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Epidemiological and animal studies assert an inverse relationship between calcium intake and risk of clinical hypertension. Nonetheless, there is a paucity of information on the effect of calcium and vitamin D co-administration on sodium chloride (NaCl)-induced blood pressure (BP) elevation in apparently healthy normotensive subjects. Hence, this study evaluated this relationship. For a 5-day study period, a group of 10 subjects (Group A) was placed on placebo while another group of 5 subjects (Group B) had dietary NaCl (200 mmol/day) and a third group of 5 subjects (Group C) had dietary NaCl (200 mmol/day) with calcium/vitamin D supplement (625 mg/200 IU). Before and after the 5-day regimen, blood pressure (BP) was measured, and blood, as well as urine samples, were collected from the subjects for evaluation of electrolyte status. Mean arterial BP (MABP) increased (p0.01) only in group C, after the 5-day regimen. Urinary excretion of calcium increased and decreased (p

Objective: This study aims to compare the average levels of IL-10 with preeclampsia and normotensive in four different tribe populations in South Sulawesi, including Makassar, Bugis, Mandar, and Toraja. Method: This research is a cross-sectional study conducted in March–May 2020 in several Health Centre and Hospitals in four areas, namely in the UNHAS Hospital, Jumpandang Baru Health Center, Barabaraya Health Center, Mattirobulu Health Center, Salo Health Center, Lasinrang Pinrang General Hospital, Totoli Health Center, Majene Regional General Hospital, Makale Health Center, Elim General Hospital, Lakipadada Tana Toraja Regional General Hospital. Samples in this study were 88 pregnant women with gestational age >20 weeks which were divided into two groups, namely 44 cases (preeclampsia) and 44 control groups (normotensive). The criteria for the sample in this study are single pregnancy, no systemic disease, and are native Makassar, Bugis, Mandar, and Toraja tribes. Data collected included age, education, occupation, parity, Body Mass Index (BMI), history of preeclampsia. Serum IL-10 levels were examined using the Human Interleukin 10 ELISA Kit. Results: There were significant differences in IL-10 levels in preeclampsia pregnant women in the Makassar, Bugis, Mandar, and Toraja tribes (p = 0.020, p 0.05). The Bugis, Mandar, and Toraja tribes show significant differences in IL-10 levels between preeclampsia pregnant women and normotensive pregnant women with mean rating values of pregnant women who have preeclampsia have lower IL-10 levels than normotensive pregnant women, while the Makassar tribe has valued insignificant difference in IL-10 levels between preeclampsia and normotensive (p = 0.309, p > 0.05). Conclusion: There are differences in IL-10 levels in preeclampsia pregnant women in Makassar, Bugis, Mandar, and Toraja tribes. The mean concentration of IL-10 in pregnant women with preeclampsia was significantly lower than in controls.

Background: Co-existence of hypertension is known in three quarter of Indian type 2 diabetics, this duo having adverse additive effect on cardiovascular health including dysautonomia. Latter can be measured by simple 5 min heart rate variability (HRV) using simple electrocardiogram, which if reduced indicates cardiac risk. Objective: We compared HRV parameters between hypertensive and normotensive type 2 diabetics, looking for significant difference if any. Materials and methods: 98 hypertensive and 40 normotensive type 2 diabetics treated as outpatients were evaluated for disease control and risk stratification. Five min resting HRV was measured by Variowin HR, software based instrument, using standard protocols to record time domain, frequency domain and Poincare plot parameters. They were compared between groups for difference. Results: Mean age was 56 and 51 years, duration 6 years and 4 years respectively in hypertensive (HT) and normotensive (NT) group of type 2 diabetics, which did not significantly differ in distribution of risk factors. There was poor glycaemic control (one third) in both groups and good pressure control in HT group. Both groups revealed all reduced HRV parameters with significant difference in-between only for LF/HF ratio (1.29 in HT vs 2.61 in NT group). Conclusion: Our findings of HRV suggest that in type 2 diabetics with poor glycaemic and good pressure control, hypertension as a co-existing factor does not make significant difference in cardiac dysautonomia emphasizing residual risk despite antihypertensive treatment and need for early HRV screening, strict glycaemic control and other interventions.

