetic variants in adiponectin and blood pressure responses to dietary sodium or potassium interventions: a family-based association study

PubMed Central

Chu, C; Wang, Y; Ren, K-y; Yan, D-y; Guo, T-s; Zheng, W-l; Yuan, Z-y; Mu, J-j

2016-01-01

Previous studies have shown that genetic factors might have an important role in blood pressure (BP) responses to dietary salt or potassium intake. The aim of this study was to assess the association of common genetic variants of the adiponectin gene with BP responses to controlled dietary sodium or potassium interventions. Subjects (n=334) from 124 families in rural areas of Northern China were recruited. After a 3-day baseline observation, participants sequentially maintained a 7-day low-sodium diet (NaCl, 3 g per day; or sodium, 51.3 mmol per day), followed by a 7-day high-sodium diet (NaCl, 18 g per day; or sodium, 307.8 mmol per day) and a 7-day high-sodium plus potassium supplementation intervention (KCl, 4.5 g per day; or potassium, 60 mmol per day). A total of seven single nucleotide polymorphisms (SNPs) in the adiponectin gene were selected as the study sites. After adjustment for multiple testing, the adiponectin SNP rs16861205 was significantly associated with the diastolic BP (DBP) response to low-salt intervention, and the DBP and mean arterial pressure (MAP) responses to high-salt intervention (P=0.028, 0.023 and 0.027, respectively). SNP rs822394 was associated with the DBP and MAP responses to low-salt intervention and the DBP response to high-salt intervention (P=0.023, 0.030 and 0.033 respectively). Meanwhile, significant association also existed between SNP rs16861194 and the systolic BP response to potassium supplementation intervention (P=0.026). In addition, SNP rs822394 was significantly associated with basal DBP after adjustment for multiple testing (P=0.033). Our study indicated that the genetic polymorphisms in the adiponectin gene are significantly associated with BP responses to dietary sodium and potassium intake. PMID:27011258

Genetic variants in adiponectin and blood pressure responses to dietary sodium or potassium interventions: a family-based association study.

PubMed

Chu, C; Wang, Y; Ren, K-Y; Yan, D-Y; Guo, T-S; Zheng, W-L; Yuan, Z-Y; Mu, J-J

2016-09-01

Previous studies have shown that genetic factors might have an important role in blood pressure (BP) responses to dietary salt or potassium intake. The aim of this study was to assess the association of common genetic variants of the adiponectin gene with BP responses to controlled dietary sodium or potassium interventions. Subjects (n=334) from 124 families in rural areas of Northern China were recruited. After a 3-day baseline observation, participants sequentially maintained a 7-day low-sodium diet (NaCl, 3 g per day; or sodium, 51.3 mmol per day), followed by a 7-day high-sodium diet (NaCl, 18 g per day; or sodium, 307.8 mmol per day) and a 7-day high-sodium plus potassium supplementation intervention (KCl, 4.5 g per day; or potassium, 60 mmol per day). A total of seven single nucleotide polymorphisms (SNPs) in the adiponectin gene were selected as the study sites. After adjustment for multiple testing, the adiponectin SNP rs16861205 was significantly associated with the diastolic BP (DBP) response to low-salt intervention, and the DBP and mean arterial pressure (MAP) responses to high-salt intervention (P=0.028, 0.023 and 0.027, respectively). SNP rs822394 was associated with the DBP and MAP responses to low-salt intervention and the DBP response to high-salt intervention (P=0.023, 0.030 and 0.033 respectively). Meanwhile, significant association also existed between SNP rs16861194 and the systolic BP response to potassium supplementation intervention (P=0.026). In addition, SNP rs822394 was significantly associated with basal DBP after adjustment for multiple testing (P=0.033). Our study indicated that the genetic polymorphisms in the adiponectin gene are significantly associated with BP responses to dietary sodium and potassium intake.

Sex differences in the association of childhood socioeconomic status with adult blood pressure change: the CARDIA study.

PubMed

Janicki-Deverts, Denise; Cohen, Sheldon; Matthews, Karen A; Jacobs, David R

2012-09-01

To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic blood pressure (DBP) trajectories during 15 years, spanning young (mean [M] [standard deviation {SD}] = 30 [3] years) and middle (M [SD] = 45 [3] years) adulthood, independent of adult SES. A total of 4077 adult participants reported father's and mother's educational attainments at study enrollment (Year 0) and own educational attainment at enrollment and at all follow-up examinations. Resting BP also was measured at all examinations. Data from examination Years 5 (when participant M [SD] age = 30 [3] years), 7, 10, 15, and 20 are examined here. Associations of own adult (Year 5), mother's, and father's educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center) and time-varying covariates that were measured at each examination (marital status, body mass, cholesterol, oral contraceptives/hormones, and antihypertensive drugs). Analyses of parental education controlled for own education. When examined without covariates, higher education - own (SBP γ = -0.03, DBP γ = -0.03), mother's (SBP γ = -0.02, DBP γ = -0.02), and father's (SBP γ = -0.02, DBP γ = -0.01) - were associated with attenuated 15-year increases in BP (p < .001). Associations of own (but not either parent's) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education-especially mother's, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ = -0.02, p = .02; DBP γ = -0.01, p = .04) but not men (SBP γ = 0.02, p = .06; DBP γ = 0.005, p = .47; p interaction SBP < .001, p interaction DBP = .01). Childhood socioeconomic status may influence women's health independent of their own adult status.

Low nocturnal blood pressure is associated with reduced cerebral blood flow in the cohort “Men born in 1914”

PubMed Central

Reinprecht, Faina; Axelsson, Johan; Siennicki-Lantz, Arkadiusz; Elmståhl, Sölve

2008-01-01

BACKGROUND: “Men born in 1914” is a population-based cohort study of the epidemiology of cardiovascular and cerebral disease. Little is known about how diurnal variation in blood pressure (BP) levels influence cerebral perfusion in very elderly populations. OBJECTIVES: To study the association between systolic (SBP) and diastolic BP (DBP) levels, during the day and at night, expressed through 24 h ambulatory BP monitoring (ABPM) and regional cerebral blood flow (rCBF) disturbances. METHODS: A cross-sectional study from a population-based cohort of 108 men 81 years of age (born in 1914) was performed in an out-patient university clinic. Cerebral blood flow measurements using 99mTc-hexamethylpropyleneamine oxime single photon emission computed tomography and 24 h ABPM were performed. Eleven men were excluded due to incomplete ABPM data. RESULTS: Mean DBP at night for each tertile was correlated to rCBF for the medial temporal right (P=0.012) and left (P=0.039) regions. Also, DBP during the day was correlated to the medial temporal right region (P=0.025). When analyses were stratified for DBP during the day, subjects with high DBP during the day (greater than 70 mmHg) showed a stronger association between low medial temporal right rCBF and low mean DBP at night (r=0.32, P=0.009) compared with subjects who had a lower daytime DBP. A corresponding positive correlation was noted for the medial temporal left region and daytime SBP, whereas a negative correlation was noted for frontal left region blood flow and SBP at night. CONCLUSIONS: A significant association was seen between low BP levels, especially at night, and rCBF in subjects with otherwise normal daytime DBP that may indicate a risk for nocturnal cerebral ischemia. PMID:22477391

Tap and Dbp5, but not Gag, are involved in DR-mediated nuclear export of unspliced Rous sarcoma virus RNA

DOE Office of Scientific and Technical Information (OSTI.GOV)

LeBlanc, Jason J.; Uddowla, Sabena; Abraham, Benjamin

2007-07-05

All retroviruses must circumvent cellular restrictions on the export of unspliced RNAs from the nucleus. While the unspliced RNA export pathways for HIV and Mason-Pfizer monkey virus are well characterized, that of Rous sarcoma virus (RSV) is not. We have previously reported that the RSV direct repeat (DR) elements are involved in the cytoplasmic accumulation of unspliced viral RNA. Here, using fluorescent in situ hybridization (FISH), we demonstrate that unspliced viral RNAs bearing a single point mutation (G8863C) in the DR exhibit a restricted cellular localization in and around the nucleus. In contrast, wild type unspliced viral RNA had amore » diffuse localization throughout the nucleus and cytoplasm. Since the RSV Gag protein has a transient localization in the nucleus, we examined the effect of Gag over-expression on a DR-mediated reporter construct. While Gag did not enhance DR-mediated nuclear export, the dominant-negative expression of two cellular export factors, Tap and Dbp5, inhibited expression of the same reporter construct. Furthermore, FISH studies using the dominant-negative Dbp5 demonstrated that unspliced wild type RSV RNA was retained within the nucleus. Taken together, these results further implicate the DR in nuclear RNA export through interactions with Tap and Dbp5.« less

Associations between height and blood pressure in the United States population.

PubMed

Bourgeois, Brianna; Watts, Krista; Thomas, Diana M; Carmichael, Owen; Hu, Frank B; Heo, Moonseong; Hall, John E; Heymsfield, Steven B

2017-12-01

The mechanisms linking short stature with an increase in cardiovascular and cerebrovascular disease risk remain elusive. This study tested the hypothesis that significant associations are present between height and blood pressure in a representative sample of the US adult population.Participants were 12,988 men and women from a multiethnic sample (age ≥ 18 years) evaluated in the 1999 to 2006 National Health and Nutrition Examination Survey who were not taking antihypertensive medications and who had complete height, weight, % body fat, and systolic and diastolic arterial blood pressure (SBP and DBP) measurements; mean arterial blood pressure and pulse pressure (MBP and PP) were calculated. Multiple regression models for men and women were developed with each blood pressure as dependent variable and height, age, race/ethnicity, body mass index, % body fat, socioeconomic status, activity level, and smoking history as potential independent variables.Greater height was associated with significantly lower SBP and PP, and higher DBP (all P < .001) in combined race/ethnic-sex group models beginning in the 4th decade. Predicted blood pressure differences between people who are short and tall increased thereafter with greater age except for MBP. Socioeconomic status, activity level, and smoking history did not consistently contribute to blood pressure prediction models.Height-associated blood pressure effects were present in US adults who appeared in the 4th decade and increased in magnitude with greater age thereafter. These observations, in the largest and most diverse population sample evaluated to date, provide support for postulated mechanisms linking adult stature with cardiovascular and cerebrovascular disease risk. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Effect of Smoking on Blood Pressure and Resting Heart Rate: A Mendelian Randomisation Meta-Analysis in the CARTA Consortium

PubMed Central

Linneberg, Allan; Jacobsen, Rikke K.; Skaaby, Tea; Taylor, Amy E.; Fluharty, Meg E.; Jeppesen, Jørgen L.; Bjorngaard, Johan H.; Åsvold, Bjørn O.; Gabrielsen, Maiken E.; Campbell, Archie; Marioni, Riccardo E.; Kumari, Meena; Marques-Vidal, Pedro; Kaakinen, Marika; Cavadino, Alana; Postmus, Iris; Ahluwalia, Tarunveer S.; Wannamethee, S. Goya; Lahti, Jari; Räikkönen, Katri; Palotie, Aarno; Wong, Andrew; Dalgård, Christine; Ford, Ian; Ben-Shlomo, Yoav; Christiansen, Lene; Kyvik, Kirsten O.; Kuh, Diana; Eriksson, Johan G.; Whincup, Peter H.; Mbarek, Hamdi; de Geus, Eco J.C.; Vink, Jacqueline M.; Boomsma, Dorret I.; Smith, George Davey; Lawlor, Debbie A.; Kisialiou, Aliaksei; McConnachie, Alex; Padmanabhan, Sandosh; Jukema, J. Wouter; Power, Chris; Hyppönen, Elina; Preisig, Martin; Waeber, Gerard; Vollenweider, Peter; Korhonen, Tellervo; Laatikainen, Tiina; Salomaa, Veikko; Kaprio, Jaakko; Kivimaki, Mika; Smith, Blair H.; Hayward, Caroline; Sørensen, Thorkild I.A.; Thuesen, Betina H.; Sattar, Naveed; Morris, Richard W.; Romundstad, Pål R.; Munafò, Marcus R.; Jarvelin, Marjo-Riitta; Husemoen, Lise Lotte N.

2015-01-01

Background Smoking is an important cardiovascular disease risk factor, but the mechanisms linking smoking to blood pressure are poorly understood. Methods and Results Data on 141,317 participants (62,666 never, 40,669 former, 37,982 current smokers) from 23 population-based studies were included in observational and Mendelian randomisation (MR) meta-analyses of the associations of smoking status and smoking heaviness with systolic and diastolic blood pressure (SBP, DBP), hypertension, and resting heart rate. For the MR analyses, a genetic variant rs16969968/rs1051730 was used as a proxy for smoking heaviness in current smokers. In observational analyses, current as compared with never smoking was associated with lower SBP, DBP, and lower hypertension risk, but with higher resting heart rate. In observational analyses amongst current smokers, one cigarette/day higher level of smoking heaviness was associated with higher (0.21 beats/minute; 95% CI 0.19; 0.24) resting heart rate, and slightly higher DBP (0.05 mmHg; 95% CI 0.02; 0.08) and SBP (0.08 mmHg; 95% CI 0.03; 0.13). However, in MR analyses amongst current smokers, while each smoking increasing allele of rs16969968/rs1051730 was associated with higher resting heart rate (0.36 beats/minute/allele; 95% CI 0.18; 0.54), there was no strong association with DBP, SBP, or hypertension. This would suggest a 7 beats/minute higher heart rate in those who smoke 20 cigarettes/day. Conclusions This MR meta-analysis supports a causal association of smoking heaviness with higher level of resting heart rate, but not with blood pressure. These findings suggest that part of the cardiovascular risk of smoking may operate through increasing resting heart rate. PMID:26538566

The impact of grape seed extract treatment on blood pressure changes: A meta-analysis of 16 randomized controlled trials.

PubMed

Zhang, Haili; Liu, Shuang; Li, Lan; Liu, Shisong; Liu, Shuqi; Mi, Jia; Tian, Geng

2016-08-01

Several clinical trials have shown that grape seed extract can reduce blood pressure, but the results are often irreproducible. We therefore sought to systematically evaluate the impact of grape seed extract treatment on the changes of systolic/diastolic blood pressure (SBP/DBP) by meta-analyzing available randomized controlled trials. Trial selection and data extraction were completed independently by 2 investigators. Effect-size estimates were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Twelve articles involving 16 clinical trials and 810 study subjects were analyzed. Overall analyses found significant reductions for SBP (WMD = -6.077; 95% CI: -10.736 to -1.419; P = 0.011) and DBP (WMD = -2.803; 95% CI: -4.417 to -1.189; P = 0.001) after grape seed extract treatment. In subgroup analyses, there were significant reductions in younger subjects (mean age < 50 years) for SBP (WMD = -6.049; 95% CI: -10.223 to -1.875; P = 0.005) and DBP (WMD = -3.116; 95% CI: -4.773 to -1.459; P < 0.001), in obese subjects (mean body mass index ≥ 25 kg/m) for SBP (WMD = -4.469; 95% CI: -6.628 to -2.310; P < 0.001), and in patients with metabolic syndrome for SBP (WMD = -8.487; 95% CI: -11.869 to -5.106; P < 0.001). Further meta-regression analyses showed that age, body mass index, and baseline blood pressure were negatively associated with the significant reductions of SBP and DBP after treatment. There was no indication of publication bias. Our findings demonstrate that grape seed extract exerted a beneficial impact on blood pressure, and this impact was more obvious in younger or obese subjects, as well as in patients with metabolic disorders. In view of the small sample size involved, we agree that confirmation of our findings in a large-scale, long-term, multiple-dose randomized controlled trial, especially among hypertensive patients is warranted.

A new automatic blood pressure kit auscultates for accurate reading with a smartphone: A diagnostic accuracy study.

PubMed

Wu, Hongjun; Wang, Bingjian; Zhu, Xinpu; Chu, Guang; Zhang, Zhi

2016-08-01

The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and -0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989-0.995) and diastolic (ICC = 0.987, 95% CI: 0.979-0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland-Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service.

Arterial and intraocular pressure changes after a single-session hot-water immersion.

PubMed

Findikoglu, Gulin; Cetin, Ebru Nevin; Sarsan, Ayse; Senol, Hande; Yildirim, Cem; Ardic, Fusun

2015-01-01

The aim of this study is to investigate the effect of head-out hot-water immersion on the intraocular pressure (IOP) of healthy subjects and investigate whether this intervention alters cardiovascular and microcirculatory responses. METHODs: 16 male and 18 female healthy young adults were immersed in 39 degrees C water up to shoulder level for 20 minutes. Blood pressure (BP), heart rate (HR) and IOP were measured pre-immersion, post-immersion and five minutes after immersion on the same day. Tono-Pen was used to measure IOP. Mean arterial blood pressure (MAP), systolic pressure rate product (S-PRP), diastolic pressure rate product (D-PRP), pulse pressure (PP), mean ocular perfusion pressure (mean-OPP), systolic ocular perfusion pressure (S-OPP) and diastolic ocular perfusion pressure (D-OPP) were calculated. Systolic BP (SBP), diastolic BP (DBP), MAP, IOP, S-OPP, D-OPP and mean-OPP decreased; HR increased five minutes after immersion in the pool and post-immersion out of the pool significantly, compared to pre-immersion data (p < 0.05). HR, S-PRP and D-PRP measured five minutes after immersion were significantly higher from post-immersion (p < 0.05). PP and S-OPP were significantly different five minutes after immersion compared to pre-immersion. There was no statistically significant correlation between IOP and SBP, DBP, MAP, S-PRP, D-PRP, PP, S-OPP, D-OPP, or mean-OPP (p > 0.05). Physiological hemodynamic response to single head-out hot-water immersion caused a statistically significant decrease in IOP. Preliminary results could help to clarify vascular reactions and IOP changes during hot-water immersion that might be potentially therapeutic in glaucoma patients.

Impact of Low Diastolic Blood Pressure on Risk of Cardiovascular Death in Elderly Patients With Coronary Artery Disease After Revascularization　- The CREDO-Kyoto Registry Cohort-1.

PubMed

Kai, Hisashi; Kimura, Takeshi; Fukuda, Kenji; Fukumoto, Yoshihiro; Kakuma, Tatsuyuki; Furukawa, Yutaka

2016-04-25

We investigated the effects of age and low diastolic blood pressure (DBP) on cardiovascular death in patients with coronary artery disease (CAD) after coronary revascularization. Stable, chronic CAD patients after coronary revascularization in the CREDO-Kyoto registry cohort-1 were allocated to the Young (≤64 years, n=2,619), Young-Old (65-74 years, n=2,932), and Old-Old (≥75 years, n=1,629) groups. Kaplan-Meier analysis showed that the crude cumulative incidence of cardiovascular death was higher in Young-Old patients with DBP <70 mmHg (P<0.001) and in Old-Old patients with DBP <60 mmHg (P=0.017), but not <70 mmHg (P=0.629), compared with each counterpart. Low DBP did not increase cardiovascular death in young patients. After adjustments with independent predictors, DBP <60 mmHg did not increase the cardiovascular death in the Old-Old group (HR=1.579 [95% CI, 0.944-2.642], P=0.082) and DBP <70 mmHg remained a predictor in the Young-Old group (HR=1.665 [1.094-2.532], P=0.017). On multivariate stepwise Cox proportional hazard regression analysis, independent predictors for cardiovascular death in low DBP patients were creatinine clearance (CCr; inversely), prior cerebrovascular disease, and aortic disease in the Young-Old group and CCr (inversely) and malignancy in the Old-Old group. DBP <60 mmHg was not an independent factor for predicting cardiovascular death in Old-Old revascularized CAD patients, whereas DBP <70 mmHg remained a predictor in the Young-Old. (Circ J 2016; 80: 1232-1241).

The Impact of Azilsartan Medoxomil Treatment (Capsule Formulation) at Doses Ranging From 10 to 80 mg: Significant, Rapid Reductions in Clinic Diastolic and Systolic Blood Pressure.

PubMed

Perez, Alfonso; Cao, Charlie

2017-03-01

In this phase 2, multicenter, parallel-group, double-blind, dose-ranging study, hypertensive adults (n=449) were randomized to receive one of five doses of a capsule formulation of azilsartan medoxomil (AZL-M; 5, 10, 20, 40, 80 mg), olmesartan medoxomil (OLM) 20 mg, or placebo once daily. The primary endpoint was change in trough clinic diastolic blood pressure (DBP) at week 8. AZL-M provided rapid statistically and clinically significant reductions in DBP and systolic blood pressure (SBP) vs placebo at all doses except 5 mg. Placebo-subtracted changes were greatest with the 40 mg dose (DBP, -5.7 mm Hg; SBP, -12.3 mm Hg). Clinic changes with AZL-M (all doses) were statistically indistinguishable vs OLM, although there were greater reductions with AZL-M 40 mg using 24-hour ambulatory blood pressure. Adverse event frequency was similar in the AZL-M and placebo groups. Based on these and other findings, subsequent trials investigated the commercial AZL-M tablet in the dose range of 20 to 80 mg/d. ©2016 Wiley Periodicals, Inc.

Relationships of vascular function with measures of ambulatory blood pressure variation.

PubMed

Hodgson, Jonathan M; Woodman, Richard J; Croft, Kevin D; Ward, Natalie C; Bondonno, Catherine P; Puddey, Ian B; Lukoshkova, Elena V; Head, Geoffrey A

2014-03-01

Characteristics of short-term blood pressure (BP) variation may influence cardiovascular disease risk via effects on vascular function. In a cross-sectional study of a group of treated hypertensive and untreated largely normotensive subjects we investigated the relationships of measures of short-term BP variation with brachial artery vasodilator function. A total of 163 treated hypertensive (n = 91) and untreated largely normotensive (n = 72) men and women were recruited from the general population. Measures of systolic and diastolic BP variation were calculated from 24 h ambulatory BP assessments and included: (i) rate of measurement-to-measurement BP variation (SBP-var and DBP-var); and (ii) day-to-night BP dip (SBP-dip and DBP dip). Endothelium-dependent vasodilation was assessed as flow-mediated dilation (FMD) and endothelium-independent vasodilation was assessed in response to glyceryl trinitrate (GTN). Relationships were explored using univariate and multivariate linear regression. The relationships of brachial artery vasodilator function with BP variation were not significantly different between treated hypertensive and untreated subjects, therefore these groups were combined for analysis. In univariate analysis, higher SBP-var (P < 0.001) and lower DBP-dip (P = 0.004) were associated with lower FMD; and higher SBP-var (P = 0.002) and lower SBP-dip (P = 0.003) and DBP-dip (P = 0.001) were associated with lower GTN-mediated dilation. In multivariate analysis, lower SBP-dip (P = 0.007) and DBP-dip (P = 0.03) were independently associated with lower GTN response. Our results indicate that a lower day-to-night BP dip is independently associated with impaired smooth muscle cell function. Although rate of BP variation was associated with measures of endothelial and smooth muscle cell function, relationships were attenuated after accounting for age and BP. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The difference in blood pressure readings between arms and survival: primary care cohort study.

PubMed

Clark, Christopher E; Taylor, Rod S; Shore, Angela C; Campbell, John L

2012-03-20

To determine whether a difference in systolic blood pressure readings between arms can predict a reduced event free survival after 10 years. Cohort study. Rural general practice in Devon, United Kingdom. 230 people receiving treatment for hypertension in primary care. Bilateral blood pressure measurements recorded at three successive surgery attendances. Cardiovascular events and deaths from all causes during a median follow-up of 9.8 years. At recruitment 24% (55/230) of participants had a mean interarm difference in systolic blood pressure of 10 mm Hg or more and 9% (21/230) of 15 mm Hg or more; these differences were associated with an increased risk of all cause mortality (adjusted hazard ratio 3.6, 95% confidence interval 2.0 to 6.5 and 3.1, 1.6 to 6.0, respectively). The risk of death was also increased in 183 participants without pre-existing cardiovascular disease with an interarm difference in systolic blood pressure of 10 mm Hg or more or 15 mm Hg or more (2.6, 1.4 to 4.8 and 2.7, 1.3 to 5.4). An interarm difference in diastolic blood pressure of 10 mm Hg or more was weakly associated with an increased risk of cardiovascular events or death. Differences in systolic blood pressure between arms can predict an increased risk of cardiovascular events and all cause mortality over 10 years in people with hypertension. This difference could be a valuable indicator of increased cardiovascular risk. Bilateral blood pressure measurements should become a routine part of cardiovascular assessment in primary care.

[Analysis on the trend of long-term change of blood pressure in hypertensive patients treated with benazepril].

PubMed

Lu, Jun; Li, Li-Ming; He, Ping-Ping; Cao, Wei-Hua; Zhan, Si-Yan; Hu, Yong-Hua

2004-06-01

To introduce the application of mixed linear model in the analysis of secular trend of blood pressure under antihypertensive treatment. A community-based postmarketing surveillance of benazepril was conducted in 1831 essential hypertensive patients (age range from 35 to 88 years) in Shanghai. Data of blood pressure was analyzed every 3 months with mixed linear model to describe the secular trend of blood pressure and changes of age-specific and gender-specific. The changing trends of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were found to fit the curvilinear models. A piecewise model was fit for pulse pressure (PP), i.e., curvilinear model in the first 9 months and linear model after 9 months of taking medication. Both blood pressure and its velocity gradually slowed down. There were significant variation for the curve parameters of intercept, slope, and acceleration. Blood pressure in patients with higher initial levels was persistently declining in the 3-year-treatment. However blood pressures of patients with relatively low initial levels remained low when dropped down to some degree. Elderly patients showed high SBP but low DBP, so as with higher PP. The velocity and sizes of blood pressure reductions increased with the initial level of blood pressure. Mixed linear model is flexible and robust when applied to the analysis of longitudinal data but with missing values and can also make the maximum use of available information.

Association of plasma Aß peptides with blood pressure in the elderly.

PubMed

Lambert, Jean-Charles; Dallongeville, Jean; Ellis, Kathryn A; Schraen-Maschke, Susanna; Lui, James; Laws, Simon; Dumont, Julie; Richard, Florence; Cottel, Dominique; Berr, Claudine; Ames, David; Masters, Colin L; Rowe, Christopher C; Szoeke, Cassandra; Tzourio, Christophe; Dartigues, Jean-François; Buée, Luc; Martins, Ralph; Amouyel, Philippe

2011-04-15

Aß peptides are often considered as catabolic by-products of the amyloid ß protein precursor (APP), with unknown physiological functions. However, several biological properties have been tentatively attributed to these peptides, including a role in vasomotion. We assess whether plasma Aß peptide levels might be associated with systolic and diastolic blood pressure values (SBP and DBP, respectively). Plasma Aß(1-40) and Aß(1-42) levels were measured using an xMAP-based assay in 1,972 individuals (none of whom were taking antihypertensive drugs) from 3 independent studies: the French population-based 3C and MONA-LISA (Lille) studies (n = 627 and n = 769, respectively) and the Australian, longitudinal AIBL study (n = 576). In the combined sample, the Aß(1-42)/ Aß(1-40) ratio was significantly and inversely associated with SBP (p = 0.03) and a similar trend was observed for DBP (p = 0.06). Using the median age (69) as a cut-off, the Aß(1-42)/Aß(1-40) ratio was strongly associated with both SBP and DBP in elderly individuals (p = 0.002 and p = 0.03, respectively). Consistently, a high Aß(1-42)/ Aß(1-40) ratio was associated with a lower risk of hypertension in both the combined whole sample (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.56-0.90) and (to an even greater extent) in the elderly subjects (OR, 0.53; 95% CI, 0.37-0.75). Lastly, all these associations appeared to be primarily driven by the level of plasma Aß(1-40). The plasma Aß(1-42)/Aß(1-40) ratio is inversely associated with SBP, DBP and the risk of hypertension in elderly subjects, suggesting that Aß peptides affect blood pressure in vivo. These results may be particularly relevant in Alzheimer's disease, in which a high Aß(1-42)/Aß(1-40) plasma ratio is reportedly associated with a decreased risk of incident disease.

HEART RATE AND INDIRECT BLOOD PRESSURE RESPONSES TO FOUR DIFFERENT FIELD ANESTHETIC PROTOCOLS IN WILD-BORN CAPTIVE CHIMPANZEES (PAN TROGLODYTES).

PubMed

Atencia, Rebeca; Stöhr, Eric J; Drane, Aimee L; Stembridge, Mike; Howatson, Glyn; Del Rio, Pablo Rodriguez Lopez; Feltrer, Yedra; Tafon, Babila; Redrobe, Sharon; Peck, Bruce; Eng, Jaclyn; Unwin, Steve; Sanchez, Carlos R; Shave, Rob E

2017-09-01

Limited data are available on hemodynamic responses to anesthetic protocols in wild-born chimpanzees (Pan troglodytes). Accordingly, this study characterized the heart rate (HR) and blood pressure responses to four anesthetic protocols in 176 clinically healthy, wild-born chimpanzees undergoing routine health assessments. Animals were anesthetized with medetomidine-ketamine (MK) (n = 101), tiletamine-zolazepam (TZ) (n = 30), tiletamine-zolazepam-medetomidine (TZM) (n = 24), or medetomidine-ketamine (maintained with isoflurane) (MKI) (n = 21). During each procedure, HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were regularly recorded. Data were grouped according to anesthetic protocol, and mean HR, SBP, and DBP were calculated. Differences between mean HR, SBP, and DBP for each anesthetic protocol were assessed using the Kruskall-Wallis test and a Dunn multiple comparisons post hoc analysis. To assess the hemodynamic time course response to each anesthetic protocol, group mean data (±95% confidence interval [CI]) were plotted against time postanesthetic induction. Mean HR (beats/min [CI]) was significantly higher in TZ (86 [80-92]) compared to MKI (69 [61-78]) and MK (62 [60-64]) and in TZM (73 [68-78]) compared to MK. The average SBP and DBP values (mm Hg [CI]) were significantly higher in MK (130 [126-134] and 94 [91-97]) compared to TZ (104 [96-112] and 58 [53-93]) and MKI (113 [103-123] and 78 [69-87]) and in TZM (128 [120-135] and 88 [83-93]) compared to TZ. Time course data were markedly different between protocols, with MKI showing the greatest decline over time. Both the anesthetic protocol adopted and the timing of measurement after injection influence hemodynamic recordings in wild-born chimpanzees and need to be considered when monitoring or assessing cardiovascular health.

Effects of Heat Wave on Body Temperature and Blood Pressure in the Poor and Elderly

PubMed Central

Kim, Soyeon; Cheong, Hae-Kwan; Ahn, Byungok; Choi, Kyusik

2012-01-01

Objectives We aimed to investigate the acute effects of heat stress on body temperature and blood pressure of elderly individuals living in poor housing conditions. Methods Repeated measurements of the indoor temperature, relative humidity, body temperature, and blood pressure were conducted for 20 elderly individuals living in low-cost dosshouses in Seoul during hot summer days in 2010. Changes in the body temperature, systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to variations in the indoor and outdoor temperature and humidity were analyzed using a repeated-measures ANOVA controlling for age, sex, alcohol, and smoking. Results Average indoor and outdoor temperatures were 31.47℃ (standard deviation [SD], 0.97℃) and 28.15℃ (SD, 2.03℃), respectively. Body temperature increased by 0.21℃ (95% confidence interval [CI], 0.16 to 0.26℃) and 0.07℃ (95% CI, 0.04 to 0.10℃) with an increase in the indoor and outdoor temperature of 1℃. DBP decreased by 2.05 mmHg (95% CI, 0.05 to 4.05 mmHg), showing a statistical significance, as the indoor temperature increased by 1℃, while it increased by 0.20 mmHg (95% CI, -0.83 to 1.22 mmHg) as outdoor temperature increased by 1℃. SBP decreased by 1.75 mmHg (95% CI, -1.11 to 4.61 mmHg) and 0.35 mmHg (95% CI, -1.04 to 1.73 mmHg), as the indoor and outdoor temperature increased by 1℃, respectively. The effects of relative humidity on SBP and DBP were not statistically significant for both indoor and outdoor. Conclusions The poor and elderly are directly exposed to heat waves, while their vital signs respond sensitively to increase in temperature. Careful adaptation strategies to climate change considering socioeconomic status are therefore necessary. PMID:22888472

Effects of heat wave on body temperature and blood pressure in the poor and elderly.

