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Microbiome Feb 2017Recently, the potential role of gut microbiome in metabolic diseases has been revealed, especially in cardiovascular diseases. Hypertension is one of the most prevalent...
BACKGROUND
Recently, the potential role of gut microbiome in metabolic diseases has been revealed, especially in cardiovascular diseases. Hypertension is one of the most prevalent cardiovascular diseases worldwide, yet whether gut microbiota dysbiosis participates in the development of hypertension remains largely unknown. To investigate this issue, we carried out comprehensive metagenomic and metabolomic analyses in a cohort of 41 healthy controls, 56 subjects with pre-hypertension, 99 individuals with primary hypertension, and performed fecal microbiota transplantation from patients to germ-free mice.
RESULTS
Compared to the healthy controls, we found dramatically decreased microbial richness and diversity, Prevotella-dominated gut enterotype, distinct metagenomic composition with reduced bacteria associated with healthy status and overgrowth of bacteria such as Prevotella and Klebsiella, and disease-linked microbial function in both pre-hypertensive and hypertensive populations. Unexpectedly, the microbiome characteristic in pre-hypertension group was quite similar to that in hypertension. The metabolism changes of host with pre-hypertension or hypertension were identified to be closely linked to gut microbiome dysbiosis. And a disease classifier based on microbiota and metabolites was constructed to discriminate pre-hypertensive and hypertensive individuals from controls accurately. Furthermore, by fecal transplantation from hypertensive human donors to germ-free mice, elevated blood pressure was observed to be transferrable through microbiota, and the direct influence of gut microbiota on blood pressure of the host was demonstrated.
CONCLUSIONS
Overall, our results describe a novel causal role of aberrant gut microbiota in contributing to the pathogenesis of hypertension. And the significance of early intervention for pre-hypertension was emphasized.
Topics: Animals; Blood Pressure; Cohort Studies; Dysbiosis; Essential Hypertension; Fecal Microbiota Transplantation; Gastrointestinal Microbiome; Gastrointestinal Tract; Germ-Free Life; Humans; Hypertension; Klebsiella; Male; Mice; Mice, Inbred C57BL; Prehypertension; Prevotella; Prospective Studies
PubMed: 28143587
DOI: 10.1186/s40168-016-0222-x -
Environmental Health Perspectives Jan 2023The associations between air pollution exposure and morbidity and mortality of cardiovascular diseases (CVDs) have been widely reported; however, evidence on such...
BACKGROUND
The associations between air pollution exposure and morbidity and mortality of cardiovascular diseases (CVDs) have been widely reported; however, evidence on such associations across different dynamic disease trajectories remain unknown.
OBJECTIVE
We examined whether ambient air pollution during the prehypertension (pre-HTN) stage could aggravate the progression from hypertension (HTN) to CVD, and consequent death.
METHODS
A total of 168,010 adults with pre-HTN ( systolic blood pressure or diastolic blood pressure) from the UK Biobank were included in this analysis. We used a multistate model to explore the associations between five air pollutants (, absorbance, , , and ) and the risk of six disease transitions (from pre-HTN to HTN, from pre-HTN to CVD, from pre-HTN to death, from HTN to CVD, from HTN to death, and from CVD to death). Mediation analyses were further conducted to explore the role of intermediate diseases in the dynamic progression of CVDs.
RESULTS
During a median follow-up of 12 y, 13,743 (8.18%) of participants with pre-HTN developed HTN, whereas 12,825 (7.63%) and 4,467 (2.66%) directly developed CVD or died, respectively. Air pollution was positively associated with the dynamic disease progression. For example, a per-interquartile range increase of was significantly associated with the hazard ratios (HRs) of 1.105 [95% confidence intervals (CI): 1.083, 1.127], 1.045 (95% CI: 1.022, 1.068), and 1.086 (95% CI: 1.047, 1.126) in the transition from pre-HTN to HTN, CVD, and death, respectively. Higher levels of air pollution were associated with increased transition probability of disease progression. Mediation analyses indicated that intermediate diseases subsequently significantly mediated air pollutant-associated risk to develop more serious disease.
CONCLUSIONS
This study provides evidence that air pollution might play a role in the early stages of CVD progression. Controlling air pollution might be an effective measure to prevent CVD progression and reduce the disease burden of CVD. https://doi.org/10.1289/EHP10967.
Topics: Adult; Humans; Cardiovascular Diseases; Prehypertension; Biological Specimen Banks; Particulate Matter; Air Pollution; Hypertension; Air Pollutants; United Kingdom; Disease Progression; Environmental Exposure
PubMed: 36696106
DOI: 10.1289/EHP10967 -
Circulation May 2018Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted...
