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ABSTRACT Introduction Methods Results Conclusions This study tests the hypothesis that self‐reported somatic symptoms are associated with biomarkers of stress, including elevated blood pressure and suppressed immune function, among Shuar adults living in the Ecuadorian Amazon.Research was conducted in three Shuar communities in the Upano Valley of the Ecuadorian Amazon and included the collection of biomarkers and a structured morbidity interview. Participants self‐reported somatic symptoms such as headaches, body pain, fatigue, and other bodily symptoms. We examined whether the number of somatic symptoms reported was associated with measures of immune (Epstein–Barr virus [EBV] antibodies) and cardiovascular (blood pressure) functioning in 97 Shuar adults (37 women, 60 men; ages 18–65 years). Multivariate linear regression analyses were used to examine the relationships among somatic symptoms and stress biomarkers, controlling for age, sex, body mass index (BMI), active infection, level of education, and income.Controlling for relevant covariates, Shuar adults reporting the highest level of somatic symptoms (three symptoms) were more likely to exhibit elevated systolic (β = 0.20, p = 0.04) and diastolic blood pressure (β = 0.23, p = 0.03), in comparison to adults reporting no symptoms. Shuar adults reporting two symptoms, compared to no symptoms, were more likely to exhibit elevated EBV antibody concentrations (β = 0.34, p = < 0.01).These preliminary findings demonstrate that somatic symptoms reported by Shuar men and women are associated with physiological measures widely associated with chronic psychosocial stress. These findings complement the cross‐cultural literature in medical anthropology documenting the close connection between the expression of somatic symptoms and stressful life circumstances and highlight the important role that human biologists can play in exploring biocultural phenomena. [ABSTRACT FROM AUTHOR]

Abstract Background Short sleep duration, defined as

Abstract Background Intradialytic hypotension (IDH) is frequently accompanied by symptoms of nausea, dizziness, fatigue, muscle spasm, and arrhythmia, which can adversely impact the daily lives of patients who undergo hemodialysis and may lead to decreased quality of life (QoL). This study employed the KDQOL™-36 scale to evaluate the impact of frequent IDH, based on the definition determined by predialysis blood pressure (BP) and nadir systolic blood pressure (SBP) thresholds, on the QoL of patients. Methods This is a single center retrospective cohort study involving 160 hemodialysis patients. We enrolled adult patients with uremia who received routine hemodialysis (4 h/time, 3 times/week) from October 1, 2019, to September 30, 2021. Frequent IDH was defined as an absolute nadir SBP

Background Avocado leaves ( Persea americana Mill.) have been traditionally used as antihypertensive. Various studies have tested the benefits of the Persea americana Mill. in treating hypertension but still using extracts not yet using nanoparticles. Therefore, this study aims to study the effectiveness of avocado leaf extract, including the nanoparticles, on salt-induced hypertensive Wistar rats in inhibiting the ACE enzyme, which causes decreasing systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as increasing urine volume. Methods This study used an experimental in vivo study design involving 24 white male Wistar rats ( Rattus norvegicus), aged 2–3 months, weighing 130–250 g, and of a healthy condition with active movement. The samples were randomly divided into six treatment groups and post-test only research design with control group design. Results The result of the study showed that the extract contained a quercetin of 1129.597 ppm and 10 mineral compounds, including potassium, with the highest content. The analysis of antioxidant activity using the 2,2-diphenyl-1-picrylhydrazyl method showed that the antioxidant activity at IC 50 was 44.734 ppm. The P. americana leaf extract nanoparticles had the most significant result in reducing blood pressure in Wistar rats induced by 16% NaCl for 14 days SBP to normal was by 68.75 mmHg (175.00±21.57 mmHg to 106.25±9.21 mmHg) and 55.25 mmHg (128.42±25.75 mmHg to 73.17±15.75 mmHg), respectively. Also, avocado leaf extract caused the decrease of SBP from 164.92±7.16 mmHg to 116.83±6.36 mmHg and DBP from 118.42±16.24 mmHg to 82.83±6.47 mmHg. The P. americana leaf extract nanoparticles resulted in the most urine volume at 13.5 ml, with the highest DAI value of 2.25. The ACE inhibitor test using the ELISA method showed that the P. americana leaf extract and the nanoparticle extract inhibition against the ACE enzyme were 60.0±12.1 % and 59.5±3%, respectively. The mean serum nitrate as a result of P. americana leaf extract (K4) and nanoparticles of P. americana leaf extract (K5) were 44.0±9.0 μmol/L and 41.1±11.5 μmol/L, respectively. The mean of serum nitrite was led by P. americana leaf extract (K4), and nanoparticles of P. americana leaf extract (K5) were 83.7±24.0 μmol/L and 81.0±23.2 μmol/L, sequentially. Conclusions The study showed that the leaf extract and nanoparticle extract of Persea americana Mill. was effective as an antihypertensive.

Background: Short sleep duration, defined as < 7 h sleep on weeknights, affects 40% of the US adult population, contributing to the increased risk for cardiometabolic diseases, decreased safety, and poorer mental health. Despite the prevalence of short sleep duration, few studies have tested interventions to extend sleep duration. The objective of this study is to test the effects of a behavioral sleep extension intervention on sleep duration, blood pressure, and other measures of cardiometabolic health among adults with elevated blood pressure or hypertension. Methods: This is a single-blind, randomized controlled trial to determine the impact of a behavioral sleep extension intervention on sleep duration and cardiometabolic health among individuals with short sleep duration (< 7 h per night) and elevated blood pressure or hypertension (SBP 120–150 mmHg or DBP 80–90 mmHg). After completing the screening, participants will be randomly assigned to either a sleep coaching (intervention) or health education (control) group. The participants will have weekly contact for either coaching or education for 8 weeks (intervention period) followed by monthly coaching or education for the next 2 months (maintenance period). Participants will complete assessment visits, actigraphy, and 24-h ambulatory blood pressure recording at baseline/screening, 8 weeks, and 6 and 12 months. The primary outcome is sleep duration at 8 weeks, and the secondary outcome is blood pressure at 8 weeks. Discussion: The results of this study will determine the effects of behavioral sleep extension on sleep and cardiometabolic health among adults with short sleep duration and elevated BP/hypertension. The results will inform the feasibility and efficacy of behavioral sleep extension and provide information needed for future multi-site effectiveness studies. Trial registration: ClinicalTrials.gov NCT04766424. Registered on 21 February 2021. [ABSTRACT FROM AUTHOR]