PubMed

Kim, Young-Min; Kim, Soyeon; Cheong, Hae-Kwan; Ahn, Byungok; Choi, Kyusik

2012-01-01

We aimed to investigate the acute effects of heat stress on body temperature and blood pressure of elderly individuals living in poor housing conditions. Repeated measurements of the indoor temperature, relative humidity, body temperature, and blood pressure were conducted for 20 elderly individuals living in low-cost dosshouses in Seoul during hot summer days in 2010. Changes in the body temperature, systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to variations in the indoor and outdoor temperature and humidity were analyzed using a repeated-measures ANOVA controlling for age, sex, alcohol, and smoking. Average indoor and outdoor temperatures were 31.47℃ (standard deviation [SD], 0.97℃) and 28.15℃ (SD, 2.03℃), respectively. Body temperature increased by 0.21℃ (95% confidence interval [CI], 0.16 to 0.26℃) and 0.07℃ (95% CI, 0.04 to 0.10℃) with an increase in the indoor and outdoor temperature of 1℃. DBP decreased by 2.05 mmHg (95% CI, 0.05 to 4.05 mmHg), showing a statistical significance, as the indoor temperature increased by 1℃, while it increased by 0.20 mmHg (95% CI, -0.83 to 1.22 mmHg) as outdoor temperature increased by 1℃. SBP decreased by 1.75 mmHg (95% CI, -1.11 to 4.61 mmHg) and 0.35 mmHg (95% CI, -1.04 to 1.73 mmHg), as the indoor and outdoor temperature increased by 1℃, respectively. The effects of relative humidity on SBP and DBP were not statistically significant for both indoor and outdoor. The poor and elderly are directly exposed to heat waves, while their vital signs respond sensitively to increase in temperature. Careful adaptation strategies to climate change considering socioeconomic status are therefore necessary.

Effects of add-on nebivolol on blood pressure and glucose parameters in hypertensive patients with prediabetes.

PubMed

Deedwania, Prakash; Shea, John; Chen, Wei; Brener, Lillian

2013-04-01

In this multicenter trial, the effects of nebivolol added to an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) were assessed in patients with hypertension (diastolic blood pressure [DBP] 80-110 mm Hg) and prediabetes (fasting blood glucose 100-125 mg/dL and/or 2-hour oral glucose tolerance test [OGTT] 140-199 mg/dL). After a 4-week run-in period (in which lisinopril [10 mg/d] or losartan [50 mg/d] treatment was initiated), patients with DBP 90-110 mm Hg were randomized (2:2:1) to 12-week, double-blind treatment with nebivolol (n=223; 5-40 mg/d), hydrochlorothiazide (HCTZ; n=212; 12.5-25 mg/d), or placebo (n=102), titrated to achievement of 130/80 mm Hg. The primary outcome measure was DBP (last observation carried forward, intent to treat population); secondary measures included systolic blood pressure (SBP) and glucose levels. At baseline, overall mean values for body mass index, triglycerides, and high-density lipoprotein cholesterol were 32.3 kg/m(2) , 1.7 mmol/L, and 1.3 mmol/L, respectively. At week 12, nebivolol and placebo groups demonstrated a decrease of -9.4 and -5.0 mm Hg, respectively (P<.001) for DBP and -10.4 and -7.8 mm Hg for SBP (P=.147). The mean changes in area under the curve OGTT were 0.0 mg/dL (nebivolol), 6.9 mg/dL (HCTZ; P=.024 vs nebivolol), and -1.0 mg/dL (placebo). Adverse event-related discontinuation rates were 10.3%, 6.6%, and 2.0%, respectively. Nebivolol, added to an ACE inhibitor or ARB, provides additional blood pressure reduction with little or no effect on glucose metabolism in hypertensive patients with prediabetes. © 2013 Wiley Periodicals, Inc.

Blood pressure reactivity to psychological stress is associated with clinical outcomes in patients with heart failure.

PubMed

Sherwood, Andrew; Hill, LaBarron K; Blumenthal, James A; Adams, Kirkwood F; Paine, Nicola J; Koch, Gary G; O'Connor, Christopher M; Johnson, Kristy S; Hinderliter, Alan L

2017-09-01

Cardiovascular (CV) reactivity to psychological stress has been implicated in the development and exacerbation of cardiovascular disease (CVD). Although high CV reactivity traditionally is thought to convey greater risk of CVD, the relationship between reactivity and clinical outcomes is inconsistent and may depend on the patient population under investigation. The present study examined CV reactivity in patients with heart failure (HF) and its potential association with long-term clinical outcomes. One hundred ninety-nine outpatients diagnosed with HF, with ejection fraction ≤40%, underwent an evaluation of blood pressure (BP) and heart rate reactivity to a laboratory-based simulated public-speaking stressor. Cox proportional hazards regression models were used to examine the prospective association between BP and heart rate reactivity on a combined end point of death or CV hospitalization over a 5-year median follow-up period. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) reactivity, quantified as continuous variables, were inversely related to risk of death or CV hospitalization (Ps < .01) after controlling for established risk factors, including HF disease severity and etiology. In similar models, heart rate reactivity was unrelated to outcome (P = .12). In models with tertiles of reactivity, high SBP reactivity, compared with intermediate SBP reactivity, was associated with lower risk (hazard ratio [HR] = .498, 95% CI .335-.742, P =.001), whereas low SBP reactivity did not differ from intermediate reactivity. For DBP, high reactivity was marginally associated with lower risk compared with intermediate DBP reactivity (HR = .767, 95% CI .515-1.14, P =.193), whereas low DBP reactivity was associated with greater risk (HR = 1.49, 95% CI 1.027-2.155, P =.0359). No relationship of heart rate reactivity to outcome was identified. For HF patients with reduced ejection fraction, a robust increase in BP evoked by a laboratory

Osteopenia is associated with glycemic levels and blood pressure in Chinese postmenopausal women: a cross-sectional study.

PubMed

Sun, Qihong; Zheng, Yu; Chen, Kang; Yan, Wenhua; Lu, Juming; Dou, Jingtao; Lv, Zhaohui; Wang, Baoan; Gu, Weijun; Ba, Jianming; Mu, Yiming

2017-02-01

The aim of present study was to explore the relationships between osteopenia and dyslipidemia, glycemic levels or blood pressure in postmenopausal Chinese women. A total of 4080 women aged 42-85 years were enrolled in this cross-sectional study, which was nested in an ongoing longitudinal (REACTION) study. Calcaneus quantitative ultrasound (QUS) was performed and QUS T score was calculated to assess bone mineral density. Osteopenia was defined as a T score ≤-1.0. The relationship between osteopenia and dyslipidemia, glycemic levels or blood pressure was investigated. The prevalence of osteopenia was significantly lower in subjects with systolic blood pressure (SBP) ≥140 mmHg, fasting blood glucose (FBG) ≥8.0 mmol/L, postprandial blood glucose (PBG) ≥15.0 mmol/L, hemoglobin A1c (HbA1C) 6.5-7.5 %, HbA1C ≥7.5 %. These relationships remained significant after controlling for multiple factors. Moreover, significant trend between osteopenia and SBP, FBG, PBG and HbA1C was observed in women. In contrast, no significant associations between osteopenia and diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were found, and no significant trend relationship between osteopenia and DBP, TC, TG, HDL-C, LDL-C was found in postmenopausal Chinese women. The present study showed a relationship between SBP, FBG, PBG, HbA1C and osteopenia in postmenopausal Chinese women, while no significant relationship was observed between dyslipidemia, DBP and osteopenia, even after controlling for multiple confounding factors.

The putative RNA helicase Dbp6p functionally interacts with Rpl3p, Nop8p and the novel trans-acting Factor Rsa3p during biogenesis of 60S ribosomal subunits in Saccharomyces cerevisiae.

PubMed Central

de la Cruz, Jesús; Lacombe, Thierry; Deloche, Olivier; Linder, Patrick; Kressler, Dieter

2004-01-01

Ribosome biogenesis requires at least 18 putative ATP-dependent RNA helicases in Saccharomyces cerevisiae. To explore the functional environment of one of these putative RNA helicases, Dbp6p, we have performed a synthetic lethal screen with dbp6 alleles. We have previously characterized the nonessential Rsa1p, whose null allele is synthetically lethal with dbp6 alleles. Here, we report on the characterization of the four remaining synthetic lethal mutants, which reveals that Dbp6p also functionally interacts with Rpl3p, Nop8p, and the so-far-uncharacterized Rsa3p (ribosome assembly 3). The nonessential Rsa3p is a predominantly nucleolar protein required for optimal biogenesis of 60S ribosomal subunits. Both Dbp6p and Rsa3p are associated with complexes that most likely correspond to early pre-60S ribosomal particles. Moreover, Rsa3p is co-immunoprecipitated with protA-tagged Dbp6p under low salt conditions. In addition, we have established a synthetic interaction network among factors involved in different aspects of 60S-ribosomal-subunit biogenesis. This extensive genetic analysis reveals that the rsa3 null mutant displays some specificity by being synthetically lethal with dbp6 alleles and by showing some synthetic enhancement with the nop8-101 and the rsa1 null allele. PMID:15126390

Nonfunctioning adrenal incidentaloma affecting central blood pressure and arterial stiffness parameters.

PubMed

Akkan, Tolga; Altay, Mustafa; Ünsal, Yasemin; Dağdeviren, Murat; Beyan, Esin

2017-12-01

Recently, cardiovascular risk is thought to be increased in patients with nonfunctioning adrenal incidentaloma (NFAI). There are no sufficient studies in the literature to evaluate this situation in NFAI patients without cardiovascular risk. The objective of this study is to compare peripheral and central blood pressure and arterial stiffness between patients with NFAI and healthy volunteers (of a similar age, gender and body mass index as the NFAI group) who have no traditional cardiovascular risk factors and autonomous cortisol secretion, with pulse wave analysis (PWA). In this cross-sectional study, we evaluated 35 NFAI patients who have no traditional cardiovascular risk factors and 35 healthy volunteers. PWA was performed in the participants of similar gender, age and body mass index, with a Mobil-O-Graph PWA/ABPM (I.E.M. GmBH, Stolberg, Germany) device. Radiological and biochemical data were obtained retrospectively in the NFAI group. In our study, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central SBP, central DBP, peripheral vascular resistance, augmentation pressure (AP), heart rate-corrected augmentation index (Aix@75) and pulse wave velocity (PWV) values were significantly higher in the NFAI group compared to the control group. In addition, peripheral and central blood pressure and arterial stiffness parameters were correlated with age and duration of NFAI diagnosis of more than 1 year. NFAIs are known as cardiometabolically innocent, but in our study, both peripheral and central blood pressure values and arterial stiffness parameters were negatively affected in patients diagnosed with NFAI who have no traditional cardiovascular risk factors. These patients are at risk of cardiovascular diseases.

Relationships between micronutrient losses in sweat and blood pressure among heat-exposed steelworkers.

PubMed

Tang, Yong-Mei; Wang, Dao-Gang; Li, Jun; Li, Xing-Hua; Wang, Qian; Liu, Nan; Liu, Wei-Tian; Li, Ying-Xue

2016-06-10

We aimed to examine the effect of micronutrient losses through sweat on blood pressure (BP) among heat-exposed steelworkers. A total of 224 heat-exposed male steelworkers from an ironworks facility were evaluated in July 2012. We measured the Wet Bulb Globe Temperature Index to evaluate the level of heat stress in the workplace. We collected sweat from the workers during an eight-hour work, and then we measured the micronutrients in the sweat. We also measured the BP of each worker. The results revealed that vitamin C, potassium, and calcium losses in sweat were positively correlated with systolic (SBP) and diastolic (DBP) blood pressure (all P<0.05). A linear stepwise regression analysis revealed that potassium, and calcium losses in sweat adversely affected SBP and DBP (all P<0.05). An analysis of covariance showed that SBP increased when potassium or calcium losses in sweat were >900 mg, or >100 mg, respectively. Further, DBP increased when potassium or calcium losses in sweat were >600 mg or >130 mg, respectively. Therefore, vitamin C, potassium, and calcium losses in sweat may adversely effect BP. To help steelworkers maintain healthy BP, facilities with high temperatures should try to lower environmental temperatures to reduce vitamin C, potassium, and calcium losses in sweat. Additionally, heat-exposed steelworkers may need to increase their dietary intakes of vitamin C, potassium, and calcium. Further research is needed to confirm these findings and support these recommendations.

Relationships between micronutrient losses in sweat and blood pressure among heat-exposed steelworkers

PubMed Central

TANG, Yong-Mei; WANG, Dao-Gang; LI, Jun; LI, Xing-Hua; WANG, Qian; LIU, Nan; LIU, Wei-Tian; LI, Ying-Xue

2016-01-01

We aimed to examine the effect of micronutrient losses through sweat on blood pressure (BP) among heat-exposed steelworkers. A total of 224 heat-exposed male steelworkers from an ironworks facility were evaluated in July 2012. We measured the Wet Bulb Globe Temperature Index to evaluate the level of heat stress in the workplace. We collected sweat from the workers during an eight-hour work, and then we measured the micronutrients in the sweat. We also measured the BP of each worker. The results revealed that vitamin C, potassium, and calcium losses in sweat were positively correlated with systolic (SBP) and diastolic (DBP) blood pressure (all P<0.05). A linear stepwise regression analysis revealed that potassium, and calcium losses in sweat adversely affected SBP and DBP (all P<0.05). An analysis of covariance showed that SBP increased when potassium or calcium losses in sweat were >900 mg, or >100 mg, respectively. Further, DBP increased when potassium or calcium losses in sweat were >600 mg or >130 mg, respectively. Therefore, vitamin C, potassium, and calcium losses in sweat may adversely effect BP. To help steelworkers maintain healthy BP, facilities with high temperatures should try to lower environmental temperatures to reduce vitamin C, potassium, and calcium losses in sweat. Additionally, heat-exposed steelworkers may need to increase their dietary intakes of vitamin C, potassium, and calcium. Further research is needed to confirm these findings and support these recommendations. PMID:27087421

Importance of Calibration Method in Central Blood Pressure for Cardiac Structural Abnormalities.

PubMed

Negishi, Kazuaki; Yang, Hong; Wang, Ying; Nolan, Mark T; Negishi, Tomoko; Pathan, Faraz; Marwick, Thomas H; Sharman, James E

2016-09-01

Central blood pressure (CBP) independently predicts cardiovascular risk, but calibration methods may affect accuracy of central systolic blood pressure (CSBP). Standard central systolic blood pressure (Stan-CSBP) from peripheral waveforms is usually derived with calibration using brachial SBP and diastolic BP (DBP). However, calibration using oscillometric mean arterial pressure (MAP) and DBP (MAP-CSBP) is purported to provide more accurate representation of true invasive CSBP. This study sought to determine which derived CSBP could more accurately discriminate cardiac structural abnormalities. A total of 349 community-based patients with risk factors (71±5years, 161 males) had CSBP measured by brachial oscillometry (Mobil-O-Graph, IEM GmbH, Stolberg, Germany) using 2 calibration methods: MAP-CSBP and Stan-CSBP. Left ventricular hypertrophy (LVH) and left atrial dilatation (LAD) were measured based on standard guidelines. MAP-CSBP was higher than Stan-CSBP (149±20 vs. 128±15mm Hg, P < 0.0001). Although they were modestly correlated (rho = 0.74, P < 0.001), the Bland-Altman plot demonstrated a large bias (21mm Hg) and limits of agreement (24mm Hg). In receiver operating characteristic (ROC) curve analyses, MAP-CSBP significantly better discriminated LVH compared with Stan-CSBP (area under the curve (AUC) 0.66 vs. 0.59, P = 0.0063) and brachial SBP (0.62, P = 0.027). Continuous net reclassification improvement (NRI) (P < 0.001) and integrated discrimination improvement (IDI) (P < 0.001) corroborated superior discrimination of LVH by MAP-CSBP. Similarly, MAP-CSBP better distinguished LAD than Stan-CSBP (AUC 0.63 vs. 0.56, P = 0.005) and conventional brachial SBP (0.58, P = 0.006), whereas Stan-CSBP provided no better discrimination than conventional brachial BP (P = 0.09). CSBP is calibration dependent and when oscillometric MAP and DBP are used, the derived CSBP is a better discriminator for cardiac structural abnormalities. © American Journal of Hypertension

Association of Thr420Lys polymorphism in DBP gene with fat-soluble vitamins and low radial bone mineral density in postmenopausal Thai women.

PubMed

Chupeerach, Chaowanee; Tungtrongchitr, Anchalee; Phonrat, Benjaluck; Schweigert, Florian J; Tungtrongchitr, Rungsunn; Preutthipan, Sangchai

2012-02-01

To investigate the genetic markers for osteoporosis bone mineral density by the genotyping of rs7041, rs4588 and rs1352845 in the DBP gene with either bone mineral density or serum 25-hydroxycholecalciferol, retinol and α-tocopherol, among 365 postmenopausal Thai women. The DBP genotypes were analyzed by a PCR restriction fragment-length polymorphism method. Serum 25-hydroxycholecalciferol was assessed using a commercial chemiluminescent immunoassay. Serum retinol and α-tocopherol were measured by reverse-phase high-performance liquid chromatography. After adjustment for age >50 years, elder Thai subjects with low BMI (≤25 kg/m(2)) and carrying the rs4588 CC genotype had a higher risk of radial bone mineral density osteoporosis (odds ratio: 6.29; p = 0.048). The rs1352845 genotype also had a statistical association with total hip bone mineral density; however, it disappeared after adjustment for age and BMI. No association was found in fat-soluble vitamins with bone mineral density. DBP genotypes may influence the osteoporosis bone mineral density in postmenopausal Thai women.

Development of a Blood Pressure Measurement Instrument with Active Cuff Pressure Control Schemes.

PubMed

Kuo, Chung-Hsien; Wu, Chun-Ju; Chou, Hung-Chyun; Chen, Guan-Ting; Kuo, Yu-Cheng

2017-01-01

This paper presents an oscillometric blood pressure (BP) measurement approach based on the active control schemes of cuff pressure. Compared with conventional electronic BP instruments, the novelty of the proposed BP measurement approach is to utilize a variable volume chamber which actively and stably alters the cuff pressure during inflating or deflating cycles. The variable volume chamber is operated with a closed-loop pressure control scheme, and it is activated by controlling the piston position of a single-acting cylinder driven by a screw motor. Therefore, the variable volume chamber could significantly eliminate the air turbulence disturbance during the air injection stage when compared to an air pump mechanism. Furthermore, the proposed active BP measurement approach is capable of measuring BP characteristics, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), during the inflating cycle. Two modes of air injection measurement (AIM) and accurate dual-way measurement (ADM) were proposed. According to the healthy subject experiment results, AIM reduced 34.21% and ADM reduced 15.78% of the measurement time when compared to a commercial BP monitor. Furthermore, the ADM performed much consistently (i.e., less standard deviation) in the measurements when compared to a commercial BP monitor.

EPA Peer Consultation Workshop Report on the Review of the Draft IRIS Toxicological Review of Dibutyl Phthalate (DBP)

EPA Science Inventory

The U.S. EPA finalized comments gathered from a public peer review of the scientific basis supporting the human health hazard and dose-response assessment of dibutyl phthalate (DBP) that will appear on the Integrated Risk Information System (IRIS) database. The peer review has en...

MODULATION OF THE CYTOTOXICITY AND GENOTOXICITY OF THE DRINKING WATER DBP IODOACETIC ACID BY SUPPRESSORS OF OXIDATIVE STRESS

EPA Science Inventory

Drinking water disinfection by-products (DBPs) are generated by the chemical disinfection of water and may pose a hazard to the public health. Previously we demonstrated that iodoacetic acid was the most cytotoxic and genotoxic DBP analyzed in a mammalian cell system. Little is k...

AGT M235T and ACE ID polymorphisms and exercise blood pressure in the HERITAGE Family Study.

PubMed

Rankinen, T; Gagnon, J; Pérusse, L; Chagnon, Y C; Rice, T; Leon, A S; Skinner, J S; Wilmore, J H; Rao, D C; Bouchard, C

2000-07-01

We investigated the association between angiotensinogen (AGT) and angiotensin-converting enzyme (ACE) gene polymorphisms and exercise training responses of resting and exercise blood pressure (BP). BP at rest and during submaximal (50 watts) and maximal exercise tests was measured before and after 20 wk of endurance training in 476 sedentary normotensive Caucasian subjects from 99 families. AGT M235T and ACE insertion/deletion polymorphisms were typed with PCR-based methods. Men carrying the AGT MM and MT genotypes showed 3. 7 +/- 0.6 and 3.2 +/- 0.5 (SE) mmHg reductions, respectively, in diastolic BP at 50 watts (DBP(50)), whereas, in the TT homozygotes, the decrease was 0.4 +/- 1.0 mmHg (P = 0.016 for trend, adjusted for age, body mass index, and baseline DBP(50)). Men with the ACE DD genotype showed a slightly greater decrease in DBP(50) (4.4 +/- 0.6 mmHg) than the II and ID genotypes (2.8 +/- 0.7 and 2.4 +/- 0.5 mmHg, respectively, P = 0.050). Furthermore, a significant (P = 0.022) interaction effect between the AGT and ACE genes was noted for DBP(50); the AGT TT homozygotes carrying the ACE D allele showed no response to training. Men with the AGT TT genotype had greater (P = 0.007) diastolic BP (DBP) response to acute maximal exercise at baseline. However, the difference disappeared after the training period. No associations were found in women. These data suggest that, in men, the genetic variation in the AGT locus modifies the responsiveness of submaximal exercise DBP to endurance training, and interactions between the AGT and ACE loci can alter this response.

Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh.

PubMed

Ali, Nurshad; Mahmood, Shakil; Manirujjaman, M; Perveen, Rasheda; Al Nahid, Abdullah; Ahmed, Shamim; Khanum, Farida Adib; Rahman, Mustafizur

2017-07-25

Hypertension is a global health issue and is currently increasing at rapid pace in South Asian countries including Bangladesh. Although, some studies on hypertension have been conducted in Bangladesh, there is a lack of scientific evidence in the adult student population that was missing from the previous and recent national cross-sectional studies. Moreover, the specific risk factors of hypertension in the Bangladeshi adults still need to be investigated. This study was conducted to estimate hypertension prevalence among adult students in Bangladesh and to test the hypothesis of Luke et al. (Hypertension 43:555-560, 2004) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size. The data was collected on 184 adult university students (118 female and 66 male) in Dhaka, Bangladesh. Anthropometric, BMR details and an average of at least two blood pressure measurements were obtained. Hypertension was defined by a systolic blood pressure (SBP) ≥ 140 mmHg and/or, diastolic blood pressure (DBP) ≥ 90 mmHg. Overall, 6.5% of participants had hypertension with significantly (p < 0.001) higher prevalence in male (12.1%) than in the female (3.4%) students. Age and BMI showed positive and significant correlation with hypertension among the students. When adjusted for body mass index (BMI), as well as other potentially confounding variables such as age, sex, smoking status and degree of urbanization, BMR was positively correlated with SBP and DBP (p < 0.001). Thus, higher BMR is associated with SBP and DBP; this is opposite the well documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMR might be an important predictor that can explain relatively high blood pressure and hypertension in humans. This study reports the prevalence and associated risk factors of hypertension in the Bangladeshi adult students. The

The difference in blood pressure readings between arms and survival: primary care cohort study

PubMed Central

Taylor, Rod S; Shore, Angela C; Campbell, John L

2012-01-01

Objective To determine whether a difference in systolic blood pressure readings between arms can predict a reduced event free survival after 10 years. Design Cohort study. Setting Rural general practice in Devon, United Kingdom. Participants 230 people receiving treatment for hypertension in primary care. Intervention Bilateral blood pressure measurements recorded at three successive surgery attendances. Main outcome measures Cardiovascular events and deaths from all causes during a median follow-up of 9.8 years. Results At recruitment 24% (55/230) of participants had a mean interarm difference in systolic blood pressure of 10 mm Hg or more and 9% (21/230) of 15 mm Hg or more; these differences were associated with an increased risk of all cause mortality (adjusted hazard ratio 3.6, 95% confidence interval 2.0 to 6.5 and 3.1, 1.6 to 6.0, respectively). The risk of death was also increased in 183 participants without pre-existing cardiovascular disease with an interarm difference in systolic blood pressure of 10 mm Hg or more or 15 mm Hg or more (2.6, 1.4 to 4.8 and 2.7, 1.3 to 5.4). An interarm difference in diastolic blood pressure of 10 mm Hg or more was weakly associated with an increased risk of cardiovascular events or death. Conclusions Differences in systolic blood pressure between arms can predict an increased risk of cardiovascular events and all cause mortality over 10 years in people with hypertension. This difference could be a valuable indicator of increased cardiovascular risk. Bilateral blood pressure measurements should become a routine part of cardiovascular assessment in primary care. PMID:22433975

Weight Status and Blood Pressure among Adolescent African American Males: The Jackson Heart KIDS Pilot Study.

PubMed

Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

2015-08-07

Obesity had not been considered a significant factor contributing to high levels of hypertension among African American males until recently. Epidemiologic research on heart disease among males has primarily focused on adults; however, the significant rise in obesity and hypertension prevalence among African American boys indicates that studies examining the relationship between excess body weight and elevated blood pressure among this high-risk population are critically needed. The purpose of our study was to examine the degree to which weight status has implications for elevated blood pressure among young African American males. The data for this cross-sectional study were drawn from adolescent males (N=105), aged 12-19 years and who participated in the Jackson Heart KIDS Pilot Study - an offspring cohort study examining cardiovascular disease risks among adolescent descendants of Jackson Heart Study participants. Blood pressure was the primary outcome of interest and weight status was a key independent variable. Other covariates were fruit and vegetable consumption, physical activity, sleep, and stress. Approximately 49% of adolescent males in the study were overweight or obese. Bivariate and multiple variable analyses suggest that obesity may be correlated with elevated diastolic blood pressure (DBP) levels among African American boys. Results from ordinary least squared regression analysis indicate that the DBP for boys carrying excess weight was 4.2 mm Hg (P<.01) higher than the corresponding DBP for their normal weight counterparts, after controlling for age, fruit and vegetable consumption, physical activity, and sleep. Additional studies are needed to specify the manner through which excess weight and weight gain can accelerate the development and progression of CVD-related diseases among African American males over the life course, thereby providing evidenced-based information for tailored interventions that can reduce risks for premature morbidity

Depletion of mRNA export regulator DBP5/DDX19, GLE1 or IPPK that is a key enzyme for the production of IP6, resulting in differentially altered cytoplasmic mRNA expression and specific cell defect

PubMed Central

Okamura, Masumi; Yamanaka, Yasutaka; Shigemoto, Maki; Kitadani, Yuya; Kobayashi, Yuhko; Kambe, Taiho; Nagao, Masaya; Kobayashi, Issei; Okumura, Katsuzumi

2018-01-01

DBP5, also known as DDX19, GLE1 and inositol hexakisphosphate (IP6) function in messenger RNA (mRNA) export at the cytoplasmic surface of the nuclear pore complex in eukaryotic cells. DBP5 is a DEAD-box RNA helicase, and its activity is stimulated by interactions with GLE1 and IP6. In addition, these three factors also have unique role(s). To investigate how these factors influenced the cytoplasmic mRNA expression and cell phenotype change, we performed RNA microarray analysis to detect the effect and function of DBP5, GLE1 and IP6 on the cytoplasmic mRNA expression. The expression of some cytoplasmic mRNA subsets (e.g. cell cycle, DNA replication) was commonly suppressed by the knock-down of DBP5, GLE1 and IPPK (IP6 synthetic enzyme). The GLE1 knock-down selectively reduced the cytoplasmic mRNA expression required for mitotic progression, results in an abnormal spindle phenotype and caused the delay of mitotic process. Meanwhile, G1/S cell cycle arrest was observed in DBP5 and IPPK knock-down cells. Several factors that function in immune response were also down-regulated in DBP5 or IPPK knock-down cells. Thereby, IFNβ-1 mRNA transcription evoked by poly(I:C) treatment was suppressed. These results imply that DBP5, GLE1 and IP6 have a conserved and individual function in the cytoplasmic mRNA expression. Variations in phenotype are due to the difference in each function of DBP5, GLE1 and IPPK in intracellular mRNA metabolism. PMID:29746542

Getting used to academic public speaking: global self-esteem predicts habituation in blood pressure response to repeated thesis presentations.

PubMed

Elfering, Achim; Grebner, Simone

2012-06-01

Global self-esteem was tested to predict quicker cardiovascular adaptation during stressful oral thesis presentation and faster habituation from the first to the second and third thesis presentations. Nineteen graduate students initially rated their global self-esteem and afterwards orally presented their theses proposals in 20-min presentations to their thesis supervisor and peers. A second and third presentation of the revised thesis concepts took place at 4-weeks intervals. Ambulatory blood pressure and heart rate were assessed repeatedly during the presentations. Post-talk self ratings of stressfulness indicated presentations to be a strong public speaking stressor. One hundred and thirty-eight measurements of systolic (SBP), diastolic blood pressure (DBP), and heart rate (HR) showed a significant adaptation (decrease) during presentations. There was an overall mean level decrease from the first to the second, and the second to the third presentations in HR, but not in SBP and DBP. However, habituation in SBP and DBP across three presentations was significantly faster (p < .05) in those participants who initially reported higher levels of global self-esteem. Higher global self-esteem did not foster adaptation within the presentations. Self-esteem is discussed as an important individual resource that allows successful coping with recurring evaluative threats.

Intragenerational Social Mobility and Changes in Blood Pressure: Longitudinal Analysis From the ELSA-Brasil Study.

PubMed

Guimarães, Joanna M N; Griep, Rosane H; Clarke, Philippa J; Fonseca, Maria J M; Barreto, Sandhi M; Giatti, Luana; Lotufo, Paulo A; Mill, Jose G; Pacheco, Antonio G; Chor, Dora

2018-05-07

During the past 4 decades, the highest worldwide blood pressure (BP) levels have shifted from high-income countries to low- and middle-income countries. We investigated the association of intragenerational social mobility with changes in BP and also with the incidence of hypertension over a 4-year follow-up. Data for 6,529 baseline participants from ELSA-Brasil born between 1938 and 1975 were used. Based on a social mobility matrix, occupational social mobility was defined as the change in occupational social class between participants' first occupation and current occupation (stable high; upward; downward; stable low). Incident hypertension was defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg or use of antihypertensive medication. Hypertensive participants at baseline were excluded. Mixed effects regression models were used. Compared to the stable high group, the downwardly mobile group showed a higher increase over time in both SBP (β = 1.49, 95% CI 0.60; 2.37) and DBP (β = 0.96, 95% CI 0.32; 1.59) after adjustments for background characteristics and also proximal risk factors such as health-related behaviors and body mass index as time-dependent covariates, and diabetes. In contrast, upward mobility had no influence on BP changes (β = 0.67, 95% CI -0.07; 1.41 for SBP, and β = 0.47, 95% CI -0.05; 1.00 for DBP). Social mobility was not associated with the incidence of hypertension. We showed socioeconomic inequalities in BP progression over the life course. The longitudinal changes in BP varied by social mobility groups in the context of low- and middle-income countries, where high BP has become most prevalent.

