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Background The longevity of people living with HIV has been enhanced by the introduction of antiretroviral (ARV) drugs in the mid-90s. Antiretroviral therapy (ART) is now mandatory for all persons who test HIV positive in South Africa and the government policy is to start treatment upon diagnosis. The ART is based on protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs) and both groups of drugs have been reported to have deleterious side effects manifesting as HIV-associated lipodystrophy syndrome, metabolic syndrome and cardiovascular diseases. HIV infection also causes dislocation of the gut microbiota which also contribute towards the observed systemic inflammation even before patients are on ART. The aim of this study is find the relationship between HIV infection, ART, endothelial function, and gut microbial dynamics and how they influence development of cardiovascular disease (CVD) and metabolic syndrome. Presented here is the detailed study protocol. Methods This is a longitudinal study to be conducted over a period of two years. Newly diagnosed patients of both genders enrolled for the ART programme will be recruited and blood, stool and anthropometric measurements will be collected every 6 months. Endothelial function, measured by non-invasive methods i.e. flow-mediated dilation and retinal microvasculature assessment. Lipid profile, viral load and other relevant blood parameters will be measured using routine methods employed by the National Health Laboratory Services in Mthatha, South Africa. Stool samples will be used for metagenomic analysis to characterise changes in the gut microbial richness and abundance. The 16S rRNA gene will be PCR amplified and amplicons will be sequenced using a next-generation sequencing platform. Multivariate analysis will be used to determine the nature of the relationship between blood chemistry parameters, gut microbial profile, endothelial function and anthropometric data. Impact of project : The study aims to determine changes in vascular function and gut flora in the in persons living with HIV on the ART programme, subsequently providing a platform for development of corrective and therapeutic nutraceuticals and probiotics for the same population.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high BP and acting as a temporary solution to the lack of screening programmes worldwide. As part of MMM, screening in South Africa in 2017 and 2018 revealed that approximately one-third of adults had hypertension, that only half of hypertensives were receiving anti-hypertensive therapy and that only a third of those with hypertension had controlled BP. These data highlight the need for continued screening and awareness campaigns. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. Blood pressure measurements, the definition of hypertension and statistical analyses followed the MMM protocol. The sites screened were general populations, pharmacies, and university campuses in preference to hospitals and clinics, aiming to raise awareness, and allow access to screening to those less likely to be aware of their BP. Of the 4727 individuals (age 40.9 ± 18.1 years) screened, 31.9% had hypertension. Of those with hypertension, only 42.5% were aware and 36.1% were receiving treatment for hypertension. A large proportion (48.5%) of individuals receiving antihypertensive medication had uncontrolled BP. In conclusion, the high proportions of individuals unaware of their hypertension and with uncontrolled BP highlight the need for hypertension awareness campaigns and more rigorous management of hypertension.

Air pollution is a global health concern. Particulate matter (PM)2.5, a component of ambient air pollution, has been identified by the World Health Organization as one of the pollutants that poses the greatest threat to public health. Cardiovascular health effects have been extensively documented, and these effects are still being researched to provide an overview of recent literature regarding air pollution-associated cardiovascular morbidity and mortality in humans. Additionally, potential mechanisms through which air pollutants affect the cardiovascular system are discussed based on human and additional animal studies. We used the strategy of a narrative review to summarize the scientific literature of studies that were published in the past 7 yr. Searches were carried out on PubMed and Web of Science using predefined search queries. We obtained an initial set of 800 publications that were filtered to 78 publications that were relevant to include in this review. Analysis of the literature showed significant associations between air pollution, especially PM2.5, and the risk of elevated blood pressure (BP), acute coronary syndrome, myocardial infarction (MI), cardiac arrhythmia, and heart failure (HF). Prominent mechanisms that underlie the adverse effects of air pollution include oxidative stress, systemic inflammation, endothelial dysfunction, autonomic imbalance, and thrombogenicity. The current review underscores the relevance of air pollution as a global health concern that affects cardiovascular health. More rigorous standards are needed to reduce the cardiovascular disease burden imposed by air pollution. Continued research on the health impact of air pollution is needed to provide further insight.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high BP and acting as a temporary solution to the lack of screening programmes worldwide. As part of MMM, screening in South Africa in 2017 revealed that 24.5% of adults (mean age = 31 years) have hypertension and only half of those with hypertension had controlled BP. These data highlight the need for continued screening and awareness campaigns. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurements, the definition of hypertension and statistical analyses followed the MMM protocol. The sites screened were general populations and university campuses in preference to hospitals and clinics, aiming to raise awareness and allow access to screening to those less likely to be aware of their BP. In total, 2965 individuals (age 40.5 ± 18.2 years) were screened. After multiple imputation for missing BP readings, 34.6% had hypertension, only 56.7% of those with hypertension were aware, 21.2% of those not receiving treatment for hypertension were hypertensive, and a large proportion (42.5%) of individuals receiving antihypertensive medication had uncontrolled BP. These results suggest that opportunistic screening campaigns can identify significant numbers with undiagnosed and uncontrolled hypertension. The high proportions of individuals with undiagnosed and treated uncontrolled hypertension highlight the need for hypertension awareness campaigns and more rigorous management of hypertension.