Background: The prime challenge of physicians in 21st century is cardiovascular disease (CVD). Cardiovascular disease principally ischemic heart disease and stroke are the leading cause of mortality and majordisability in the world. The most important modifiable risk factors of CVDs are dyslipidemia, obesity and hypertension. The effects of unhealthy diet and physical inactivity include abnormal blood lipids, obesity and hypertension. Objective: To evaluate & correlate the pattern of lipid profile & blood pressure in obese & non-obese patients. Materials and methods: This is a cross-sectional study based on a database of 180 adults who received routine health screening. Subjects (n=180) include both male and female age between 20- 50 years who were willing to participate in the study, having body mass index (BMI) > 18.5 kg/m², were considered. Subjects who are known case of obesity secondary to hypothyroidism, Cushing’s syndrome, hypothalamic disease, pregnant, congestive cardiac failure, renal failure, cirrhosis with as cites and those on lipid lowering drugs or any drugs affecting lipid metabolism were also excluded. Subjects who are on antihypertensive drugs were also excluded. Statistical analysis: The data are expressed in numbers as means ± SD. The t test was used to compare continuous variables, such as obesity indicators and biochemical parameters, between the two groups. Statistical analyses were performed using SPSS version 26.0 (SPSS Inc.,). A p value < 0.05 was considered statistically significant. Result: Blood pressure was elevated in Gr-III as compared to Gr-I+II (p<0.001). Serum Cholesterol, triglycerides, LDL, VLDL were elevated in Gr-III as compared to Gr-I+II (p<0.001). HDL was decreased in Gr-III compared Gr-I+II (P<0.001). In our study shows comparison of lipid profile parameters and blood pressure parameters between nonobese (Gr-I+II) and obese subjects(Gr-III). Elevated cholesterol, triglycerides, LDL, VLDL in Gr-III as compared to Gr-I+II. It also shows elevated blood pressure parameters in Gr-III compared to Gr-I+II. Conclusion: Obese persons are prone to develop elevated serum cholesterol, triglyceride, LDL and VLDL cholesterol as compare to non-obese. There is a positive correlation of serum cholesterol, triglyceride, LDL and VLDL level with body mass index in this study, and there is negative correlation of serum HDL level with body mass index. The mean values of blood pressure parameters are more in obese subjects as compared to non-obese subjects. [ABSTRACT FROM AUTHOR]

Background: Intradialytic hypotension (IDH) is frequently accompanied by symptoms of nausea, dizziness, fatigue, muscle spasm, and arrhythmia, which can adversely impact the daily lives of patients who undergo hemodialysis and may lead to decreased quality of life (QoL). This study employed the KDQOL™-36 scale to evaluate the impact of frequent IDH, based on the definition determined by predialysis blood pressure (BP) and nadir systolic blood pressure (SBP) thresholds, on the QoL of patients. Methods: This is a single center retrospective cohort study involving 160 hemodialysis patients. We enrolled adult patients with uremia who received routine hemodialysis (4 h/time, 3 times/week) from October 1, 2019, to September 30, 2021. Frequent IDH was defined as an absolute nadir SBP < 90 mmHg occurring in no less than 30% of hemodialysis sessions when predialysis SBP < 159 mmHg (or < 100 mmHg when predialysis BP ≥ 160 mmHg).The differences between patients with and without frequent IDH were compared using the independent t test, Kruskal‒Wallis test, or chi-square test. The primary visit was at month 36, and the remaining visits were exploratory outcomes. Results: Compared to patients with infrequent IDH at baseline, those with frequent IDH had significantly lower scores on the symptoms and discomfort of kidney disease dimension at all follow-up points (P < 0.05). The symptoms and discomfort of kidney disease dimension were worse in patients with frequent IDH. Those with frequent IDH had a significantly poorer QoL regarding the dimensions of symptoms and discomfort of kidney disease and the impact of kidney disease on life. Conclusions: The findings of the study suggest an association between frequent IDH and QoL dimensions of symptoms and discomfort of kidney disease and the impact of kidney disease on life dimension under the definition of frequent IDH. [ABSTRACT FROM AUTHOR]

In genetic association studies, the multivariate analysis of correlated phenotypes offers statistical and biological advantages compared to analyzing one phenotype at a time. The joint analysis utilizes additional information contained in the correlation and avoids multiple testing. It also provides an opportunity to investigate and understand shared genetic mechanisms of multiple phenotypes. Bivariate logistic Bayesian LASSO (LBL) was proposed earlier to detect rare haplotypes associated with two binary phenotypes or one binary and one continuous phenotype jointly. There is currently no haplotype association test available that can handle multiple continuous phenotypes. In this study, by employing the framework of bivariate LBL, we propose bivariate quantitative Bayesian LASSO (QBL) to detect rare haplotypes associated with two continuous phenotypes. Bivariate QBL removes unassociated haplotypes by regularizing the regression coefficients and utilizing a latent variable to model correlation between two phenotypes. We carry out extensive simulations to investigate the performance of bivariate QBL and compare it with that of a standard (univariate) haplotype association test, Haplo. score (applied twice to two phenotypes individually). Bivariate QBL performs better than Haplo. score in all simulations with varying degrees of power gain. We analyze Genetic Analysis Workshop 19 exome sequencing data on systolic and diastolic blood pressures and detect several rare haplotypes associated with the two phenotypes. [ABSTRACT FROM AUTHOR]

Abstract Background Frailty is a clinical condition characterized by increased vulnerability to adverse health outcomes. Elderly people are screened for frailty as part of preventative care. However, the risk factors for frailty among older adults who undergo Ningen Dock, a comprehensive medical checkup, remain unclear. Thus, this cross-sectional study aims to identify the risk factors for frailty in older adults who received Ningen Dock. The study included 372 participants over 65 years of age who underwent Ningen Dock at the Health Care Center of Gunma Chuo Hospital between April 2019 and March 2020. Frailty was defined using the Kihon Checklist, a basic checklist. Clinical variables were obtained from Ningen Dock records, a vascular function test, and a questionnaire on medication, among others. Multivariate ordinal logistic regression models were used to assess risk factors. Results Prevalence for frailty and pre-frailty was 12.6% and 26.6%, respectively. The mean age of participants was 72.0 ± 5.1 years old, and 43.5% were female. Compared with systolic blood pressure (SBP) ≥ 130 mmHg, the odds ratios for the 100–129 mmHg and < 100 mmHg groups were 2.43 (P = 0.020) and 8.95 (P 0.6 mg/dL. Compared with an exercise habit of ≥ 4 metabolic equivalents (METs), the odds ratio for < 2 METs/week was 2.45 (P < 0.001). The odds ratio for the cardio-ankle vascular index (CAVI) ≥ 9 group was 1.84 (P = 0.020) compared to < 9. Conclusions In older adults who received Ningen Dock, SBP < 100 mmHg, medications ≥ 7, serum iron ≤ 85 μg/dL, total bilirubin ≤ 0.6 mg/dL, exercise habits < 2 METs, and CAVI ≥ 9 were associated with frailty.