Blood pressure and cognitive function: a prospective analysis among adolescents in the Seychelles

PubMed Central

Lyngdoh, Tanica; Viswanathan, Bharathi; Kobrosly, Roni; van Wijngaarden, Edwin; Huber, Brittany; Davidson, Philip W.; Cory-Slechta, Deborah A.; Strain, JJ; Myers, Gary J.; Bovet, Pascal

2013-01-01

Objective An inverse relationship between blood pressure and cognitive function has been found in adults, but limited data are available in adolescents and young adults. We examined the prospective relation between blood pressure and cognitive function in adolescence. Methods We examined the association between BP measured at the ages of 12–15 years in school surveys and cognitive endpoints measured in the Seychelles Child Development Study at ages 17 (n=407) and 19 (n=429) years, respectively. We evaluated multiple domains of cognition based on subtests of the Cambridge Neurological Test Automated Battery (CANTAB), the Woodcock Johnson Test of Scholastic Achievement (WJTA), the Finger Tapping test (FT) and the Kaufman Brief Intelligence Test (K-BIT). We used age-, sex- and height-specific z-scores of systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP). Results Six out of the 21 cognitive endpoints tested were associated with BP. However, none of these associations were found to hold for both males and females or for different subtests within the same neurodevelopmental domain or for both SBP and DBP. Most of these associations disappeared when analyses were adjusted for selected potential confounding factors such as socio-economic status, birth weight, gestational age, body mass index, alcohol consumption, blood glucose, and total n-3 and n-6 polyunsaturated fats. Conclusions Our findings do not support a consistent association between BP and subsequent performance on tests assessing various cognitive domains in adolescents. PMID:23572201

Alcohol consumption and ambulatory blood pressure: a community-based study in an elderly cohort.

PubMed

Jaubert, Marie-Perrine; Jin, Zhezhen; Russo, Cesare; Schwartz, Joseph E; Homma, Shunichi; Elkind, Mitchell S V; Rundek, Tatjana; Sacco, Ralph L; Di Tullio, Marco R

2014-05-01

Although heavy alcohol consumption is associated with hypertension, the impact of lighter consumption on blood pressure (BP) is controversial. The protective effect of light alcohol consumption on cardiovascular disease described in previous studies could be, in part, mediated by effects of alcohol on BP. However, only a few studies investigating the association between alcohol and BP included elderly subjects, despite their higher risk of hypertension sequelae. Accordingly, we evaluated the relationship between alcohol consumption and 24-hour ambulatory BP in a community-based elderly cohort. Among the participants in the Cardiac Abnormalities and Brain Lesion study, 553 subjects (mean age = 70.6 ± 9.6 years) who underwent 24-hour ambulatory BP monitoring were examined. Alcohol consumption was categorized as (i) none (reference; <1 drink/month); (ii) very light consumption (1 drink/month to 1 drink/week); (iii) light consumption (2 drinks/week to 1 drink/day); (iv) moderate-to-heavy consumption (>1 drink/day). Former drinkers were excluded. After adjustment for relevant covariables, mean values of daytime diastolic BP (DBP), nighttime DBP, and 24-hour DBP were significantly higher in moderate-to-heavy drinkers than in the reference group, whereas systolic BP parameters were not significantly different across consumption groups. Daytime systolic BP and DBP variability (SD of the measurements) were significantly lower in very light drinkers than in the reference group, independent of potential confounders. Moderate-to-heavy alcohol consumption was associated with higher DBP values. Very light alcohol consumption was associated with reduced daytime BP variability. The latter association may contribute to the known beneficial cardiovascular effects of light alcohol consumption.

Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: A systematic review and network meta-analysis.

PubMed

Schwingshackl, Lukas; Chaimani, Anna; Schwedhelm, Carolina; Toledo, Estefania; Pünsch, Marina; Hoffmann, Georg; Boeing, Heiner

2018-05-02

Pairwise meta-analyses have shown beneficial effects of individual dietary approaches on blood pressure but their comparative effects have not been established. Therefore we performed a systematic review of different dietary intervention trials and estimated the aggregate blood pressure effects through network meta-analysis including hypertensive and pre-hypertensive patients. PubMed, Cochrane CENTRAL, and Google Scholar were searched until June 2017. The inclusion criteria were defined as follows: i) Randomized trial with a dietary approach; ii) hypertensive and pre-hypertensive adult patients; and iii) minimum intervention period of 12 weeks. In order to determine the pooled effect of each intervention relative to each of the other intervention for both diastolic and systolic blood pressure (SBP and DBP), random effects network meta-analysis was performed. A total of 67 trials comparing 13 dietary approaches (DASH, low-fat, moderate-carbohydrate, high-protein, low-carbohydrate, Mediterranean, Palaeolithic, vegetarian, low-GI/GL, low-sodium, Nordic, Tibetan, and control) enrolling 17,230 participants were included. In the network meta-analysis, the DASH, Mediterranean, low-carbohydrate, Palaeolithic, high-protein, low-glycaemic index, low-sodium, and low-fat dietary approaches were significantly more effective in reducing SBP (-8.73 to -2.32 mmHg) and DBP (-4.85 to -1.27 mmHg) compared to a control diet. According to the SUCRAs, the DASH diet was ranked the most effective dietary approach in reducing SBP (90%) and DBP (91%), followed by the Palaeolithic, and the low-carbohydrate diet (ranked 3rd for SBP) or the Mediterranean diet (ranked 3rd for DBP). For most comparisons, the credibility of evidence was rated very low to moderate, with the exception for the DASH vs. the low-fat dietary approach for which the quality of evidence was rated high. The present network meta-analysis suggests that the DASH dietary approach might be the most effective dietary measure

THE OCCURRENCE OF DISINFECTION BY-PRODUCTS OF HEALTH CONCERN IN DRINKING WATER: RESULTS OF A NATIONWIDE DBP OCCURRENCE STUDY

EPA Science Inventory

The motivation for this Nationwide Disinfection By-product (DBP) Occurrence Study was two-fold: First, more than 500 DBPs have been reported in the literature, yet there is almost no quantitative occurrence information for most. As a result, there is significant uncertainty ove...

Acute blood pressure response in hypertensive elderly women immediately after water aerobics exercise: A crossover study.

PubMed

Cunha, Raphael Martins; Vilaça-Alves, José; Noleto, Marcelo Vasconcelos; Silva, Juliana Sá; Costa, Andressa Moura; Silva, Christoffer Novais Farias; Póvoa, Thaís Inácio Rolim; Lehnen, Alexandre Machado

2017-01-01

Water aerobics exercise is widely recommended for elderly people. However, little is known about the acute effects on hemodynamic variables. Thus, we assessed the effects of a water aerobic session on blood pressure in hypertensive elderly women. Fifty hypertensive elderly women aged 67.8 ± 4.1 years, 1.5 ± 0.6 m high and BMI 28.6 ± 3.9 kg/m 2 , participated in a crossover clinical trial. The experiment consisted of a 45-minute water aerobics session (70%-75% HRmax adjusted for the aquatic environment) (ES) and a control session (no exercise for 45 minutes) (CS). Heart rate was monitored using a heart rate monitor and systolic blood pressure (SBP) and diastolic (DBP) measurements were taken using a semi-automatic monitor before and immediately after the sessions, and at 10, 20 and 30 minutes thereafter. It was using a generalized estimating equation (GEE) with Bonferroni's post-hoc test (p < 0.05). At the end of the experimental session, ES showed a rise in SBP of 17.4 mmHg (14.3%, p < 0.001) and DBP of 5.4 mmHg (7.8%, p < 0.001) compared to CS. At 10 minutes after exercise, BP declined in ES by a greater magnitude than in CS (SBP 7.5 mmHg, 6.2%, p = 0.005 and DBP 3.8 mmHg, 5.5%, p = 0.013). At 20 minutes after exercise and thereafter, SBP and DBP were similar in both ES and CS. In conclusion, BP returned to control levels within 10-20 minutes remaining unchanged until 30 minutes after exercise, and post-exercise hypotension was not observed. Besides, BP changed after exercise was a safe rise of small magnitude for hypertensive people.

Effect of mechanical behaviour of the brachial artery on blood pressure measurement during both cuff inflation and cuff deflation.

PubMed

Zheng, Dingchang; Pan, Fan; Murray, Alan

2013-10-01

The aim of this study was to investigate the effect of different mechanical behaviour of the brachial artery on blood pressure (BP) measurements during cuff inflation and deflation. BP measurements were taken from each of 40 participants, with three repeat sessions under three randomized cuff deflation/inflation conditions. Cuff pressure was linearly deflated and inflated at a standard rate of 2-3 mmHg/s and also linearly inflated at a fast rate of 5-6 mmHg/s. Manual auscultatory systolic and diastolic BPs, and pulse pressure (SBP, DBP, PP) were measured. Automated BPs were determined from digitally recorded cuff pressures by fitting a polynomial model to the oscillometric pulse amplitudes. The BPs from cuff deflation and inflation were then compared. Repeatable measurements between sessions and between the sequential order of inflation/deflation conditions (all P > 0.1) indicated stability of arterial mechanical behaviour with repeat measurements. Comparing BPs obtained by standard inflation with those from standard deflation, manual SBP was 2.6 mmHg lower (P < 0.01), manual DBP was 1.5 mmHg higher (P < 0.01), manual PP was 4.2 mmHg lower (P < 0.001), automated DBP was 6.7 mmHg higher (P < 0.001) and automatic PP was 7.5 mmHg lower (P < 0.001). There was no statistically significant difference for any automated BPs between fast and standard cuff inflation. The statistically significant BP differences between inflation and deflation suggest different arterial mechanical behaviour between arterial opening and closing during BP measurement. We have shown that the mechanical behaviour of the brachial artery during BP measurement differs between cuff deflation and cuff inflation.

Low Blood Pressure

MedlinePlus

... a problem. Sometimes blood pressure that is too low can also cause problems. Blood pressure is the ... reading is 90/60 or lower, you have low blood pressure. Some people have low blood pressure ...

Sex Differences in the Association of Childhood Socioeconomic Status with Adult Blood Pressure Change: The CARDIA Study

PubMed Central

Janicki-Deverts, Denise; Cohen, Sheldon; Matthews, Karen A.; Jacobs, David R.

2012-01-01

Objective To examine sex differences in the relation of childhood socioeconomic status (CSES) to systolic (SBP) and diastolic (DBP) blood pressure trajectories during 15-years spanning young (30 ± 3 years) and middle (45±3 years) adulthood, independent of adult SES. Method 4077 adult participants reported father’s and mother’s educational attainments at study enrollment (Year 0), and own educational attainment at enrollment and at all follow-up exams. Resting BP also was measured at all exams. Data from exam Years 5 (when participant mean age=30± 3 years), 7, 10, 15, and 20 are examined here. Associations of own adult [Year 5], mother’s, and father’s educations with 15-year BP trajectories were examined in separate multilevel models. Fully controlled models included time-invariant covariates (age, sex, race, recruitment center), and time-varying covariates that were measured at each exam (marital status, body mass, cholesterol, oral contraceptives/hormones, antihypertensives). Parental education analyses controlled for own education. Results When examined without covariates, higher education -- own (SBP γ=−0.03, DBP γ= −0.03), mother’s (SBP γ= −0.02, DBP γ= −0.02), and father’s (SBP γ= −0.02, DBP γ= −0.01) -- were associated with attenuated 15-year increases in BP (p<0.001). Associations of own (but not either parent’s) education with BP trajectories remained independent of standard controls. Sex moderated the apparent null effects of parental education, such that higher parental education–especially mother’s, predicted attenuated BP trajectories independent of standard covariates among women (SBP γ= −.02, p=.02; DBP γ= −.01, p=0.04) but not men (SBP γ=0.02, p=0.06; DBP γ=0.005, p=0.47; p-interaction SBP<0.001, p-interaction DBP=0.01). Conclusion CSES may influence women’s health independent of their own adult status. PMID:22822232

External pressure measurement system

NASA Astrophysics Data System (ADS)

Chandler, Jon K.; Fowler, Don P.

Hydraulic systems comprise an important part of jet aircraft and their pressure needs must be checked constantly. Tests of the prototype external pressure measurement system show that it is possible to accurately convert the small expansion of tubing with pressure into a direct pressure reading without inserting a pressure gage into the piping system. The tool described in the paper is a clamp-on displacement transducer that can read pressure directly in PSI from 0 to 5000. Some limitations concerning temperature and accuracy should be remedied by additional design work. The system promises to streamline troubleshooting of all types of piping systems.

Non-invasive estimate of blood glucose and blood pressure from a photoplethysmograph by means of machine learning techniques.

PubMed

Monte-Moreno, Enric

2011-10-01

This work presents a system for a simultaneous non-invasive estimate of the blood glucose level (BGL) and the systolic (SBP) and diastolic (DBP) blood pressure, using a photoplethysmograph (PPG) and machine learning techniques. The method is independent of the person whose values are being measured and does not need calibration over time or subjects. The architecture of the system consists of a photoplethysmograph sensor, an activity detection module, a signal processing module that extracts features from the PPG waveform, and a machine learning algorithm that estimates the SBP, DBP and BGL values. The idea that underlies the system is that there is functional relationship between the shape of the PPG waveform and the blood pressure and glucose levels. As described in this paper we tested this method on 410 individuals without performing any personalized calibration. The results were computed after cross validation. The machine learning techniques tested were: ridge linear regression, a multilayer perceptron neural network, support vector machines and random forests. The best results were obtained with the random forest technique. In the case of blood pressure, the resulting coefficients of determination for reference vs. prediction were R(SBP)(2)=0.91, R(DBP)(2)=0.89, and R(BGL)(2)=0.90. For the glucose estimation, distribution of the points on a Clarke error grid placed 87.7% of points in zone A, 10.3% in zone B, and 1.9% in zone D. Blood pressure values complied with the grade B protocol of the British Hypertension society. An effective system for estimate of blood glucose and blood pressure from a photoplethysmograph is presented. The main advantage of the system is that for clinical use it complies with the grade B protocol of the British Hypertension society for the blood pressure and only in 1.9% of the cases did not detect hypoglycemia or hyperglycemia. Copyright © 2011 Elsevier B.V. All rights reserved.

Validation of a smartphone auscultatory blood pressure kit Accutension XYZ-110 in adults according to the ANSI/AAMI/ISO 81060-2: 2013 standard.

PubMed

Chu, Guang; Zhang, Zhi; Xu, Mengdan; Huang, Daini; Dai, Qiuyan

2017-10-01

The aim of this study was to validate the accuracy of the Accutension XYZ-110 blood pressure (BP) kit according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060-2:2013 standard. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured simultaneously on the same arm in 85 Chinese adults (female : male=48 : 37) with a mean age of 43.2 years using the mercury sphygmomanometer (two observers) and the Accutension XYZ-110 device (one supervisor). The ANSI/AAMI/ISO 81060-2:2013 standard for the validation of BP-measuring devices in adults was followed precisely. A total of 255 comparison pairs were obtained for analysis. The mean device-observer difference in the 255 separate BP data pairs was 2.45±2.24 mmHg for SBP and 0.69±2.09 mmHg for DBP. The data were in accordance with the criterion 1 of the ANSI/AAMI/ISO 81060-2:2013 standard requirements (≤5±8 mmHg). In addition, the mean device-observer difference of the 85 participants was 2.45±1.47 mmHg for SBP and 0.69±1.36 mmHg for DBP. The device accuracy also fulfilled the criterion 2 with the SD of less than or equal to 6.47 for SBP and less than or equal to 6.90 mmHg for DBP. The Accutension XYZ-110 BP kit fulfilled the requirements of the ANSI/AAMI/ISO 81060-2:2013 standard, and hence could be recommended for both clinical and self/home BP measurement in adults.

Comparison of valsartan and amlodipine on ambulatory blood pressure variability in hypertensive patients.

PubMed

Eguchi, Kazuo; Imaizumi, Yuki; Kaihara, Toshiki; Hoshide, Satoshi; Kario, Kazuomi

We tested the hypothesis that calcium channel blockers (CCBs: amlodipine group, n = 38)) are superior to angiotensin receptor blockers (ARBs: valsartan group, n = 38) against ambulatory blood pressure variability (BPV) in untreated Japanese hypertensive patients. Both drugs significantly reduced ambulatory systolic and diastolic BP values. With regard to BPV, standard deviation (SD) in SBP did not change with the administration of either drug, but the ARB significantly increased SD in awake DBP (12 ± 4-14 ± 4 mmHg). The ARB also significantly increased the coefficients of variation (CVs)in awake and 24-h SBP/DBP (all P < 0.05), but amlodipine did not change the CV. CCB significantly reduced the maximum values of awake SBP (193 ± 24-182 ± 27 mmHg, P = 0.02), sleep SBP (156 ± 18-139 ± 14 mmHg, P < 0 .001), and awake and sleep DBP (P < 0.01 in both cases), but the ARB did not change the maximum BP values. In conclusion, a once-daily morning dose of CCB amlodipine was more effective at controlling ambulatory BPV than ARB valsartan, especially in reducing maximum BP levels.

Are self-reported telemonitored blood pressure readings affected by end-digit preference: a prospective cohort study in Scotland.

PubMed

Parker, Richard A; Paterson, Mary; Padfield, Paul; Pinnock, Hilary; Hanley, Janet; Hammersley, Vicky S; Steventon, Adam; McKinstry, Brian

2018-01-31

Simple forms of blood pressure (BP) telemonitoring require patients to text readings to central servers creating an opportunity for both entry error and manipulation. We wished to determine if there was an apparent preference for particular end digits and entries which were just below target BPs which might suggest evidence of data manipulation. Prospective cohort study SETTING: 37 socioeconomically diverse primary care practices from South East Scotland. Patients were recruited with hypertension to a telemonitoring service in which patients submitted home BP readings by manually transcribing the measurements into text messages for transmission ('patient-texted system'). These readings were compared with those from primary care patients with uncontrolled hypertension using a system in which readings were automatically transmitted, eliminating the possibility of manipulation of values ('automatic-transmission system'). A generalised estimating equations method was used to compare BP readings between the patient-texted and automatic-transmission systems, while taking into account clustering of readings within patients. A total of 44 150 BP readings were analysed on 1068 patients using the patient-texted system compared with 20 705 readings on 199 patients using the automatic-transmission system. Compared with the automatic-transmission data, the patient-texted data showed a significantly higher proportion of occurrences of both systolic and diastolic BP having a zero end digit (OR 2.1, 95% CI 1.7 to 2.6) although incidence was <2% of readings. Similarly, there was a preference for systolic 134 and diastolic 84 (the threshold for alerts was 135/85) (134 systolic BP OR 1.5, 95% CI 1.3 to 1.8; 84 diastolic BP OR 1.5, 95% CI 1.3 to 1.9). End-digit preference for zero numbers and specific-value preference for readings just below the alert threshold exist among patients in self-reporting their BP using telemonitoring. However, the proportion of readings

Lifetime racial/ethnic discrimination and ambulatory blood pressure: The moderating effect of age

PubMed Central

Moody, Danielle L. Beatty; Waldstein, Shari R.; Tobin, Jonathan; Cassels, Andrea; Schwartz, Joseph C.; Brondolo, Elizabeth

2016-01-01

Objective To determine if the relationships of lifetime discrimination to ambulatory blood pressure (ABP) varied as a function of age in a sample of Black and Latino(a) adults ages 19 – 65. Methods Participants were 607 Black (n = 318) and Latino(a) (n = 289) adults (49% female) who completed the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), which assesses lifetime exposure to racism/ethnic discrimination. They were outfitted with an ABP monitor to assess systolic and diastolic blood pressure (SBP, DBP) across a 24-hour period. Mixed-level modeling was conducted to examine potential interactive effects of lifetime discrimination and age to 24-hour, daytime, and nighttime ABP after adjustment for demographic, socioeconomic, personality and life stress characteristics, and substance consumption covariates (e.g., smoking, alcohol). Results There were significant interactions of Age × Lifetime Discrimination on 24-hour and daytime DBP (ps ≤ .04), and in particular significant interactions for the Social Exclusion component of Lifetime Discrimination. Post-hoc probing of the interactions revealed the effects of Lifetime Discrimination on DBP were seen for older, but not younger participants. Lifetime discrimination was significantly positively associated with nocturnal SBP, and these effects were not moderated by age. All associations of Lifetime Discrimination to ABP remained significant controlling for recent exposure to discrimination as well as all other covariates. Conclusions Exposure to racial/ethnic discrimination across the life course is associated with elevated ABP in middle to older aged Black and Latino(a) adults. Further research is needed to understand the mechanisms linking discrimination to ABP over the life course. PMID:27018724

Does pre-pregnancy BMI determine blood pressure during pregnancy? A prospective cohort study

PubMed Central

Zuithoff, Peter; Browne, Joyce L; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E; Uiterwaal, Cuno S P M

2016-01-01

Objectives To evaluate if pre-pregnancy body mass index (BMI) determines blood pressure throughout pregnancy and to explore the role of gestational weight gain in this association. In addition, the effects of pre-pregnancy BMI and gestational weight gain on the occurrence of gestational hypertension and pre-eclampsia were investigated. Design Prospective cohort study. Setting Maternal and child health primary care referral centre, Jakarta, Indonesia. Population and measurements 2252 pregnant women visiting Budi Kemuliaan Hospital and its branch for regular antenatal care visits from July 2012 to April 2015. Pre-pregnancy BMI (kg/m2) was based on self-reported pre-pregnancy weight and measured height at first visit. Gestational weight gain was calculated as weight at the day of delivery minus the pre-pregnancy weight. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured during pregnancy at every visit. Linear mixed models were used to analyse this relation with repeated blood pressure measures as the outcome and pre-pregnancy BMI as the predictor. When looking at gestational hypertension and pre-eclampsia as outcomes, (multiple) logistic regression was used in the analysis. Results Independent of pre-pregnancy BMI, SBP and DBP increased by 0.99 mm Hg/month and 0.46 mm Hg/month, respectively. Higher pre-pregnancy BMI was associated with higher pregnancy SBP (0.25 mm Hg/kg/m2; 95% CI 0.17 to 0.34; p<0.01) and DBP (0.18 mm Hg/kg/m2; 0.13 to 0.24; p<0.01) in adjusted analysis. Every 1 kg/m2 higher pre-pregnancy BMI was associated with 6% and 9% higher odds for gestational hypertension (adjusted OR (aOR) 1.06; 95% CI 1.03 to 1.09; p<0.01) and pre-eclampsia (aOR 1.09; 1.04 to 1.14; p<0.01). Accounting for gestational weight gain did not attenuate these associations. Conclusions Pre-pregnancy BMI determines the level, but not the change, of blood pressure in pregnancy and is linked to higher odds for gestational hypertension and

The diagnostic value of supine blood pressure in hypertension.

PubMed

Krzesiński, Paweł; Stańczyk, Adam; Gielerak, Grzegorz; Piotrowicz, Katarzyna; Banak, Małgorzata; Wójcik, Agnieszka

2016-04-01

Correct blood pressure (BP) measurement is crucial in the diagnosis of arterial hypertension (AH), and controversy exists whether supine BP should be treated as equal to sitting BP. The aim of this study was to evaluate the relation of supine BP to sitting BP and ambulatory BP with regard to identification of diagnostic cut-offs for hypertension. This study included 280 patients with AH (mean age: 44.3 ±10.6 years). The following measurements of BP were performed and analyzed: 1) sitting office blood pressure measurement (OSBP and ODBP); 2) supine BP (supSBP and supDBP), measured automatically (5 times with a 2-minute interval) during evaluation by the Niccomo device (Medis, Germany); 3) 24-hour ambulatory blood pressure (ABP) monitoring. The mean supSBP and supDBP were found to be lower than OSBP and ODBP (130.9 ±14.2 vs. 136.6 ±15.5 mm Hg and 84.8 ±9.4 vs. 87.8 ±10.2 mm Hg, respectively; p < 0.000001). The correlations between ABP and supBP/OBP were moderate and strong (correlation coefficients in range 0.55-0.76). The ROC analysis revealed that mean supBP ≥ 130/80 mm Hg was more precise than OBP ≥ 140/90 mm Hg in diagnosing hypertension (AUC: 0.820 vs. 0.550; sensitivity 80.7% vs. 57.4%; specificity 83.2% vs. 52.7%; p < 0.0001) and the additive value derived mostly from its higher predictive power of identifying patients with increased night-time BP. In young and middle-aged hypertensive patients the blood pressure during a 10-minute supine rest was lower than in the sitting position. The supine blood pressure ≥ 130/80 mm Hg was found to be a specific and sensitive threshold for hypertension.

Bromide's effect on DBP formation, speciation, and control; Part 1: Ozonation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shukairy, H.M.; Summers, R.S.; Miltner, R.J.

1994-06-01

The effect of variable ozone dosage and bromide concentration on the formation of organic disinfection by-products (DBPs) and bromate were evaluated. Low ozone dosages resulted in oxidation of organic precursors, yielding decreases in the formation potential for total trihalomethanes (THMs), six haloacetic acids (HAAs), and total organic halide (TOX). Increasing the ozone dosage oxidized bromide to bromate, decreasing the bromide for incorporation into DBPs. Bromate concentrations were linearly correlated with ozone residuals. Changes in the bromine incorporation factors n and n[prime] reflected differences in the resulting speciation of THMs and HAAs, respectively. Because TOX measurements based on chloride equivalence maymore » underestimate the halogenated DBP yield for high-bromide waters, a procedure is described whereby bromide and bromate concentrations were used to correct the TOX measurement.« less

Effects of a brisk walk on blood pressure responses to the Stroop, a speech task and a smoking cue among temporarily abstinent smokers.

PubMed

Taylor, Adrian; Katomeri, Magdalena

2006-01-01

A review and meta-analysis by Hamer et al. (2006) showed that a single session of exercise can attenuate post-exercise blood pressure (BP) responses to stress, but no studies examined the effects among smokers or with brisk walking. Healthy volunteers (n=60), averaging 28 years of age and smoking 15 cigarettes daily, abstained from smoking for 2 h before being randomly assigned to a 15-min brisk semi-self-paced walk or passive control condition. Subject characteristics, typical smoking cue-elicited cravings and BP were assessed at baseline. After each condition, BP was assessed before and after three psycho-social stressors were carried out: (1) computerised Stroop word-colour interference task, (2) speech task and (3) only handling a lit cigarette. A two-way mixed ANCOVA (controlling for baseline) revealed a significant overall interaction effect for time by condition for both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Univariate ANCOVAs (to compare between-groups post-stressor BP, controlling for pre-stressor BP) revealed that exercise attenuated systolic BP and diastolic BP responses to the Stroop and speech tasks and SBP to the lit cigarette equivalent to an attenuated SBP and DBP of up to 3.8 mmHg. Post-exercise attenuation effects were moderated by resting blood pressure and self-reported smoking cue-elicited craving. Effects were strongest among those with higher blood pressure and smokers who reported typically stronger cravings when faced with smoking cues. Blood pressure responses to the lit cigarette were not associated with responses to the Stroop and speech task. A self-paced 15-min walk can reduce smokers' SBP and DBP responses to stress, of a magnitude similar on average to non-smokers.

Effects of Standing and Light-Intensity Activity on Ambulatory Blood Pressure.

PubMed

Zeigler, Zachary S; Mullane, Sarah L; Crespo, Noe C; Buman, Matthew P; Gaesser, Glenn A

2016-02-01

This study aimed to compare ambulatory blood pressure (ABP) response to accumulated standing (STAND), cycling (CYCLE), and walking (WALK) to a sitting-only (SIT) day in adults. Nine overweight or obese (body mass index, 28.7 ± 2.7 kg · m(-2)) adults (30 ± 15 yr) participated in this randomized crossover full-factorial study. Four conditions (WALK, STAND, CYCLE, and SIT) were randomly performed 1 wk apart. WALK, STAND, and CYCLE conditions consisted of progressively increasing activity time to accumulate 2.5 h during an 8-h simulated workday. WALK (1.0 mph) and STAND (0.0 mph) were completed on a treadmill placed underneath a standing-height desk. During CYCLE, participants pedaled on a Monark cycle ergometer at a cadence and energy expenditure equivalent to WALK. Participants remained seated during the SIT condition. Participants wore an ABP cuff from 0800 h until 2200 h on all conditions. Linear mixed models were used to test condition differences in systolic (SBP) and diastolic (DBP) blood pressure. Chi-square was used to detect frequency difference of BP load. There was a whole-day (during and after work hours) SBP and DBP treatment effect (P < 0.01). Systolic blood pressure during STAND (132 ± 17 mm Hg), WALK (133 ± 17 mm Hg), and CYCLE (130 ± 16 mm Hg) were lower compared with that during SIT (137 ± 17 mm Hg) (all P < 0.01). CYCLE was lower than STAND (P = 0.04) and WALK (P < 0.01). For DBP, only CYCLE (69 ± 12 mm Hg) was lower than SIT (71 ± 13 mm Hg; P < 0.01). Compared with SIT, WALK, STAND, and CYCLE reduced SBP load by 4%, 4%, and 13%, respectively (all P < 0.01). Compared with sitting, accumulating 2.5 h of light-intensity physical activity or standing during an 8-h workday may reduce ABP during and after work hours.

Comparative analysis of performance in reading and writing of children exposed and not exposed to high sound pressure levels.

PubMed

Santos, Juliana Feitosa dos; Souza, Ana Paula Ramos de; Seligman, Lilian

2013-01-01

To analyze the possible relationships between high sound pressure levels in the classroom and performance in the use of lexical and phonological routes in reading and writing. This consisted on a quantitative and exploratory study. The following measures were carried out: acoustic measurement, using the dosimeter, visual inspection of the external auditory canal, tonal audiometry thresholds, speech recognition tests and acoustic immittance; instrument for evaluation of reading and writing of isolated words. The non-parametric χ² test and Fisher's exact test were used for data analysis. The results of acoustic measurements in 4 schools in Santa Maria divided the sample of 87 children of third and fourth years of primary school, aged 8 to 10 years, in 2 groups. The 1st group was exposed to sound levels higher than 80 dB(A) (Study group) and the 2nd group at levels lower than 80 dB(A) (Control group). Higher prevalence of correct answers in reading and writing of nonwords, reading irregular words and frequency effect were observed. Predominance of correct answers in the writing of irregular words was observed in the Control group. For the Study group, a higher number of type errors neologism in reading and writing were observed, especially regarding the writing of nonwords and the extension effect; fewer errors of lexicalization type and verbal paragraphy in writing were observed. In assessing the reading and writing skills, children in the Study group exposed to high noise levels had poorer performance in the use of lexical and phonological routes, both in reading and in writing.