Background: Though gut permeability has shown to be associated with measures of obesity and hypertension, its relation- ship with endothelial dysfunction, an early predictor for cardiovascular diseases remains unknown. Objective: This study assessed the relationship between hypertension, measures of obesity, gut permeability and endothelial dysfunction. Methods: A cross-sectional quantitative study which enrolled 151 South African youths was conducted. Anthropometric and blood pressure measurements were performed. Zonulin, a marker for gut permeability; adiponectin, an anti-inflamma- tory molecule, as well as asymmetric dimethylarginine (ADMA) and Nitric oxide (NO) which are markers for endothelial- function were assayed. Results: Approximately eighteen percent (17.88%) of the participants were hypertensive while 40.4% were pre-hyperten- sive. Adiponectin significantly increased in hypertensive subjects and negatively correlated (p

Background: It has been reported that maternal gestational environment may be programmed to have a significant impact on foetal and offspring health later in life. Studies have shown that children born to pre-eclamptic mothers are prone to obesity, hypertension, and diabetes in their adult life. However, such findings are yet to be established in an African population. This protocol is for a study aiming to investigate the relationship between pre-eclampsia (PE) and cardiovascular risk in children born to pre-eclamptic mothers in a South African population of African descents.Methods: A prospective case-control design will be employed to recruit pre-eclamptic and normotensive pregnant women and their offspring after birth. Pregnant women will be assessed for cardiovascular risk factors including PE, obesity, haemodynamics, lipids, glycaemic indices, oxidative stress, and vascular function at 30 weeks of gestation. The cardiovascular risk profile of their offspring will be assessed at birth and 6 weeks later. The difference in cardiovascular risk profile between children born to the pre-eclamptic and normotensive mothers will be compared and the correlation between maternal and offspring cardiovascular risks will be investigated.Discussion: This will be the first prospective study to assess the in-utero effect of cardiovascular risk in offspring born to pre-eclamptic women of African ancestry. It is expected that findings from this study will provide information on the cardiovascular effect of in-utero exposure to PE in a population of African ancestry. This knowledge will advise policy on the management of women with PE with a view of protecting cardiovascular health in offspring.

Background Central obesity and insulin resistance are associated with metabolic syndrome (MetS) which is aggravated by diet and sedentary lifestyle. Athrixia phylicoides (AP) is reported by rural communities to have medicinal benefits associated with MetS such as obesity and type 2 diabetes. This study was aimed to investigate the effects of AP on diet-induced MetS in Wistar rats to validate its ethnopharmacological use. Methods AP was profiled for phytochemicals by LC-MS. After induction of MetS with high energy diet (HED), 30 male rats were divided into five treatment groups (n = 6): normal diet control, HED control, HED + AP 50 mg/Kg BW, HED + AP 100 mg/Kg BW and HED + 50 mg/Kg BW metformin. The rats were treated daily for 8 weeks orally after which weight gain, visceral fat, total cholesterol, free fatty acids (FFAs) and adipokine regulation; leptin: adiponectin ratio (LAR) were assessed. Also, glucose homeostatic parameters including fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glucose transporter 4 (GLUT 4), insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were determined. Results Findings showed that AP was rich in polyphenols. The HED control group showed derangements of the selected blood parameters of MetS. AP reversed diet-induced weight gain by reducing visceral fat, total blood cholesterol and circulating FFAs (p ≤ 0.05). Treatment with AP improved adipokine regulation depicted by reduced LAR (pp ≤ 0.05) and increased GLUT 4 (p Conclusion Athrixia phylicoides tea infusion was shown to possess anti-obesity and anti-inflammatory properties, improved glucose uptake and reduce insulin resistance in diet-induced MetS in rats which could be attributed to its richness in polyphenols. Therefore, AP could have potential benefits against type 2 diabetes and obesity which are components of MetS validating its ethnopharmacological use.

Taraxacum officinale (T. officinale) is a leafy vegetable that is commonly used traditionally as a diuretic agent. In the current study, we aimed at exploring the potential antihypertensive effect ...

Simple Summary The diagnosis of obesity in sub-Saharan African children relies on cut-off values for body mass index percentile (pBMI) and waist-to-height ratio (WtHR) established in western populations. Hence, this study assessed anthropometric indices to determine optimal cut-off values for obesity screening in the South African adolescent population. Findings from this study showed that the cut-off value for pBMI was p85.2th, which improved the sensitivity of the test by approximately 30% compared to the CDC recommended BMI percentile of p95.0th. Moreover, the optimal cut-off for WHtR was 0.481, which was close to the recommended cut-off value of 0.5. This study reveals a lower pBMI cut-off value, different from the CDC recommended cut-off, for screening obesity in a South African adolescent population and suggests that the optimal pBMI cut-off for obesity screening may be ethnic-specific. Abstract The assessment of obesity in sub-Saharan Africa relies on cut-offs established from western populations. This study assessed anthropometric indices to determine optimal cut-off values for obesity screening in the South African adolescent population. A cross-sectional study involving 1144 (796 females and 348 males) adolescents aged 11–17 years from the Eastern Cape Province of South African was conducted. Anthropometric parameters were measured. Receiver operating characteristic (ROC) analysis was performed to assess the sensitivity and specificity of obesity screening tools and establish cut-offs. The optimal cut-offs for obesity in the cohort using waist-to-height ratio (WHtR) as reference were: neck circumference (NC) = 30.6 cm, mid-upper arm circumference (MUAC) = 25.9 cm, waist circumference (WC) = 75.1 cm, hip circumference (HC) = 92.15 cm and body mass index percentile (pBMI) = p85.2th. The new pBMI cut-off value at p85.2th improved the sensitivity of the test by approximately 30% compared to the CDC recommended BMI percentile (pBMIr) of p95.0th. When pBMI was used as reference, the optimal cut-offs in the cohort were: WHtR = 0.481, NC = 30.95 cm, MUAC = 27.95 cm, WC = 76.1 cm and HC = 95.75 cm. The WHtR optimal cut-off of 0.481 was close to the recommended cut-off value of 0.5. The predicted prevalence of obesity obtained using cut-offs from ROC analysis was higher than those from recommended references. All cut-off values for the various anthropometric measures generally increased with age for all percentile ranges. This study reveals a lower pBMI cut-off value, different from the CDC recommended cut-off, for screening obesity in a South African adolescent population. The study has established that the optimal pBMI cut-off for obesity screening may be ethnic-specific.