Background: Patients with acute pulmonary embolism (PE) and hypotension (high-risk PE) have high mortality. Cardiogenic shock can also occur in nonhypotensive or normotensive patients (intermediate-risk PE) but is less well characterized., Objectives: The authors sought to evaluate the prevalence and predictors of normotensive shock in intermediate-risk PE., Methods: Intermediate-risk PE patients in the FLASH (FlowTriever All-Comer Registry for Patient Safety and Hemodynamics) registry undergoing mechanical thrombectomy with the FlowTriever System (Inari Medical) were included. The prevalence of normotensive shock (systolic blood pressure ≥90 mm Hg but cardiac index ≤2.2 L/min/m 2 ) was assessed. A composite shock score consisting of markers of right ventricular function and ischemia (elevated troponin, elevated B-type natriuretic peptide, moderately/severely reduced right ventricular function), central thrombus burden (saddle PE), potential additional embolization (concomitant deep vein thrombosis), and cardiovascular compensation (tachycardia) was prespecified and assessed for its ability to identify normotensive shock patients., Results: Over one-third of intermediate-risk PE patients in FLASH (131/384, 34.1%) were in normotensive shock. The normotensive shock prevalence was 0% in patients with a composite shock score of 0 and 58.3% in those with a score of 6 (highest score). A score of 6 was a significant predictor of normotensive shock (odds ratio: 5.84; 95% CI: 2.00-17.04). Patients showed significant on-table improvements in hemodynamics post-thrombectomy, including normalization of the cardiac index in 30.5% of normotensive shock patients. Right ventricular size, function, dyspnea, and quality of life significantly improved at the 30-day follow-up., Conclusions: Although hemodynamically stable, over one-third of intermediate-risk FLASH patients were in normotensive shock with a depressed cardiac index. A composite shock score effectively further risk stratified these patients. Mechanical thrombectomy improved hemodynamics and functional outcomes at the 30-day follow-up., Competing Interests: Funding Support and Author Disclosures Inari Medical sponsored the FLASH registry. Dr Bangalore is a consultant for Abbott Vascular, Boston Scientific, Biotronik, Amgen, Pfizer, Merck, Reata, and Inari Medical. Dr Jaber is a consultant for Inari Medical and Medtronic. Dr Toma is a consultant for Medtronic and Philips. Dr Weinberg is a consultant for Boston Scientific, Magneto Thrombectomy Solutions, and Medtronic. Dr Mina is a consultant for Inari Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to assess the association between maternal serum levels of TNF-α and preeclampsia., Methods: An analytical cross-sectional study involving 45 women diagnosed with preeclampsia and 45 healthy normotensive pregnant women matched for age, and gestational age at enrolment. Venous samples were collected from each participant after informed consent was obtained. Serum TNF-α level was determined using the human TNF-α competitive enzyme-linked immunosorbent assay (ELISA) technique with ELISA Kit. Hypothesis testing was done using the Chi-square test for categorical variables, the independent samples t-test and the Kruskal-Wallis test for numerical variables. All significances were reported at P < 0.05., Results: The median concentrations of TNF-α in women with preeclampsia of varying severity were significantly higher than those with normotensive pregnancies (P = 0.001). The median level of TNF-α was also significantly higher in patients with severe features of preeclampsia than in those without. The estimated cut-off levels of serum TNF-α were 15.6 ng/mL and 26.4 ng/mL respectively for the development and severity of preeclampsia. Maternal serum TNF-α level in preeclamptic patients is strongly correlated with systolic and diastolic BP, serum uric acid and alkaline phosphatase levels, proteinuria, and platelet count (P < 0.05)., Conclusion: We can infer from this study that increased maternal serum levels of TNF-α may play a significant role in the pathogenesis of preeclampsia. We recommend further validation of these findings with a more robust longitudinal characterization of maternal serum TNF-α profiles in pregnancy through a well-designed prospective cohort study., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