In genetic association studies, the multivariate analysis of correlated phenotypes offers statistical and biological advantages compared to analyzing one phenotype at a time. The joint analysis utilizes additional information contained in the correlation and avoids multiple testing. It also provides an opportunity to investigate and understand shared genetic mechanisms of multiple phenotypes. Bivariate logistic Bayesian LASSO (LBL) was proposed earlier to detect rare haplotypes associated with two binary phenotypes or one binary and one continuous phenotype jointly. There is currently no haplotype association test available that can handle multiple continuous phenotypes. In this study, by employing the framework of bivariate LBL, we propose bivariate quantitative Bayesian LASSO (QBL) to detect rare haplotypes associated with two continuous phenotypes. Bivariate QBL removes unassociated haplotypes by regularizing the regression coefficients and utilizing a latent variable to model correlation between two phenotypes. We carry out extensive simulations to investigate the performance of bivariate QBL and compare it with that of a standard (univariate) haplotype association test, Haplo.score (applied twice to two phenotypes individually). Bivariate QBL performs better than Haplo.score in all simulations with varying degrees of power gain. We analyze Genetic Analysis Workshop 19 exome sequencing data on systolic and diastolic blood pressures and detect several rare haplotypes associated with the two phenotypes.

Introduction: This study tests the hypothesis that self-reported somatic symptoms are associated with biomarkers of stress, including elevated blood pressure and suppressed immune function, among Shuar adults living in the Ecuadorian Amazon., Methods: Research was conducted in three Shuar communities in the Upano Valley of the Ecuadorian Amazon and included the collection of biomarkers and a structured morbidity interview. Participants self-reported somatic symptoms such as headaches, body pain, fatigue, and other bodily symptoms. We examined whether the number of somatic symptoms reported was associated with measures of immune (Epstein-Barr virus [EBV] antibodies) and cardiovascular (blood pressure) functioning in 97 Shuar adults (37 women, 60 men; ages 18-65 years). Multivariate linear regression analyses were used to examine the relationships among somatic symptoms and stress biomarkers, controlling for age, sex, body mass index (BMI), active infection, level of education, and income., Results: Controlling for relevant covariates, Shuar adults reporting the highest level of somatic symptoms (three symptoms) were more likely to exhibit elevated systolic (β = 0.20, p = 0.04) and diastolic blood pressure (β = 0.23, p = 0.03), in comparison to adults reporting no symptoms. Shuar adults reporting two symptoms, compared to no symptoms, were more likely to exhibit elevated EBV antibody concentrations (β = 0.34, p = < 0.01)., Conclusions: These preliminary findings demonstrate that somatic symptoms reported by Shuar men and women are associated with physiological measures widely associated with chronic psychosocial stress. These findings complement the cross-cultural literature in medical anthropology documenting the close connection between the expression of somatic symptoms and stressful life circumstances and highlight the important role that human biologists can play in exploring biocultural phenomena., (© 2024 The Author(s). American Journal of Human Biology published by Wiley Periodicals LLC.)

Background Long-term chemical drug consumption to treat hypertension may have side effects because the levels are sometimes difficult for the body to tolerate. Therefore, some people have used plants as herbal medicine, including avocado leaves ( Persea americana Mill.) as antihypertensive. This study aims to find out the differences in the effectiveness of modern drugs and natural antihypertensive ingredients in avocado leaf extract (containing flavonoids and quercetin compounds) in inhibiting the ACE enzyme, which causes decreasing systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as increasing urine volume. Methods This study used an experimental in vivo study design involving 24 white male Wistar rats ( Rattus norvegicus), aged 2–3 months, weighing 130–250 g, and of a healthy condition with active movement. The samples were randomly divided into six treatment groups and post-test only research design with control group design. Results The result of the study showed that avocado leaf extract was effective in reducing blood pressure in Wistar rats with hypertension induced by 16% NaCl for 14 days. SBP fell from 164.92 mmHg to 116.83 mmHg and DBP from 118.42 mmHg to 82.83 mmHg. One-way ANOVA test value significance SBP p=0.000 and Kruskal–Wallis test value of DBP p=0.030, Kruskal–Wallis test urine volume value of p=0.002. The statistical test results proved that avocado leaf extract significantly reduced the blood pressure and increased the urine volume in hypertensive rats. The ACE inhibitor test, performed using an ELISA, showed that the extract inhibition against the ACE enzyme was 60.0±12.1%, serum nitrate levels 41.1±11.5. The decrease in blood pressure occurred because the extract contained a quercetin compound discovered by the high-performance liquid chromatography (HPLC) method of 1129.597 ppm. Conclusions The study showed that the leaf extract of Persea americana Mill. was effective as an antihypertensive.

Objective: Subdural hematomas (SDH) account for an estimated 5 to 25% of intracranial hemorrhages. Acute SDH occur secondary to rupture of the bridging veins leading to blood collecting within the dural space. Risk factors associated with SDH expansion are well documented, however, there are no established guidelines regarding blood pressure goals in the management of acute SDH. This study aims to retrospectively evaluate if uncontrolled blood pressure within the first 24 h of hospitalization in patients with acute SDH is linked to hematoma expansion as determined by serial CT imaging. Methods: A single center, retrospective study looked at 1,083 patients with acute SDH, predominantly above age 65. Of these, 469 patients met the inclusion criteria. Blood pressure was measured during the first 24 h of admission along with PT, INR, platelets, blood alcohol level, anticoagulation use and antiplatelet use. Follow-up CT performed within the first 24 h was compared to the initial CT to determine the presence of hematoma expansion. Mean systolic blood pressure (SBP), peak SBP, discharge disposition, length of stay and in hospital mortality were evaluated. Results: We found that patients with mean SBP <140 in the first 24 h of admission had a lower rate of hematoma expansion than those with SBP > 140. Patients with peak SBP > 200 had an increased frequency of hematoma expansion with the largest effect seen in patients with SBP > 220. Other risk factors did not contribute to hematoma expansion. Conclusions: These results suggest that blood pressure is an important factor to consider when treating patients with SDH with medical management. Blood pressure management should be considered in addition to serial neurological exams, repeat radiological imaging, seizure prophylaxis and reversal of anticoagulation. [ABSTRACT FROM AUTHOR]