Background COVID-19 has affected almost every country in the world, especially in terms of health system capacity and economic burden. People from sub-Saharan Africa (SSA) often face interaction between human immunodeficiency virus (HIV) infection and non-communicable diseases such as cardiovascular disease. Role of HIV infection and anti-retroviral treatment (ART) in altered cardiovascular risk is questionable and there is still need to further carry out research in this field. However, thus far it is unclear, what impact the COVID-19 co-infection in people living with HIV (PLHIV), with or without therapy will have. The ENDOCOVID project aims to investigate whether and how HIV-infection in COVID-19 patients modulates the time course of the disease, alters cardiovascular risk, and changes vascular endothelial function and coagulation parameters/ thrombosis risk. Methods A total of 1026 patients will be included into this study. Cardiovascular research PLHIV with (n = 114 in each of the three recruiting centers) - or without - ART (n = 114 in each of the three recruiting centers) with COVID-19 and HIV-negative with COVID-19 (n = 114 in each of the three recruiting centers) will be carried out via clinical and biochemical measurements for cardiovascular risk factors and biomarkers of cardiovascular disease (CVD). Vascular and endothelial function will be measured by brachial artery flow-mediated dilatation (FMD), carotid intima-media thickness (IMT) assessments, and retinal blood vessel analyses, along with vascular endothelial biomarkers and cogualation markers. The correlation between HIV-infection in COVID-19 PLHIV with or without ART and its role in enhancement of cardiovascular risk and endothelial dysfunction will be assessed at admission, weekly, at discharge and, 4 weeks post-discharge (if possible). Impact of project The ENDOCOVID project aims to evaluate in the long-term the cardiovascular risk and vascular endothelial function in PLHIV thus revealing an important transitional cardiovascular phenotype in COVID-19. The study was registered under clinicaltrials.gov (NCT04709302).

Background. Particulate matter (PM) air pollution is an important environmental health risk factor. Although some studies have shown PM to be associated with obesity and hypertension, very few studies have assessed the association of indoor PM specifically with obesity and blood pressure measures in children with respect to seasonal variation. Objectives. The present study investigated the relationship of PM with obesity and blood pressure variables in children across the winter and summer seasons. Methods. A comparative descriptive approach was adopted and school children from 10–14 years of age from selected rural and urban localities of the Eastern Cape Province of South Africa were assessed in winter and summer. Anthropometric measurements were taken, including height, weight, waist circumference, body mass index (BMI), and total fat mass (TFM), while blood pressure variables including systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured. Indoor air PM concentrations were measured in the classrooms in the presence of children. Results. The prevalence of obesity and hypertension in children were 13.4% and 5.1% in winter and 12.9% and 1.0% in summer, respectively. High blood pressure was more prevalent in children in rural areas, while the prevalence of obesity in children was higher in urban areas. Particulate matter was significantly (p Conclusions. High concentrations of indoor PM were positively associated with obesity in children in summer, particularly among rural children. This association could be accounted for by location and seasonal differences. Participant Consent. Obtained Ethics Approval. Ethics approval was obtained from the Health Sciences Ethics Committee of Walter Sisulu University, South Africa (Ref No: CHI011SCHU01). Competing Interests. The authors declare no competing financial interests.

ObjectivesPrevalence of child and adolescents’ overweight and obesity in low- and middle-income countries has increased dramatically. Simultaneously, the incidence of pre-hypertension/hypertension is also increasing in children, which, in turn, predisposes these children to the risk of cardiovascular disease (CVD) in later life. The present study assessed cardiometabolic risk factors and early indicators of vascular dysfunction in adolescents from a low socio-economic rural area in South Africa.DesignCross-sectional cohort study.SettingThe study was conducted in public schools in Mthatha, OR Tambo district municipality, Eastern Cape Province, South Africa.ParticipantsA total of 244 adolescents (188 females) of African ancestry aged 13–16 years were enrolled.Primary and secondary outcome measuresAnthropometric and haemodynamic measures and pulse wave velocity (PWV) were related to overweight/obesity and hypertension. Blood markers of cardiometabolic syndrome were assessed as well as vascular function (via PWV).ResultsOne-third (33.0%) of the adolescents exceeded the age and sex-specific body mass index percentiles for overweight (≥85th) or obesity (>95th) with a prevalence of 61.1% pre-hypertensives in this group. Overweight/obesity and hypertension were associated with higher triglycerides (lean:overweight: 0.794.69 mmol/L, pConclusionOverweight/obesity and hypertension show a high prevalence in rural South African youth. Almost half of the studied adolescents are at risk for developing CVD. The high association between cardiometabolic risk factors and PWV further suggests that hypertension in adolescents may promote the progression of CVD in adulthood. Early detection of those at risk and the implementation of preventive strategies in underprivileged young people is urgently needed to stop the progression of vascular damage and manifestation of CVD in rural African children.

Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIV+ART+), 163 HIV-positive individuals not on ART (HIV+ART&minus, ) and 171 individuals without HIV (HIV&minus, ) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIV+ART+ participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIV+ART+ participants compared with the controls (HIV+ART&minus, and HIV&minus, participants). FMD was not different between HIV+ART+ participants and the controls. Moreover, HIV+ART+ participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV&minus, and HIV+ART&minus, participants. A positive relationship between FMD and CD4 count was observed in HIV+ART+ participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART.