Blood pressure-to-height ratio as a screening indicator of elevated blood pressure among children and adolescents in Chongqing, China.

PubMed

Wang, L Y; Liu, Q; Cheng, X T; Jiang, J J; Wang, H

2017-07-01

We aimed to evaluate the performance of blood pressure-to-height ratio (BPHR) and establish their optimal thresholds for elevated blood pressure (BP) among children aged 6 to 17 years in Chongqing, China. Data were collected from 11 029 children and adolescents aged 6-17 years in 12 schools in Chongqing according to multistage stratified cluster sampling method. The gold standard for elevated BP was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ⩾95th percentile for gender, age and height. The diagnostic performance of systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) to screen for elevated BP was evaluated through receiver-operating characteristic curves (including the area under the curve (AUC) and its 95% confidence interval, sensitivity and specificity). The prevalence of elevated BP in children and adolescents in Chongqing was 10.36% by SBP and/or DBP ⩾95th percentile for gender, age and height. The optimal thresholds of SBPHR/DBPHR for identifying elevated BP were 0.86/0.58 for boys and 0.85/0.57 for girls among children aged 6 to 8 years, 0.81/0.53 for boys and 0.80/0.52 for girls among children aged 9 to 11 years and 0.71/0.45 for boys and 0.72/0.47 for girls among adolescents aged 12-17 years, respectively. Across gender and the specified age groups, AUC ranged from 0.82 to 0.88, sensitivity were above 0.94 and the specificities were over 0.7. The positive predictive values ranged from 0.30 to 0.38 and the negative predictive values were ⩾0.99. BPHR, with uniform values across broad age groups (6-8, 9-11 and 12-17 years) for boys and for girls is a simple indicator to screen elevated BP in children and adolescents in Chongqing.

Vascular Endothelial Function Assessed by Postischemic Diastolic Blood Pressure Is Associated with Acclimatization and Acute Mountain Sickness.

PubMed

He, Lipeng; Jiang, Yu; Su, Hai; Li, Juxiang; Cheng, Xiaoshu

2016-03-01

This study assessed whether the brachial diastolic blood pressure (DBP) decline induced by 5-minute arm ischemia is associated with acclimatization and acute mountain sickness (AMS). Forty-two age- and body mass index-matched young male residents at sea level (<400 m) or moderate altitude (1000-2000 m above sea level) were enrolled. All subjects had never been to 3200 m before. Brachial BP was measured at a station at 1380 m altitude before and 1, 5, and 10 minutes after right arm ischemia. AMS score was evaluated after 3-day training at a high altitude of 3200 m. In moderate altitude versus sea-level residents: (1) systolic BP curves for both arms overlapped well; (2) mean right arm DBP decline post right arm ischemia was larger, while left arm, which was not subjected to ischemia, did not show DBP decline in either group; and (3) AMS scores were significantly lower (3.19 ± 2.16 vs. 5.52 ± 4.58, p = 0.043) in those residing at moderate altitude compared to those from low altitude. There was a low negative correlation between AMS score and right arm area between curves-DBP (r = -0.320, p = 0.039). Moderate altitude relative to sea-level residents had a larger mean postischemic DBP decline in weak but significant association with lower mean AMS score at 3200 m. These data suggest that differences in vascular endothelial function related to altitude of residence persist during travel to high altitude and might contribute to AMS risk.

The Age-Dependent Relationship between Blood Pressure and Cognitive Impairment: A Cross-Sectional Study in a Rural Area of Xi'an, China

PubMed Central

Shang, Suhang; Li, Pei; Deng, Meiying; Jiang, Yu; Chen, Chen; Qu, Qiumin

2016-01-01

Background Hypertension is a modifiable risk factor for cognitive impairment, although the relationship between hypertension and cognitive impairment is not fully understood. The objective of this study was to investigate the effect of age on the relationship between blood pressure and cognitive impairment. Methods Blood pressure and global cognitive function information was collected from 1799 participants (age 40–85) who lived in a village in the suburbs of Xi'an, China, during in-person interviews. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score lower than the cutoff value. The effect of age on the relationship between blood pressure parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), and high blood pressure (HBP, SBP≥140 mm Hg and/or DBP≥90 mm Hg)] and cognitive impairment was analyzed by logistic regression models using interaction and stratified analysis. Blood pressure and age were regarded as both continuous and categorical data. Results A total of 231 participants were diagnosed as having cognitive impairment based on our criteria. Interaction analysis for the total population showed that SBP (when regarded as continuous data) was positively correlated with cognitive impairment (OR = 1.130 [95% CI, 1.028–1.242] per 10mmHg, P = 0.011); however, the age by SBP interaction term was negatively correlated with cognitive impairment (OR = 0.989 [95% CI, 0.982–0.997] per 10mmHg×year, P = 0.006), indicating that the relationship between SBP and cognitive impairment was age-dependent (OR = 1.130×0.989(age-55.5) per 10mmHg,40 ≤age≤85). When the blood pressure and age were considered as binary data, the results were similar to those obtained when they were considered as continuous variables. Stratified multivariate analysis revealed that the relationship between SBP (when regarded as continuous data) and cognitive impairment was positive for patients aged 40�

The Age-Dependent Relationship between Blood Pressure and Cognitive Impairment: A Cross-Sectional Study in a Rural Area of Xi'an, China.

PubMed

Shang, Suhang; Li, Pei; Deng, Meiying; Jiang, Yu; Chen, Chen; Qu, Qiumin

2016-01-01

Hypertension is a modifiable risk factor for cognitive impairment, although the relationship between hypertension and cognitive impairment is not fully understood. The objective of this study was to investigate the effect of age on the relationship between blood pressure and cognitive impairment. Blood pressure and global cognitive function information was collected from 1799 participants (age 40-85) who lived in a village in the suburbs of Xi'an, China, during in-person interviews. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score lower than the cutoff value. The effect of age on the relationship between blood pressure parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), and high blood pressure (HBP, SBP≥140 mm Hg and/or DBP≥90 mm Hg)] and cognitive impairment was analyzed by logistic regression models using interaction and stratified analysis. Blood pressure and age were regarded as both continuous and categorical data. A total of 231 participants were diagnosed as having cognitive impairment based on our criteria. Interaction analysis for the total population showed that SBP (when regarded as continuous data) was positively correlated with cognitive impairment (OR = 1.130 [95% CI, 1.028-1.242] per 10mmHg, P = 0.011); however, the age by SBP interaction term was negatively correlated with cognitive impairment (OR = 0.989 [95% CI, 0.982-0.997] per 10mmHg×year, P = 0.006), indicating that the relationship between SBP and cognitive impairment was age-dependent (OR = 1.130×0.989(age-55.5) per 10mmHg,40 ≤age≤85). When the blood pressure and age were considered as binary data, the results were similar to those obtained when they were considered as continuous variables. Stratified multivariate analysis revealed that the relationship between SBP (when regarded as continuous data) and cognitive impairment was positive for patients aged 40-49 years (OR = 1.349 [95% CI: 1

Association between central obesity and circadian parameters of blood pressure from the korean ambulatory blood pressure monitoring registry: Kor-ABP registry.

PubMed

Kang, In Sook; Pyun, Wook Bum; Shin, Jinho; Kim, Ju Han; Kim, Soon Gil; Shin, Gil Ja

2013-10-01

Central obesity has been reported as a risk for atherosclerosis and metabolic syndrome. The influence of central obesity on diurnal blood pressure (BP) has not been established. In this study, we investigated the influence of central obesity on the circadian parameters of BP by 24 hr ambulatory BP monitoring. Total 1,290 subjects were enrolled from the Korean Ambulatory BP registry. Central obesity was defined as having a waist circumference≥90 cm in males and ≥85 cm in females. The central-obese group had higher daytime systolic BP (SBP), nighttime SBP and diastolic BP (DBP) than the non-obese group (all, P<0.001). There were no differences in nocturnal dipping (ND) patterns between the groups. Female participants showed a higher BP mean difference (MD) than male participants with concerns of central obesity (daytime SBP MD 5.28 vs 4.27, nighttime SBP MD 6.48 vs 2.72) and wider pulse pressure (PP). Central obesity within the elderly (≥65 yr) also showed a higher BP MD than within the younger group (daytime SBP MD 8.23 vs 3.87, daytime DBP 4.10 vs 1.59). In conclusion, central obesity has no influence on nocturnal dipping patterns. However, higher SBP and wider PP are associated with central obesity, which is accentuated in women.

Three-step effluent chlorination increases disinfection efficiency and reduces DBP formation and toxicity.

PubMed

Li, Yu; Zhang, Xiangru; Yang, Mengting; Liu, Jiaqi; Li, Wanxin; Graham, Nigel J D; Li, Xiaoyan; Yang, Bo

2017-02-01

Chlorination is extensively applied for disinfecting sewage effluents, but it unintentionally generates disinfection byproducts (DBPs). Using seawater for toilet flushing introduces a high level of bromide into domestic sewage. Chlorination of sewage effluent rich in bromide causes the formation of brominated DBPs. The objectives of achieving a disinfection goal, reducing disinfectant consumption and operational costs, as well as diminishing adverse effects to aquatic organisms in receiving water body remain a challenge in sewage treatment. In this study, we have demonstrated that, with the same total chlorine dosage, a three-step chlorination (dosing chlorine by splitting it into three equal portions with a 5-min time interval for each portion) was significantly more efficient in disinfecting a primary saline sewage effluent than a one-step chlorination (dosing chlorine at one time). Compared to one-step chlorination, three-step chlorination enhanced the disinfection efficiency by up to 0.73-log reduction of Escherichia coli. The overall DBP formation resulting from one-step and three-step chlorination was quantified by total organic halogen measurement. Compared to one-step chlorination, the DBP formation in three-step chlorination was decreased by up to 23.4%. The comparative toxicity of one-step and three-step chlorination was evaluated in terms of the development of embryo-larva of a marine polychaete Platynereis dumerilii. The results revealed that the primary sewage effluent with three-step chlorination was less toxic than that with one-step chlorination, indicating that three-step chlorination could reduce the potential adverse effects of disinfected sewage effluents to aquatic organisms in the receiving marine water. Copyright © 2016 Elsevier Ltd. All rights reserved.

Left ventricular mass predicted by a single reading of ambulatory blood pressure in essential hypertension.

PubMed

Ohmori, S; Matsumura, K; Kajioka, T; Fukuhara, M; Abe, I; Fujishima, M

2000-07-01

The spectral power of heart rate variability has been shown to be negatively correlated with left ventricular mass (LVM), suggesting the contribution of left ventricular hypertrophy to autonomic dysfunction in essential hypertension. However, a simultaneous assessment of autonomic function and ambulatory blood pressure in relation to LVM has not been carried out. The objective of the present study was to elucidate the synergistic effects of ambulatory blood pressure and autonomic nerve activity on the heart. We enrolled 25 ambulant patients with untreated essential hypertension (9 men and 16 women; mean age 50.6 +/- 2.0 years). The ambulatory blood pressure and heart rate variability were simultaneously monitored every 30 min for 24 h. The spectral power of high-frequency (HF: 0.15 to 0.4 Hz) and low-frequency (LF: 0.05 to 0.15 Hz) bands were measured, and the ratio of LF to HF (LF/HF) was calculated. LF/HF and HF were used as indexes of sympathetic and parasympathetic activities, respectively. LVM was determined by echocardiography. Both the average daytime and nighttime systolic ambulatory blood pressures significantly correlated with the LVM index (r= 0.644, p< 0.001; and r= 0.428, p< 0.05; respectively), although there was no such correlation with the clinic blood pressures. In contrast, a single reading of ambulatory systolic blood pressure measured when LF/HF reached a maximum value was significantly correlated with the LVM index independently of age and sex (partial r= 0.484, p< 0.05). These results suggest that the ambulatory systolic blood pressure during increases in the activity of the sympathetic nervous system is able to infer LVM in essential hypertension.

Association of Neck Circumference and Obesity with Blood Pressure among Adolescents in Urban and Rural Population in North Tamil Nadu.

PubMed

Rajagopalan, Archana; Balaji, Nisha

2017-01-01

Since a few studies exist on the association of neck circumference (NC) and obesity with blood pressure (BP) among adolescents in India, we found it highly relevant to measure the NC and body mass index (BMI) using them as indicators of upper body subcutaneous fat and obesity and relate them to BP in a rural and urban adolescent population in North Tamil Nadu. This is a community-based cross-sectional study of descriptive design where 500 students from urban and rural areas were selected, and their BMI, NC, and BP were measured using standardized instruments. Among urban and rural population high and normal NC positively correlated with BMI, systolic BP (SBP) and diastolic BP (DBP), indicating that the data clearly reflects increase in BMI, SBP, and DBP values with increase in NC or vice versa. The correlation was statistically significant ( P < 0.001) significantly higher BMI ( P < 0.01), SBP ( P < 0.05), and NC ( P < 0.001) was observed in urban population than rural. DBP was not significantly different in rural and urban population. 95 th percentile values are significantly higher than rest in both urban and rural population. Only the 95 th percentile values correlate and reflect similar changes in BMI, SBP, and DBP. Our studies indicate a strong association of elevation in BP with high NC and increase in BMI. Overweight and obesity were positively correlated with increase in SBP and DBP.

Blood pressure measurements in the ankle are not equivalent to blood pressure measurements in the arm.

PubMed

Goldstein, Lara Nicole; Wells, Mike; Sliwa, Karen

2014-07-25

Blood pressure (BP) is often measured on the ankle in the emergency department (ED), but this has never been shown to be an acceptable alternative to measurements performed on the arm. To establish whether the differences between arm and ankle non-invasive BP measurements were clinically relevant (i.e. a difference of ≥10 mmHg). This was a prospective cross-sectional study in an urban ED making use of a convenience sample of 201 patients (18 - 50 years of age) who were not in need of emergency medical treatment. BP was measured in the supine position on both arms and ankles with the correct size cuff according to the manufacturer's guidelines. The arm and ankle BP measurements were compared. There was a clinically and statistically significant difference between arm and ankle systolic BP (SBP) and mean arterial pressure (MAP) (-13 mmHg, 95% confidence interval (CI) -28 - 1 mmHg and -5 mmHg, 95% CI -13 - 4 mmHg, respectively), with less difference in diastolic BP (DBP) (2 mmHg, 95% CI -7 - 10 mmHg). Only 37% of SBP measurements and 83% of MAP measurements were within an error range of 10 mmHg, while 95% of DBP measurements agreed within 10 mmHg. While the average differences (or the bias) were generally not large, large variations in individual patients (indicating poor precision) made the prediction of arm BP from ankle measurements unreliable. Ankle BP cannot be used as a substitute for arm BP in the ED.

Genetic factors in familial aggregation of blood pressure of Portuguese nuclear families.

PubMed

Fermino, Rogério César; Seabra, André; Garganta, Rui; Maia, José António Ribeiro

2009-03-01

Despite of the increase in the prevalence of hypertension in Portugal, the importance of genetic factors in blood pressure (BP) has not been studied extensively in our country. To verify the indirect presence of vertical transmission of genetic factors between parents and children in BP values, and to estimate the magnitude of genetic factors contributing for variation in BP values in the population. Sample size comprises 367 individuals (164 parents and 203 children) pertaining the 107 nuclear families participating in 'Familias Activas' project, proceeding from different regions of North Portugal. The BP was measured with Omron model M6 (HEM-7001-E) digital device. SPSS 15.0 was used for data analysis; PEDSTATS was used to verify the structure of each family data. Familial correlations and heritability estimates were computed in FCOR and ASSOC modules of S.A.G.E. version 5.3. For systolic BP (SBP), correlation values were low to moderate (0.21< or = r < or =0.35); for diastolic BP (DBP) values were found to be moderate (0.24< or = r < or =0. 50). Genetic factors explain 43 and 49% of the total variation in SBP and DBP, respectively. A moderate amount of the SBP and the DBP is accounted for by genetic factors.

A cross-sectional survey of blood pressure of a coastal city's resident victims of the 2011 Tohoku tsunami.

PubMed

Murakami, Hitoshi; Akashi, Hidechika; Noda, Shinichiro; Mizoue, Tetsuya; Okazaki, Osamu; Ouchi, Yoshiko; Okaji, Yuki; Kajiwara, Chieko; Miyoshi, Chiaki

2013-06-01

Blood pressure (BP) increase as a reaction to major disasters has been well documented; however, the impact has been underdocumented for tsunamis. This study aimed to confirm whether different levels of flooding/inundation and other damage caused by the 2011 Tohoku (northeast Japan) tsunami were associated with BP among resident victims in Higashi-Matsushima, Miyagi. Cross-sectional household screening was conducted 7-19 weeks after the disaster in administrative areas totally or partially flooded by the tsunami. Systolic and diastolic BP (SBP/DBP) were measured in 4,311 residents. There was a degree-dependent association between SBP/DBP and flooding height above sea level among victims not on antihypertensive medication (P < 0.01 for both). Disruption of the gas supply was also significantly associated with SBP/DBP (P < 0.01 for both). Among individuals on antihypertensive medication, the discontinuation of medication was associated with SBP/DBP (P < 0.01 for both). After adjusting for confounding and multiplicity, a matched case-control analysis did not identify any significant associations between the tsunami or lifeline indicators and high BP (SBP ≥160mm Hg or DBP ≥100mm Hg). This study suggests that after a major tsunami, resident victims in areas highly inundated by flood waters and those with disrupted gas supply are more likely to have higher BP and thus might warrant getting BP screening earlier than other residents. Those with hypertension should be given assistance to resume or commence antihypertensive medication as soon as possible to reduce the risk of cardiovascular morbidity and mortality.

The influence of participant characteristics on the relationship between cuff pressure and level of blood flow restriction.

PubMed

Hunt, Julie E A; Stodart, Clare; Ferguson, Richard A

2016-07-01

Previous investigations to establish factors influencing the blood flow restriction (BFR) stimulus have determined cuff pressures required for complete arterial occlusion, which does not reflect the partial restriction prescribed for this training technique. This study aimed to establish characteristics that should be accounted for when prescribing cuff pressures required for partial BFR. Fifty participants were subjected to incremental blood flow restriction of the upper and lower limbs by proximal pneumatic cuff inflation. Popliteal and brachial artery diameter, blood velocity and blood flow was assessed with Doppler ultrasound. Height, body mass, limb circumference, muscle-bone cross-sectional area, adipose thickness (AT) and arterial blood pressure were measured and used in different models of hierarchical linear regression to predict the pressure at which 60 % BFR (partial occlusion) occurred. Combined analysis revealed a difference in cuff pressures required to elicit 60 % BFR in the popliteal (111 ± 12 mmHg) and brachial arteries (101 ± 12 mmHg). MAP (r = 0.58) and AT (r = -0.45) were the largest independent determinants of lower and upper body partial occlusion pressures. However, greater variance was explained by upper and lower limb regression models composed of DBP and BMI (48 %), and arm AT and DBP (30 %), respectively. Limb circumference has limited impact on the cuff pressure required for partial blood flow restriction which is in contrast to its recognised relationship with complete arterial occlusion. The majority of the variance in partial occlusion pressure remains unexplained by the predictor variables assessed in the present study.

The risk of diabetic renal function impairment in the first decade after diagnosed of diabetes mellitus is correlated with high variability of visit-to-visit systolic and diastolic blood pressure: a case control study.

PubMed

Yeh, Chi-Hsiao; Yu, Hsiu-Chin; Huang, Tzu-Yen; Huang, Pin-Fu; Wang, Yao-Chang; Chen, Tzu-Ping; Yin, Shun-Ying

2017-03-22

The variability of visit-to-visit (VVV) in systolic blood pressure (SBP) and diastolic blood pressure (DBP) is proved as a predictor of renal function deterioration in patients with non-diabetic chronic kidney disease. The purpose of this study was to investigate the relationship of the variability in SBP and the magnitude of renal function impairment for normal renal function patients in the first 10-years diagnosed with type II diabetes mellitus (DM). We retrospectively reviewed the electronic medical records of 789 patients who were first diagnosed with diabetes mellitus during 2000-2002 and regularly followed for 10 years with a total of 53,284 clinic visits. The stages of Chronic Kidney Disease (CKD) of every patient were determined using estimated glomerular filtration rate. The occurrence of nephropathy was defined in those patients whose CKD stages elevated equal or larger than three. Patients were categorized according to the VVV of systolic and diastolic BP into three groups. Patients with high VVV of both SBP and DBP had a 2.44 fold (95% CI: 1.88-3.17, p < 0.001) increased risk of renal function impairment compared with patients with low VVV of both SBP and DBP. Risk of renal function impairment for patients with high VVV of either SBP or DBP had a 1.43-fold increase (95% CI: 1.08-1.89, p = 0.012) compared with patients with low VVV of both SBP and DBP. Cox regression analysis also demonstrated that every 1-year increase of DM diagnosed age significantly raised the risk of renal function impairment with a hazard ration of 1.05 (95% CI: 1.04-1.06, p < 0.001). Not only VVV of SBP but also VVV in DBP is correlated with diabetic nephropathy in the first decade for patients diagnosed with type 2 DM.

Validation of the custo screen pediatric blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Beime, Beate; Deutsch, Cornelia; Krüger, Ralf; Wolf, Andreas; Müller, Peter; Hammel, Gertrud; Bramlage, Peter

2017-05-01

The purpose of the study was to validate the ambulatory blood pressure monitoring (ABPM) device custo screen pediatric in children aged 3 to 12 years according to the International Protocol of the European Society of Hypertension (ESH-IP revision 2010). Thirty-three children were included and systolic and diastolic blood pressure measurements were performed according to the ESH-IP. The protocol was modified for children considering data from the German Health Interview and Examination Survey for Children and Adolescents (KIGGS). The custo screen pediatric met all the requirements of the ESH-IP. The mean difference between the test device and the reference was -1.4 ± 3.0 mmHg for systolic blood pressure (SBP) and -0.7 ± 3.2 mmHg for diastolic blood pressure (DBP). For SBP and DBP, all 99 measurements were within the absolute difference of 10 mmHg between the test device and the reference. As to part 2 of the protocol, for DBP in all subjects, two out of three measurements were within 5 mmHg between the device and the standard, whereas for SBP in 32 of 33 subjects, two out of three measurements were within this range. The custo screen pediatric met all criteria of the ESH-IP review 2010, modified for children from 3 to about 12 years, and can be recommended for ABPM in children. What is Known: • Validation of blood pressure measuring devices is essential to provide patients with an accurate blood pressure measuring device. • The majority of devices has not been validated in children. What is New: • Prior to the present validation, study protocol adjustments of ESH-IP review 2010 for children were defined according to German Health Interview and Examination Survey for Children and Adolescents 2013 (KIGGS). • The custo screen pediatric test device met all criteria of ESH-IP revision 2010, modified for children, and can be recommended for ABPM in children aged 3 to about 12 years.

Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events

NASA Astrophysics Data System (ADS)

Wang, Yan Xiu; Song, Lu; Xing, Ai Jun; Gao, Ming; Zhao, Hai Yan; Li, Chun Hui; Zhao, Hua Ling; Chen, Shuo Hua; Lu, Cheng Zhi; Wu, Shou Ling

2017-02-01

The predictive value of cumulative blood pressure (BP) on all-cause mortality and cardiovascular and cerebrovascular events (CCE) has hardly been studied. In this prospective cohort study including 52,385 participants from the Kailuan Group who attended three medical examinations and without CCE, the impact of cumulative systolic BP (cumSBP) and cumulative diastolic BP (cumDBP) on all-cause mortality and CCEs was investigated. For the study population, the mean (standard deviation) age was 48.82 (11.77) years of which 40,141 (76.6%) were male. The follow-up for all-cause mortality and CCEs was 3.96 (0.48) and 2.98 (0.41) years, respectively. Multivariate Cox proportional hazards regression analysis showed that for every 10 mm Hg·year increase in cumSBP and 5 mm Hg·year increase in cumDBP, the hazard ratio for all-cause mortality were 1.013 (1.006, 1.021) and 1.012 (1.006, 1.018); for CCEs, 1.018 (1.010, 1.027) and 1.017 (1.010, 1.024); for stroke, 1.021 (1.011, 1.031) and 1.018 (1.010, 1.026); and for MI, 1.013 (0.996, 1.030) and 1.015 (1.000, 1.029). Using natural spline function analysis, cumSBP and cumDBP showed a J-curve relationship with CCEs; and a U-curve relationship with stroke (ischemic stroke and hemorrhagic stroke). Therefore, increases in cumSBP and cumDBP were predictive for all-cause mortality, CCEs, and stroke.

Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients.

PubMed

Wang, Yan; Zhang, Jin; Qian, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

2016-07-14

Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24-3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309-3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study.

Effect of dance therapy on blood pressure and exercise capacity of individuals with hypertension: A systematic review and meta-analysis.

PubMed

Conceição, Lino Sergio Rocha; Neto, Mansueto Gomes; do Amaral, Mayra Alves Soares; Martins-Filho, Paulo Ricardo Saquete; Oliveira Carvalho, Vitor

2016-10-01

Dance therapy is a less conventional modality of physical activity in cardiovascular rehabilitation. We performed a systematic review and meta-analysis to investigate the effects of dance therapy in hypertensive patients. Pubmed, Scopus, LILACS, IBECS, MEDLINE and SciELO via Virtual Health Library (Bireme) (from the earliest data available to February 2016) for controlled trials that investigated the effects of dance therapy on exercise capacity, systolic (SBP) and diastolic (DBP) blood pressure in hypertensive patients. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. Four studies met the eligibility criteria. Dance therapy resulted in a significant reduction in systolic blood pressure (WMD -12.01mmHg; 95% CI: -16.08, -7.94mmHg; P<0.0001) when compared with control subjects. Significant reduction in diastolic blood pressure were also found (WMD -3.38mmHg; 95% CI: -4.81, -1.94mmHg; P<0.0001), compared with control group. Exercise capacity showed a significant improvement (WMD 1.31; 95% CI: 0.16, 2.47; P<0.03). A moderate to high heterogeneity was observed in our analysis: I(2)=92% to SBP, I(2)=55% to DBP, and I(2)=82% to exercise capacity. Our meta-analysis showed a positive effect of dance therapy on exercise capacity and reduction of SBP and DBP in individuals with hypertension. However, the moderate to high heterogeneity found in our analysis limits a pragmatic recommendation of dance therapy in individuals with hypertension. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ambulatory (24 hour) blood pressure monitoring in police officers.

PubMed

Tomei, Francesco; Rosati, Maria Valeria; Baccolo, Tiziana Paola; Cherubini, Emilia; Ciarrocca, Manuela; Caciari, Tiziana; Tomao, Enrico

2004-05-01

The aim of the study is to evaluate, by ambulatory (24 h) blood pressure monitoring (ABPM), whether police officers exposed to urban pollutants and possible psycho-social stressors could be at risk of changes in ambulatory systolic blood pressure (SBP), and ambulatory diastolic blood pressure (DBP) compared to controls. After excluding the principal confounding factors, police officers and controls have been subdivided into non-smoker and smoker subjects. Police officers were compared by sex, age, length of service, family history of cardiovascular disease, serum total cholesterol, serum HDL cholesterol, serum LDL cholesterol, plasma triglyceride, body mass index (BMI kg/m (2)) and drinking habits with controls. Smoker police officers were compared with controls also by the smoking habit. In the non smoker group 77 police officers with outdoor activity (38 men and 39 women) and 87 controls with indoor activity (43 men and 44 women) were studied. In the smoker group 43 police officers (21 men and 22 women) and 29 controls (15 men and 14 women) were studied. In non smoker male police officers ambulatory SBP mean values during 24 h, during day-time and during night-time were significantly higher than controls. In the same group ambulatory DBP values during 24 h and between 6 AM and 11 AM and between 10 PM and 6 AM were significantly higher in police officers than controls. The results suggest that occupational exposure to urban pollutants and possible psycho-social stressors could cause changes in ABPM values in male police officers compared to controls.

Pathways from parental educational attainment to adolescent blood pressure.

PubMed

Kwok, Man Ki; Schooling, Catherine Mary; Subramanian, Subu V; Leung, Gabriel M; Kawachi, Ichiro

2016-09-01

Lower parental education is associated with higher adolescent blood pressure (BP). We examined the contribution of modifiable risk factors from infancy to adolescence that could potentially explain the link between parental education and SBP and DBP in the offspring. In a prospective Chinese birth cohort, 'Children of 1997' of 5604 adolescents (68% follow-up), we analyzed the relation between parental educational attainment and sex-specific, age-specific and height-specific BP z-scores at ∼13 years. Using mediation analysis, we examined the contribution of household income at birth (both absolute income and relative income deprivation), exposures during infancy (breastfeeding and early life second-hand smoking), lifestyles during childhood (diet, physical activity and screen-time), weight or BMI status during fetal, infancy, childhood and puberty, pubertal stage as well as parental BMI. We found that adolescent BMI, but not birth weight or infant growth or childhood BMI, mediated the inverse association of parental education with adolescent SBP (proportion mediated: 24%), followed by maternal BMI (proportion mediated: 18%). Factors explaining the link between parental education and DBP were less clear. Absolute income, breastfeeding, childhood diet and physical activity, pubertal stage and paternal BMI did not mediate the association between parental education and adolescent BP. Low parental education is a risk factor for high SBP and, to a lesser extent, DBP in adolescents. Important mediators of this relation include adolescent and maternal body weight.

Relationship quality: effects on ambulatory blood pressure and negative affect in a biracial sample of men and women.

PubMed

Grewen, Karen M; Girdler, Susan S; Light, Kathleen C

2005-06-01

Prospective studies link marriage to better cardiovascular health, but marital dissatisfaction and discord predict increased rates of hypertension, higher blood pressure (BP), greater reactivity to stress, and left ventricular mass. To determine and compare effects of partner status and relationship quality on 24-h BP, urinary norepinephrine and cortisol, and self-reported stress and negative affect. Ambulatory BP (ABP) and 24-h urine collections were obtained during a typical work day in 325 adults, including 139 African Americans (AAs). Participants cohabiting with a spouse or partner were classified into high, intermediate and low relationship quality (RQ) groups and compared to those without partners (Alone). Mean ABP was nearly identical in participants with versus without partners (125.7/76.9 versus 125.9/76.7 mmHg). High RQ subjects had lower mean waking ABP than intermediate/low RQ and Alone groups [systolic blood pressure (SBP), F=3.45; diastolic blood pressure (DBP), F=3.38, P-values <0.05]. High RQ was related to lower SBP and DBP in African Americans, and to lower SBP in Whites. High RQ was also linked to lower SBP and DBP in men, and to lower SBP in women. High RQ subjects reported less negative affect and stress than all other groups (P<0.05). Norepinephrine was lower in partnered versus Alone women regardless of RQ status. Relationship quality is a better predictor of daily BP, affect and stress than partner status. High RQ is linked to lower ABP across race and gender. This reduced ABP may be due, in part, to the stress buffering effects of better RQ and/or the stress enhancing effects of poor RQ.

Childhood social class and adult adiposity and blood-pressure trajectories 36-53 years: gender-specific results from a British birth cohort.