BACKGROUND
Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted from October 2012 to December 2015 to assess the prevalence of HTN in China.
METHODS
A stratified multistage random sampling method was used to obtain a nationally representative sample of 451 755 residents ≥18 years of age from 31 provinces in mainland China from October 2012 to December 2015. Blood pressure (BP) was measured after resting for 5 minutes by trained staff using a validated oscillometric BP monitor. HTN was defined as systolic BP (SBP) ≥140 mm Hg/or diastolic BP (DBP) ≥90 mm Hg or use of antihypertensive medication within 2 weeks. Pre-HTN was defined as SBP 120 to 139 mm Hg and DBP 80 to 89 mm Hg without antihypertensive medication. HTN control was defined as SBP <140 mm Hg and DBP<90 mm Hg. In addition, the prevalence of HTN (SBP ≥130 or DBP ≥80 mm Hg) and control rate (SBP <130 and DBP <80 mm Hg) of HTN were also estimated according to the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline.
RESULTS
Overall, 23.2% (≈244.5 million) of the Chinese adult population ≥18 years of age had HTN, and another 41.3% (≈435.3 million) had pre-HTN according to the Chinese guideline. There were no significant differences of HTN prevalence between urban and rural residents (23.4% versus 23.1%, =0.819). Among individuals with HTN, 46.9% were aware of their condition, 40.7% were taking prescribed antihypertensive medications, and 15.3% had controlled HTN. Calcium channel blockers were the most commonly used antihypertensive medication (46.5%) as monotherapy, and 31.7% of treated hypertensive patients used ≥2 medications. The prevalence of HTN based on the 2017 American College of Cardiology/American Heart Association guideline was twice as high as that based on 2010 Chinese guideline (46.4%), whereas the control rate fell to 3.0%.
CONCLUSIONS
In China, there is a high prevalence of HTN and pre-HTN, and awareness, treatment, and control of HTN were low. Management of medical therapy for HTN needs to improve.
Topics: Adolescent; Adult; Aged; Antihypertensive Agents; Blood Pressure; Body Mass Index; China; Educational Status; Female; Health Surveys; Humans; Hypertension; Male; Middle Aged; Prehypertension; Prevalence; Risk Assessment; Young Adult
PubMed: 29449338
DOI: 10.1161/CIRCULATIONAHA.117.032380 -
Journal of the American Heart... Oct 2020Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and... (Meta-Analysis)
Meta-Analysis
Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta-analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta-analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow-up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high-quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering systolic BP (weighted mean difference, 6.97 mm Hg; 95% credible interval, 4.50-9.47) and diastolic BP (weighted mean difference, 3.54 mm Hg; 95% credible interval, 1.80-5.28). Compared with usual care, moderate- to high-quality evidence indicated that aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, breathing-control, and meditation could lower systolic BP and diastolic BP. For patients with hypertension, moderate- to high-quality evidence suggested that the interventions listed (except comprehensive lifestyle modification) were associated with greater systolic BP and diastolic BP reduction than usual care; salt restriction was also effective in lowering both systolic BP and diastolic BP. Among overweight and obese participants, low-calorie diet and low-calorie diet plus exercise could lower more BP than exercise. Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension. Aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, salt restriction, breathing-control, meditation and low-calorie diet also have obvious effects on BP reduction.
Topics: Comparative Effectiveness Research; Diet Therapy; Diet, Sodium-Restricted; Exercise; Humans; Hypertension; Prehypertension; Risk Reduction Behavior
PubMed: 32975166
DOI: 10.1161/JAHA.120.016804 -
Medicine and Science in Sports and... Jun 2019This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008...
PURPOSE
This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008 Physical Activity Guidelines Advisory Committee Scientific Report.
METHODS
We performed a systematic review to identify systematic reviews and meta-analyses involving adults with normal BP, prehypertension, and hypertension published from 2006 to February 2018.
RESULTS
In total, 17 meta-analyses and one systematic review with 594,129 adults ≥18 yr qualified. Strong evidence demonstrates: 1) an inverse dose-response relationship between PA and incident hypertension among adults with normal BP; 2) PA reduces the risk of cardiovascular disease (CVD) progression among adults with hypertension; 3) PA reduces BP among adults with normal BP, prehypertension, and hypertension; and 4) the magnitude of the BP response to PA varies by resting BP, with greater benefits among adults with prehypertension than normal BP. Moderate evidence indicates the relationship between resting BP and the magnitude of benefit does not vary by PA type among adults with normal BP, prehypertension, and hypertension. Limited evidence suggests the magnitude of the BP response to PA varies by resting BP among adults with hypertension. Insufficient evidence is available to determine if factors such as sex, age, race/ethnicity, socioeconomic status, and weight status or the frequency, intensity, time, and duration of PA influence the associations between PA and BP.