Vascular dysfunction is known to be an initiator of the development and progression of cardiovascular diseases (CVDs). However, there is paucity of information on the relationship of vascular dysfunction with cardiovascular risk factors in children of African ancestry. This study investigated the relationship between cardiovascular risk factors and vascular function in South African children of African ancestry. A cross-sectional study on 6&ndash, 9-year-old children in randomly selected rural and urban schools of the Eastern Cape Province of South Africa was conducted. General anthropometric indices were measured, followed by blood pressure (BP) measurements. The pulse wave velocity (PWV) was measured using a Vicorder. Albumin to creatinine ratio (ACR), asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG) and thiobarbituric acid reactive substance (TBARS) were assayed in urine. Children from urban settings (10.8%) had a higher prevalence of overweight/obesity than their rural counterparts (8.5%) while the prevalence of elevated/high blood pressure was higher in rural (23.2%) than urban children (19.0%). Mean arterial blood pressure (MAP) and diastolic blood pressure (DBP) increased with increasing PWV (p &lt, 0.05). Body mass index (BMI), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) positively associated (p &lt, 0.05) with PWV. Creatinine, albumin and ACR significantly (p &lt, 0.005) increased with increasing ADMA. ADMA associated positively (p &lt, 0.05) with creatinine and 8-OHdG. In conclusion, vascular dysfunction was associated with obesity, high blood pressure, oxidative stress and microalbuminuria in South African children of African ancestry.

Background: Endothelial dysfunction is known to be an initiator to the development and progression of atherosclerotic cardiovascular disease (CVD). However, there is paucity o knowledge on its relationship with cardiovascular risk factors in children. More so, some of these cardiovascular risk factors are known to be influenced by feeding habits and life style changes which often vary between rural and urban settings. This study was aimed to investigate the relationship between cardiovascular risk factors and endothelial function in rural and urban children. Methods: A cross-sectional study on 6-9 years old children in randomly selected rural and urban schools of the Eastern Cape Province of South Arica was conducted. General anthropometric indices were measured followed by blood pressure (BP) measurements. The pulse wave velocity (PWV) was measured using a Vicorder. Urine sample was collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG) and thiobarbituric acid reactive substance (TBARS). Albumin to creatinine ratio (ACR) was calculated.Results: Children from urban settings (10.8%) had a higher prevalence of overweight/obesity than their rural counterparts (8.5%) while the prevalence of elevated/high blood pressure was higher in rural children (23.2%) than in urban children (19.0%). Diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly (pppConclusion: Endothelial dysfunction was associated with obesity, high blood pressure, oxidative stress and microalbuminuria in children, and this relationship varied between rural and urban children.

Background Senecio serratuloides DC is used in folk medicine for treating hypertension, skin disorders, internal and external sores, rashes, burns and wounds. This study aimed at investigating the antihypertensive effects of the hydroethanol extract of S. serratuloides (HESS) in N-Nitro-L-arginine methyl ester (L-NAME) induced hypertension in rats. Methods: Acute toxicity of HESS was first determined to provide guidance on doses to be used in this study. Lorke’s method was used to determine safety of the extract in mice. Female Wistar rats were treated orally once daily with L-NAME (40 mg/kg) for 4 weeks and then concomitantly with L-NAME (20 mg/kg) and plant extract (150 and 300 mg/kg), captopril (20 mg/kg) or saline as per assigned group for 2 weeks followed by a 2-week period of assigned treatments only. Blood pressure was monitored weekly. Lipid profile, nitric oxide, renin and angiotensin II concentrations were determined in serum while mineralocorticoid receptor concentration was quantified in the kidney homogenate. Nitric oxide (NO) concentration was determined in serum and cardiac histology performed. Results HESS was found to be non-toxic, having a LD50 greater than 5000 mg/kg. Blood pressure increased progressively in all animals from the second week of L-NAME treatment. HESS treatment significantly and dose-dependently lowered systolic blood pressure (p

IntroductionThe Metabolic Syndrome (MetS) describes the clustering of cardio-metabolic risk factors—including abdominal obesity, insulin resistance, elevated blood pressure, high levels of triglycerides, and low levels of high-density lipoproteins—that increase the risk for developing cardiovascular diseases and type 2 diabetes mellitus. However, a generally accepted definition of MetS in pediatric patients is still lacking.ObjectivesThe aim was to summarize current prevalence data of childhood MetS as well as to discuss the continuing disagreement between different pediatric definitions and the clinical importance of such diagnosis.MethodologyA systematic literature search on the prevalence of pediatric MetS was conducted. Articles that were published during the past 5 years (2014–2019), using at least one of four predetermined classifications (International Diabetes Federation, Cook et al., Ford et al., and de Ferranti et al.), were included.ResultsThe search resulted in 1167 articles, of which 31 publications met all inclusion criteria.DiscussionThe prevalence of MetS ranged between 0.3 and 26.4%, whereby the rising number of children and adolescents with MetS partly depended on the definition used. The IDF definition generally provided the lowest prevalences (0.3–9.5%), whereas the classification of de Ferranti et al. yielded the highest (4.0–26.4%). In order to develop a more valid definition, further research on long-term consequences of childhood risk factors such as abdominal obesity, insulin resistance, hypertension, and dyslipidemia is needed. There is also a temptation to suggest one valid, globally accepted definition of metabolic syndrome for pediatric populations but we believe that it is more appropriate to suggest definitions of MetS that are specific to males vs. females, as well as being specific to race/ethnicity or geographic region. Finally, while this notion of definitions of MetS specific to certain subgroups is important, it still needs to be tested in future research.