Background: Determining the risk factors for symptomatic lumbar epidural hematoma (SLEH) is important for preventing postoperative SLEH. However, the relationship between blood pressure and SLEH is still debatable. The purpose of our study was to determine the risk factors for postoperative SLEH, to assess the influence of high blood pressure on developing SLEH after posterior lumbar spinal fusion surgery, and to evaluate the usefulness of big data analysis utilizing a clinical data warehouse (CDW). Methods: The clinical data of patients who had undergone posterior lumbar spinal fusion surgery were acquired from the CDW of Hallym University Medical Center. The acquired clinical data were compared between patients without postoperative SLEH and with postoperative SLEH. Results: Postoperative SLEH that required hematoma evacuation surgery within 72 h after posterior lumbar spinal fusion surgery occurred in 17 (1.3%) of 1313 patients. According to the multivariate logistic regression analysis, the risk factors for postoperative SLEH are platelet count difference (OR 1.28, p = 0.03), postoperative international normalized ratio (INR) difference (OR 31.4, p = 0.028), and postoperative systolic blood pressure (SBP) difference (≥10 mmHg) (OR 1.68, p = 0.048). An increase in postoperative SBP (OR 1.68, p = 0.048) had a statistically significant influence on the occurrence of postoperative SLEH. Conclusions: Big data analysis utilizing a CDW could be useful for extending our knowledge of the risk factors for postoperative SLEH and preventing postoperative SLEH after posterior lumbar spinal fusion surgery. [ABSTRACT FROM AUTHOR]

ObjectiveSubdural hematomas (SDH) account for an estimated 5 to 25% of intracranial hemorrhages. Acute SDH occur secondary to rupture of the bridging veins leading to blood collecting within the dural space. Risk factors associated with SDH expansion are well documented, however, there are no established guidelines regarding blood pressure goals in the management of acute SDH. This study aims to retrospectively evaluate if uncontrolled blood pressure within the first 24 h of hospitalization in patients with acute SDH is linked to hematoma expansion as determined by serial CT imaging.MethodsA single center, retrospective study looked at 1,083 patients with acute SDH, predominantly above age 65. Of these, 469 patients met the inclusion criteria. Blood pressure was measured during the first 24 h of admission along with PT, INR, platelets, blood alcohol level, anticoagulation use and antiplatelet use. Follow-up CT performed within the first 24 h was compared to the initial CT to determine the presence of hematoma expansion. Mean systolic blood pressure (SBP), peak SBP, discharge disposition, length of stay and in hospital mortality were evaluated.ResultsWe found that patients with mean SBP 140. Patients with peak SBP > 200 had an increased frequency of hematoma expansion with the largest effect seen in patients with SBP > 220. Other risk factors did not contribute to hematoma expansion.ConclusionsThese results suggest that blood pressure is an important factor to consider when treating patients with SDH with medical management. Blood pressure management should be considered in addition to serial neurological exams, repeat radiological imaging, seizure prophylaxis and reversal of anticoagulation.

Introduction: There is a lack of data describing the blood pressure response (BPR) in welltrained individuals. In addition, continuous bio-signal measurements are increasingly investigated to overcome the limitations of intermittent cuff-based BP measurements during exercise testing. Thus, the present study aimed to assess the BPR in well-trained individuals during a cycle ergometer test with a particular focus on the systolic BP (SBP) and to investigate pulse arrival time (PAT) as a continuous surrogate for SBP during exercise testing. Materials and Methods: Eighteen well-trained male cyclists were included (32.4 ± 9.4 years; maximal oxygen uptake 63 ± 10 ml/min/kg) and performed a stepwise lactate threshold test with 5-minute stages, followed by a continuous test to voluntary exhaustion with 1-min increments when cycling on an ergometer. BP was measured with a standard automated exercise BP cuff. PAT was measured continuously with a noninvasive physiological measurements device (IsenseU) and metabolic consumption was measured continuously during both tests. Results: At lactate threshold (281 ± 56W) and maximal intensity test (403 ± 61 W), SBP increased from resting values of 136 ± 9 mmHg to maximal values of 219 ± 21 mmHg and 231 ± 18 mmHg, respectively. Linear within-participant regression lines between PAT and SBP showed a mean r² of 0.81 ± 17. Conclusion: In the present study focusing on the BPR in well-trained individuals, we observed a more exaggerated systolic BPR than in comparable recent studies. Future research should follow up on these findings to clarify the clinical implications of the high BPR in well-trained individuals. In addition, PAT showed strong intra-individual associations, indicating potential use as a surrogate SBP measurement during exercise testing. [ABSTRACT FROM AUTHOR]

Aims: We aimed to assess trends in glycosylated hemoglobin A1c (HbA1c) and systolic blood pressure (SBP) thresholds at initiation of glucose- and blood pressure-lowering medication among patients with type 2 diabetes and assess the influence of age and sex on these trends. Materials and Methods: We used the Groningen Initiative to ANalyze Type 2 diabetes Treatment (GIANTT) primary care database. Patients initiating a first non-insulin glucose-lowering or any blood pressure-lowering medication between 2015 and 2020 with an HbA1c or SBP measurement in the 120 days before initiation were included. We used multilevel regression analyses adjusted for potential confounders to assess the influence of calendar year, age or sex, and the interaction between calendar year and age or sex on trends in HbA1c and SBP thresholds at initiation of medication. Results: We included 2,671 and 2,128 patients in the analyses of HbA1c and SBP thresholds, respectively. The overall mean HbA1c threshold at initiation of glucose-lowering medication significantly increased from 7.4% in 2015 to 8.0% in 2020 (p < 0.001), and particularly in the younger age groups. Compared to patients ≥80 years, patients aged 60–69 years initiated medication at lower levels mainly in the early years. Patients <60 years and between 70–79 years initiated medication at similar levels as patients ≥80 years. Females initiated medication at lower levels than males throughout the study period (p < 0.001). The mean SBP threshold at initiation of blood pressure-lowering medication varied from 145 to 149 mmHg without a clear trend (p = 0.676). There were no differences in SBP thresholds between patients of different ages or sex. Conclusion: The rising trend in the HbA1c threshold for initiating glucose-lowering medication in the lower age groups was unexpected and requires further investigation. Males appear to receive less timely initiation of glucose-lowering medication than females. The lack of higher thresholds for the oldest age group or lower thresholds for the youngest age group in recent years is not in line with the age-related recommendations for personalized diabetes care and calls for health systems interventions. [ABSTRACT FROM AUTHOR]