CONCLUSIONS
Future research is needed that adheres to standard BP measurement protocols and classification schemes to better understand the influence of PA on the risk of comorbid conditions, health-related quality of life, and CVD progression and mortality; the interactive effects between PA and antihypertensive medication use; and the immediate BP-lowering benefits of PA.
Topics: Biomedical Research; Blood Pressure; Cardiovascular Diseases; Disease Progression; Exercise; Exercise Therapy; Humans; Hypertension; Practice Guidelines as Topic; Prehypertension; Risk Reduction Behavior; Socioeconomic Factors
PubMed: 31095088
DOI: 10.1249/MSS.0000000000001943 -
Scientific Reports May 2020Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves... (Randomized Controlled Trial)
Randomized Controlled Trial
Different exercise training modalities produce similar endothelial function improvements in individuals with prehypertension or hypertension: a randomized clinical trial Exercise, endothelium and blood pressure.
Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves endothelial function. However, the effects of resistance training (RT) and combined training (CT) on endothelial function remain controversial in individuals with SAH. We determined the effects of AT, RT, and CT on endothelial function and systolic (SBP)/diastolic blood pressure (DBP) in individuals with prehypertension or hypertension. Forty-two participants (54 ± 11 y, resting SBP/DBP 137 ± 9/86 ± 6 mmHg) were randomly allocated into AT (n = 14, 40 min of cycling, 50-75% heart rate reserve), RT (n = 14, 6 resistance exercises, 4 × 12 repetitions, 60% maximum strength) and CT (n = 14, 2 × 12 repetitions of RT + 20 min of AT). All participants performed a 40-minute exercise session twice a week for 8 weeks. Endothelial function was evaluated by brachial artery flow-mediated dilation (FMD). Blood pressure was evaluated through ambulatory monitoring for 24 hours. After 8 weeks of exercise training, blood pressure was reduced in all 3 groups: -5.1 mmHg in SBP (95%CI -10.1, 0.0; p = 0.003) in AT; -4.0 mmHg in SBP (95%CI -7.8, -0.5; p = 0.027) in RT; and -3.2 mmHg in DBP (95%CI -7.9, 1.5; p = 0.001) in CT. All 3 exercise training modalities produced similar improvements in FMD: + 3.2% (95%CI 1.7, 4.6) (p < 0.001) in AT; + 4.0% (95%CI 2.1, 5.7) (p < 0.001) in RT; and +6.8% (95%CI 2.6, 11.1) (p = 0.006) in CT. In conclusion, different exercise training modalities were similarly effective in improving endothelial function but impacts on ambulatory blood pressure appear to be variable in individuals with prehypertension or hypertension.
Topics: Blood Pressure; Endothelium, Vascular; Exercise; Female; Humans; Hypertension; Male; Middle Aged; Prehypertension; Resistance Training
PubMed: 32376984
DOI: 10.1038/s41598-020-64365-x -
Journal of Clinical Hypertension... Feb 2021Prevalence of pre-hypertension is higher among young adults and may increase the risk for hypertension and cardiovascular morbidity. Music therapy has been investigated... (Randomized Controlled Trial)
Randomized Controlled Trial
Prevalence of pre-hypertension is higher among young adults and may increase the risk for hypertension and cardiovascular morbidity. Music therapy has been investigated to reduce the blood pressure in the hypertensive population; however, its efficacy on blood pressure in pre-hypertensive young adults is not known. Thirty pre-hypertensive (systolic blood pressure [SBP] = 120-139 mmHg and diastolic blood pressure [DBP] = 80-89 mmHg) young adults were recruited and randomly assigned into two groups. Music group (N = 15) received music therapy by passive listening to music for 30 minutes/day, 5 days/week for 4 weeks, along with Dietary Approaches to Stop Hypertension (DASH) eating plan (a diet rich in fruits and vegetables, low-fat dairy or unsaturated fat) and limit the daily sodium intake less than 100 mmol/day. The control group (N = 15) practiced only DASH eating plan and sodium restriction. The SBP, DBP, and heart rate (HR) were measured before and after 4 weeks of intervention. There was a significant reduction in SBP (8.73 mmHg, p < .001) and HR (6.42 beats/minute, p = .002); however, the reduction in DBP (1.44 mmHg, p = .101) was not statistically significant in the music group. Control group did not exhibit any significant reduction in SBP (0.21 mmHg, p < .836), DBP (0.81 mmHg, p < .395) and HR (0.09 beats/minute, p < .935). In conclusion, music therapy reduced significantly SBP and HR suggesting that it could be a promising tool to prevent the progression of pre-hypertension toward hypertension among young adults.