Cardiovascular disease (CVD) risk factors are known to begin early in life, but limited data on the relationship of obesity and hypertension with other known CVD risk factors, such as endothelial dysfunction, oxidative stress, and chronic low-grade inflammation is available on children. In this cross-sectional study involving 6&ndash, 9 years old school children aged from the Eastern Cape Province of South Africa the relationship between obesity/hypertension and other risk factors for CVDs was investigated. General anthropometric parameters were measured, followed by blood pressure (BP) measurements and pulse wave velocity (PWV). Urine samples were collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG), and thiobarbituric acid-reactive substance (TBARS). Overweight/obesity (19.28%) and pre-hypertension/hypertension (42.16%) were prevalent in children. Mid-upper arm circumference (MUAC), a marker of obesity, was positively correlated with ADMA, while ADMA and PWV were significantly different (p &lt, 0.05) between hypertensive and normotensive children. Also, TBARS and 8-OHdG were significantly (p &lt, 0.05) increased in hypertensive subjects. Creatinine was significantly (p &lt, 0.05) increased in obese, as well as in hypertensive children, and positively associated with waist circumference (WC) and neck circumference (NC). In conclusion, obesity and hypertension were associated with renal-cardiovascular disease risk, while oxidative stress showed a possible association with obesity in 6 to 9 year old South African children of African descent. This suggests that South African children of African descent may be becoming more prone to developing CVDs, and therefore may require early intervention for the prevention of CVDs in the near future.

The biosynthesis of silver nanoparticles (Ag-NPs) using the hydrosol extract of the dry stem bark of Acacia mearnsii as reducing and capping agents, and their antinociceptive properties are hereby reported. By varying the temperature and reaction time, the temporal evolution of the optical and morphological properties of the as-synthesized material was investigated. The NPs were characterized by UV–visible absorption spectroscopy, transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy-dispersive x-ray spectroscopy (EDS) and x-ray diffractometry (XRD) The optical analyses show that the position of the maximum surface plasmon resonance (SPR) peak is red-shifted as the reaction temperature decreased. The TEM micrographs show that the as-synthesized Ag-NPs are spherical while the X-ray diffraction shows that the material is highly crystalline with face-centered cubic structures. The anti-inflammatory efficacy, analyzed by the formalin model, indicates that the as-synthesized Ag-NPs are very effective, with an inhibition rate of about 76%.

BackgroundHypertension is a silent killer with no obvious signs and symptoms; thus, it is crucial to prevent its development. Oxidative stress and hyperlipidemia are associated risk factors for developing hypertension. This study aimed at investigating the role of a crude extract of Senecio serratuloidesin preventing the development of hypertension, oxidative stress and hyperlipidemia in a rat model of nitric oxide deficiency.MethodsFemale Wistar rats were co-treated with Nω-Nitro L-arginine methyl ester (L-NAME) (40 mg/kg) and the hydroethanolic extract ofS. Serratuloides(HESS150 or HESS300 mg/kg) for 4 weeks. Twenty-hour urine samples were collected weekly during the study. At the end of the study serum, heart and kidneys were harvested for biochemical and histopathological analysis.ResultsThe higher dose (300 mg/kg) of the extract was more effective in preventing increase in systolic (pConclusionThese findings demonstrate the potential ofS. Serratuloidesin protecting rats from developing hypertension, hyperlipidemia and oxidative stress.

Senecio serratuloides commonly referred to as “two day cure” is used in folk medicine for treating hypertension and wounds in South Africa. This study was aimed at isolating and testing the antihypertensive effects of bioactive compounds from S. serratuloides. Senecio serratuloides was serially extracted using solvents of increasing polarity. Phytochemical analysis, antioxidant capacity and antihypertensive properties of fractions were investigated. Bioactive compounds were isolated from ethyl acetate and methanol fractions, their antihypertensive effects and effect on urine norepinephrine concentration were determined. Ethyl acetate and methanol fractions had all eight phytochemicals tested, better antioxidant capacity and significantly (p < 0.001) prevented the increase in blood pressure induced by Nω-Nitro-l-arginine methyl ester hydrochloride. The isolated bioactive compounds were phytosteroids and Estran-3-one, 17-(acetyloxy)-2-methyl-, (2à,5à,17á) – which was isolated from methanol fraction had significantly (p < 0.001) better antihypertensive effects through the 4-h period of the study. Senecio serratuloides may be a potential source of antihypertensive lead compounds.

Oxidative stress has gained attention as one of the fundamental mechanisms responsible for the development of hypertension. The present study investigated in vitro and in vivo antioxidant effects of 70% ethanol-water (v/v) leaf and root extracts of T. officinale (TOL and TOR, respectively). Total phenolic and flavonoid content of plant extracts were assessed using Folin Ciocalteau and aluminium chloride colorimetric methods, while, 2,2-diphenyl-1-picrlhydrazyl (DPPH), 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and ferric reducing antioxidant power (FRAP) protocols were used to determine the free radical scavenging and total antioxidant capacities (TAC), respectively. The in vivo total antioxidant capacity and malondialdehyde acid (MDA) levels for lipid peroxidation tests were performed on organ homogenate samples from N&omega, nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats treated with leaf extract, TOL (500 mg/kg/day) and TOR (500 mg/kg/day) for 21 days. Results showed that compared to TOR, TOL possessed significantly higher (p &lt, 0.01) polyphenol (4.35 &plusmn, 0.15 compared to 1.14 &plusmn, 0.01) and flavonoid (23.17 &plusmn, 0.14 compared to 3 &plusmn, 0.05) content, free radical scavenging activity (EC50 0.37 compared to 1.34 mg/mL) and total antioxidant capacities (82.56% compared to 61.54% ABTS, and 156 &plusmn, 5.28 compared to 40 &plusmn, 0.31 FRAP) and both extracts showed no toxicity (LD50 &gt, 5000 mg/kg). TOL and TOR significantly (p &lt, 0.01) elevated TAC and reduced MDA levels in targets organs. In conclusion, T. officinale leaf extract possesses significant anti-oxidant effects which conferred significant in vivo antioxidant protection against free radical-mediated oxidative stress in L-NAME-induced hypertensive rats.