Introduction: There is a lack of data describing the blood pressure response (BPR) in well-trained individuals. In addition, continuous bio-signal measurements are increasingly investigated to overcome the limitations of intermittent cuff-based BP measurements during exercise testing. Thus, the present study aimed to assess the BPR in well-trained individuals during a cycle ergometer test with a particular focus on the systolic BP (SBP) and to investigate pulse arrival time (PAT) as a continuous surrogate for SBP during exercise testing.Materials and Methods: Eighteen well-trained male cyclists were included (32.4 ± 9.4 years; maximal oxygen uptake 63 ± 10 ml/min/kg) and performed a stepwise lactate threshold test with 5-minute stages, followed by a continuous test to voluntary exhaustion with 1-min increments when cycling on an ergometer. BP was measured with a standard automated exercise BP cuff. PAT was measured continuously with a non-invasive physiological measurements device (IsenseU) and metabolic consumption was measured continuously during both tests.Results: At lactate threshold (281 ± 56 W) and maximal intensity test (403 ± 61 W), SBP increased from resting values of 136 ± 9 mmHg to maximal values of 219 ± 21 mmHg and 231 ± 18 mmHg, respectively. Linear within-participant regression lines between PAT and SBP showed a mean r2 of 0.81 ± 17.Conclusion: In the present study focusing on the BPR in well-trained individuals, we observed a more exaggerated systolic BPR than in comparable recent studies. Future research should follow up on these findings to clarify the clinical implications of the high BPR in well-trained individuals. In addition, PAT showed strong intra-individual associations, indicating potential use as a surrogate SBP measurement during exercise testing.

Aims: We aimed to assess trends in glycosylated hemoglobin A1c (HbA1c) and systolic blood pressure (SBP) thresholds at initiation of glucose- and blood pressure-lowering medication among patients with type 2 diabetes and assess the influence of age and sex on these trends.Materials and Methods: We used the Groningen Initiative to ANalyze Type 2 diabetes Treatment (GIANTT) primary care database. Patients initiating a first non-insulin glucose-lowering or any blood pressure-lowering medication between 2015 and 2020 with an HbA1c or SBP measurement in the 120 days before initiation were included. We used multilevel regression analyses adjusted for potential confounders to assess the influence of calendar year, age or sex, and the interaction between calendar year and age or sex on trends in HbA1c and SBP thresholds at initiation of medication.Results: We included 2,671 and 2,128 patients in the analyses of HbA1c and SBP thresholds, respectively. The overall mean HbA1c threshold at initiation of glucose-lowering medication significantly increased from 7.4% in 2015 to 8.0% in 2020 (p < 0.001), and particularly in the younger age groups. Compared to patients ≥80 years, patients aged 60–69 years initiated medication at lower levels mainly in the early years. Patients

In this study, single-channel photoplethysmography (PPG) signals were used to estimate the heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP). A deep learning model was proposed using a long-term recurrent convolutional network (LRCN) modified from a deep learning algorithm, the convolutional neural network model of the modified inception deep learning module, and a long short-term memory network (LSTM) to improve the model's accuracy of BP and HR measurements. The PPG data of 1,551 patients were obtained from the University of California Irvine Machine Learning Repository. How to design a filter of PPG signals and how to choose the loss functions for deep learning model were also discussed in the study. Finally, the stability of the proposed model was tested using a 10-fold cross-validation, with an MAE ± SD of 2.942 ± 5.076 mmHg for SBP, 1.747 ± 3.042 mmHg for DBP, and 1.137 ± 2.463 bpm for the HR. Compared with its existing counterparts, the model entailed less computational load and was more accurate in estimating SBP, DBP, and HR. These results established the validity of the model. [ABSTRACT FROM AUTHOR]

Biomarkers have already been proposed as powerful classification features for use in the training of neural network-based and other machine learning and artificial intelligence-based prognostic models in the scientific field of personalized nutrition. In this paper, we construct and study cascaded SVM-based classifiers for automated metabolic syndrome diagnosis. Specifically, using blood exams, we achieve an average accuracy of about 84% in correctly classifying body mass index. Similarly, cascaded SVM-based classifiers achieve a 74% accuracy in correctly classifying systolic blood pressure. Next, we propose and implement a system that achieves an 84% accuracy in metabolic syndrome prediction. The proposed system relies not only on prediction of the body mass index but also on prediction from blood exams of total cholesterol, triglycerides and glucose. For the aim of self-completeness of the paper, the key concepts with regard to metabolic syndrome are summarized, and a review of previous related work is included. Finally, conclusions are drawn and indications for related future research are outlined. [ABSTRACT FROM AUTHOR]

IntroductionAlthough the association between blood pressure and vitamin D has been well studied, the effects of dietary magnesium intake on this relationship are still unclear. Thus, this study aimed to determine the effects of dietary magnesium intake on the association between vitamin D and blood pressure.MethodsThe present study analyzed data from the continuous the National Health and Nutrition Examination Survey (NHANES) 2007–2014. We included 8,799 participants aged 20 years or older. Multivariable linear regression was performed to assess the association between vitamin D and systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dietary magnesium intake was stratified by low magnesium intake (

Objective: This study assessed the characteristics of intravenous thrombolysis (IVT) with respect to early neurological deterioration (END) and functional outcome in mild ischemic stroke patients.Methods: Data were obtained from acute mild ischemic stroke patients (defined as having a National Institute of Health Stroke Score (NIHSS) ≤ 5) treated with IVT in our hospital from July 2017 to December 2020. END was defined as the NIHSS increased ≥1 over the baseline at 24 h after IVT. A modified Rankin scale (mRS) ≤ 1 at 3 months was considered as a favorable outcome, and an mRS ≥2 at 3 months was an unfavorable outcome.Results: Two hundred thirty-three acute mild ischemic stroke patients (all patients underwent MRI and DWI restriction) with IVT were included in this study. Thirty-one patients experienced END, and 57 patients experienced an unfavorable outcome at 3 months. With multivariate analysis, END was associated with an elevated baseline systolic blood pressure (SBP) (OR = 1.324, 95% CI, 1.053–1.664, p = 0.016) and coronary heart disease (OR = 4.933, 95% CI, 1.249–19.482, p = 0.023). An unfavorable outcome at 3 months after IVT was independently associated with a baseline elevated SBP (OR = 1.213, 95% CI, 1.005–1.465, p = 0.045), baseline NIHSS (OR = 1.515, 95% CI, 1.186–1.935, p = 0.001), prior hyperlipemia (OR = 3.065, 95% CI, 1.107–8.482, p = 0.031), cardioembolic stroke (OR = 0.323, 95% CI, 0.120–0.871, p = 0.025), and END at 24 h (OR = 4.531, 95% CI, 1.950–10.533, p < 0.001) in mild ischemic stroke patients.Conclusion: In mild ischemic stroke patients with IVT, an elevated baseline SBP and coronary heart disease were associated with END. The elevated baseline SBP, baseline NIHSS, a history of prior hyperlipemia, cardioembolic stroke, and END at 24 h after IVT were useful in predicting an unfavorable outcome at 3 months.