PubMed

Strand, Bjørn Heine; Murray, Emily T; Guralnik, Jack; Hardy, Rebecca; Kuh, Diana

2012-06-01

In this study, the authors investigate gender-specific effects of childhood socio-economic position (SEP) on adiposity and blood pressure at three time points in adulthood. Mixed models were used to assess the association of childhood SEP with body mass index (BMI), waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at ages 36, 43 and 53 years in a British birth cohort. The adverse effect of lower childhood SEP on adiposity increased between ages 36 and 53 years in women (BMI: trend test: p=0.03) and remained stable in men, but the opposite was seen for SBP, where inequalities increased in men (p=0.01). Childhood SEP inequalities in DBP were stable with age in both men and women. Educational attainment mediated some but not all of the effects of childhood SEP on adiposity and SBP, and their rate of change; adult social class was a less important mediator. Childhood SEP is important for adult adiposity and blood pressure across midlife, especially for BMI in women and for blood pressure in men. Thus, pathways to adult health differ for men and women, and public health policies aimed at reducing social inequalities need to start early in life and take account of gender.

Lifetime racial/ethnic discrimination and ambulatory blood pressure: The moderating effect of age.

PubMed

Beatty Moody, Danielle L; Waldstein, Shari R; Tobin, Jonathan N; Cassells, Andrea; Schwartz, Joseph C; Brondolo, Elizabeth

2016-04-01

To determine whether the relationships of lifetime discrimination to ambulatory blood pressure (ABP) varied as a function of age in a sample of Black and Latino(a) adults ages 19 - 65. Participants were 607 Black (n = 318) and Latino(a) (n = 289) adults (49% female) who completed the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), which assesses lifetime exposure to racism/ethnic discrimination. They were outfitted with an ABP monitor to assess systolic and diastolic blood pressure (SBP, DBP) across a 24-hr period. Mixed-level modeling was conducted to examine potential interactive effects of lifetime discrimination and age to 24-hr, daytime, and nighttime ABP after adjustment for demographic, socioeconomic, personality and life stress characteristics, and substance consumption covariates (e.g., smoking, alcohol). There were significant interactions of Age × Lifetime Discrimination on 24-hr and daytime DBP (ps ≤ .04), and in particular significant interactions for the Social Exclusion component of Lifetime Discrimination. Post hoc probing of the interactions revealed the effects of Lifetime Discrimination on DBP were seen for older, but not younger participants. Lifetime discrimination was significantly positively associated with nocturnal SBP, and these effects were not moderated by age. All associations of Lifetime Discrimination to ABP remained significant controlling for recent exposure to discrimination as well as all other covariates. Exposure to racial/ethnic discrimination across the life course is associated with elevated ABP in middle to older aged Black and Latino(a) adults. Further research is needed to understand the mechanisms linking discrimination to ABP over the life course. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Gender differences in the accuracy of time-dependent blood pressure indices for predicting coronary heart disease: A random-effects modeling approach.

PubMed

Brant, Larry J; Ferrucci, Luigi; Sheng, Shan L; Concin, Hans; Zonderman, Alan B; Kelleher, Cecily C; Longo, Dan L; Ulmer, Hanno; Strasak, Alexander M

2010-12-01

Previous studies on blood pressure (BP) indices as a predictor of coronary heart disease (CHD) have provided equivocal results and generally relied on Cox proportional hazards regression methodology, with age and sex accounting for most of the predictive capability of the model. The aim of the present study was to use serially collected BP measurements to examine age-and gender-related differences in BP indices for predicting CHD. The predictive accuracy of time-dependent BP indices for CHD was investigated using a method of risk prediction based on posterior probabilities calculated from mixed-effects regression to utilize intraindividual differences in serial BP measurements according to age changes within gender groups. Data were collected prospectively from 2 community-dwelling cohort studies in the United States (Baltimore Longitudinal Study of Aging [BLSA]) and Europe (Vorarlberg Health Monitoring and Promotion Program [VHM&PP]). The study comprised 152,633 participants (aged 30-74 years) and 610,061 BP measurements. During mean follow-up of 7.5 years, 2457 nonfatal and fatal CHD events were observed. In both study populations, pulse pressure (PP) and systolic blood pressure (SBP) performed best as individual predictors of CHD in women (area under the receiver operating characteristic curve [AUC(ROC)] was between 0.83 and 0.85 for PP, and between 0.77 and 0.81 for SBP). Mean arterial pressure (MAP) and diastolic blood pressure (DBP) performed better for men (AUC(ROC) = 0.67 and 0.65 for MAP and DBP, respectively, in the BLSA; AUC(ROC) = 0.77 and 0.75 in the VHM&PP) than for women (AUC(ROC) = 0.60 for both MAP and DBP in the BLSA; AUC(ROC) = 0.75 and 0.52, respectively, in the VHM&PP). The degree of discrimination in both populations was overall greater but more varied for all BP indices for women (AUC(ROC) estimates between 0.85 [PP in the VHM&PP] and 0.52 [DBP in the VHM&PP]) than for men (AUC(ROC) estimates between 0.78 [MAP + PP in the VHM&PP] and 0.63 [PP

A synoptic approach to weather conditions discloses a relationship with ambulatory blood pressure in hypertensives.

PubMed

Morabito, Marco; Crisci, Alfonso; Orlandini, Simone; Maracchi, Giampiero; Gensini, Gian F; Modesti, Pietro A

2008-07-01

Higher blood pressure (BP) values in cold than in hot months has been documented in hypertensives. These changes may potentially contribute to the observed excess winter cardiovascular mortality. However, the association with weather has always been investigated by considering the relationship with a single variable rather than considering the combination of ground weather variables characterizing a specific weather pattern (air mass (AM)). We retrospectively investigate in Florence (Italy) the relationship between BP and specific AMs in hypertensive subjects (n = 540) referred to our Hypertension Unit for 24-h ambulatory BP monitoring during the period of the year characterized by the highest weather variability (winter). Five different winter daily AMs were classified according to the combination of ground weather data (air temperature, cloud cover, relative humidity, atmospheric pressure, wind speed, and direction). Multiple variable analysis selected the AM as a significant predictor of mean 24-h BP (P < 0.01 for diastolic BP (DBP) and P < 0.05 for systolic BP (SBP)), daytime DBP (P < 0.001) and nighttime BP (P < 0.01 for both SBP and DBP), with higher BP values observed in cyclonic (unstable, cloudy, and mild weather) than in anticyclonic (settled, cloudless, and cold weather) days. When the association with 2-day sequences of AMs was considered, an increase in ambulatory BP followed a sudden day-to-day change of weather pattern going from anticyclonic to cyclonic days. The weather considered as a combination of different weather variables may affect BP. The forecast of a sudden change of AM could provide important information helpful for hypertensives during winter.

LB01.06: VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CARDIOVASCULAR OUTCOMES IN FELODIPINE EVENT REDUCTION STUDY.

PubMed

Zhang, Y; Zhang, X; Liu, L; Zanchetti, A

2015-06-01

Many antihypertensive outcome trials have shown that visit-to-visit blood pressure variability is correlated closely with clinical outcomes in hypertensive patients. The objective of the study was to investigate the relationship between visit-to-visit blood pressure variability (BPV) and the major cardiovascular outcomes in the Chinese hypertensive patients. Felodipine Event Reduction (FEVER) study was a double-blind, randomized trial on 9711 Chinese hypertensive patients, in whom cardiovascular outcomes were significantly reduced by more intense therapy achieving a mean of 138 mmHg SBP compared with less-intense therapy achieving a mean of 142 mmHg. Visit-to-visit BPV during the follow-up period [defined as standard deviation (SD), coefficient of variation (CV), and average real variability(ARV)] was derived from casual cuff BP measures after six months follow-up until the end of the study. Hazard ratios (HRs), for the incidence of CVD associated with SD, CV, and ARV of SBP and DBP were calculated using Cox proportional hazard models. Overall predictive power [area under receiver operating characteristic (AUC ROC) curve] of the level of blood pressure, blood pressure variability and other baseline characteristics was calculated. In FEVER study, visit-to-visit variability in SBP were significant predictors of subsequent stroke [eg, hazard ratios [HR] for ARV, SD and CV was 1.071 (95% CI: 1.025-1.118), 1.373 (95% CI: 1.159-1.626) and 0.572 (95% CI: 0.451-0,726)]. Visit-to-visit variability in DBP were also showed similar trend [eg, HR for ARV, SD and CV was 1.066 (95% CI: 0.992-1.145), 1.931 (95% CI: 1.435-2.598) and 0.558 (95% CI: 0.438-0,710)]. However, using the analysis of AUC ROC analysis, the risk importance sequence of the stroke events in this cohort was level of SBP, age, level of DBP ARV, SD, sex, CV and treatment. Visit-to-visit blood pressure variability has some effects on the cardiovascular outcomes in the Chinese hypertensive patents in the cohort in

Removal of disinfection byproduct (DBP) precursors in water by two-stage biofiltration treatment.

PubMed

Fu, Jie; Lee, Wan-Ning; Coleman, Clark; Nowack, Kirk; Carter, Jason; Huang, Ching-Hua

2017-10-15

The removal of precursors of 36 disinfection byproducts (DBPs) in effluents from flocculation/sedimentation process was evaluated across a pilot-scale two-stage biofiltration process, i.e., a sand/anthracite (SA) biofilter (empty bed contact time (EBCT) of 7.5 min) coupled with a biologically-active granular activated carbon (GAC) contactor (EBCT of 15 min). The biofiltration process exhibited a good capacity for removal of the total DBP formation potential (DBPFP) (by 25.90 ± 2.63%), and GAC contactors contributed most to the DBPFP removal (accounting for 60.63 ± 16.64% of the total removal). The removal percentage of DBPFPs of different structure types was in the following order: halonitroalkanes (58.50%) > haloaldehydes (33.62%) > haloacetic acids (HAAs, 28.13%) > haloalkanes (20.46%) > haloketones (13.46%) > nitrosamines (10.23%) > halonitriles (-8.82%) > haloalkenes (-9.84%). The precursors of bromo-DBPs (containing only bromine atoms) and maximal halogenated DBPs (containing 3 & 4 halo atoms) were removed largely compared to other DBPs. Among the total DBPFP, trihalomethanes (THMs), HAAs, and chloral hydrate were the dominant DBPs, and they accounted for >92% of the total targeted DBPs by weight. Pearson correlation analysis (CA) and principal components analysis (PCA) indicated a significant association among these dominant DBPs. Canonical correspondence analysis (CCA) revealed specific ultraviolet absorbance (SUVA 254 ) could serve as a good surrogate parameter for DBPFP. Pre-chlorination upstream of the biofilters may not greatly impact the overall removal of DBPFP by SA/GAC biofiltration. In addition, results showed that SA/GAC biofiltration was a useful procedure to remove the inorganic DBP chlorite. Copyright © 2017 Elsevier Ltd. All rights reserved.

The associations of diastolic blood pressure with the risk of stroke in Western and Eastern populations.

PubMed

Ni Mhurchu, C; Rodgers, A; MacMahon, S

1999-01-01

This paper reviews evidence from two overviews of prospective, observational studies of the association of diastolic blood pressure (DBP) with the risk of stroke in populations from the US and Europe and populations from China and Japan. The Western overview included seven studies involving a total of 405,511 individuals. During a mean follow-up period of 11 years, 843 strokes were observed. The Eastern overview included 18 cohorts involving a total of 124,774 participants. During a mean follow-up duration of 9 years, 1,798 strokes were observed. The shape of the association between usual DBP and the risk of stroke was similar in Western and Eastern populations, but in Eastern populations the size of the association was about 50% steeper than that in Western populations. This may be due, at least in part, to cerebral haemorrhage comprising a greater proportion of total stroke in Eastern populations. This finding, together with the high stroke rates in many Eastern Asian populations, suggests that the potential benefits of blood pressure lowering may be greater in Eastern Asia.

The combined effects of genetic risk and perceived discrimination on blood pressure among African Americans in the Jackson Heart Study

PubMed Central

Taylor, Jacquelyn Y.; Sun, Yan V.; Barcelona de Mendoza, Veronica; Ifatunji, Mosi; Rafferty, Jane; Fox, Ervin R.; Musani, Solomon K.; Sims, Mario; Jackson, James S.

2017-01-01

Abstract Both genomics and environmental stressors play a significant role in increases in blood pressure (BP). In an attempt to further explain the hypertension (HTN) disparity among African Americans (AA), both genetic underpinnings (selected candidate genes) and stress due to perceived racial discrimination (as reported in the literature) have independently been linked to increased BP among AAs. Although Gene x Environment interactions on BP have been examined, the environmental component of these investigations has focused more on lifestyle behaviors such as smoking, diet, and physical activity, and less on psychosocial stressors such as perceived discrimination. The present study uses candidate gene analyses to identify the relationship between Everyday Discrimination (ED) and Major Life Discrimination (MLD) with increases in systolic BP (SBP) and diastolic BP (DBP) among AA in the Jackson Heart Study. Multiple linear regression models reveal no association between discrimination and BP after adjusting for age, sex, body mass index (BMI), antihypertensive medication use, and current smoking status. Subsequent candidate gene analysis identified 5 SNPs (rs7602215, rs3771724, rs1006502, rs1791926, and rs2258119) that interacted with perceived discrimination and SBP, and 3 SNPs (rs2034454, rs7602215, and rs3771724) that interacted with perceived discrimination and DBP. Most notably, there was a significant SNP × discrimination interaction for 2 SNPs on the SLC4A5 gene: rs3771724 (MLD: SBP P = .034, DBP P = .031; ED: DBP: P = .016) and rs1006502 (MLD: SBP P = .034, DBP P = .030; ED: DBP P = .015). This study supports the idea that SNP × discrimination interactions combine to influence clinically relevant traits such as BP. Replication with similar epidemiological samples is required to ascertain the role of genes and psychosocial stressors in the development and expression of high BP in this understudied population. PMID:29069027

The combined effects of genetic risk and perceived discrimination on blood pressure among African Americans in the Jackson Heart Study.

PubMed

Taylor, Jacquelyn Y; Sun, Yan V; Barcelona de Mendoza, Veronica; Ifatunji, Mosi; Rafferty, Jane; Fox, Ervin R; Musani, Solomon K; Sims, Mario; Jackson, James S

2017-10-01

Both genomics and environmental stressors play a significant role in increases in blood pressure (BP). In an attempt to further explain the hypertension (HTN) disparity among African Americans (AA), both genetic underpinnings (selected candidate genes) and stress due to perceived racial discrimination (as reported in the literature) have independently been linked to increased BP among AAs. Although Gene x Environment interactions on BP have been examined, the environmental component of these investigations has focused more on lifestyle behaviors such as smoking, diet, and physical activity, and less on psychosocial stressors such as perceived discrimination.The present study uses candidate gene analyses to identify the relationship between Everyday Discrimination (ED) and Major Life Discrimination (MLD) with increases in systolic BP (SBP) and diastolic BP (DBP) among AA in the Jackson Heart Study. Multiple linear regression models reveal no association between discrimination and BP after adjusting for age, sex, body mass index (BMI), antihypertensive medication use, and current smoking status.Subsequent candidate gene analysis identified 5 SNPs (rs7602215, rs3771724, rs1006502, rs1791926, and rs2258119) that interacted with perceived discrimination and SBP, and 3 SNPs (rs2034454, rs7602215, and rs3771724) that interacted with perceived discrimination and DBP. Most notably, there was a significant SNP × discrimination interaction for 2 SNPs on the SLC4A5 gene: rs3771724 (MLD: SBP P = .034, DBP P = .031; ED: DBP: P = .016) and rs1006502 (MLD: SBP P = .034, DBP P = .030; ED: DBP P = .015).This study supports the idea that SNP × discrimination interactions combine to influence clinically relevant traits such as BP. Replication with similar epidemiological samples is required to ascertain the role of genes and psychosocial stressors in the development and expression of high BP in this understudied population.

Effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on blood pressure and markers of arterial stiffness in patients with type 2 diabetes mellitus: a post hoc analysis.

PubMed

Pfeifer, Michael; Townsend, Raymond R; Davies, Michael J; Vijapurkar, Ujjwala; Ren, Jimmy

2017-02-27

Physiologic determinants, such as pulse pressure [difference between systolic blood pressure (SBP) and diastolic BP (DBP)], mean arterial pressure (2/3 DBP + 1/3 SBP), and double product [beats per minute (bpm) × SBP], are linked to cardiovascular outcomes. The effects of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, on pulse pressure, mean arterial pressure, and double product were assessed in patients with type 2 diabetes mellitus (T2DM). This post hoc analysis was based on pooled data from four 26-week, randomized, double-blind, placebo-controlled studies evaluating canagliflozin in patients with T2DM (N = 2313) and a 6-week, randomized, double-blind, placebo-controlled, ambulatory BP monitoring (ABPM) study evaluating canagliflozin in patients with T2DM and hypertension (N = 169). Changes from baseline in SBP, DBP, pulse pressure, mean arterial pressure, and double product were assessed using seated BP measurements (pooled studies) or averaged 24-h BP assessments (ABPM study). Safety was assessed based on adverse event reports. In the pooled studies, canagliflozin 100 and 300 mg reduced SBP (-4.3 and -5.0 vs -0.3 mmHg) and DBP (-2.5 and -2.4 vs -0.6 mmHg) versus placebo at week 26. Reductions in pulse pressure (-1.8 and -2.6 vs 0.2 mmHg), mean arterial pressure (-3.1 and -3.3 vs -0.5 mmHg), and double product (-381 and -416 vs -30 bpm × mmHg) were also seen with canagliflozin 100 and 300 mg versus placebo. In the ABPM study, canagliflozin 100 and 300 mg reduced mean 24-h SBP (-4.5 and -6.2 vs -1.2 mmHg) and DBP (-2.2 and -3.2 vs -0.3 mmHg) versus placebo at week 6. Canagliflozin 300 mg provided reductions in pulse pressure (-3.3 vs -0.8 mmHg) and mean arterial pressure (-4.2 vs -0.6 mmHg) compared with placebo, while canagliflozin 100 mg had more modest effects on these parameters. Canagliflozin was generally well tolerated in both study populations. Canagliflozin improved all three cardiovascular physiologic

Relationship of blood pressure, behavioral mood state, and physical activity following caffeine ingestion in younger and older women.

PubMed

Arciero, Paul J; Ormsbee, Michael J

2009-08-01

The purpose of this study was to examine the age-related differences in blood pressure, heart rate, and behavioral mood state after caffeine ingestion in younger and older women. Using a placebo-controlled, double-blind design, 10 younger (Y; 18-22 years) and 10 older (O; 50-67 years) healthy women who were moderate consumers of caffeine (self-reported mean intake: Y, 139 +/- 152 mg.day-1; O, 204 +/- 101 mg.day-1) were investigated. All volunteers were characterized for fasting plasma glucose, insulin, free-fatty acids and caffeine levels, body composition, cardiovascular fitness, physical activity, and energy intake. Before and after placebo and caffeine ingestion (5 mg.kg-1 fat-free mass; approximately 208-270 mg) test days, the following variables were measured in all subjects: plasma caffeine levels, heart rate, blood pressure, and behavioral mood state. Results showed that, following caffeine ingestion: (i) both systolic and diastolic blood pressure (SBP and DBP, respectively) increased significantly (p < 0.05) in the older women (SBP, 128.4 +/- 14.2 vs. 132.1 +/- 13.0 mm Hg (3%); DBP, 80.2 +/- 6.9 vs. 83.4 +/- 7.5 mm Hg (4%), whereas only DBP increased in the younger women (67.1 +/- 4.7 vs. 69.9 +/- 5.4 mm Hg (4.2%); p < 0.05); (ii) heart rate decreased significantly (Y, 59.2 +/- 8.7 to 53.9 +/- 10.6 beats.min-1 (p < 0.05); O, 61.9 +/- 9.2 to 59.2 +/- 8.4 beats.min-1 (p < 0.05)) in both groups; and (iii) self-reported feelings of tension and vigor increased and feelings of fatigue decreased (p < 0.05) in younger women, whereas depression decreased (p < or = 0.05) in older women. Self-reported level of physical activity was inversely related to change in DBP following caffeine ingestion in younger women. In conclusion, blood pressure response is augmented and subjective feelings of behavioral mood state are attenuated to a greater degree in older than in younger women following acute caffeine ingestion. Less physically active younger women are more vulnerable

Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial.

PubMed

Akilen, R; Tsiami, A; Devendra, D; Robinson, N

2010-10-01

To determine the blood glucose lowering effect of cinnamon on HbA1c, blood pressure and lipid profiles in people with type 2 diabetes. 58 type 2 diabetic patients (25 males and 33 females), aged 54.9 ± 9.8, treated only with hypoglycemic agents and with an HbA1c more than 7% were randomly assigned to receive either 2g of cinnamon or placebo daily for 12 weeks. After intervention, the mean HbA1c was significantly decreased (P<0.005) in the cinnamon group (8.22% to 7.86%) compared with placebo group (8.55% to 8.68%). Mean systolic and diastolic blood pressures (SBP and DBP) were also significantly reduced (P<0.001) after 12 weeks in the cinnamon group (SBP: 132.6 to 129.2 mmHg and DBP: 85.2 to 80.2 mmHg) compared with the placebo group (SBP: 134.5 to 134.9 mmHg and DBP: 86.8 to 86.1 mmHg). A significant reduction in fasting plasma glucose (FPG), waist circumference and body mass index (BMI) was observed at week 12 compared to baseline in the cinnamon group, however, the changes were not significant when compared to placebo group. There were no significant differences in serum lipid profiles of total cholesterol, triglycerides, HDL and LDL cholesterols neither between nor within the groups. Intake of 2g of cinnamon for 12 weeks significantly reduces the HbA1c, SBP and DBP among poorly controlled type 2 diabetes patients. Cinnamon supplementation could be considered as an additional dietary supplement option to regulate blood glucose and blood pressure levels along with conventional medications to treat type 2 diabetes mellitus. © 2010 The Authors. Diabetic Medicine © 2010 Diabetes UK.

The relationship of age-adjusted Charlson comorbidity ındex and diurnal variation of blood pressure.

PubMed

Kalaycı, Belma; Erten, Yunus Turgay; Akgün, Tunahan; Karabag, Turgut; Kokturk, Furuzan

2018-03-05

Charlson Comorbidity index (CCI) is a scoring system to predict prognosis and mortality. It exhibits better utility when combined with age, age-adjusted Charlson Comorbidity Index (ACCI). The aim of this study was to evaluate the relationship between ACCI and diurnal variation of blood pressure parameters in hypertensive patients and normotensive patients. We enrolled 236 patients. All patients underwent a 24-h ambulatory blood pressure monitoring (ABPM) for evaluation of dipper or non-dipper pattern. We searched the correlation between ACCI and dipper or non-dipper pattern and other ABPM parameters. To further investigate the role of these parameters in predicting survival, a multivariate analysis using the Cox proportional hazard model was performed. 167 patients were in the hypertensive group (87 patients in non-dipper status) and 69 patients were in the normotensive group (41 patients in non-dipper status) of all study patients. We found a significant difference and negative correlation between AACI and 24-h diastolic blood pressure (DBP), awake DBP, awake mean blood pressure (MBP) and 24-h MBP and awake systolic blood pressure(SBP). Night decrease ratio of blood pressure had also a negative correlation with ACCI (p = 0.003, r = -0.233). However, we found a relationship with non-dipper pattern and ACCI in the hypertensive patients (p = 0.050). In multivariate Cox analysis sleep MBP was found related to mortality like ACCI (p = 0.023, HR = 1.086, %95 CI 1.012-1.165) Conclusion: ACCI was statistically significantly higher in non-dipper hypertensive patients than dipper hypertensive patients while ACCI had a negative correlation with blood pressure. Sleep MBP may predict mortality.

Sustained use of biogas fuel and blood pressure among women in rural Nepal

PubMed Central

Neupane, Maniraj; Basnyat, Buddha; Fischer, Rainald; Froeschl, Guenter; Wolbers, Marcel; Rehfuess, Eva A

2015-01-01

Background More than two fifths of the world's population cook with solid fuels and are exposed to household air pollution (HAP). As of now, no studies have assessed whether switching to alternative fuels like biogas could impact cardiovascular health among cooks previously exposed to solid fuel use. Methods We conducted a propensity score matched cross-sectional study to explore if the sustained use of biogas fuel for at least ten years impacts blood pressure among adult female cooks of rural Nepal. We recruited one primary cook ≥30 years of age from each biogas (219 cooks) and firewood (300 cooks) using household and measured their systolic (SBP) and diastolic blood pressure (DBP). Household characteristics, kitchen ventilation and 24-h kitchen carbon monoxide were assessed. We matched cooks by age, body mass index and socio-economic status score using propensity scores and investigated the effect of biogas use through multivariate regression models in two age groups, 30–50 years and >50 years to account for any post-menopausal changes. Results We found substantially reduced 24-h kitchen carbon monoxide levels among biogas-using households. After matching and adjustment for smoking, kitchen characteristics, ventilation status and additional fuel use, the use of biogas was associated with 9.8 mmHg lower SBP [95% confidence interval (CI), −20.4 to 0.8] and 6.5 mmHg lower DBP (95% CI, −12.2 to −0.8) compared to firewood users among women >50 years of age. In this age group, biogas use was also associated with 68% reduced odds [Odds ratio 0.32 (95% CI, 0.14 to 0.71)] of developing hypertension. These effects, however, were not identified in younger women aged 30–50 years. Conclusions Sustained use of biogas for cooking may protect against cardiovascular disease by lowering the risk of high blood pressure, especially DBP, among older female cooks. These findings need to be confirmed in longitudinal or experimental studies. PMID:25460655

Sustained use of biogas fuel and blood pressure among women in rural Nepal.

PubMed

Neupane, Maniraj; Basnyat, Buddha; Fischer, Rainald; Froeschl, Guenter; Wolbers, Marcel; Rehfuess, Eva A

2015-01-01

More than two fifths of the world's population cook with solid fuels and are exposed to household air pollution (HAP). As of now, no studies have assessed whether switching to alternative fuels like biogas could impact cardiovascular health among cooks previously exposed to solid fuel use. We conducted a propensity score matched cross-sectional study to explore if the sustained use of biogas fuel for at least ten years impacts blood pressure among adult female cooks of rural Nepal. We recruited one primary cook ≥ 30 years of age from each biogas (219 cooks) and firewood (300 cooks) using household and measured their systolic (SBP) and diastolic blood pressure (DBP). Household characteristics, kitchen ventilation and 24-h kitchen carbon monoxide were assessed. We matched cooks by age, body mass index and socio-economic status score using propensity scores and investigated the effect of biogas use through multivariate regression models in two age groups, 30-50 years and >50 years to account for any post-menopausal changes. We found substantially reduced 24-h kitchen carbon monoxide levels among biogas-using households. After matching and adjustment for smoking, kitchen characteristics, ventilation status and additional fuel use, the use of biogas was associated with 9.8 mmHg lower SBP [95% confidence interval (CI), -20.4 to 0.8] and 6.5 mmHg lower DBP (95% CI, -12.2 to -0.8) compared to firewood users among women >50 years of age. In this age group, biogas use was also associated with 68% reduced odds [Odds ratio 0.32 (95% CI, 0.14 to 0.71)] of developing hypertension. These effects, however, were not identified in younger women aged 30-50 years. Sustained use of biogas for cooking may protect against cardiovascular disease by lowering the risk of high blood pressure, especially DBP, among older female cooks. These findings need to be confirmed in longitudinal or experimental studies. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

The effect of depression on sleep quality and the circadian rhythm of ambulatory blood pressure in older patients with hypertension.

PubMed

Ma, Lina; Li, Yun

2017-05-01

To explore the effect of depression on the sleep quality, and the circadian rhythm of ambulatory blood pressure in patients with essential hypertension. A total of 73 older patients with hypertension were screened for depression and divided into two groups. The Pittsburgh Sleep Quality Index (PSQI) and the circadian rhythm of ambulatory blood pressure were compared between the non-depressed (control) and depressed (case) group. In the case group, 24h ambulatory SBP and DBP, and nocturnal SBP and DBP were higher than in the control group, and the circadian rhythm of non-dipper was higher (67.22% vs 40.13%，P<0.01). There was a positive correlation between PSQI and depression (r=0.432, P<0.01). There was a significant correlation between sleep quality and depression in older patients with hypertension. Depression increases the circadian rhythm of non-dipper in older patients with hypertension. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of posttraumatic stress disorder on blood pressure and heart rate in a veteran population.

PubMed

Paulus, Eric J; Argo, Tami R; Egge, Jason A

2013-02-01

Hyperarousal is a hallmark of posttraumatic stress disorder (PTSD). PTSD has been associated with increased blood pressure (BP) and heart rate (HR) in veteran populations. We retrospectively identified male patients consulted to outpatient psychiatry at the Iowa City Veterans Affairs Healthcare System. Patients were divided into PTSD (n = 88) and non-PTSD (n = 98) groups. All PTSD patients and a subset of non-PTSD patients had documented blast exposure during service. The study investigated whether patients with PTSD had higher systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) than patients without PTSD. The effect of trauma exposure on BP was also examined. Mean SBP (133.8 vs. 122.3 mm Hg; p < .001), DBP (87.6 vs. 78.6 mm Hg; p < .001), and HR (78.9 vs. 73.1 bpm; p < .001) were all significantly higher in the PTSD group. Trauma-exposed patients without PTSD had significantly higher BP than nonexposed patients. The prevalence of hypertension (HTN) was 34.1% (diagnosed and undiagnosed) among PTSD patients. Patients with PTSD had higher BP and HR compared to patients without PTSD. Trauma exposure may increase BP in this population. These findings will increase awareness about the cardiovascular implications of PTSD. Copyright © 2013 International Society for Traumatic Stress Studies.

Ethnic and socioeconomic influences on childhood blood pressure: the Child Heart and Health Study in England.

PubMed

Thomas, Claudia; Nightingale, Claire M; Donin, Angela S; Rudnicka, Alicja R; Owen, Christopher G; Cook, Derek G; Whincup, Peter H

2012-11-01

Compared to UK white European adults, UK black African-Caribbean adults have higher mean SBP and DBP; UK South Asian adults have higher mean DBP but lower SBP. Information on blood pressure (BP) in UK children from different ethnic groups is limited. The aim of this study was to compare BP levels in UK children of black African-Caribbean, South Asian and white European origin. BP and body build were measured in 5666 children in a cross-sectional study of UK primary school children of South Asian, black African-Caribbean and white European origin aged 9-10 years. Ethnic and socioeconomic differences in BP were obtained from multilevel linear regression models. After adjustment for height and adiposity, black African-Caribbean children had lower mean SBP than white Europeans [difference 1.62  mmHg, 95% confidence interval (CI) 0.86-2.38  mmHg], whereas mean DBP was similar (difference 0.58  mmHg, 95% CI -0.12 to 1.28  mmHg). The lower SBP was particularly marked in black African rather than Caribbean children (P  =  0.002). South Asian children had lower mean SBP (difference 1.10  mmHg, 95% CI 0.34-1.86  mmHg) than white Europeans and higher mean DBP (difference 1.07  mmHg, 95% CI 0.37-1.76  mmHg). The higher mean DBP was particularly marked among Indian and Bangladeshi, rather than Pakistani, children (P  =  0.01). BP was unrelated to socioeconomic circumstances; ethnic differences in BP were not affected by socioeconomic adjustment. A BP pattern similar to that in adults is present in UK South Asian but not in UK black African-Caribbean children at 9-10 years.