Morongwe Annah Sekokotla,1 Nandu Goswami,2 Constance Rufaro Sewani-Rusike,1 Jehu Erapu Iputo,3 Benedicta Ngwenchi Nkeh-Chungag4 1Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa; 2Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria; 3Department of Medical Education, Faculty of Health Sciences, Walter Sisulu University, 4Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa Objective: Metabolic syndrome (MetS), defined as the clustering of three of five risk factors (hypertension, obesity, triglyceridemia, dyslipidemia and hyperglycemia), is being increasingly mentioned among children and adolescents despite there being no consensus on how it should be defined in this set of population. Furthermore, very few studies have focused on MetS in children and adolescents in sub-Saharan populations. This study, therefore, aimed at determining the prevalence of the MetS and contributing risk in adolescents living in Mthatha, South Africa.Research design and methods: Four hundred and ten adolescents (age range: 13–18 years, both sexes) were recruited into this cross-sectional study. In addition to a lifestyle questionnaire being administered, anthropometric measurements (weight, height and waist circumferences) were carried out for each participant. Fasting venous blood was collected for lipid profile and blood glucose assessments. Blood pressure was also measured. MetS was assessed using appropriate diagnostic criteria for children and adolescents.Results: Complete data sets were collected from 371 participants. Females showed an elevation in the risk factors for MetS. Of the 371 participants, 40.2% were overweight/obese (47.5% females; 22.5% males). MetS was diagnosed in 3.1% female participants compared with 6.0% in male participants.Conclusions: More risk factors for the MetS are seen among the overweight/obese as compared to lean adolescents. Given the fact that childhood overweight/obesity often continues into adulthood, it is important to address the causes of increased risk for MetS earlier in life to prevent the development of disease in adult life. Keywords: metabolic syndrome, adolescent health, overweight, obesity

OBJECTIVES: Previous studies suggest a strong relationship between obesity and hypertension. This study aimed at evaluating the prevalence of hypertension and pre-hypertension in 10- to 14-year-old boys and girls in the Eastern Cape Province of South Africa and to determine the association between blood pressure parameters and selected measures of adiposity. METHODS: A cross-sectional, school-based study of 540 10- to14-year-old children from seven schools in the Eastern Cape Province was carried out. Anthropometry and blood pressure parameters were determined. RESULTS: All measures of adiposity and blood pressure were significantly higher in the girls (p < 0.05). The prevalence of hypertension and pre-hypertension was over 20 and 12%, respectively. Systolic blood pressure and pulse pressure were associated (r > 0.27; p < 0.05) with increasing levels of adiposity. CONCLUSION: This study highlights the importance of weightcontrol strategies for the prevention of hypertension in these adolescents and later on in life.

Arterial stiffness is an independent predictor of cardiovascular disease. Although mostly detected in adults evidence in children is conflicting. Many more children are being diagnosed with hypertension indicating that these children might have some level of endothelial dysfunction. The current study set out to investigate the relationship between endothelial function as measured by the Vicorder and anthropometric measurements as well as blood pressure in 6-8 year old children. A total of 202 children were recruited from a rural and an urban community were recruited into a cross sectional study between March and November 2017. Anthropometry was performed followed by measurement of blood pressure parameters and flow mediated slowing (FMS) using the Vicorder. Urine samples were collected for creatinine/albumin ratio. Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP) were converted to percentiles for age, height and sex. Stata ® was used for all data analysis. Mean PWV and FMS% were 5.0 m/s and 25.7% respectively. PWV and heart rate (HR) were different by sex and location (p

Hypertension is becoming a major health problem in children worldwide. There is evidence suggesting a complex association between hypertension, endothelial function and other cardiovascular disease risk factors in the adult population. Very few studies have investigated the relationship between hypertension and endothelial function in sub-Saharan children. The aim of this study was to explore the relationship between blood pressure parameters and pulse wave velocity (PWV) in 6-8 years old children in the Eastern Cape of South Africa. A cross-sectional study of 202 children (103 girls and 99 boys) aged 6-8 years old was conducted between March and November 2017. General anthropometric measurements were measured and blood pressure measurements were recorded. Blood pressure measurements were converted to blood pressure percentiles for height, age and sex. Flow mediated slowing was used to measure endothelial function. The prevalence of hypertension and prehypertension was higher in girls compared to boys (7.9% and 28.7% vs 7.1% and 20.2% respectively). Systolic and diastolic pressure (SBP, DBP) and pulse pressures were similar in boys and girls. No sex related difference in PWV was noted thought the strength of correlation was different. PWV correlated modestly with age, SBP, DBP and mean arterial BP in females (r= 0.24, 0.30, 0.40, 0.49 p

Several studies have shown a relationship between indoor particulate matter and cardiovascular diseases in adults though this relationship is yet to be clarified in children and adolescents. This study purposed to investigate the relationship between indoor air particulate matter and blood pressure in 10-14 year old rural and urban children in Eastern Cape, South Africa. A cross sectional study of 10-14 year old children was carried out in selected rural and urban schools of the Eastern Cape. Anthropometry was performed and blood pressure measured. Indoor air particle counts were determine. Blood pressure parameters and body mass index (BMI) were converted to percentiles for height, sex and age. Prevalence of overweight/obesity were 10.9%/14.0% and hypertension/prehypertension were 12%/20%. Hypertension/prehypertension were more prevalent in rural compared to urban adolescents. All blood parameters were higher in rural adolescents and higher in rural girls compared to boys. In hypertensive/prehypertensive adolescents, systolic blood pressure (SBP) showed a strong correlation with BMI, waist, hip and mid upper arm circumferences (0.50, 0.51, 0.52, 0.53, 0.49; p