Objective: This study assessed the characteristics of intravenous thrombolysis (IVT) with respect to early neurological deterioration (END) and functional outcome in mild ischemic stroke patients. Methods: Data were obtained from acute mild ischemic stroke patients (defined as having a National Institute of Health Stroke Score (NIHSS) ≤ 5) treated with IVT in our hospital from July 2017 to December 2020. END was defined as the NIHSS increased ≥1 over the baseline at 24 h after IVT. A modified Rankin scale (mRS) ≤ 1 at 3 months was considered as a favorable outcome, and an mRS ≥2 at 3 months was an unfavorable outcome. Results: Two hundred thirty-three acute mild ischemic stroke patients (all patients underwent MRI and DWI restriction) with IVT were included in this study. Thirty-one patients experienced END, and 57 patients experienced an unfavorable outcome at 3 months. With multivariate analysis, END was associated with an elevated baseline systolic blood pressure (SBP) (OR = 1.324, 95% CI, 1.053–1.664, p = 0.016) and coronary heart disease (OR = 4.933, 95% CI, 1.249–19.482, p = 0.023). An unfavorable outcome at 3 months after IVT was independently associated with a baseline elevated SBP (OR = 1.213, 95% CI, 1.005–1.465, p = 0.045), baseline NIHSS (OR = 1.515, 95% CI, 1.186–1.935, p = 0.001), prior hyperlipemia (OR = 3.065, 95% CI, 1.107–8.482, p = 0.031), cardioembolic stroke (OR = 0.323, 95% CI, 0.120–0.871, p = 0.025), and END at 24 h (OR = 4.531, 95% CI, 1.950–10.533, p < 0.001) in mild ischemic stroke patients. Conclusion: In mild ischemic stroke patients with IVT, an elevated baseline SBP and coronary heart disease were associated with END. The elevated baseline SBP, baseline NIHSS, a history of prior hyperlipemia, cardioembolic stroke, and END at 24 h after IVT were useful in predicting an unfavorable outcome at 3 months. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of telmisartan and atenolol in management of patients with essential hypertension. Study Design: Randomized comparative trial. Place and Duration of Study: Department of Medicine Combined Military Hospital Peshawar, from Feb 2010 to Aug 2010. Material and Methods: One hundred & eighty patients diagnosed with essential hypertension fulfilling the inclusion criteria were included in study using consecutive non-probability sampling after taking informed consent. Patients were allocated to either telmisartan or atenolol group by using a table of random numbers. Follow up of patients was carried out in 4 visits with recording of sitting systolic and diastolic blood pressures. Results: Among total of 180 patients, 60% were females and 40% were males. Majority were between age group 56-75 years. Reduction of both systolic and diastolic blood pressures at the end of eight weeks was significantly greater with telmisartan as compared to atenolol (p-value=0.000 and 0.016 respectively). Conclusion: At the end of eight weeks of treatment, telmisartan was more effective than atenolol in lowering systolic and diastolic blood pressure.

Measurement of blood pressure (BP) from photoplethysmograph (PPG) signal has been investigated by several researchers in recent years. Use of PPG signal for BP measurement has advantages over conventional cuff-based sphygmomanometric methods. Signals from two different measurement instruments, such as electrocardiogram (ECG) and photoplethysmogram, are mostly used to determine BP. In this article, a novel approach for determining BP by measurement of only one signal, viz., PPG, is presented. Two specific methods have been discussed for determining mean arterial blood pressure (MABP), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The first method, presented in , needs an initial value of BP while the second method uses a learning-based nonparametric regression technique. PPG signals from more than 150 volunteers have been used to assess the BP. Mean and standard deviation of error magnitudes in measuring DBP is 2.12 ± 1.79 mmHg. [ABSTRACT FROM AUTHOR]

The renin‐angiotensin system (RAS) is an ever‐evolving endocrine system with considerable checks and balances on the production and catabolism of angiotensin peptides most likely due to the manifold effects of angiotensins. We aimed to explore the effects of different inhibitors of RAS on blood pressure and expression of inflammatory factors in patients with coronary heart disease (CHD). We initially searched PubMed, EMBASE and Cochrane Library electronic databases with nine eligible randomized controlled trials enrolled. Direct and indirect evidence was combined to calculate the weighted mean difference value and draw surface under the cumulative ranking curves. The results demonstrated that, compared with placebo and enalapril, ramipril had a better effect on reducing systolic blood pressure after short‐term usage of drugs (<12 months), while perindopril had better effects on reducing diastolic blood pressure and C‐reactive protein expression. Furthermore, after long‐term usage of drugs (≥12 months), there was no significant difference among olmesartan, quinapril and candesartan in the treatment of patients with CHD. Perindopril and ramipril had better effects on inhibiting blood pressure and expression of inflammatory factors among eight inhibitors after short‐term usage of drugs (<12 months); while quinapril had better effects on reducing blood pressure and expression of inflammatory factor after long‐term usage of drugs, and there was little difference in the effects between olmesartan and candesartan (≥12 months). Perindopril may have better short‐term effects on reducing blood pressure and expression of inflammatory factor, while quinapril may have better long‐term effects on reducing blood pressure and expression of inflammatory factor. Perindopril may have better short‐term effects on reducing blood pressure and expression of inflammatory factor, while quinapril may have better long‐term effects on reducing blood pressure and expression of inflammatory factor. [ABSTRACT FROM AUTHOR]

Abstract Background Hypertension is the primary out-auditory adverse outcome caused due to occupational noise exposure. This study investigated the associations of noise exposure in an occupational setting with blood pressure and risk of hypertension. Methods A total of 1,390 occupational noise-exposed workers and 1399 frequency matched non-noise-exposed subjects were recruited from a cross-sectional survey of occupational noise-exposed and the general population, respectively. Blood pressure was measured using a mercury sphygmomanometer following a standard protocol. Multiple logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of noise exposure adjusted by potential confounders. Results Noise-exposed subjects had significantly higher levels of systolic blood pressure(SBP) (125.1 ± 13.9 mm Hg) and diastolic blood pressure (DBP) (77.6 ± 10.7 mm Hg) than control subjects (SBP: 117.2 ± 15.7 mm Hg, DBP: 70.0 ± 10.5 mm Hg) (P 0.05). Conclusions Occupational noise exposure was associated with higher levels of SBP, DBP, and the risk of hypertension. These findings indicate that effective and feasible measures should be implemented to reduce the risk of hypertension caused by occupational noise exposure.