Family history of diabetes modifies the effect of blood pressure for incident diabetes in Middle Eastern women: Tehran Lipid and Glucose Study.

PubMed

Hatami, M; Hadaegh, F; Khalili, D; Sheikholeslami, F; Azizi, F

2012-02-01

Elevated blood pressure (BP) may lead to incident diabetes. However, data about the effect of different BP components on incident diabetes in Middle Eastern women is lacking. We evaluated systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP) and mean arterial pressure (MAP) as independent predictors of diabetes in Iranian women. We performed a population-based prospective study among 3028 non-diabetic women, aged ≥20 years. Odds ratios (ORs) of diabetes were calculated for every 1 s.d. increase in SBP, DBP, PP and MAP. During ≈6 years of follow-up, 220 women developed diabetes. There were significant interactions between family history of diabetes and SBP, PP and MAP (P≤0.01) in predicting incident diabetes. In women without a family history of diabetes, all BP components were significantly associated with diabetes in the age-adjusted model; the risk factor-adjusted ORs were significant (P<0.05) for SBP, PP and MAP (1.30, 1.34 and 1.27, respectively) with similar predictive ability (area under the receiver operating characteristic curve ≈83%). In women with family history of diabetes, in the age-adjusted model, SBP, DBP and MAP were associated with diabetes; in multivariable model, they were not independent predictors of diabetes. In conclusion, in women without family history of diabetes, SBP, PP and MAP, were independent predictors of diabetes with almost similar predictive ability; hence, in the evaluation of the risk of BP components for prediction of diabetes, the presence of family history of diabetes should be considered.

The relation of body mass index and blood pressure in Iranian children and adolescents aged 7-18 years old.

PubMed

Hosseini, M; Ataei, N; Aghamohammadi, A; Yousefifard, M; Taslimi, Sh; Ataei, F

2010-01-01

The obesity and hypertension are the major risk factors of several life threatening diseases. The present study was aimed to investigate the relation between body mass index (BMI) the validated index of adiposity and different aspect of blood pressure (BP). Systolic and diastolic blood pressures and also weight and height of 7 to 18 years old children and adolescent collected in 2002 and 2004 respectively. Data was consisted of 14865 schoolchildren and adolescents from representative sample of country. BMI was classified according to CDC 2000 standards into normal (BMI<85th percentile), at risk of overweight (BMI≥85th and <95th percentile) and overweight (BMI≥95th percentile). Then, age-sex specific prevalence of being overweight was derived. ANOVA was used to investigate the effect of BMI on systolic blood pressure and diastolic blood pressure and mean arterial pressure of participants. Mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly increased with BMI (P< 0.0001) and age groups (P< 0.0001), and was significantly (P< 0.0001) higher in boys than girls especially in older ages. (P< 0.0001, interaction of age and BMI level). The proportion of being overweight was significantly higher in boys than girls was (7.4% vs. 3.6%; P< 0.0001). There is an association between BP and BMI in children and adolescence. SBP, DBP and MAP are associated with rise in BMI and age, which was lower in girls. This data can provide basics for public health policy makers and primary prevention policies in the country.

Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients

PubMed Central

Wang, Yan; Zhang, Jin; Qian, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

2016-01-01

Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24–3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309–3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study. PMID:27412818

Deep learning ensemble with asymptotic techniques for oscillometric blood pressure estimation.

PubMed

Lee, Soojeong; Chang, Joon-Hyuk

2017-11-01

This paper proposes a deep learning based ensemble regression estimator with asymptotic techniques, and offers a method that can decrease uncertainty for oscillometric blood pressure (BP) measurements using the bootstrap and Monte-Carlo approach. While the former is used to estimate SBP and DBP, the latter attempts to determine confidence intervals (CIs) for SBP and DBP based on oscillometric BP measurements. This work originally employs deep belief networks (DBN)-deep neural networks (DNN) to effectively estimate BPs based on oscillometric measurements. However, there are some inherent problems with these methods. First, it is not easy to determine the best DBN-DNN estimator, and worthy information might be omitted when selecting one DBN-DNN estimator and discarding the others. Additionally, our input feature vectors, obtained from only five measurements per subject, represent a very small sample size; this is a critical weakness when using the DBN-DNN technique and can cause overfitting or underfitting, depending on the structure of the algorithm. To address these problems, an ensemble with an asymptotic approach (based on combining the bootstrap with the DBN-DNN technique) is utilized to generate the pseudo features needed to estimate the SBP and DBP. In the first stage, the bootstrap-aggregation technique is used to create ensemble parameters. Afterward, the AdaBoost approach is employed for the second-stage SBP and DBP estimation. We then use the bootstrap and Monte-Carlo techniques in order to determine the CIs based on the target BP estimated using the DBN-DNN ensemble regression estimator with the asymptotic technique in the third stage. The proposed method can mitigate the estimation uncertainty such as large the standard deviation of error (SDE) on comparing the proposed DBN-DNN ensemble regression estimator with the DBN-DNN single regression estimator, we identify that the SDEs of the SBP and DBP are reduced by 0.58 and 0.57  mmHg, respectively. These

Sex, Obesity, and Blood Pressure Among African American Adolescents: The Jackson Heart KIDS Pilot Study.

PubMed

Bruce, Marino A; Beech, Bettina M; Norris, Keith C; Griffith, Derek M; Sims, Mario; Thorpe, Roland J

2017-09-01

This study examined the degree to which sex, weight status, and the presence of hypertension and obesity in parents/grandparents were associated with systolic (SBP) and diastolic (DBP) blood pressure (BP) among African American youth in a pilot offspring study examining obesity-related cardiovascular disease (CVD) risks among adolescents. Fully adjusted linear regression models of the total sample produced results indicating that obesity was associated with BP (SBP: β = 7.08, P < 0.01; DBP: β = 8.14, P < 0.001). Sex-stratified analyses indicated that overweight and obesity were associated with SBP (overweight: β = 6.77, P < 0.01; obese: β = 11.65, P < 0.001) and obesity was correlated with DBP (β = 9.86, P < 0.001) among males. For females, overweight was correlated with SBP (β = 4.11, P < 0.05) while obesity was associated with DBP (β = 6.98, P < 0.01). Attempting to lose weight was inversely related to SBP (β = -4.01, P < 0.05) in the full sample and among males (β = -11.94, P < 0.001). Familial presence of hypertension and/or obesity was significantly associated with SBP among adolescent females but not males. The relationship between weight status, familial hypertension and obesity status, and BP among adolescents vary by sex. This study underscores the need for additional research investigating the relationship between individual sex, weight status, BP and familial BP, and obesity status on risk among African American adolescents. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Increase in body mass index and waist circumference is associated with high blood pressure in children and adolescents in Mexico city.

PubMed

Flores-Huerta, Samuel; Klünder-Klünder, Miguel; Reyes de la Cruz, Lorenzo; Santos, José Ignacio

2009-04-01

Currently, obesity has become a worldwide health problem affecting even children and yet little is known about its role as a determinant of high blood pressure in this age group. The aim of this epidemiological study was to determine the relationship between the increment of body mass index (BMI) and waist circumference (WC) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children and teenagers. The study was performed in Mexico City schools. Overweight was established if BMI ranged from >or=85(th) to <95(th) percentiles and obesity if BMI was >or=95(th) percentile. WC was classified in two categories, one ranging between the 75(th) and 89.9(th) percentiles and >90(th) percentile. Blood pressure was measured four times during one visit by the auscultatory method. High blood pressure was defined if the levels were >or=90(th) percentile according to the guidelines of the 2004 North American Task Force. Ages of the study population ranged from 5-8 (n = 474), 9-12 (n = 643) and 13-17 (n = 912) years, respectively. The levels of blood pressure and prevalence of high blood pressure were higher in overweight and obese children and adolescents. In both genders, the prevalence of SBP and DBP increased directly correlated with increments in age, BMI and WC, although prevalence and odd ratios of high blood pressure were higher in individuals with increased WC in comparison to BMI. Increases in WC and BMI are parameters directly associated with high blood pressure in children and adolescents.

Body fat, resting and exercise blood pressure and the angiotensinogen M235T polymorphism: the heritage family study.

PubMed

Rankinen, T; Gagnon, J; Pérusse, L; Rice, T; Leon, A S; Skinner, J S; Wilmore, J H; Rao, D C; Bouchard, C

1999-09-01

The association of resting and exercise blood pressure (BP) and fat mass with the angiotensinogen (AGT) M235T polymorphism was investigated in 522 sedentary Caucasian subjects from 99 families. Resting BP was measured on two separate days, three times each day, and the mean of six valid measurements was used. Exercise BP was measured during a cycle ergometer test at a constant power output (50 W). Body composition was derived from under-water weighing and the AGT M235T polymorphism was typed with a polymerase chain reaction-based method. Neither resting nor exercise BP was associated with the AGT genotypes. In mothers, the homozygotes for the T allele showed 8.8 kg and 7.1 kg greater (p=0.017) age-adjusted body fat mass (FM) than the MM homozygotes and heterozygotes, respectively. Sixty-nine percent of all TT homozygotes were found in the highest FM tertile, whereas only 16% of the MM homozygotes fell in the same tertile (p = 0.008). Moreover, a significant interaction was seen between FM and T-allele carrier status in women with regard to resting diastolic BP (p = 0.002). Among women with a FM> or =24 kg, carriers of the T allele showed a 6.3 mmHg higher diastolic blood pressure (DBP) than non-carriers whereas no difference was found in women with a FM less than 24 kg. A similar trend toward an interaction term was evident with resting systolic blood pressure (p = 0.011) and exercise DBP (p = 0.012). Body fat was not associated with the AGT polymorphism in fathers or in offspring. These data suggest that the AGT M235T polymorphism is associated with body fatness in women, and that the relationship between DBP and AGT M235T polymorphism is dependent on FM in middle-aged sedentary normotensive women.

Risk of Progression to Hypertension in a Low-Income Mexican Population with Pre-hypertension and Normal Blood Pressure

PubMed Central

Jimenez-Corona, Aida; Lopez-Ridaura, Ruy; Stern, Michael P; Gonzalez-Villalpando, Clicerio

2007-01-01

BACKGROUND Blood pressure (BP) levels below the pre-hypertension category may be associated with the risk of developing hypertension. We estimated the incidence rates of hypertension in low-income Mexican population according to several subcategories of baseline BP within normal and pre-hypertension categories. METHODS A total of 1572 nonhypertensive men (n=632) and non-pregnant women (n=940), aged 35 to 64 years at baseline, were followed for a median of 5.8 years. Hypertension was defined as systolic blood pressure (SBP) ≥140 mm Hg, diastolic blood pressure (DBP) ≥90 mm Hg, or self-reported physician diagnosis with anti-hypertensive medications. RESULTS During follow-up, 267 subjects developed hypertension, of whom 83 were men and 184 were women. Age-adjusted incidence rate was higher in women (37.1 per 1000 person-years) than in men (23.7 per 1000 person-years). There was a significant association between BP levels at baseline and hypertension incidence even within the normal category. For the upper levels of normal SBP (110-119 mm Hg), the HR (95%CI) was 2.43 (1.50-3.93) in women and 2.44 (1.05-5.69) in men, compared with SBP <110 mm Hg. For the upper levels of normal DBP (70-79 mm Hg), the HR (95%CI) was 2.33 (1.65-3.31) in women and 1.80 (0.92-3.52) in men, compared with DBP <70 mm Hg, after adjustment for recognized predictors. CONCLUSIONS High risk of hypertension incidence was associated with levels of BP even within the normal category. This information could help define a population at high risk of progression to hypertension, in order to establish preventive measures. PMID:17765131

Effects of caffeinated versus decaffeinated energy shots on blood pressure and heart rate in healthy young volunteers.

PubMed

Kurtz, Abigail M; Leong, Jessica; Anand, Monica; Dargush, Anthony E; Shah, Sachin A

2013-08-01

To evaluate the effects of a caffeinated 5-hour Energy shot compared with a decaffeinated 5-hour Energy shot as assessed by changes in blood pressure and heart rate in healthy, nonhypertensive volunteers. Randomized, double-blind, controlled, crossover study. University campus. Twenty healthy volunteers. Subjects were randomized to receive either the caffeinated 5-hour Energy shot or the decaffeinated 5-hour Energy shot; after a washout period of at least 6 days, subjects were given the alternate energy shot. Systolic (SBP) and diastolic (DBP) blood pressures were recorded for each subject at baseline and at 1, 3, and 5 hours after consumption of the energy shot. Heart rate, adverse effects, and energy levels were also assessed. Mean ± standard deviation (SD) baseline SBP for all study subjects was 114.06 ± 11.30 mm Hg and DBP was 69.53 ± 7.63 mm Hg. Mean changes in SBP between the caffeinated arm and the decaffeinated arm at the 1- and 3-hour time points were significantly increased compared with baseline (mean ± SD 6.08 ± 7.71 mm Hg at 1 hour [p=0.001] vs 3.33 ± 6.99 mm Hg at 3 hours [p=0.042]). Similarly, mean DBP changes between the caffeinated arm and the decaffeinated arm were significantly increased at the 1- and 3-hour time points compared with baseline (mean ± SD 5.18 ± 8.38 mm Hg at 1 hour [p=0.007] and 5.43 ± 7.21 mm Hg at 3 hours [p=0.005]). Heart rate, adverse effects, and energy levels were similar between the two groups. Caffeinated energy shots significantly increased SBP and DBP over a 3-hour period compared with decaffeinated energy shots in healthy, nonhypertensive individuals. © 2013 Pharmacotherapy Publications, Inc.

Garlic Lowers Blood Pressure in Hypertensive Individuals, Regulates Serum Cholesterol, and Stimulates Immunity: An Updated Meta-analysis and Review.

PubMed

Ried, Karin

2016-02-01

Garlic has been shown to have cardiovascular protective and immunomodulatory properties. We updated a previous meta-analysis on the effect of garlic on blood pressure and reviewed the effect of garlic on cholesterol and immunity. We searched the Medline database for randomized controlled trials (RCTs) published between 1955 and December 2013 on the effect of garlic preparations on blood pressure. In addition, we reviewed the effect of garlic on cholesterol and immunity. Our updated meta-analysis on the effect of garlic on blood pressure, which included 20 trials with 970 participants, showed a mean ± SE decrease in systolic blood pressure (SBP) of 5.1 ± 2.2 mm Hg (P < 0.001) and a mean ± SE decrease in diastolic blood pressure (DBP) of 2.5 ± 1.6 mm Hg (P < 0.002) compared with placebo. Subgroup analysis of trials in hypertensive subjects (SBP/DBP ≥140/90 mm Hg) at baseline revealed a larger significant reduction in SBP of 8.7 ± 2.2 mm Hg (P < 0.001; n = 10) and in DBP of 6.1 ± 1.3 mm Hg (P < 0.001; n = 6). A previously published meta-analysis on the effect of garlic on blood lipids, which included 39 primary RCTs and 2300 adults treated for a minimum of 2 wk, suggested garlic to be effective in reducing total and LDL cholesterol by 10% if taken for >2 mo by individuals with slightly elevated concentrations [e.g., total cholesterol >200 mg/dL (>5.5 mmol/L)]. Garlic has immunomodulating effects by increasing macrophage activity, natural killer cells, and the production of T and B cells. Clinical trials have shown garlic to significantly reduce the number, duration, and severity of upper respiratory infections. Our review suggests that garlic supplements have the potential to lower blood pressure in hypertensive individuals, to regulate slightly elevated cholesterol concentrations, and to stimulate the immune system. Garlic supplements are highly tolerated and may be considered as a complementary treatment option for hypertension, slightly elevated cholesterol

Temporal variation of the arterial pressure in healthy young people and its relation to geomagnetic activity in Mexico

NASA Astrophysics Data System (ADS)

Azcárate, T.; Mendoza, B.; Sánchez de la Peña, S.; Martínez, J. L.

2012-11-01

We present a study of the temporal behavior of the systolic (SBP) and diastolic (DBP) blood pressure for a sample of 51 normotensive, healthy volunteers, 18 men and 33 women with an average age of 19 years old in Mexico City, Mexico, during April and May, 2008. We divided the data by sex along the circadian rhythm. Three geomagnetic storms occurred during the studied time-span. The strongest one, a moderate storm, is attributed to a coronal hole border that reached the Earth. The ANOVA test applied to the strongest storm showed that even though we are dealing with a moderate geomagnetic storm, there are statistically significant responses of the blood pressure. The superposed epoch analysis during a three-day window around the strongest storm shows that on average the largest changes occurred for the SBP. Moreover, the SBP largest increases occurred two days before and one day after this storm, and women are the most sensitive group as they present larger SBP and DBP average changes than men. Finally, given the small size of the sample, we cannot generalize our results.

Cuff-Free Blood Pressure Estimation Using Pulse Transit Time and Heart Rate.

PubMed

Wang, Ruiping; Jia, Wenyan; Mao, Zhi-Hong; Sclabassi, Robert J; Sun, Mingui

2014-10-01

It has been reported that the pulse transit time (PTT), the interval between the peak of the R-wave in electrocardiogram (ECG) and the fingertip photoplethysmogram (PPG), is related to arterial stiffness, and can be used to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP). This phenomenon has been used as the basis to design portable systems for continuously cuff-less blood pressure measurement, benefiting numerous people with heart conditions. However, the PTT-based blood pressure estimation may not be sufficiently accurate because the regulation of blood pressure within the human body is a complex, multivariate physiological process. Considering the negative feedback mechanism in the blood pressure control, we introduce the heart rate (HR) and the blood pressure estimate in the previous step to obtain the current estimate. We validate this method using a clinical database. Our results show that the PTT, HR and previous estimate reduce the estimated error significantly when compared to the conventional PTT estimation approach (p<0.05).

Food and drug administration regulation of drugs that raise blood pressure.

PubMed

Blankfield, Robert P; Iftikhar, Imran H

2015-01-01

Although it is recognized that a systolic blood pressure (SBP) increase ≥ 2 mm Hg or a diastolic blood pressure (DBP) increase ≥ 1 mm Hg increases the risk of heart attacks and strokes in middle-aged adults, the Food and Drug Administration (FDA) lacks an adequate policy for regulating medications that increase blood pressure (BP). Some FDA reviewers consider a clinically significant increase in BP to occur only if a drug raises SBP ≥ 20 mm Hg or if a drug raises DBP ≥ 10 to 15 mm Hg. In recent years, numerous drugs have been regulated or taken off the market due to cardiovascular safety concerns. The list includes rofecoxib (Vioxx), valdecoxib (Bextra), nonselective nonsteroidal anti-inflammatory drugs, sibutramine (Meridia), and phenylpropanolamine. It is probable that the hypertensive effect of these drugs explains why they increase the risk of adverse cardiovascular events. Other drugs, notably serotonin-norepinephrine reuptake inhibitors and drugs used to treat attention deficit hyperactivity disorder, were approved without cardiovascular safety data despite the fact that they raise BP comparable to valdecoxib and sibutramine. It is the responsibility of the FDA to ensure that drugs are properly labeled regarding risk. Even if a drug raises BP only modestly, FDA guidelines for new drug approvals should include a requirement for cardiovascular safety data. However, such guidelines will not address the problem of how to obtain cardiovascular safety data for the many already approved drugs that increase BP. The FDA should play a role in obtaining cardiovascular safety data for such drugs. © The Author(s) 2014.

Validation of the Pangao PG-800B11 blood pressure monitor according to the European Society of Hypertension and the British Hypertension Society protocols.

PubMed

Bing, Sen; Zhang, Cunhai; Wang, Liping; Li, Linyi; Wan, Yi

2014-12-01

The study aimed to determine the accuracy of the fully automated oscillometric upper-arm blood pressure (BP) monitor Pangao PG-800B11 according to the European Society of Hypertension-International Protocol (ESH-IP) revision 2010 and the British Hypertension Society (BHS) protocol 1993. Data from 33 participants were initially examined according to the ESH-IP revision 2010. Furthermore, 52 participants were then enrolled to fulfill the BHS protocol requirements. In all participants, sequential left arm measurements were performed by two trained observers using a mercury sphygmomanometer and one supervisor using the device. The protocols' requirements were followed precisely. The device passed all parts of the ESH protocol for systolic blood pressure (SBP) and diastolic blood pressure (DBP) and was graded A according to the criteria of the BHS protocol for both SBP and DBP. The A/A grade was achieved in low (<130/80 mmHg), medium (130-160/80-100 mmHg), and high (>160/100 mmHg) BP categories. The mean BP difference between PG-800B11 and observers in the 85 participants was -0.6±5.0 mmHg for SBP and -0.6±4.5 mmHg for DBP; thus, the device also fulfilled the requirements of the Association for the Advancement of Medical Instrumentation (AAMI). The Pangao PG-800B11 passed all requirements of the ESH-IP revision 2010 and achieved A/A grade of the BHS protocol across a wide range of BPs.

Aliskiren in Patients Failing to Achieve Blood Pressure Targets With Angiotensin Converting Enzyme Inhibitors or Angiotensin Receptor Blockers

PubMed Central

Hawkins, Elizabeth B.; Ling, Hua; Burns, Tammy L.; Mooss, Aryan N.; Hilleman, Daniel E.

2012-01-01

Background To assess the efficacy of aliskiren in patients failing to reach blood pressure (BP) goals with angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB). Methods A total of 107 patients who failed to reach BP goals on ACEI or ARB were switched to aliskiren. Changes in BP were determined during maximal ACEI, ARB, or aliskiren therapy. Results Mean reduction in sBP and dBP with ACEI was 8.5 ± 6.3 mmHg and 6.0 ± 4.7 mmHg, respectively. Mean reduction in sBP and dBP with ARB was 8.3 ± 6.7 mmHg and 5.0 ± 5.2 mmHg, respectively. Mean reduction in sBP and dBP with aliskiren 150 mg/d was 6.7 ± 5.4 mmHg and 5.4 ± 4.8 mmHg, respectively. Mean reduction in sBP and dBP with aliskiren 300 mg/d was 8.6 ± 6.3 mmHg and 6.0 ± 4.9 mmHg, respectively. BP reductions between ACEI, ARB, and aliskiren were not significantly different. Conclusions Aliskiren is ineffective in patients failing ACEI or ARB therapy. Given the label changes restricting the use of aliskiren in combination with ACEI and ARB, excess cost compared to ACEI and ARB, and a paucity of outcome data, there is a limited role for aliskiren in practice. PMID:28348679

A Model for the Study of Reading in Agriscience

ERIC Educational Resources Information Center

Park, Travis D.; Osborne, Ed

2007-01-01

Agriscience is facing pressure to document and contribute to student achievement in math, science, and reading. Agriscience teachers may be able to foster student reading and comprehension through utilization of research-based reading strategies to further develop literacy in and about agriculture. Building on Dunkin and Biddle's (1974) model of…

9C.03: THE BENEFIT FROM HEMODYNAMICALLY GUIDED ANTIHYPERTENSIVE THERAPY DEPENDS ON BASELINE BLOOD PRESSURE.

PubMed

Krzesinski, P; Gielerak, G; Stanczyk, A; Piotrowicz, K; Skrobowski, A

2015-06-01

Impedance cardiography (ICG) revealed to be useful in tailoring antihypertensive therapy to the patient's individual hemodynamic profile but little is known who benefits more from such therapeutic approach. The aim of this study was to estimate the effectiveness of ICG-guided antihypertensive therapy in 12-weeks observation with respect to baseline blood pressure (BP). This analysis involved 272 patients with untreated AH, recruited in two randomized, prospective and controlled trials (www.nauka-polska.pl: ID227062 and ClinicalTrials.gov: NCT01996085). After baseline evaluation including office blood pressure measurement (OBPM: OSBP, ODBP, OMBP) and ambulatory blood pressure monitoring (ABPM: 24-mean_SBP, 24-mean_DBP) the subjects were randomly assigned to groups of: [GE] empiric and [HD] ICG-guided antihypertensive therapy. The effectiveness of ICG-guided therapy was evaluated after 12 weeks in subgroups derived from median of OMBP (110 mmHg) of: higher (n = 120) and lower baseline OMBP (n = 121). The comparative analysis included absolute change of BP (d_OSBP, d_ODBP, d_24-mean_SBP, d_24-mean_DBP) and percentage of patients with change of BP equal or higher than 10 mmHg (d10_OSBP, d10_ODBP, d10_24-mean_SBP, d10_24-mean_DBP). In the whole study group the BP reduction in HD group was higher than in GE group: d_OSBP (18.3 vs. 14.3 mmHg; p = 0.011), d_ODBP (11.9 vs. 8.5 mmHg; p = 0.011), d_24-mean SBP (15.9 vs. 11.6 mmHg; p = 0.011) and d_24-mean SBP (10.4 vs. 8.9 mmHg; p = 0.147). However, the effect of ICG-guided therapy was significantly more pronounced in subjects with higher baseline OMBP - Table.(Figure is included in full-text article.) : The ICG-guided therapy effects with increased BP reduction in patients with AH, especially those with higher baseline BP. The patients with advanced AH can benefit more from individual these therapeutic approach.

Adverse Childhood Experiences and Blood Pressure Trajectories from Childhood to Young Adulthood: The Georgia Stress and Heart Study

PubMed Central

Su, Shaoyong; Wang, Xiaoling; Pollock, Jennifer S.; Treiber, Frank A.; Xu, Xiaojing; Snieder, Harold; McCall, W. Vaughn; Stefanek, Michael; Harshfield, Gregory A.

2015-01-01

Background The purpose of this study was to assess the long-term effect of adverse childhood experiences (ACEs) on blood pressure (BP) trajectories from childhood to young adulthood and to examine whether this relation is explained by childhood socioeconomic status (SES) and/or risk behaviors that are associated with ACEs. Methods and Results Systolic and diastolic blood pressure (SBP and DBP) were measured up to 16 times (13 times on average) over a 23-year period in 213 African Americans (AAs) and 181 European Americans (EAs) aged 5 to 38 years. Retrospective data on traumatic experiences prior to age 18 were collected, including abuse, neglect and household dysfunction. Individual growth curve modeling within a multilevel framework was used to examine the relation between exposure to ACEs and BP development. No main effect of ACEs on average BP levels was found. However, a significant interaction of ACE score with age3 was observed (SBP: p=0.033; DBP: p=0.017). Subjects who experienced multiple traumatic events during childhood showed a faster rise of BP levels after age of 30 years than those without ACEs. As expected, a graded association of ACEs with childhood SES and negative health behaviors was observed (p<0.001). The ACE-SBP relation was not explained by these factors, while the ACE-DBP relation was partially mediated by illicit drug use. Conclusions In this novel longitudinal study, we observed that participants who were exposed to multiple ACEs displayed a greater increase of BP levels in young adulthood compared to their counterparts without ACEs. PMID:25858196

Comparison of exercise blood pressure measured by technician and an automated system.

PubMed

Garcia-Gregory, J A; Jackson, A S; Studeville, J; Squires, W G; Owen, C A

1984-05-01

We evaluated the automated system Blood Pressure Measuring System (BPMS) developed by NASA on 277 adult males who elected to have a treadmill test as part of their annual physical. The BPMS uses acoustic transduction with a computer-assisted ECG gating to detect nonsynchronous noise. The BPMS readings were compared to pressures simultaneously measured by trained technicians. For all stages of work, BPMS readings were higher for systolic and lower for diastolic than technician readings. At peak stages of work, BPMS systolic pressures were about 20 mmHg higher than technician readings. Within each 3-min workstage, BPMS readings were found to be more inconsistent than technician readings. The standard errors of measurement for BPMS were from two to three times higher than technician values. These data showed automated blood pressure readings were significantly different than technician values and subject to more random fluctuations. These findings demonstrate the need to view exercise blood pressure measured by automated systems with caution.

[Blood pressure values in adolescents in the Community of Madrid: Tables based on the MEPAFAC Study].

PubMed

Molinero, A; Cervero, M; Magro, M C; Partearroyo, T; Zuluaga, P; Martín, A

High blood pressure (HBP) is a modifiable cardiovascular risk factor and its detection at early ages may allow strategies to be designed to reduce cardiovascular risk in adulthood. To provide blood pressure (BP) values in a sample of adolescents using an electronic oscillometric device. BP was measured according the European Society of Hypertension guidelines using an oscillometric device. Height and weight were also measured. Four height groups were used in order to associate the 90, 95, and 99 percentiles with systolic BP (pSBP) and diastolic BP percentiles (pDBP) for sex and age: H150 (≤ 150cm), H160(151-160cm), H170(161-170cm), and H180(≥171cm). Data from 2,758 students aged 12-17 years were included in the analysis. BP increases with age, with differences of up to 11mmHg in boys vs. 3mmHg in girls for SBP and 3mmHg vs. 1mmHg for DBP. In high SBP, for the younger adolescents, the difference related to height was 15mmHg in boys vs. 8mmHg in girls, with no significant increase in the older ones in either gender. The high BDP varied depending on the height, 10mmHg in younger boys and 3mmHg in older ones, while in girls the variation was 3mmHg for all ages. SBP/DBP in adolescents increases with age and also with height, giving similar figures in the taller ones, regardless of age. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Accuracy of blood pressure measurement and anthropometry among volunteer observers in a large community survey.

PubMed

Adams, Claire; Burke, Valerie; Beilin, Lawrie J

2002-04-01

The Busselton Survey is a population survey that is held about every three years. In 1994-1995 a re-survey was held of all past participants and 8,502 attended. Financial constraints precluded employing staff for data collection for blood pressure and anthropometry, these therefore were collected by unpaid lay volunteers. Quality control by a health professional was critical to the assessment and maintenance of accuracy in these measurements. For blood pressure three readings were taken simultaneously by a quality control person and the volunteer using a dual stethoscope. Duplicate anthropometric measurements were taken by a criterion anthropometrist and the volunteer. Inter and intra-observer technical errors of measurement (TEM) were calculated. Sixty-two volunteers were trained to take BP measurements; of these, 38 collected data, and 63 were trained in anthropometry; of these, 30 were suitable as measurers. Training was conducted on a group and individual basis by the quality assurance person for the study both in the Perth metropolitan area and rural Busselton. The TEM for SBP was 1.6 mm Hg (SD 1.0 mm Hg) and 1.5 mm Hg (SD 0.8) for DBP. For skin-folds intra-observer TEM ranged from 0.6 mm to 1.0 mm. Between-observer TEM ranged from 2.1 mm to 5.4 mm. For limb and waist circumferences, intra-observer TEM ranged from 0.3 cm to 1.6 cm. Between-observer TEM for circumferences ranged from 0.5 cm to 1.9 cm. Unpaid volunteer measurers can, if carefully trained and supervised, provide acceptable blood pressure data and anthropometry in large population surveys.

Long-term follow-up of GH-treated girls with Turner syndrome: BMI, blood pressure, body proportions.