Background: Herbal practitioners in the Eastern Cape of South Africa use valerian root (Valeriana capensis, Valerianaceae) to manage pains, arthritis and inflammation. The herb prepared from this plant was studied to determine the chemical composition of its essential oil, carried out phytochemical screening and biological activities on its infusion extract as used by the herbal practitioner. Materials and Methods : Essential oil of V alerian root was obtained by hydrodistillation and subjected to chemical analyses. Infusion extract of the Valerian root was screened to determine its secondary metabolites and the relative abundance of some major metabolites. The infusion extract was further evaluated for acute toxicity (LD50), anti-inflammatory and analgesic activities in rodents. Results : The yield of the essential oil was 0.18% w/w. The GC/MS analysis indicated the presence of 42 compounds with major ones being caryophyllene oxide (18.11%), viridiflorol (9.37%) and bornyl acetate (8.84%). Phytochemicals found in the infusion extract were alkaloids, saponins, tannins and flavonoids while quantitative screenings showed saponins and flavonoids accounted for 6.39% and 7.40% respectively. The LD50 of the extract was found to be 3808 mg/kg per oral. The infusion extract of the root (250-500 mg/kg, p.o.) caused significant (p

Cymbopogon genus is a member of the family of Gramineae which are herbs known worldwide for their high essential oil content. They are widely distributed across all continents where they are used for various purposes. The commercial and medicinal uses of the various species of Cymbopogon are well documented. Ethnopharmacology evidence shows that they possess a wide array of properties that justifies their use for pest control, in cosmetics and as anti-inflammation agents. These plants may also hold promise as potent anti-tumor and chemopreventive drugs. The chemo-types from this genus have been used as biomarkers for their identification and classification. Pharmacological applications of Cymbopogon citratus are well exploited, though studies show that other species may also useful pharmaceutically. Hence this literature review intends to discuss these species and explore their potential economic importance.

The purpose of this study was to determine the chemical composition of essential oils from Tagetes minuta from the Eastern Cape of South Africa and evaluate their antioxidant potential for medicinal end use. The essential oils were extracted by hydrodistillation method from fresh and dry parts (stem, leaves and flowers) of Tagetes minuta collected from Komga, Eastern Cape Province, South Africa and analyzed by gas chromatography coupled with mass spectrometry (GC-MS) and gas chromatography (GC). This analysis has led to the identification of 12, 31, 10, 37, 4 and 39 compounds representing 99.16, 98.07, 98.86, 98.30, 100 and 97.66% of fresh stem (TMFS), dry stem (TMDS), fresh leaves (TMFL), dry leaves (TMDL), fresh flower (TMFF) and dry flower (TMDF) essential oil respectively. The major components were identified to be cis-β-ocimene (38.03%) for TMFS; caryophyllene oxide (18.04%) for TMDS; trans, cis-alloocimene (25.35%) for TMFL; isopropyl tetradecanoate (17.02%) for TMDL; cis-β-ocimene (38.14%), for TMFF and trans-β-ocimene (37.03%), for TMDF. The dry parts (TMDS, TMDL and TMDF) essential oil were evaluated for antioxidant activity using DPPH and FRAP bioassays. Standard equivalent values from DPPH assay were between 6.74 ± 0.27 and 18.7 ± 0.35 μg/mL AAE with scavenging ability in descending order: TMDF > TMDL > TMDS. Standard equivalent values from FRAP assay were between 26.30 ± 0.41 and 113.0 ± 1.2 μg/mL AAE with antioxidant activity in descending order: TMDF > TMDL > TMDS. These results suggest that T. minuta may be used as a potential natural source of antioxidant.

Background: Oxidative stress is implicated in the pathogenesis of many diseases. Proper management of oxidative stress requires antioxidants from external sources to supplement that of the body. Plants are considered as a major source of antioxidants because of their natural origin and therapeutic benefits. Objectives: This study was aimed at investigating the renoprotective and antioxidant capacity of hydroethanolic extract of Senecio serratuloides (HESS). Materials and Methods: In vitro and ex vivo antioxidant capacity of the extract was investigated. Female Wistar rats were treated with Nw-nitro L-arginine methyl ester (L-NAME) (40 mg/kg) for 4 weeks and then cotreating with L-NAME (20 mg/kg) and extract (HESS150 or HESS300 mg/kg) for 2 weeks and finally with plant extract or normal saline only for 2 weeks making a total of 8 weeks. Twenty-four-hour urine samples were collected during the study, and at the end of the study; blood and kidneys were harvested for biochemical and histological assays. Results: HESS exhibited high antiradical activity against 1,1-diphenyl-2-picrylhydrazyl and 2,2'-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) radicals with IC50values of 0.1 and 0.4 mg/ml, respectively. HESS significantly (P

The volatile oils of the leaves and the stem bark of Acacia mearnsii de Wild obtained by hydro-distillation were analysed by gas chromatography-mass spectrometry. A total of 20, 38, 29 and 38 components accounted for 93.8%, 92.1%, 78.5% and 90.9% of the total oils of the fresh, dry leaves and fresh, dry stem bark, respectively. The major components of the oil were octadecyl alcohol (25.5%) and phytol (10.5%); cis-verbenol (29.5%); phytol (10.1%) and phytol (23.4%) for the fresh leaves, dried leaves, fresh stem, dry stem bark, respectively. Oral administration of essential oils at a dose of 2% showed significant (p < 0.05) anti-inflammatory properties in the albumin-induced test model in rats. Oils from the fresh leaves and dry stems inhibited inflammation beyond 4 h post treatment. The potent anti-inflammatory activity of essential oils of A. mearnsii hereby confirmed its traditional use in treating various inflammatory diseases.