Background: A systolic blood pressure (SBP) lower than the heart rate (HR) could indicate a poor condition in trauma patients. In such scenarios, the reversed shock index (RSI) is < 1, as calculated by the SBP divided by the HR. This study aimed to clarify whether RSI could be used to identify high-risk adult patients with isolated traumatic brain injury (TBI).Methods: This retrospective study reviewed 1216 hospitalized adult patients with isolated TBI at a Level I trauma center between January 1, 2009 and December 31, 2015. The patients were grouped and analyzed according to RSI (<1 or ≥ 1). Subgroups of patients with severe TBI (Glasgow Coma Scale [GCS] ≤ 8) or non-severe TBI (GCS > 8) were also compared. The primary outcome was in-hospital mortality. The odds ratios (ORs) of categorical variables were calculated by chi-square tests with 95% confidence intervals (CIs). Mann-Whitney U-tests were used to analyze non-normally distributed continuous data.Results: Among patients with isolated TBI, those with an RSI <1 had higher mortality (44.7% vs. 7.1%, OR: 10.5, 95% CI: 5.36-20.75; P < 0.001) than those with an RSI ≥1. An RSI <1 indicated a higher risk of mortality (OR: 5.1, 95% CI: 2.08-12.49; P < 0.001) in patients with severe isolated TBI but not in patients with non-severe isolated TBI (OR: 3.6, 95% CI: 0.45-28.71; P = 0.267).Conclusion: Patients with isolated TBI may be at risk for shock. In trauma patients with severe isolated TBI, an SBP lower than the HR indicates a poor outcome. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of telmisartan and atenolol in management of patients with essential hypertension. Study Design: Randomized comparative trial. Place and Duration of Study: Department of Medicine Combined Military Hospital Peshawar, from Feb 2010 to Aug 2010. Material and Methods: One hundred & eighty patients diagnosed with essential hypertension fulfilling the inclusion criteria were included in study using consecutive non-probability sampling after taking informed consent. Patients were allocated to either telmisartan or atenolol group by using a table of random numbers. Follow up of patients was carried out in 4 visits with recording of sitting systolic and diastolic blood pressures. Results: Among total of 180 patients, 60% were females and 40% were males. Majority were between age group 56-75 years. Reduction of both systolic and diastolic blood pressures at the end of eight weeks was significantly greater with telmisartan as compared to atenolol (p-value=0.000 and 0.016 respectively). Conclusion: At the end of eight weeks of treatment, telmisartan was more effective than atenolol in lowering systolic and diastolic blood pressure. [ABSTRACT FROM AUTHOR]

We sought to investigate whether the polymorphisms rs243865 (− 1306C > T); rs243866 (− 1575G > A) and rs2285053 (− 735C > T) in metalloproteinases 2 - MMP-2 gene and rs17576 (Q279R), rs17577 (Q668R) and rs3918242 (− 1562C > T) in MMP-9 gene are associated with clinical outcomes in obese resistant hypertensive (RH) subjects. One hundred and twenty RH were enrolled in this cross-sectional study and divided into obese ( n = 63) and non-obese ( n = 57) according to body mass index. Genotypes were determined by real-time PCR using TaqMan probes. We determined pulse wave velocity (PWV), microalbuminuria and left ventricular mass index (LVMI) to assess TODs. Obese and non-obese RH had similar allele, genotype and haplotype distributions for all polymorphisms assessed but obese RH subjects carrying the low frequency allele for SNPs in MMP-2 gene had higher ambulatory diastolic blood pressure. Also, PWV and LVMI were higher in subjects carrying the low frequency allele for SNPs in MMP-2 gene. Regarding MMP-9 gene, office diastolic BP levels were higher in the AA genotype individuals compared to the G allele group for rs17576 polymorphism, while the opposite was found regarding the microalbuminuria level. Independent multiple linear regression analyses revealed that both A allele for rs243865 and T allele for rs243866 in MMP-2 gene were associated with ambulatory diastolic levels in obese RH subjects, apart from potential confounders. Our study suggests that rs243866/rs243865 in the MMP-2 gene are related to BP levels in obese RH subjects, although TODs present in this population seem to be dependent of a combination of other factors besides the genetic polymorphisms. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the exposure-response (E-R) relationships of blood pressure (BP) and heart rate (HR) changes in healthy adults taking methylphenidate (MPH). Intensive time profiles of BP and HR from healthy adults in placebo and MPH treatment arms of seven clinical trials from the FDA internal database were utilized for this analysis. The analysis model contains a circadian component for placebo effect and an E-R component to describe drug effect. Internal validation was performed using goodness-of-fit plots and visual predictive check. A meta-database based on a systemic literature search was constructed and used for external validation of the developed models. We found that circadian models could quantify the time profiles of BP/HR in placebo arms. Linear models could describe the correlations between MPH concentrations, and BP/HR changes. The BP and HR changes were highly dependent on the shapes of MPH pharmacokinetic (PK) profiles without an apparent time delay. MPH has the greatest effect on HR, followed by systolic BP, and diastolic BP. Internal validation revealed that the developed models could adequately describe the circadian rhythms of HR and BP in placebo arms and the E-R relationships of MPH. External validation showed the models had good predictive capability of the literature data. In conclusion, the developed models adequately characterized the circadian rhythm and the MPH induced effects on BP and HR. The changes in BP and HR were highly correlated with MPH blood levels with no apparent delay. The time courses of BP and HR are similar to the MPH PK profiles. As a result, the immediate-release formulation may yield larger maximum BP and HR effect than the extended-release formulation under similar dose. [ABSTRACT FROM AUTHOR]

In medical practice, blood pressure is intensively studied parameter and often measured for diagnosis at primary healthcare level. In this paper, the state-of-the-art Bluetooth technology has been used for designing an innovative wireless blood pressure monitoring system to display the systolic and diastolic blood pressure values on Android-based smartphone. A pilot study was undertaken on 12 healthy subjects to validate the performance of developed prototype by comparing with OMRON HEM-7111 and mercury sphygmomanometer. Comparison shows an accuracy of 98.63% and 97.13% with OMRON HEM-7111 and 98.99% and 98% with mercury sphygmomanometer for systolic blood pressure and diastolic blood pressure, respectively. Bias value in Bland-Altman plots gives good level of agreement within 95% confidence limits. The developed prototype device mean and standard deviation of differences is less than 5 and 8 mmHg, respectively, and it fulfills the recommendation criteria as per the requirement of the Association for Advancement of Medical Instruments protocol. [ABSTRACT FROM PUBLISHER]