As reported scoring systems of renal artery stenosis (RAS) screening were not easily validated, we further proposed a simple method to predict or rule out RAS in selective patients undergoing coronary angiography (CAG). After preliminary inclusive criterion (severe hypertension or atherosclerosis, flash pulmonary edema, or unexplained renal dysfunction), 503 and 158 consecutive patients undergoing renal arteriography at the timing of CAG were separately enrolled between 2012 and 2015, and 2016 and 2017 as the development and validation cohort. A nomogram was derived from the multivariable logistic regression model, and its accuracy was assessed by the area under the receiver operating characteristic. Hypertension (odds ratio [OR] 17.92), estimated glomerular filtration rate ≤72.66 mL/min·1.73 m 2 (OR 2.75), early to late transmitral flow velocity ratio ≤1.02 (OR 2.58) and low-density lipoprotein cholesterol ≤3.17 mmol/L (OR 1.85) were identified as independent predictors for RAS. The area under the curve of the nomogram in the development and validation cohort were 0.754 (0.704, 0.804) and 0.772 (0.700, 0.844). The negative predictive value of hypertension (88.9%) was much higher than the other three predictors. The concise predictive nomogram can effectively estimate the probability of significant RAS during CAG. Along with normotensive, findings reported could easily evaluate RAS screening necessity based on clinical data., (Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.)

We hypothesized that testosterone-induced increase in blood pressure involve changes in aldosterone levels and expression of epithelial sodium channel (ENaC) in the kidneys., Methods: Ovariectomized female normotensive Wistar Kyoto (WKY) and Spontaneous hypertensive (SHR) rats were given six weeks treatment with testosterone via subcutaneous silastic implant. The rats were anesthetized and mean arterial pressure (MAP) was measured via direct cannulation of the carotid artery. Animals were sacrificed and kidneys were removed and subjected for α, β and γ-ENaC protein and mRNA expression analyses by Western blotting and Real-time polymerase chain reaction (qPCR), respectively. Distributions of α, β and γ-ENaC proteins in kidneys were observed by immunofluorescence. Plasma testosterone, aldosterone, electrolytes, osmolality, urea and creatinine levels were determined by biochemical assays. Analysis were also performed in non-testosterone treated orchidectomized and sham-operated male WKY and SHR rats., Results: Treatment of ovariectomized female WKY and SHR rats with testosterone causes increased in MAP but decreased in plasma aldosterone, sodium (Na + ), osmolality and expression and distribution of α, β and γ-ENaC subunits in the kidneys. Orchidectomy decreased the MAP but increased plasma aldosterone, Na + , osmolality and α, β and γ-ENaC expression and distribution in the kidneys of male WKY and SHR rats., Conclusions: Decreased in plasma aldosterone, Na + and ENaC levels in kidneys under testosterone influence indicated that testosterone-induced increased in MAP were not due to increased plasma aldosterone and ENaC levels in kidneys, and thus the testosterone effect on MAP likely involve other mechanisms., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Co-existence of hypertension is known in three quarter of Indian type 2 diabetics, this duo having adverse additive effect on cardiovascular health including dysautonomia. Latter can be measured by simple 5min heart rate variability (HRV) using simple electrocardiogram, which if reduced indicates cardiac risk., Objective: We compared HRV parameters between hypertensive and normotensive type 2 diabetics, looking for significant difference if any., Materials and Methods: 98 hypertensive and 40 normotensive type 2 diabetics treated as outpatients were evaluated for disease control and risk stratification. Fivemin resting HRV was measured by Variowin HR, software based instrument, using standard protocols to record time domain, frequency domain and Poincare plot parameters. They were compared between groups for difference., Results: Mean age was 56 and 51 years, duration 6 years and 4 years respectively in hypertensive (HT) and normotensive (NT) group of type 2 diabetics, which did not significantly differ in distribution of risk factors. There was poor glycaemic control (one third) in both groups and good pressure control in HT group. Both groups revealed all reduced HRV parameters with significant difference in-between only for LF/HF ratio (1.29 in HT vs 2.61 in NT group)., Conclusion: Our findings of HRV suggest that in type 2 diabetics with poor glycaemic and good pressure control, hypertension as a co-existing factor does not make significant difference in cardiac dysautonomia emphasizing residual risk despite antihypertensive treatment and need for early HRV screening, strict glycaemic control and other interventions., (Copyright © 2016. Published by Elsevier B.V.)