PubMed

Bannink, Ellen M N; van der Palen, Roel L F; Mulder, Paul G H; de Muinck Keizer-Schrama, Sabine M P F

2009-01-01

To investigate whether long-term growth hormone (GH) treatment influenced blood pressure (BP), body proportions and BMI in young Turner syndrome (TS) women several years after GH discontinuation. A follow-up study of a randomized GH dose-response trial with 3 GH dosages (1.3, 2.0, and 2.7 mg/m(2)/day). 39 TS patients (20.0 +/- 2.1 years) participated 4.8 (1.9) years after GH discontinuation. Mean GH duration was 8.7 (2.0) years. BP, BMI and body proportions. During GH treatment, DBP had decreased. At the long-term follow-up study, DBP had increased and was similar to pretreatment levels. DBP was negatively influenced by GH dose. SBP was not influenced by GH dose or duration. The BMI increased gradually during and after GH therapy. During GH therapy, shape values of sitting height had decreased to normal values, of foot had increased, and both remained constant after GH discontinuation. GH therapy in girls with TS has, besides height, additional beneficial effects on BP and body proportions, except foot length. Nearly 5 years after ending GH, the favorable effect of GH on BP was still noticeable. The BMI increased gradually over the years, not influenced by GH. 2009 S. Karger AG, Basel

Association of parental blood pressure with retinal microcirculatory abnormalities indicative of endothelial dysfunction in children.

PubMed

Islam, Muhammad; Jafar, Tazeen H; Bux, Rasool; Hashmi, Shiraz; Chaturvedi, Nish; Hughes, Alun D

2014-03-01

Microcirculatory abnormalities precede the onset of hypertension and may explain its familial nature. We examined the relationship between parental blood pressure (BP) and offspring retinal microvasculature in Pakistani trios [father, mother, and child (aged 9-14 years)]. This is a substudy of a population-based trial of BP reduction. Data were available on 358 normotensive, and 410 offspring of at least one hypertensive parent. Retinal vessel characteristics were measured from digital images. Multivariable linear regression models were built to assess the associations between maternal and paternal BP and offspring retinal microvasculature. Optimality deviation was greatest in offspring of two hypertensive parents, compared with those with one or no hypertensive parent (P=0.030 for trend). Paternal SBP and DBP were each significantly associated with optimality deviation in offspring (P=0.023 and P=0.006, respectively). This relationship persisted after accounting for offspring cardiovascular risk factors [increase in optimality deviation (95% confidence interval, CI) 0.0053 (0.0001-0.0106, P=0.047) and 0.0109 (0.0025-0.0193, P=0.011), for each 10 mmHg increase in paternal SBP and DBP, respectively]. Maternal DBP was inversely associated with offspring arteriovenous ratio -0.0102 (-0.0198 to -0.0007, P=0.035). Microvascular endothelial dysfunction in children is associated with increasing levels of parental hypertension. The association with paternal BP is independent of other cardiovascular risk factors, including the child's BP. Higher maternal DBP is associated with evidence of arteriolar narrowing in offspring. These early microcirculatory changes may help explain familial predisposition to hypertension in people of Pakistani origin at an early age. :

Accuracy of the Omron HEM-705 CP for blood pressure measurement in large epidemiologic studies.

PubMed

Vera-Cala, Lina M; Orostegui, Myriam; Valencia-Angel, Laura I; López, Nahyr; Bautista, Leonelo E

2011-05-01

Accurate measurement of blood pressure is of utmost importance in hypertension research. In the context of epidemiologic and clinical studies, oscillometric devices offer important advantages to overcome some of the limitations of the auscultatory method. Even though their accuracy has been evaluated in multiple studies in the clinical setting, there is little evidence of their performance in large epidemiologic studies. We evaluated the accuracy of the Omron HEM-705-CP, an automatic device for blood pressure (BP) measurement, as compared to the standard auscultatory method with a mercury sphygmomanometer in a large cohort study. We made three auscultatory measurements, followed by two measurements with the Omron device in 1,084 subjects. Bias was estimated as the average of the two Omron minus the average of the last two auscultatory measurements, with its corresponding 95% limits of agreement (LA). The Omron overestimated systolic blood pressure (SBP) by 1.8 mmHg (LA:-10.1, 13.7) and underestimated diastolic blood pressure (DBP) by 1.6 mmHg (LA:-12.3, 9.2). Bias was significantly larger in men. Bias in SBP increased with age and decreased with BP level, while bias in DBP decreased with age and increased with BP level. The sensitivity and specificity of the Omron to detect hypertension were 88.2% and 98.6%, respectively. Minimum bias in the estimates of the effects of several factors resulted from the use of Omron measurements. Our results showed that the Omron HEM-705-CP could be used for measuring BP in large epidemiology studies without compromising study validity or precision.

Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome

PubMed Central

Seron, Bruna Barboza; Goessler, Karla Fabiana; Modesto, Everaldo Lambert; Almeida, Eloise Werle; Greguol, Márcia

2015-01-01

Background Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of young individuals with DS. Methods A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p < 0.05. Results After twelve weeks of aerobic and/or resistance training, significant reductions in variables SBP, DBP and MBP were observed. Conclusion This study suggests a chronic hypotensive effect of moderate aerobic and resistance exercises on young individuals with DS. PMID:26131704

Blood Pressure Changes and Chemical Constituents of Particulate Air Pollution: Results from the Healthy Volunteer Natural Relocation (HVNR) Study

PubMed Central

Wu, Shaowei; Deng, Furong; Huang, Jing; Wang, Hongyi; Shima, Masayuki; Wang, Xin; Qin, Yu; Zheng, Chanjuan; Wei, Hongying; Hao, Yu; Lv, Haibo; Lu, Xiuling

2012-01-01

Background: Elevated blood pressure (BP) has been associated with particulate matter (PM) air pollution, but associations with PM chemical constituents are still uncertain. Objectives: We investigated associations of BP with various chemical constituents of fine PM (PM2.5) during 460 repeated visits among a panel of 39 university students. Methods: Resting BP was measured using standardized methods before and after the university students relocated from a suburban campus to an urban campus with different air pollution contents in Beijing, China. Air pollution data were obtained from central monitors close to student residences. We used mixed-effects models to estimate associations of various PM2.5 constituents with systolic BP (SBP), diastolic BP (DBP), and pulse pressure. Results: An interquartile range increase of 51.2 μg/m3 in PM2.5 was associated with a 1.08-mmHg (95% CI: 0.17, 1.99) increase in SBP and a 0.96-mmHg (95% CI: 0.31, 1.61) increase in DBP on the following day. A subset of PM2.5 constituents, including carbonaceous fractions (organic carbon and elemental carbon), ions (chloride and fluoride), and metals/metalloid elements (nickel, zinc, magnesium, lead, and arsenic), were found to have robust positive associations with different BP variables, though robust negative associations of manganese, chromium, and molybdenum with SBP or DBP also were observed. Conclusions: Our results support relationships between specific PM2.5 constituents and BP. These findings have potential implications for the development of pollution abatement strategies that maximize public health benefits. PMID:23086577

Blood pressure and cognitive function: a prospective analysis among adolescents in Seychelles.

PubMed

Lyngdoh, Tanica; Viswanathan, Bharathi; Kobrosly, Roni; van Wijngaarden, Edwin; Huber, Brittany; Davidson, Philip W; Cory-Slechta, Deborah A; Strain, John J; Strain, Sean; Myers, Gary J; Bovet, Pascal

2013-06-01

An inverse relationship between blood pressure (BP) and cognitive function has been found in adults, but limited data are available in adolescents and young adults. We examined the prospective relation between BP and cognitive function in adolescence. We examined the association between BP measured at the ages of 12-15 years in school surveys and cognitive endpoints measured in the Seychelles Child Development Study at ages 17 (n = 407) and 19 (n = 429) years, respectively. We evaluated multiple domains of cognition based on subtests of the Cambridge Neurological Test Automated Battery (CANTAB), the Woodcock Johnson Test of Scholastic Achievement (WJTA), the Finger Tapping test (FT) and the Kaufman Brief Intelligence Test (K-BIT). We used age, sex and height-specific z-scores of SBP, DBP and mean arterial pressure (MAP). Six out of the 21 cognitive endpoints tested were associated with BP. However, none of these associations were found to hold for both males and females or for different subtests within the same neurodevelopmental domain or for both SBP and DBP. Most of these associations disappeared when analyses were adjusted for selected potential confounding factors such as socio-economic status, birth weight, gestational age, BMI, alcohol consumption, blood glucose, and total n-3 and n-6 polyunsaturated fats. Our findings do not support a consistent association between BP and subsequent performance on tests assessing various cognitive domains in adolescents.

Intrafamilial aggregation and heritability of office-day blood pressure difference in a community of African ancestry: implications for genetic association studies.

PubMed

Djami-Tchatchou, Arnaud T; Norton, Gavin R; Redelinghuys, Michelle; Maseko, Muzi J; Majane, Olebogeng H I; Woodiwiss, Angela J

2014-12-01

An inability to show consistent relationships between gene variants and blood pressure (BP) may be confounded by the use of office BP measurement. Whether the difference between office BP and day BP (office-day) is genetically predetermined is unknown. We therefore aimed to determine the intrafamilial aggregation and heritability of office-day BP. Nurse-derived office BP (mean of 5 measurements according to guidelines) and 24-h ambulatory BP were determined for 592 participants from 198 families (67 spouse pairs, 361 parent-child pairs, and 169 sibling-sibling pairs), with 12 families having three generations, from an urban developing community of black Africans. Heritability estimates were determined using SAGE software. With adjustments for confounders, office systolic BP (SBP) (h=0.35±0.09, P<0.0001) showed comparable heritability estimates to 24-h SBP (h=0.33±0.09, P<0.0001). Similarly, with adjustments for confounders, office diastolic BP (DBP) (h=0.37±0.09, P<0.0001) showed comparable heritability estimates as 24-h DBP (h=0.35±0.09, P<0.0001). However, multivariate adjusted heritability estimates of day SBP (h=0.29±0.09, P<0.0001) and DBP (h=0.33±0.09, P<0.0001) were not diminished by further adjustments for office SBP (h=0.42±0.09, P<0.0001) or DBP (h=0.34±0.09, P<0.0001). Further, independent of confounders, office-day BP showed significant intrafamilial aggregation and heritability (SBP: h=0.51±0.10, P<0.0001; DBP: h=0.37±0.09, P<0.0001), effects that persisted with further adjustments for office, day, or day-night BP (P<0.0005 for SBP and DBP). Although office and ambulatory BP may show similar heritability estimates, genetic associations with carefully determined office BP measurements may be confounded by the heritability of office-day BP differences.

An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate (Dbp) Case Study (External Review Draft)

EPA Science Inventory

This draft report is a description of an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of...

Meditation and blood pressure: a meta-analysis of randomized clinical trials.

PubMed

Shi, Lu; Zhang, Donglan; Wang, Liang; Zhuang, Junyang; Cook, Rebecca; Chen, Liwei

2017-04-01

We meta-analyzed the effect of meditation on blood pressure (BP), including both transcendental meditation and non-transcendental meditation interventions. We identified randomized controlled trials (RCTs) that examined the BP responses to meditation interventions through a systematic literature search of the PubMed, ABI/INFORM, MEDLINE, EMBASE, PsycINFO, and CINAHL databases (from January 1980 to October 2015). We meta-analyzed the change in SBP and DBP, stratified by type of meditation (transcendental meditation vs. non-transcendental meditation intervention) and by type of BP measurement [ambulatory BP monitoring (ABPM) vs. non-ABPM measurement]. Nineteen studies met the eligibility criteria. Among the studies using the ABPM measurement, the pooled SBP effect estimate was -2.49 mmHg [95% confidence interval (CI): -7.51, 2.53] for transcendental meditation intervention (statistically insignificant) and -3.77 mmHg (95% CI: -5.33, -2.21) for non-transcendental meditation interventions, whereas the pooled DBP effect estimate was -4.26 mmHg (95% CI: -6.21, -2.31) for transcendental meditation interventions and -2.18 mmHg (95% CI: -4.28, -0.09) for non-transcendental meditation interventions. Among the studies using the non-ABPM measurement, the pooled SBP effect estimate from transcendental meditation interventions was -5.57 mmHg (95% CI: -7.41, -3.73) and was -5.09 mmHg with non-transcendental meditation intervention (95% CI: -6.34, -3.85), whereas the pooled effect size in DBP change for transcendental meditation interventions was -2.86 mmHg (95% CI: -4.27, -1.44) and was -2.57 mmHg (95% CI: -3.36, -1.79) for non-transcendental meditation interventions. Non-transcendental meditation may serve as a promising alternative approach for lowering both SBP and DBP. More ABPM-measured transcendental meditation interventions might be needed to examine the benefit of transcendental meditation intervention on SBP reduction.

Nebivolol withdrawal results in blood pressure returning toward pretreatment levels, but without rebound symptoms: phase IV randomized trial.

PubMed

Lewin, Andrew; Lasseter, Kenneth C; Dong, Fang; Whalen, John C

2012-01-01

Rapid withdrawal of antihypertensive drugs may lead to blood pressure (BP) increase above pretreatment values or symptoms such as palpitations, chest pain, and tremor. This phase IV trial assessed the consequences of abrupt and stepwise withdrawal of nebivolol, a β(1)-selective blocker, in individuals with stage I-II hypertension. After a 4- to 5-week placebo washout phase and 12-week single-blind nebivolol treatment (10-40 mg/day, titrated based on BP response), participants achieving BP control (systolic BP [SBP]/diastolic BP [DBP] <140/90 mm Hg) or response (SBP decrease ≥10 mm Hg or DBP decrease ≥5 mm Hg) entered a 4-week, randomized, double-blind phase of continued nebivolol treatment (n = 102) or withdrawal to placebo (n = 105). Primary and secondary efficacy measures were changes in mean sitting DBP and SBP, respectively, analyzed using an analysis of covariance model. Safety and tolerability were also assessed. In the withdrawal phase, nebivolol and placebo groups demonstrated mean DBP increases of 1.8 and 7.7 mm Hg, respectively (P < .001), and SBP increases of 3.5 and 7.6 mm Hg (P = .011). Twenty-three (22.5%) nebivolol-treated and 18 (17.1%) placebo-treated participants experienced a treatment-emergent adverse event. No adverse events associated with β-blocker withdrawal and considered causally related to nebivolol were reported. Nebivolol withdrawal resulted in a mean BP increase near pretreatment levels and was not associated with rebound hypertension. Copyright © 2012 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Anthropometry and blood pressure changes in a Caribbean adolescent population of African ancestry: an evaluation of longitudinal data using a multilevel mixed regression approach.

PubMed

Nichols, S; Cadogan, F

2012-10-01

The aim of this study was to determine the effect of growth pattern on blood pressure changes in an adolescent population of African ancestry based on longitudinal data and to compare this with estimates derived from cross-sectional data. Participants had measurements of weight, height, blood pressure and percentage body fat taken annually using standardized procedures. Annual blood pressure and anthropometry velocities as well as one- and three-year interval gender specific tracking coefficients were computed. We investigated whether changes in blood pressure could be explained by measures of growth using a multilevel mixed regression approach. The results showed that systolic blood pressure (SBP) increased by 1.27 and 3.09 mmHg per year among females and males, respectively. Similarly, diastolic blood pressure (DBP) increased by 1.16 and 1.92 mmHg per year among females and males, respectively. Multilevel analyses suggested that weight, body mass index, percentage body fat and height were the strongest anthropometric determinants of blood pressure change in this population. The results also suggest that there are gender differences in the relative importance of these anthropometric measures with height playing a minor role in predicting blood pressure changes among adolescent females. With the exception of DBP at 18 years among females, there were no significant differences between mean blood pressure generated from cross-sectional and longitudinal data by age in both males and females. Anthropometric measures are important covariates of age-related blood pressure changes and cross-sectional data may provide a more cost-effective and useful proxy for generating age-related blood pressure estimates in this population.

Prevalence of masked uncontrolled hypertension according to the number of office blood pressure measurements.

PubMed

Vinyoles, E; Camafort, M; Domenech, M; Coca, A; Sobrino, J

2015-11-01

The reported prevalence of masked uncontrolled hypertension (MUCH) varies because many studies are not comparable as they use different measurement methodologies. To evaluate the influence of the number of office blood pressure readings on the prevalence of MUCH we conducted a cross-sectional, multicenter study in treated hypertensive patients. We carried out an observational, cross-sectional, multicenter study in 33 Spanish hospital-based hypertension units, involving 35 investigators and 12 Autonomous Communities. Six blood pressure readings and a 24-h ambulatory blood pressure monitoring were performed in treated hypertensive patients. The means of the first 3 readings (P123), the 2nd, 3rd and 4th readings (P234), the 3rd, 4th and 5th readings (P345) and the last 3 readings (P456) were compared with mean 24-h blood pressure. MUCH was defined as office blood pressure <140/90mmHg and 24-h blood pressure ≥130/80mmHg, considering the first 3 readings (MUCH123), the 2nd, 3rd and 4th readings (MUCH234), the 3rd, 4th and 5th readings (MUCH345) and the last 3 readings (MUCH456). We included 498 hypertensive patients. Mean (standard deviation) office blood pressure measurements were: (P123) 141(18)/82(11); (P234) 139(17)/81(11); (P345) 138(17)/81(11) and (P456) 137(16)/80(10) mmHg. Mean 24-h blood pressure was 127(13.8)/75(9.5) mmHg. The correlation coefficients between ambulatory and office systolic/diastolic blood pressure were (P123):0.48/0.50; (P234):0.50/0.52; (P345):0.50/0.54; and (P456):0.50/0.55 (p<0.001, all). The prevalences of MUCH123, MUCH234, MUCH345 and MUCH456 were 14.5%, 18.9%, 19.5% and 21.1%, respectively. The prevalence of MUCH diagnosis depends on the serial office blood pressure readings, being much higher for the last three blood pressure readings. Discarding the first and second office blood pressure measures seems to be the most accurate method for diagnosing MUCH. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina

An association of platelet indices with blood pressure in Beijing adults: Applying quadratic inference function for a longitudinal study.

PubMed

Yang, Kun; Tao, Lixin; Mahara, Gehendra; Yan, Yan; Cao, Kai; Liu, Xiangtong; Chen, Sipeng; Xu, Qin; Liu, Long; Wang, Chao; Huang, Fangfang; Zhang, Jie; Yan, Aoshuang; Ping, Zhao; Guo, Xiuhua

2016-09-01

The quadratic inference function (QIF) method becomes more acceptable for correlated data because of its advantages over generalized estimating equations (GEE). This study aimed to evaluate the relationship between platelet indices and blood pressure using QIF method, which has not been studied extensively in real data settings.A population-based longitudinal study was conducted in Beijing from 2007 to 2012, and the median of follow-up was 6 years. A total of 6515 cases, who were aged between 20 and 65 years at baseline and underwent routine physical examinations every year from 3 Beijing hospitals were enrolled to explore the association between platelet indices and blood pressure by QIF method. The original continuous platelet indices were categorized into 4 levels (Q1-Q4) using the 3 quartiles of P25, P50, and P75 as a critical value. GEE was performed to make a comparison with QIF.After adjusting for age, usage of drugs, and other confounding factors, mean platelet volume was negatively associated with diastolic blood pressure (DBP) (Equation is included in full-text article.)in males and positively linked with systolic blood pressure (SBP) (Equation is included in full-text article.). Platelet distribution width was negatively associated with SBP (Equation is included in full-text article.). Blood platelet count was associated with DBP (Equation is included in full-text article.)in males.Adults in Beijing with prolonged exposure to extreme value of platelet indices have elevated risk for future hypertension and evidence suggesting using some platelet indices for early diagnosis of high blood pressure was provided.

Relationship between sensibility and ability to read braille in diabetics.

PubMed

Nakada, M; Dellon, A L

1989-01-01

Twenty-five vision-impaired diabetics received an evaluation of sensibility. Each subject had received 2 years of instruction in braille reading at the Konan Rehabilitation Center prior to the sensibility testing. Sensibility evaluation consisted of cutaneous pressure threshold measurements with the Semmes-Weinstein monofilament and evaluation of moving and static two-point discrimination with Disk-Criminator. The ability to read braille was graded by the braille-teaching instructors as good, fair, and unable. The results of the evaluation of sensibility demonstrated that the value of the cutaneous pressure threshold did not correlate with the ability to read braille. Moving and static two-point discrimination were found to correlate highly (P less than .001) with the ability to read braille at a level of fair or good. No patient in this study with a moving two-point discrimination value of 4 or more or a static two-point discrimination value of 5 or more was able to read braille even at the fair level of ability.

Overtime work and blood pressure in normotensive Japanese male workers.

PubMed

Nakamura, Koshi; Sakurai, Masaru; Morikawa, Yuko; Miura, Katsuyuki; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

2012-09-01

Epidemiological studies have observed conflicting patterns as to whether overtime work increases blood pressure (BP), probably as a consequence of methodological issues. We conducted a prospective cohort study to investigate the relationship between overtime work hours and 1-year changes in BP in 1,235 normotensive Japanese male workers who carried out a variety of jobs in a manufacturing factory. Casual BP measurements were repeated at annual health examinations in 2004-2005, using an automatic manometer. An analysis of covariance that incorporated potential confounding factors including baseline age, body mass index (BMI), and lifestyle factors was used to calculate and compare the means of the 1-year change in systolic (SBP) and diastolic BP (DBP). The participants were grouped according to their average monthly overtime work hours obtained from timecard data between April and September 2004. The multivariate-adjusted mean for 1-year change in DBP in 611 male assembly-line workers was 1.5 mm Hg (95% confidence interval (CI) 0.8-2.2) for <40.0 h/month, 2.3 mm Hg (95% CI 1.3-3.2) for 40.0-79.9 h/month, and 5.3 mm Hg (95% CI 2.7-7.9) for ≥ 80.0 h/month (P for heterogeneity = 0.02). A broadly similar pattern was observed for SBP. In contrast, there was no significant difference in means 1-year change for both SBP and DBP in 315 clerks and 309 engineers/special technicians, grouped according to overtime work hours. Extensive overtime work was associated with increased BP in normotensive male assembly-line workers, but not in clerks and engineers/special technicians.

Sleep Duration and Its Association With Ambulatory Blood Pressure in a School-Based, Diverse Sample of Adolescents

PubMed Central

Gallagher, Martina R.; Eissa, Mona A.; Nguyen, Thong Q.; Chan, Wenyaw

2014-01-01

BACKGROUND Evidence is accumulating that sleep duration is related to blood pressure (BP) and hypertensive status, but the strength of the association varies by age, and findings are inconsistent for adolescents. This cross-sectional study tested the hypothesis that sleep duration, both during the night and during naps, would be negatively associated with ambulatory systolic BP (SBP) and diastolic BP (DBP) measured over 24 hours in adolescents. METHODS In this ethnically diverse (37% non-Hispanic black, 31% Hispanic, 29% non-Hispanic white, 3% other), school-based sample of 366 adolescents aged 11–16 years, ambulatory BP was measured every 30 minutes for 24 hours on a school day; actigraphy was used to measure sleep duration. Covariables included demographic factors, anthropometric indices, physical activity, and position and location at the time of each BP measurement. Mixed models were used to test day and night sleep duration as predictors of 24-hour SBP and DBP, controlling for covariables. RESULTS The mean sleep duration was 6.83 (SD = 1.36) hours at night, and 7.23 (SD = 1.67) hours over 24 hours. Controlling for duration of sleep during the day and covariables, each additional hour of nighttime sleep was associated with lower SBP (−0.57; P < 0.0001); controlling for nighttime sleep duration and covariables, each additional hour of daytime sleep was associated with lower SBP (−0.73; P < 0.001) and lower DBP (−0.50; P < 0.001). CONCLUSIONS Longer sleep duration was significantly associated with lower ambulatory SBP and DBP in adolescents. The findings have potential implications for cardiovascular health in this age group. PMID:24487981

Percentiles of waist-hip ratio and the relationship with blood pressure among children and adolescents in Shandong, China.

PubMed

Zhang, Ying-Xiu; Wang, Shu-Rong; Zhou, Jing-Yang; Zhao, Jin-Shan; Chu, Zun-Hua

2014-01-01

Anthropometric indices such as waist circumference (WC), waist-to-height ratio (WHtR) and waist-hip ratio (WHR) have been recognized as useful alternatives to visceral fat measurement in epidemiological studies. WHR has been used extensively in adults. However, there are very few published data for WHR among children and adolescents. The present study examined the distribution of WHR and the relationship with blood pressure (BP) among children and adolescents in Shandong, PR China. Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010. A total of 38,822 students (19,456 boys and 19,366 girls) aged 7-17 years participated in this study. WC, Hip circumference (HC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were measured; WHR was calculated as WC divided by HC. Abdominal obesity was defined by previously published WHR references based on Chinese children and adolescents living in Beijing. All subjects were divided into two groups (group 1 with WHR <85th; group 2 with WHR ≥85th) according to the percentiles of WHR and comparisons of the SBP and DBP between the two groups were made. The WHR levels in Shandong boys and girls were lower than those from German and Pakistani. The overall prevalence of abdominal obesity was 9.53% (95% CI = 9.12-9.95%) for boys and 9.82% (95% CI = 9.40-10.24%) for girls, no statistical differences between the two genders were observed (p > 0.05). In both boys and girls, the Z-scores of SBP and DBP were all significantly lower in group 1 than in group 2 (p < 0.01), indicating that children and adolescents with high WHR tended to have higher BP values. WHR is useful in identifying children and adolescents at risk of developing high BP. These findings, together with the known tracking of BP from adolescence into adulthood, highlight the importance of preventing overweight and obesity among children and adolescents in order to prevent the development of

Hypertension Knowledge, Awareness, and Attitudes in a Hypertensive Population

PubMed Central

Oliveria, Susan A; Chen, Roland S; McCarthy, Bruce D; Davis, Catherine C; Hill, Martha N

2005-01-01

OBJECTIVE Improved recognition of the importance of systolic blood pressure (SBP) has been identified as one of the major public health and medical challenges in the prevention and treatment of hypertension (HTN). SBP is a strong independent risk factor for cardiovascular disease but no information is available on whether patients understand the importance of their SBP level. The purpose of this study was to assess HTN knowledge, awareness, and attitudes, especially related to SBP in a hypertensive population. DESIGN/SETTING/PATIENTS We identified patients with HTN (N =2,264) in the primary care setting of a large midwestern health system using automated claims data (International Classification of Diseases, Ninth Revision [ICD-9] codes 401.0–401.9). We randomly selected 1,250 patients and, after excluding ineligible patients, report the results on 826 completed patient telephone interviews (72% response rate [826/1,151]). MAIN RESULTS Ninety percent of hypertensive patients knew that lowering blood pressure (BP) would improve health and 91% reported that a health care provider had told them that they have HTN or high BP. However, 41% of patients did not know their BP level. Eighty-two percent of all patients correctly identified the meaning of HTN as “high blood pressure.” Thirty-four percent of patients correctly identified SBP as the “top” number of their reading; 32% correctly identified diastolic blood pressure (DBP) as the “bottom” number; and, overall, only 30% of patients were able to correctly identify both systolic and diastolic BP measures. Twenty-seven percent of patients with elevated SBP and DBP (as indicated by their medical records) perceived that their BP was high. Twenty-four percent of patients did not know the optimal level for either SBP or DBP. When asked whether the DBP or SBP level was more important in the control and prevention of disease, 41% reported DBP, 13% reported SBP, 30% reported that both were important, and 17% did

Validation of the iHealth BP3 upper-arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Chen, Can; Shang, Fujun; Wang, Jiepin; Chen, Jianghong; Ji, Na; Wan, Yi

2012-12-01

This study aimed to evaluate the performance of the iHealth BP3 upper-arm blood pressure monitor, which is designed for clinic use and self-measurement of blood pressure using Apple touch devices as an interface. The European Society of Hypertension International Protocol (ESH-IP) revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. Ninty-nine couples of test device and reference blood pressure measurements were obtained during the study (three pairs for each of the 33 participants). The 33 participants, age 47.1±12.3 years (age range 27-69 years) and arm circumference 30.0±4.4 cm, had a mean systolic blood pressure (SBP) of 143.9±27.4 mmHg and a mean diastolic blood pressure (DBP) of 90.1±18.3 mmHg. The device passed all of the requirements fulfilling the standards of the protocol, and the mean±SD device-observer difference was 2.8±4.2 mmHg for SBP and -0.4±3.5 mmHg for DBP. According to the results of the validation study on the basis of the ESH-IP revision 2010, the iHealth BP3 can be recommended for clinic use and self-measurement in an adult population. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial.

PubMed

Eguchi, Eri; Funakubo, Narumi; Tomooka, Kiyohide; Ohira, Tetsuya; Ogino, Keiki; Tanigawa, Takeshi

2016-01-01

The aim of this study was to investigate the effects of aroma foot massage on blood pressure, anxiety, and health-related quality of life (QOL) in Japanese community-dwelling men and women using a crossover randomized controlled trial. Fifty-seven eligible participants (5 men and 52 women) aged 27 to 72 were randomly divided into 2 intervention groups (group A: n = 29; group B: n = 28) to participate in aroma foot massages 12 times during the 4-week intervention period. Systolic and diastolic blood pressure (SBP and DBP, respectively), heart rate, state anxiety, and health-related QOL were measured at the baseline, 4-week follow-up, and 8-week follow-up. The effects of the aroma foot massage intervention on these factors and the proportion of participants with anxiety were analyzed using a linear mixed-effect model for a crossover design adjusted for participant and period effects. Furthermore, the relationship between the changes in SBP and state anxiety among participants with relieved anxiety was assessed using a linear regression model. Aroma foot massage significantly decreased the mean SBP (p = 0.02), DBP (p = 0.006), and state anxiety (p = 0.003) as well as the proportion of participants with anxiety (p = 0.003). Although it was not statistically significant (p = 0.088), aroma foot massage also increased the score of mental health-related QOL. The change in SBP had a significant and positive correlation with the change in state anxiety (p = 0.01) among participants with relieved anxiety. The self-administered aroma foot massage intervention significantly decreased the mean SBP and DBP as well as the state anxiety score, and tended to increase the mental health-related QOL scores. The results suggest that aroma foot massage may be an easy and effective way to improve mental health and blood pressure. University Hospital Medical Information Network 000014260.

Relationship between daily exposure to biomass fuel smoke and blood pressure in high-altitude Peru

PubMed Central

Peña, Melissa Burroughs; Romero, Karina M.; Velazquez, Eric J.; Davila-Roman, Victor G.; Gilman, Robert H.; Wise, Robert A; Miranda, J. Jaime; Checkley, William

2015-01-01

Household air pollution from biomass fuel use affects three billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity (FVC) were conducted to evaluate for effect modification. Data from 1004 individuals (mean age 55.3 years, 51.7% female) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio 5.0, 95% CI 2.6 to 9.9) and hypertension (adjusted relative risk ratio 3.5, 95% CI 1.7 to 7.0). Biomass fuel users had a higher SBP (7.01 mmHg, 95% CI 4.4 to 9.6) and a higher DBP (5.9 mmHg, 95% CI 4.2 to 7.6) when compared to nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted FVC for either SBP or DBP. Biomass fuel use was associated with an increased risk of hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention. PMID:25753976

Aluminum electrocoagulation as pretreatment during microfiltration of surface water containing NOM: A review of fouling, NOM, DBP, and virus control.