A study to assess the lifestyle related risk factors for cardiovascular diseases among adolescents' in selected schools, Kochi. Objectives of the Study: (1) Identify the presence of lifestyle related risk factors for cardiovascular diseases among adolescents (2) Assess selected anthropometric (height, weight and Body Mass Index) and physiological (Blood Pressure) parameters of adolescent children (3) Associate Body Mass Index and Blood Pressure with lifestyle related risk factors for cardiovascular diseases among adolescents. (4) Associate the existing lifestyle related risk factors with selected demographic variables. Methodology & Design: Design was descriptive survey design. Multi staged sampling technique was used in this study. Tool developed for the study was a rating scale, checklist and a physical proforma documentation chart. Consent was obtained from parents and children. Results: Among 280 subjects 70.4% of the subjects have normal systolic blood pressure and 16.4% have pre-hypertension and 13.2% have hypertension. Among 280 subjects 67.9% of the subjects have normal diastolic blood pressure and 23.9% have pre-hypertension and 8.2% have hypertension. Out of 280 subjects 12.1% were underweight, 58.2% were belongs to normal weight, 23.2% were overweight and 6.4% were obese children. There is an association between family history of death due to heart disease with lifestyle related risk factors (p=0.024). The result shows that among 280 subjects, about 8.6% are at mild risk and 91.4% are at moderate risk for developing cardiovascular diseases in future. Conclusion: Identifying at-risk children and adolescents is the fi rst step in modifying or preventing lifestyle related risk factors. [ABSTRACT FROM AUTHOR]

Rationale & Objective: The association between short-term blood pressure variability (BPV) and kidney outcomes is poorly understood. This study evaluated the association between short-term BPV and kidney disease outcomes in people with hypertension., Study Design: Prospective observational cohort study., Setting & Participants: 1,173 hypertensive participants in the Cardiovascular and Metabolic Disease Etiology Research Center-High Risk (2013-2018) Study with estimated glomerular filtration rate (eGFR) ≥60mL/min/1.73m 2 ., Exposure: Short-term BPV assessed by average real variability (ARV)., Outcome: Composite kidney disease outcome (30% decline in eGFR from baseline, new occurrence of eGFR <60mL/min/1.73m 2 , or onset of UACR >300mg/g)., Analytical Approach: Multivariable Cox regression analyses to evaluate the association between systolic and diastolic BP ARV (SBP-ARV and DBP-ARV) and outcomes., Results: During a median follow-up of 5.4 [4.1-6.5] years, 271 events of the composite kidney disease outcome occurred (46.5 per 1,000 person-years). Multivariable Cox analysis revealed that the highest SBP-ARV and DBP-ARV tertiles were associated with a higher risk of the composite kidney disease outcome than the lowest tertiles, independent of the 24-hour SBP or DBP levels (HR, 1.64 [95% CI, 1.16-2.33], and 1.60 [95% CI, 1.15-2.24] for SBP-ARV and DBP-ARV, respectively). These associations were consistent when SBP-ARV and DBP-ARV were treated as continuous variables (HR per 1.0-unit greater SBP-ARV, 1.03 [95% CI, 1.01-1.06]; HR per 1.0-unit greater DBP-ARV, 1.04 [95% CI, 1.01-1.08]). These associations were consistent, irrespective of subgroups (age, sex, 24-hour SBP or DBP, and moderate albuminuria). However, other measures of short-term BPV including SD, coefficient of variation, and dipping patterns were not associated with the composite kidney disease outcome., Limitations: Observational study design, the use of single measurement of 24-hour BP, lack of information on changes in antihypertensive medication during the follow-up., Conclusions: Short-term BPV is associated with the development of a composite kidney disease outcome in hypertensive patients., (Copyright © 2022 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Conflicting associations between define ( KCNJ11) variations and susceptibility to late-onset (>40 years old) type 2 diabetes mellitus (T2DM) have been reported in different ethnic groups. We investigated whether the E23K (G→A, rs5219) or A190A (C→T, rs5218) variations in KCNJ11 are associated with early-onset T2DM and blood pressure in the Chinese population. Case-control study of 175 unrelated Chinese patients with early-onset T2DM (age of onset <40 years old) who receive (ins+, n = 57) or do not receive insulin (ins−, n = 118), and 182 non-diabetic control subjects. PCR-direct sequencing was performed to genotype E23K and A190A; the genotypic frequencies and associations with clinical characteristics were analyzed. The genotypic frequencies of E23K-GA+AA were higher and A190A-TT was lower in the early-onset T2DM group, especially the T2D-ins+ group, compared to the non-diabetic control group ( p < 0.01 or 0.05, respectively). In non-diabetic subjects, E23K-AA carriers had significantly higher 2 h plasma glucose and lower 2 h insulin than E23K-GG carriers (both p < 0.05). A190A-TT or E23K-GG carriers had higher systolic blood pressure (SBP) than CC or AA carriers in the non-diabetic control and T2DM groups (both p < 0.05). In the T2DM ins+ group, E23K-AA carriers had lower onset age and duration of diabetes and higher BMI than GG carriers, and A190A-TT carriers had higher SBP than CC carriers (all p < 0.05). The E23K-GA or AA genotypes may increase the susceptibility to early-onset T2DM, while A190A-TT may protect against early-onset T2DM. On the other hand the A190A-TT or E23K-GG genotypes may increase the risk of hypertension in the Chinese population. [ABSTRACT FROM AUTHOR]

Abstract: Chronic glomerulonephritis (CGN) is one of the most severe kidney diseases. Genes of vascular reactivity are thought to play an important role in development and progression of CGN. In this study, we analyzed association of genes of vascular homeostasis with hypertension and renal survival of CGN patients. The study sample included 238 patients with CGN and 304 healthy subjects of population control. Ten polymorphisms of ten genes of vascular homeostasis were genotyped through polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) analysis and TaqMan assays. Association of the genotypes with renal survival was analyzed by the Kaplan–Meier estimator. Genotypes 311SC and 311SS of the PON2 gene, (−1166)AC and (−1166)CC of the AGTR1 gene, (+46)AA of the ADRB2 gene, and 198KK and 198KN of the EDN1 gene were associated with decreased rate of renal survival of the patients. Polymorphisms S311C PON2, (−1166)A/C AGTR1, (+46)G/A ADRB2, and K198N EDN1 were associated with the accelerated decline in kidney function in the CGN patients. [Copyright &y& Elsevier]