Background: The bioavailability of potassium should be considered in setting requirements, but to our knowledge, the bioavailability from individual foods has not been determined. Potatoes provide 19-20% of potassium in the American diet., Objective: We compared the bioavailability and dose response of potassium from nonfried white potatoes with skin [targeted at 20, 40, and 60 milliequivalents (mEq) K] and French fries (40 mEq K) with potassium gluconate at the same doses when added to a basal diet that contained ∼60 mEq K., Design: Thirty-five healthy, normotensive men and women with a mean ± SD age of 29.7 ± 11.2 y and body mass index (in kg/m(2)) of 24.3 ± 4.4 were enrolled in a single-blind, crossover, randomized controlled trial. Participants were partially randomly assigned to the order of testing for nine 5-d interventions of additional potassium as follows: 0 (control; repeated at phases 1 and 5), 20, 40, and 60 mEq K/d consumed as a potassium gluconate supplement or as unfried potato or 40 mEq K from French fries completed at phase 9. The bioavailability of potassium was determined from the area under the curve (AUC) of serial blood draws and cumulative urinary excretion during a 24-h period and from a kinetic analysis. The effects of the potassium source and dose on the change in blood pressure and augmentation index (AIx) were determined., Results: The serum potassium AUC increased with the dose (P < 0.0001) and did not differ because of the source (P = 0.53). Cumulative 24-h urinary potassium also increased with the dose (P < 0.0001) and was greater with the potato than with the supplement (P < 0.0001). The kinetic analysis showed the absorption efficiency was high across all interventions (>94% ± 12%). There were no significant differences in the change in blood pressure or AIx with the treatment source or dose., Conclusions: The bioavailability of potassium is as high from potatoes as from potassium gluconate supplements. Future studies that measure the effect of dietary potassium on blood pressure will need to evaluate the effect of various dietary sources on potassium retention and in both normal and hypertensive populations. This trial was registered at clinicaltrials.gov as NCT01881295., (© 2016 American Society for Nutrition.)

Background: Although both serum gamma-glutamyltransferase (GGT) and uric acid are correlated with hypertension, studies on the association between serum GGT and uric acid in normotensive individuals are rare. In this study, we tried to reveal this relationship in normotensive Chinese adults., Methods: Four hundred seven normotensive adults were recruited. The subjects were divided into 3 subgroups according to serum GGT tertiles. Anthropometric parameters as well as systolic blood pressure (SBP), diastolic blood pressure (DBP), uric acid, GGT, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood glucose, blood lipids, and fasting insulin were measured. Insulin resistance was assessed using HOMA-IR index., Results: Uric acid was increased in parallel with increasing serum GGT (P<0.001). After correction for age, sex, smoking and alcohol consumption, serum GGT was positively associated with uric acid (r=0.42, P<0.001), SBP (r=0.22, P<0.001), and DBP (r=0.19, P<0.001). When compared with lowest GGT tertile, the odds ratio of the middle tertile for the increased serum uric acid was 3.43 (95% CI, 1.39-8.47) and 7.29 (95% CI, 1.57-33.82) for the highest tertile after adjustment for age, sex, BMI, smoking, alcohol consumption, SBP, DBP, creatinine and HOMA-IR., Conclusions: Serum GGT is strongly associated with the increased uric acid concentrations in normotensive Chinese adults., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: It has been shown that left ventricular diastolic dysfunction (LVDD) develops in patients with metabolic syndrome (MetS). However, there is not sufficient evidence in the literature to determine whether this condition is due to increase in blood pressure, which is frequently encountered in MetS. The purpose of this study was to test the hypothesis whether LVDD in MetS is independent from the presence of hypertension., Methods: A total of 60 patients diagnosed with MetS and 30 healthy people, who were age- and gender-matched with the patient group, were included in the study as the control group. In the study group, 30 of the patients were normotensive whereas the other 30 had hypertension. Conventional echocardiographic examinations and tissue Doppler imaging were performed besides measurements of demographic and biochemical parameters., Results: In the hypertensive MetS group, early diastolic filling flow (E), early diastolic mitral annular velocity (E'), and E/A ratio were significantly lower compared to the control group. Late diastolic filling flow (A), deceleration time (DT), late diastolic mitral annular velocity (A'), and E/E' ratio were higher in the hypertensive MetS group than the control group. In the normotensive MetS group, E, E', and E/A ratio were also lower compared to the control group whereas DT, A', and E/E' ratio were higher., Conclusion: These findings support the idea that LVDD may develop in patients with MetS even in the absence of hypertension. In addition, co-existence of hypertension with MetS contributes to further worsening of diastolic functions., (Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)