Acetylation and methylation semisynthesis of oleanolic acid (OA) isolated from Syzygium aromaticum L. yielded two compounds: 3-acetoxyoleanolic acid (3-AOA) and 3-acetoxy, 28-methylester oleanolic acid (3-A,28-MOA). Anti-inflammatory properties of these compounds were assessed using the serotonin and fresh egg albumin-induced inflammatory test models in male Wistar rats weighing 250–300 g. Furthermore, erythrocyte membrane-stabilizing property of these compounds was evaluated in the heat- and hypotonicity-induced in vitro hemolysis test models. The two semisynthetic compounds significantly (p < 0.05) inhibited albumin-induced inflammation better than OA and indomethacin from 1–5 h post administration. Both compounds were membrane stabilizing in heat-induced hemolysis test while only 3-AOA showed membrane-stabilizing effects in a hypotonic milieu. Semisynthesis of OA yielded two compounds which had better in vivo anti-inflammatory and in vitro membrane-stabilizing properties.

Purpose: To investigate the in vivo analgesic and anti-inflammatory activities of essential oil of dried flowers of Chamaemelum nobile (Asteraceae L. All) in Swiss mice and Wistar rats, respectively.Methods: The volatile oil of the dried flowers of C. nobile obtained by hydrodistillation was analyzed by gas chromatography-mass spectrometry (GC-MS). Animals were assigned to the following experimental groups: C. nobile (180 mg/kg), ibuprofen (100 mg/kg) and vehicle-treated groups. Chemical and thermal pain models were used for the antinociceptive study in mice while fresh egg albumin-induced acute inflammation model in rats was used for anti-inflammatory study of the essential oil.Results: The most abundant components of the oil were α-bisabolol (50 %) and farnesene (5.35 %). Oral administration of essential oil (180 mg/kg, po) significantly (p < 0.05) reduced pain and prevented inflammation in the different test models used in this study.Conclusion: The essential oil of the dried flowers of C. nobile shows in vivo analgesic and antiinflammatory activities in rodents, and therefore, possesses potentials for development into effective analgesic and anti-inflammatory agent.Keywords: Chamaemelum nobile, Asteracea, essential oil, anti-inflammatory, antinociceptive

Only one study has reported on the medicinal properties of Cordia platythyrsa (C. platythyrsa) though it is used in African traditional medicine for treatment of fever and pain. The current study aimed at investigating the analgesic and anti-inflammatory properties of C. platythyrsa using various animal models: writhing test, tail flick, thermal hyperalgesia, mechanically induced-pain, formalin-induced pain and carrageenan-induced inflammation tests. Like aspirin, the two doses of plant extracts used inhibited acetic acid-induced pain though these effects were weaker than the effects of morphine. Although, the plant extract significantly (p

Fernandoa adolfi friderici is used traditionally to treat menopause related symptoms. The effects of the ethanolic extract of this plant in ovariectomized (OVX) rats were investigated. 40 of 50 rats were OVX and separated into four groups of 10 each. 84 days after ovariectomy, animal groups were started on one of four treatments: ethanol/0.09% NaCl (control group), oestrogen, extracts of F. adolfi friderici (FA 150 and 300 mg/kg), respectively. 5 animals from each group were terminated after 14 and 28 days of treatment, respectively and vaginal smears, vaginal/uterine wall cytology, lipid profiles and bone mass and histology were studied.F. adolfi friderici treated OVX rats had superficial cells which were absent in vaginal smears of control animals. The former had improved vaginal epithelial thickness after 28 days of treatment (55.8±8.6 versus 13.2±0.8) compared to control animals. F. adolfi friderici extracts also improved serum triglyceride (27.2%/28.2% reduction versus 73% increase in controls) and high density lipoprotein (HDL) (0.78±0.01/0.98±0.09 g/L versus 0.6±0.05 g/L) levels while improving bone architecture and preventing bone resorption. F. adolfi friderici may be the source of a useful phytoestrogen for the complementary management of menopausal symptoms. Key words: Fernandoa adolfi friderici, ovariectomized, phytoestrogen.

Purpose: To determine the phytochemical content, toxicity and hypertension prevention effects of Osteospermum imbricatum leaf and root extracts.Methods: Phytochemical screening of leaf and root extracts of O. imbricatum was performed by colorimetric procedure. Acute toxicity of leaf and root extracts was conducted in two phases; phase I consisted of three groups of mice (n = 3) for each dose level of 10, 100 and 1000 mg/kg while phase II had three mice that received 1600, 2900 or 5000 mg/kg. Wistar rats were grouped into 7 groups that were co-treated with L-NAME and normal saline or L-NAME and hydroethanolic leaf extract (150 and 300 mg/kg) or L-NAME and hydroethanolic root extract (150 and 300 mg/kg) or L-NAME and amlodipine (5 mg/kg) or normal saline only for 4 weeks. Treatment was carried out via the oral route while blood pressure was measured weekly for 4 weeks by non-invasive tail cuff method.Results: The phytochemical profile of the leaf and root extracts revealed the presence of phenols, terpenoids, flavonoids, glycosides, tannins, steroids and saponins. Both the leaf and root extracts were toxic at 5000 mg/kg with an LD50 of 3807.89 mg/kg. In the fourth week of the study, only the leaf extract significantly (p < 0.01) prevented the progression of L-NAME induced hypertension; systolic and diastolic blood pressure of the group treated with L-NAME and leaf extract (300 mg/kg) were 183 ± 1 and 140 ± 1 mmHg, respectively, compared to the group that was treated with L-NAME and normal saline which produced systolic and diastolic BP values of 213 ± 3 and 172 ± 4 mmHg, respectively. The extracts, especially OIR300, exhibited diuretic effects in the second and third week of study by promoting excretion of 16 and 19 ml urine, respectively, compared to 11 and 14 ml for LN group.Conclusion: The results suggest that O. imbricatum is moderately toxic at a high dose and contains a wide range of phytochemicals which offer partial protection against the development of nitric oxide deficiency hypertension.Keywords: Hypertension, Phytochemicals, Acute toxicity, Nω-Nitro-L-arginine methyl ester (L-NAME), Osteospermum imbricatum