PubMed

Chellam, Shankararaman; Sari, Mutiara Ayu

2016-03-05

Electrocoagulation (EC) is the intentional corrosion of sacrificial anodes (typically aluminum or iron) by passing electricity to release metal-ion coagulant species and destabilize a wide range of suspended, dissolved, and macromolecular contaminants. It can be integrated ahead of microfiltration (MF) to effectively control turbidity, microorganisms, and disinfection by-products (DBPs) and simultaneously maintain a high MF specific flux. This manuscript summarizes the current knowledge on MF pretreatment by aluminum EC particularly focusing on mechanisms of (i) electrocoagulant dosing, (ii) (bio)colloid destabilization, (iii) fouling reductions, and (iv) enhanced removal of viruses, natural organic matter (NOM), and DBP precursors. Electrolysis efficiently removes hydrophobic NOM, viruses, and siliceous foulants. Aluminum effectively electrocoagulates viruses by physically encapsulating them in flocs, neutralizing their surface charge and reducing electrostatic repulsion, and increasing hydrophobic interactions between any sorbed NOM and free viruses. New results included herein demonstrate that EC achieves DBP control by removing NOM, reducing chlorine-reactivity of remaining NOM, and inducing a slight shift toward more brominated trihalomethanes and haloacetic acids. EC reduces MF fouling by forming large flocs that tend to deposit on the membrane surface, i.e. decrease pore penetration and forming more permeable cakes and by reducing foulant mass in case of significant floc-flotation. Copyright © 2015 Elsevier B.V. All rights reserved.

The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials.

PubMed

Mohammadifard, Noushin; Salehi-Abargouei, Amin; Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Humphries, Karin; Sarrafzadegan, Nizal

2015-05-01

Although several studies have assessed the effects of nut consumption (tree nuts, peanuts, and soy nuts) on blood pressure (BP), the results are conflicting. The aim was to conduct a systematic review and meta-analysis of published randomized controlled trials (RCTs) to estimate the effect of nut consumption on BP. The databases MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched for RCTs carried out between 1958 and October 2013 that reported the effect of consuming single or mixed nuts (including walnuts, almonds, pistachios, cashews, hazelnuts, macadamia nuts, pecans, peanuts, and soy nuts) on systolic BP (SBP) or diastolic BP (DBP) as primary or secondary outcomes in adult populations aged ≥18 y. Relevant articles were identified by screening the abstracts and titles and the full text. Studies that evaluated the effects for <2 wk or in which the control group ingested different healthy oils were excluded. Mean ± SD changes in SBP and DBP in each treatment group were recorded for meta-analysis. Twenty-one RCTs met the inclusion criteria. Our findings suggest that nut consumption leads to a significant reduction in SBP in participants without type 2 diabetes [mean difference (MD): -1.29; 95% CI: -2.35, -0.22; P = 0.02] but not in the total population. Subgroup analyses of different nut types suggest that pistachios, but not other nuts, significantly reduce SBP (MD: -1.82; 95% CI: -2.97, -0.67; P = 0.002). Our study suggests that pistachios (MD: -0.80; 95% CI: -1.43, -0.17; P = 0.01) and mixed nuts (MD: -1.19; 95% CI: -2.35, -0.03; P = 0.04) have a significant reducing effect on DBP. We found no significant changes in DBP after the consumption of other nuts. Total nut consumption lowered SBP in participants without type 2 diabetes. Pistachios seemed to have the strongest effect on reducing SBP and DBP. Mixed nuts also reduced DBP. © 2015 American Society for Nutrition.

Validation of the SEJOY BP-1307 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Lei, Lei; Chen, Yi; Chen, Qi; Li, Yan; Wang, Ji-Guang

2017-12-01

The present study aimed to evaluate the accuracy of the automated oscillometric upper-arm blood pressure monitor SEJOY BP-1307 (also called JOYTECH DBP-1307) for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese individuals (13 women, 45.1 years of mean age) using a mercury sphygmomanometer (two observers) and the SEJOY BP-1307 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The average±SD of the device-observer differences was 0.2±4.1 and -1.7±4.7 mmHg for systolic and diastolic blood pressure, respectively. The SEJOY BP-1307 device achieved the criteria in both part 1 and part 2 of the validation study. The SEJOY upper-arm blood pressure monitor BP-1307 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: the HIPARCO randomized clinical trial.

PubMed

Martínez-García, Miguel-Angel; Capote, Francisco; Campos-Rodríguez, Francisco; Lloberes, Patricia; Díaz de Atauri, María Josefa; Somoza, María; Masa, Juan F; González, Mónica; Sacristán, Lirios; Barbé, Ferrán; Durán-Cantolla, Joaquín; Aizpuru, Felipe; Mañas, Eva; Barreiro, Bienvenido; Mosteiro, Mar; Cebrián, Juan J; de la Peña, Mónica; García-Río, Francisco; Maimó, Andrés; Zapater, Jordi; Hernández, Concepción; Grau SanMarti, Nuria; Montserrat, Josep María

2013-12-11

More than 70% of patients with resistant hypertension have obstructive sleep apnea (OSA). However, there is little evidence about the effect of continuous positive airway pressure (CPAP) treatment on blood pressure in patients with resistant hypertension. To assess the effect of CPAP treatment on blood pressure values and nocturnal blood pressure patterns in patients with resistant hypertension and OSA. Open-label, randomized, multicenter clinical trial of parallel groups with blinded end point design conducted in 24 teaching hospitals in Spain involving 194 patients with resistant hypertension and an apnea-hypopnea index (AHI) of 15 or higher. Data were collected from June 2009 to October 2011. CPAP or no therapy while maintaining usual blood pressure control medication. The primary end point was the change in 24-hour mean blood pressure after 12 weeks. Secondary end points included changes in other blood pressure values and changes in nocturnal blood pressure patterns. Both intention-to-treat (ITT) and per-protocol analyses were performed. A total of 194 patients were randomly assigned to receive CPAP (n = 98) or no CPAP (control; n = 96). The mean AHI was 40.4 (SD, 18.9) and an average of 3.8 antihypertensive drugs were taken per patient. Baseline 24-hour mean blood pressure was 103.4 mm Hg; systolic blood pressure (SBP), 144.2 mm Hg; and diastolic blood pressure (DBP), 83 mm Hg. At baseline, 25.8% of patients displayed a dipper pattern (a decrease of at least 10% in the average nighttime blood pressure compared with the average daytime blood pressure). The percentage of patients using CPAP for 4 or more hours per day was 72.4%. When the changes in blood pressure over the study period were compared between groups by ITT, the CPAP group achieved a greater decrease in 24-hour mean blood pressure (3.1 mm Hg [95% CI, 0.6 to 5.6]; P = .02) and 24-hour DBP (3.2 mm Hg [95% CI, 1.0 to 5.4]; P = .005), but not in 24-hour SBP (3.1 mm Hg [95% CI, -0.6 to 6

Reading Skill Development: A Survey of Need and Responsibility

ERIC Educational Resources Information Center

Polkinghorne, Frederick W.; Hagler, Barbara; Anderson, Marcia

2010-01-01

Background: According to research, adolescent reading skills tend to be poor, and increased pressure from Federal legislation has been placed on educators to improve these skills. Research lacks on business teacher educators' preparation to provide reading skill instruction. Purpose: The research purpose was to better understand the perceptions of…

Development of a cuffless blood pressure measurement system.

PubMed

Shyu, Liang-Yu; Kao, Yao-Lin; Tsai, Wen-Ya; Hu, Weichih

2012-01-01

This study constructs a novel blood pressure measurement device without the air cuff to overcome the problem of discomfort and portability. The proposed device measures the blood pressure through a mechanism that is made of silicon rubber and pressure transducer. The system uses a microcontroller to control the measurement procedure and to perform the necessary computation. To verify the feasibility of the constructed device, ten young volunteers were recruited. Ten blood pressure readings were obtained using the new system and were compared with ten blood pressure readings from bedside monitor (Spacelabs Medical, model 90367). The results indicated that, when all the readings were included, the mean pressure, systolic pressure and diastolic pressure from the new system were all higher than those from bedside monitor. The correlation coefficients between these two were 0.15, 0.18 and 0.29, for mean, systolic and diastolic pressures, respectively. After excluding irregular apparatus utilization, the correlation coefficient increased to 0.71, 0.60 and 0.41 for diastolic pressure, mean pressure and systolic pressure, respectively. We can conclude from these results that the accuracy can be improved effectively by defining the user regulation more precisely. The above mentioned irregular apparatus utilization factors can be identified and eliminated by the microprocessor to provide a reliable blood pressure measurement in practical applications in the future.

Fixed-pressure CPAP versus auto-adjusting CPAP: comparison of efficacy on blood pressure in obstructive sleep apnoea, a randomised clinical trial.

PubMed

Pépin, J L; Tamisier, R; Baguet, J P; Lepaulle, B; Arbib, F; Arnol, N; Timsit, J F; Lévy, P

2016-08-01

Millions of individuals with obstructive sleep apnoea (OSA) are treated by CPAP aimed at reducing blood pressure (BP) and thus cardiovascular risk. However, evidence is scarce concerning the impact of different CPAP modalities on BP evolution. This double-blind, randomised clinical trial of parallel groups of patients with OSA indicated for CPAP treatment compared the efficacy of fixed-pressure CPAP (FP-CPAP) with auto-adjusting CPAP (AutoCPAP) in reducing BP. The primary endpoint was the change in office systolic BP after 4 months. Secondary endpoints included 24 h BP measurements. Patients (322) were randomised to FP-CPAP (n=161) or AutoCPAP (n=161). The mean apnoea+hypopnoea index (AHI) was 43/h (SD, 21); mean age was 57 (SD, 11), with 70% of males; mean body mass index was 31.3 kg/m(2) (SD, 6.6) and median device use was 5.1 h/night. In the intention-to-treat analysis, office systolic blood pressure decreased by 2.2 mm Hg (95% CI -5.8 to 1.4) and 0.4 mm Hg (-4.3 to 3.4) in the FP-CPAP and AutoCPAP group, respectively (group difference: -1.3 mm Hg (95% CI -4.1 to 1.5); p=0.37, adjusted for baseline BP values). 24 h diastolic BP (DBP) decreased by 1.7 mm Hg (95% CI -3.9 to 0.5) and 0.5 mm Hg (95% CI -2.3 to 1.3) in the FP-CPAP and AutoCPAP group, respectively (group difference: -1.4 mm Hg (95% CI -2.7 to -0.01); p=0.048, adjusted for baseline BP values). The result was negative regarding the primary outcome of office BP, while FP-CPAP was more effective in reducing 24 h DBP (a secondary outcome). NCT01090297. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials123

PubMed Central

Juraschek, Stephen P; Guallar, Eliseo; Appel, Lawrence J

2012-01-01

Background: In observational studies, increased vitamin C intake, vitamin C supplementation, and higher blood concentrations of vitamin C are associated with lower blood pressure (BP). However, evidence for blood pressure–lowering effects of vitamin C in clinical trials is inconsistent. Objective: The objective was to conduct a systematic review and meta-analysis of clinical trials that examined the effects of vitamin C supplementation on BP. Design: We searched Medline, EMBASE, and Central databases from 1966 to 2011. Prespecified inclusion criteria were as follows: 1) use of a randomized controlled trial design; 2) trial reported effects on systolic BP (SBP) or diastolic BP (DBP) or both; 3) trial used oral vitamin C and concurrent control groups; and 4) trial had a minimum duration of 2 wk. BP effects were pooled by random-effects models, with trials weighted by inverse variance. Results: Twenty-nine trials met eligibility criteria for the primary analysis. The median dose was 500 mg/d, the median duration was 8 wk, and trial sizes ranged from 10 to 120 participants. The pooled changes in SBP and DBP were −3.84 mm Hg (95% CI: −5.29, −2.38 mm Hg; P < 0.01) and −1.48 mm Hg (95% CI: −2.86, −0.10 mm Hg; P = 0.04), respectively. In trials in hypertensive participants, corresponding reductions in SBP and DBP were −4.85 mm Hg (P < 0.01) and −1.67 mm Hg (P = 0.17). After the inclusion of 9 trials with imputed BP effects, BP effects were attenuated but remained significant. Conclusions: In short-term trials, vitamin C supplementation reduced SBP and DBP. Long-term trials on the effects of vitamin C supplementation on BP and clinical events are needed. PMID:22492364

DBP formation in hot and cold water across a simulated distribution system: effect of incubation time, heating time, pH, chlorine dose, and incubation temperature.

PubMed

Liu, Boning; Reckhow, David A

2013-10-15

This paper demonstrates that disinfection byproducts (DBP) concentration profiles in heated water were quite different from the DBP concentrations in the cold tap water. Chloroform concentrations in the heated water remained constant or even decreased slightly with increasing distribution system water age. The amount of dichloroacetic acid (DCAA) was much higher in the heated water than in the cold water; however, the maximum levels in heated water with different distribution system water ages did not differ substantially. The levels of trichloroacetic acid (TCAA) in the heated water were similar to the TCAA levels in the tap water, and a slight reduction was observed after the tap water was heated for 24 h. Regardless of water age, significant reductions of nonregulated DBPs were observed after the tap water was heated for 24 h. For tap water with lower water ages, there were significant increases in dichloroacetonitrile (DCAN), chloropicrin (CP), and 1,1-dichloropropane (1,1-DCP) after a short period of heating. Heating of the tap water with low pH led to a more significant increase of chloroform and a more significant short-term increase of DCAN. High pH accelerated the loss of the nonregulated DBPs in the heated water. The results indicated that as the chlorine doses increased, levels of chloroform and DCAA in the heated water increased significantly. However, for TCAA, the thermally induced increase in concentration was only notable for the chlorinated water with very high chlorine dose. Finally, heating may lead to higher DBP concentrations in chlorinated water with lower distribution system temperatures.

Effects of a hot-water extract of porcini (Boletus aestivalis) mushrooms on the blood pressure and heart rate of spontaneously hypertensive rats.

PubMed

Midoh, Naoki; Miyazawa, Noriko; Eguchi, Fumio

2013-01-01

The repeated once-daily oral administration of a hot-water extract of porcini, Boletus aestivalis, mushrooms (WEP) to spontaneously hypertensive rats (SHR) for 18 weeks decreased the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate. The WEP administration also decreased blood urea nitrogen (BUN), creatinine (Cre), and triglyceride (TG), and increased high-density lipoprotein-cholesterol (HDL-C) in the blood, suggesting that WEP improved the status of hypertension, as well as the high heart rate and metabolic abnormalities involved in hypertension.

Impact of Empagliflozin on Blood Pressure in Patients With Type 2 Diabetes Mellitus and Hypertension by Background Antihypertensive Medication.

PubMed

Mancia, Giuseppe; Cannon, Christopher P; Tikkanen, Ilkka; Zeller, Cordula; Ley, Ludwin; Woerle, Hans J; Broedl, Uli C; Johansen, Odd Erik

2016-12-01

In the EMPA-REG BP trial, empagliflozin 10 mg and 25 mg once daily reduced glycohemoglobin, blood pressure (BP), and weight versus placebo in patients with type 2 diabetes mellitus and hypertension. Patients received placebo (n=271), empagliflozin 10 mg (n=276), or empagliflozin 25 mg (n=276) for 12 weeks (n=full analysis set). This present analysis investigated changes from baseline to week 12 in mean 24-hour systolic BP (SBP) and diastolic BP (DBP) in patients receiving 0, 1, or ≥2 antihypertensive medications and patients receiving/not receiving diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Compared with placebo, empagliflozin 10 mg and 25 mg reduced mean 24-hour SBP/DBP in patients receiving 0 (10 mg: -3.89/-2.58 mm Hg; 25 mg: -3.77/-2.45 mm Hg), 1 (10 mg: -4.74/-1.97 mm Hg; 25 mg: -4.27/-1.81 mm Hg), or ≥2 (10 mg: -2.36/-0.68 mm Hg; 25 mg: -4.17/-1.54 mm Hg) antihypertensives. The effect of empagliflozin was not significantly different between subgroups by number of antihypertensives for changes in SBP (interaction P value 0.448) or DBP (interaction P value 0.498). Empagliflozin reduced 24-hour mean SBP/DBP irrespective of diuretic or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, with no significant difference between subgroups by use/no use of diuretics (interaction P values 0.380 [systolic]; 0.240 [diastolic]) or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (interaction P values 0.900 [systolic]; 0.359 [diastolic]). In conclusion, in patients with type 2 diabetes mellitus and hypertension, empagliflozin for 12 weeks reduced SBP and DBP versus placebo, irrespective of the number of antihypertensives and use of diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. URL: https://clinicaltrials.gov. Unique identifier: NCT01370005. © 2016 American Heart Association, Inc.

The Impact of Read Right: Semester-Only versus Year-Long Inplementation

ERIC Educational Resources Information Center

Sell, John B.

2013-01-01

Faced with meeting the requirements of the No Child Left Behind Act of 2001, schools are under pressure to have 100% of their students meet national standards in reading by 2014. For the 2010-2011 and 2011-2012 school years, Sussex Technical High School (STHS) in Georgetown, Delaware chose to adopt Read Right, a reading comprehension improvement…

Aortic Stiffness, Ambulatory Blood Pressure, and Predictors of Response to Antihypertensive Therapy in Hemodialysis.

PubMed

Georgianos, Panagiotis I; Agarwal, Rajiv

2015-08-01

Arterial stiffness is associated with elevated blood pressure (BP), but it is unclear whether it also makes hypertension more resistant to treatment. Among hypertensive dialysis patients, this study investigated whether aortic stiffness determines ambulatory BP and predicts its improvement with therapy. Post hoc analysis of the Hypertension in Hemodialysis Patients Treated With Atenolol or Lisinopril (HDPAL) trial. 179 hypertensive hemodialysis patients with echocardiographic left ventricular hypertrophy. Baseline aortic pulse wave velocity (PWV). Baseline and treatment-induced change in 44-hour ambulatory BP at 3, 6, and 12 months. Aortic PWV was assessed with an echocardiographic-Doppler technique (ACUSON Cypress, Siemens Medical), and 44-hour interdialytic ambulatory BP monitoring was performed with a Spacelabs 90207 monitor. Mean baseline aortic PWV was 7.6±2.7 (SD) m/s. Overall treatment-induced changes in ambulatory systolic BP (SBP) were -15.6±20.4, -18.9±22.5, and -20.0±19.7 mmHg at 3, 6, and 12 months. Changes in SBP were no different among tertiles of baseline PWV. Aortic PWV was associated directly with baseline ambulatory SBP and pulse pressure (PP) and inversely with diastolic BP (DBP). After adjustment for several cardiovascular risk factors, each 1-m/s higher PWV was associated with 1.34-mm Hg higher baseline SBP (β=1.34±0.46; P=0.004) and 1.02-mm Hg higher PP (β=1.02±0.33; P=0.002), whereas the association with DBP was no longer significant. Baseline PWV did not predict treatment-induced changes in SBP (Wald test, P=0.3) and DBP (Wald test, P=0.7), but was a predictor of an overall improvement in PP during follow-up (Wald test, P=0.03). Observational design; predominantly black patients were studied. Because aortic PWV is not a predictor of treatment-induced change in ambulatory BP among hypertensive dialysis patients, it indicates that among these patients, hypertension can be controlled successfully regardless of aortic stiffness

[Effect of anthocyanins from Aronia melanocarpa on blood pressure, concentration of endothelin-1 and lipids in patients with metabolic syndrome].

PubMed

Broncel, Marlena; Koziróg-Kołacińska, Marzena; Andryskowski, Grzegorz; Duchnowicz, Piotr; Koter-Michalak, Maria; Owczarczyk, Aleksandra; Chojnowska-Jezierska, Julita

2007-08-01

To estimate the influence of anthocyanins from Aronia melanocarpa on blood pressure, concentration of endothelin-1 (ET-1), serum lipids, fasting glucose, uric acid and membrane cholesterol in erythrocytes of patients (pts) with metabolic syndrome (MS). The study comprised 22 healthy volunteers and 25 pts with MS treated with anthocyanins (3 x 100 mg/d) for 2 months. Waist circumference (> or = 80 cm for women and > or =94 cm for men), triglicerydes (TG) level >150 mg/dl (1.7 mmol/l), cholesterol-HDL (HDL-C) level < 40 mg/dl (1.0 mmol/l) for men and <50 mg/dl (1.3 mmol/l) for women, systolic blood pressure (SBP) >130 mmHg and/or diastolic blood pressure (DBP) >85 mmHg were inclusion criteria for patients with MS. Before and after 2 months of treatment the following parameters were determined: SBP, DBP, serum lipids (total cholesterol--TC, cholesterol LDL--LDL-C, cholesterol HDL--HDL-C, TG--by enzymatic method), membrane cholesterol in erythrocytes (method of IIcy), ET-1 (immunoenzymatic method), fasting glucose level was (colorimetric method), uric acid (enzymatic--colorimetric method). After two months therapy of anthocyanins from Aronia melanocarpa in comparison with baseline it was observed a significant decrease of: SBP (144.20 +/- 9.97 vs. 131.83 +/- 12.24 mmHg, p < 0.001) and DBP (87.20 +/- 9.9 vs. 82.13 +/- 10.33 mmHg, p < 0.05), TC (242.80 +/- 34.48 vs. 227.96 +/- 33.07 mg/dl, p < 0.001), LDL-C (158.71 +/- 35.78 vs. 146.21 +/- 34.63 mg/dl, p < 0.01), TG (215.92 +/- 63.61 vs. 187.58 +/- 90 mg/dl, p < 0.05), ET-1 (2.44 +/- 0.51 vs. 1.74 +/- 0.42 pg/ml, p < 0.001) and membrane cholesterol (4.85 +/- 0.65 vs. 2.81 +/- 0.54 mmol/Lpc, p < 0.001), uric acid and fasting blood glucose levels did not change significantly after study cessation. The results of our study show that anthocyanins from Aronia melanocarpa may be of benefit to patients with MS as for as atherosclerosis prevention is concerned. It seems to result from anthocyanins influence on blood pressure

MALFORMATIONS IN GUBERNACULAR LIGAMENT DEVELOPMENT INDUCED BY DEHP, DBP, AND BBP ARE ASSOCIATED WITH DECREASES IN INSL3 GENE EXPRESSION IN THE FETAL RAT TESTIS

EPA Science Inventory

Malformations in gubernacular ligament development induced by DEHP, DBP, and BBP are associated with decreases in insl3 gene expression in the fetal rat testis.
Vickie S.Wilson, Christy Lambright, Johnathan Furr, Carmen Wood, Gary Held, L. Earl Gray Jr. U.S. EPA, ORD, NHEER...

Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials.

PubMed

Binia, Aristea; Jaeger, Jonathan; Hu, Youyou; Singh, Anurag; Zimmermann, Diane

2015-08-01

To evaluate the efficacy of daily potassium intake on decreasing blood pressure in non-medicated normotensive or hypertensive patients, and to determine the relationship between potassium intake, sodium-to-potassium ratio and reduction in blood pressure. Mixed-effect meta-analyses and meta-regression models. Medline and the references of previous meta-analyses. Randomized controlled trials with potassium supplementation, with blood pressure as the primary outcome, in non-medicated patients. Fifteen randomized controlled trials of potassium supplementation in patients without antihypertensive medication were selected for the meta-analyses (917 patients). Potassium supplementation resulted in reduction of SBP by 4.7 mmHg [95% confidence interval (CI) 2.4-7.0] and DBP by 3.5 mmHg (95% CI 1.3-5.7) in all patients. The effect was found to be greater in hypertensive patients, with a reduction of SBP by 6.8 mmHg (95% CI 4.3-9.3) and DBP by 4.6 mmHg (95% CI 1.8-7.5). Meta-regression analysis showed that both increased daily potassium excretion and decreased sodium-to-potassium ratio were associated with blood pressure reduction (P < 0.05). Increased total daily potassium urinary excretion from 60 to 100 mmol/day and decrease of sodium-to-potassium ratio were shown to be necessary to explain the estimated effect. Potassium supplementation is associated with reduction of blood pressure in patients who are not on antihypertensive medication, and the effect is significant in hypertensive patients. The reduction in blood pressure significantly correlates with decreased daily urinary sodium-to-potassium ratio and increased urinary potassium. Patients with elevated blood pressure may benefit from increased potassium intake along with controlled or decreased sodium intake.

Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

PubMed

Graudal, Niels Albert; Hubeck-Graudal, Thorbjorn; Jurgens, Gesche

2017-04-09

In spite of more than 100 years of investigations the question of whether a reduced sodium intake improves health is still unsolved. To estimate the effects of low sodium intake versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to March 2016: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 3), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the reference lists of relevant articles. Studies randomising persons to low-sodium and high-sodium diets were included if they evaluated at least one of the above outcome parameters. Two review authors independently collected data, which were analysed with Review Manager 5.3. A total of 185 studies were included. The average sodium intake was reduced from 201 mmol/day (corresponding to high usual level) to 66 mmol/day (corresponding to the recommended level).The effect of sodium reduction on blood pressure (BP) was as follows: white people with normotension: SBP: mean difference (MD) -1.09 mmHg (95% confidence interval (CI): -1.63 to -0.56; P = 0.0001); 89 studies, 8569 participants; DBP: + 0.03 mmHg (MD 95% CI: -0.37 to 0.43; P = 0.89); 90 studies, 8833 participants. High-quality evidence. Black people with normotension: SBP: MD -4.02 mmHg (95% CI:-7.37 to -0.68; P = 0.002); seven studies, 506 participants; DBP: MD -2.01 mmHg (95% CI:-4.37 to 0.35; P = 0.09); seven studies, 506 participants. Moderate-quality evidence. Asian people with normotension: SBP: MD -0.72 mmHg (95% CI: -3.86 to 2.41; P = 0.65); DBP: MD -1.63 mmHg (95% CI:-3.35 to 0

Average blood pressure and cardiovascular disease-related mortality in middle-aged women.

PubMed

van Trijp, Marijke J C A; Grobbee, Diederick E; Peeters, Petra H M; van Der Schouw, Yvonne T; Bots, Michiel L

2005-02-01

The aim of this study was to assess which average blood pressure (BP) component (ie, systolic BP [SBP], diastolic BP [DBP], pulse pressure [PP], or mean arterial pressure [MAP]), is most strongly related to cardiovascular disease (CVD)-related mortality and to evaluate whether the strength of the relation varies with follow-up time. This was a prospective cohort study. The studied cohort comprised a population of postmenopausal women (n = 7813) between the ages of 49 and 66 years of age, of whom four BP measurements were available, obtained at four different time points. Average BP, ie, the mean of the four measurements divided by the standard deviation, was entered in Cox proportional hazards models to facilitate direct comparison. Hazard ratios (HR) were calculated adjusted for age, body mass index, presence of diabetes mellitus, smoking habit, and use of BP-lowering medication. In addition analyses were repeated in strata of follow-up time (10, 15, and 20 years). During a mean follow-up of 13.1 years, 463 CVD-related deaths occurred. For SBP and MAP the highest HR for CVD mortality were found; however, the confidence intervals (CI) overlapped (SBP: HR = 1.43, 95% CI = 1.30 to 1.58; DBP: HR = 1.35, 95% CI = 1.23 to 1.50; PP: HR = 1.30, 95% CI = 1.19 to 1.42; MAP: HR = 1.43, 95% CI = 1.30 to 1.58). Analyses in strata of follow-up time did not show a difference in strength of the associations with increasing follow-up time. In this prospective follow-up study of postmenopausal women, SBP and MAP seemed to be strongest related with CVD-related death; however the CI of the HR overlapped.

A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index.

PubMed

Ates, Hale; Ates, Ihsan; Kundi, Harun; Arikan, Mehmet Fettah; Yilmaz, Fatma Meric

2017-10-01

This study aims to investigate the role of the blood pressure index (BPI), which is a new index that we developed, in detection of right ventricular dysfunction (RVD) in acute pulmonary embolism (APE). A total of 539 patients, (253 males and 286 females), diagnosed with APE using computer tomography pulmonary angiography were included in the study. The BPI was obtained by dividing systolic blood pressure (SBP) by diastolic blood pressure (DBP). Mean DBP (75±11mmHg vs 63±15mmHg; p<0.001, respectively) was found to be higher in RVD patients compared to those without RVD, whereas BPI (1.5±0.1 vs 1.9±0.2; p<0.001, respectively) was lower. Examining the performance of BPI in prediction of RVD using receiver operating characteristic curve analysis (area under curve±SE=0.975±0.006; p<0.001), it was found that BPI could predict RVD with very high sensitivity (92.8%) and specificity (100%) and had a positive predictive value of 100% and a negative predictive value of 42.1%. According to the analysis, the highest youden index for the optimal prediction value was found to be 0.478 and the BPI≤1.4 was found to predict mortality 68.6% sensitivity and 80.8% specificity (Area under curve±SE=0.777±0.051; p<0.001). We found that BPI was an index with high positive predictive value and low negative predictive value in detection of RVD. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of symbiotic and vitamin E supplementation on blood pressure, nitric oxide and inflammatory factors in non-alcoholic fatty liver disease.

PubMed

Ekhlasi, Golnaz; Zarrati, Mitra; Agah, Shahram; Hosseini, Agha Fatemeh; Hosseini, Sharieh; Shidfar, Shahrzad; Soltani Aarbshahi, Seyed Soroush; Razmpoosh, Elham; Shidfar, Farzad

2017-01-01

Non-alcoholic fatty liver disease (NAFLD) has been suggested to be well correlated with altered blood pressure. This study was conducted to determine the effects of symbiotic and vitamin E supplementation on blood pressure and inflammatory indices of patients with NAFLD. This randomized, double-blind, placebo-controlled trial was performed among 60 NAFLD patients aged 25 to 64 years old. Participants were randomly divided into four groups to receive a 400 IU alpha-tocopherol and 2 × 10 8 CFU/g symbiotic supplement for 8 weeks. The anthropometric parameters, systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum malondialdehyde (MDA), nitric oxide (NO) and tumor necrosis factor α (TNFα) were assessed at baseline and after 8 weeks of intervention. After 8 weeks of intervention, combined symbiotic and alpha-tocopherol, symbiotic and alpha-tocopherol alone administration, compared with the placebo, resulted in significant decreases in SBP (-17.07±2.1, -16.07±3.56, -1.73±2.25 and -1.55±3.01 mmHg, P=0.01), serum MDA (-1.19±0.5, -0.12±0.65, 0.14 ± 0.64 and 0.16±0.34 nmol/mL, P<0.001), serum TNFα (-15.62±13.93, -9.24±7.12, -11.44 ± 15.47 and 3.01±1.71 pg/ml, P<0.001) concentrations. A significant decrease in serum AST (-11.36±4.52, -7.43±8.58, -5.93±6.61 and 2.5±5.75 μmol/L, P <0.001), ALT (-12.79±3.65, -3.66±6.81, -6.54±7.66 and 4.16±3.43 μmol/L, P <0.001) and ALP (-26.8±11.1, -4.56±9.22, -14.48±12.22 and 5.19±2.64 μmol/L, P <0.001) was seen. Variations in DBP and serum NO concentration were not significant. Alpha-tocopherol and symbiotic supplementation among patients with NAFLD resulted in decreased SBP, serum MDA, TNFα levels and enzymes liver; however, they did not affect DBP and serum NO concentration.

Blood pressure in head‐injured patients

PubMed Central

Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R

2007-01-01

Objective To determine the statistical characteristics of blood pressure (BP) readings from a large number of head‐injured patients. Methods The BrainIT group has collected high time‐resolution physiological and clinical data from head‐injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic. PMID:17138594

Chlorine decay and DBP formation under different flow regions in PVC and ductile iron pipes: Preliminary results on the role of flow velocity and radial mass transfer