Topics: Blood Pressure; Dietary Approaches To Stop Hypertension; Heart Rate; Humans; Hypertension; Music; Prehypertension; Young Adult
PubMed: 33347732
DOI: 10.1111/jch.14126 -
Experimental Gerontology Jun 2023The chronic antihypertensive effect of resistance training (RT) has been widely recognized in mixed-aged populations. However, the specific effect of RT on blood... (Meta-Analysis)
Meta-Analysis Review
The chronic antihypertensive effect of resistance training (RT) has been widely recognized in mixed-aged populations. However, the specific effect of RT on blood pressure (BP) in older individuals (≥60 years) remains unknown. Therefore, this meta-analysis of randomized controlled trials explored the chronic effects of dynamic RT alone on BP in older people. The study followed the PRISMA statement, and the search was performed using MeSH terms "strength training", "blood pressure" and "aged" on MEDLINE (PubMed), SCOPUS, and Web of Science databases. From 1783 potential articles, 24 studies met all inclusion criteria resulting in 835 participants randomized into 26 RT interventions (n = 430) and 24 control groups (n = 405). Overall, BP reduction favoring RT was observed both in SBP (-6.88 [-10.02, -3.73] mmHg) and DBP (-3.37 [-4.71, -2.22] mmHg). Subgroup analysis revealed BP decreases in both participants with hypertension (SBP: -10.42 [-15.67, -5.17]; DBP: -3.99 [-5.76,-2.22] mmHg), and prehypertension (SBP: -4.87 [-7.76, -1.98]; DBP: -2.77 [-4.88, -0.66] mmHg). Improvement in BP was found in studies using traditional RT (free weights and machines) (SBP: -7.04 [-11.04, -3.05]; DBP: -2.60 [-3.72, -1.47] mmHg) and elastic band interventions (SBP: -2.79 [-3.72, -1.86]; DBP:-1.68 [-3.18, -0.18] mmHg). RT performed at moderate intensity (60-80 % 1RM) reduced SBP (-6.98, [-11.93, -2.03]mmHg) and DBP (-3.64 [-5.11, -2.18] mmHg). In conclusion, RT can reduce BP in older people at prehypertensive and hypertensive stage, with traditional RT performed with moderate loads leading to an effect estimate of approximately -7 mmHg for SBP and -4 mmHg for DBP.
Topics: Humans; Aged; Prehypertension; Resistance Training; Hypertension; Blood Pressure; Antihypertensive Agents
PubMed: 37121334
DOI: 10.1016/j.exger.2023.112193 -
Current Hypertension Reports Oct 2017Hypertension is an important preventable risk factor for disease and death worldwide. In light of the world's population growth and aging, hypertension is a global... (Review)
Review
Hypertension is an important preventable risk factor for disease and death worldwide. In light of the world's population growth and aging, hypertension is a global public health issue. Many studies have shown associations between pre-hypertension and a higher risk of the future development of hypertension and cardiovascular disease in general populations. However, pre-hypertension per se is not a disease with an immediate high risk, and the clinical value of the identification of pre-hypertension is the potential detection of the early stage of the risk of hypertension and/or cardiovascular disease over an individual's lifespan. We recently assessed the impacts of age-related differences in risk factors on new-onset hypertension among normotensive individuals. As risk factors of the new onset of hypertension, the impact of diastolic blood pressure compared with systolic blood pressure (SBP), men compared with women, and higher body mass index were greater in the younger adults, whereas in the older adults, the impact of SBP and female sex were greater. Proteinuria was a risk factor for hypertension in both younger and older adults. Non-pharmacological approaches such as body weight reduction, low-salt diet, physical exercise, and good sleep hygiene should be first-line treatments for pre-hypertension. In addition, careful observation to detect the new onset of hypertension and the identification of the appropriate timing of pharmacologic treatment should be conducted, especially in adults with pre-hypertension and the risk factors mentioned above.
Topics: Comorbidity; Health Behavior; Humans; Hypertension; Prehypertension; Risk Factors; Risk Reduction Behavior; Weight Loss
PubMed: 29046988
DOI: 10.1007/s11906-017-0789-z -
Journal of Hypertension Dec 2022Hypertension is the most prevalent cardiovascular risk factor underlying atrial fibrillation and is present in up to 40% of patients with atrial fibrillation....
Hypertension is the most prevalent cardiovascular risk factor underlying atrial fibrillation and is present in up to 40% of patients with atrial fibrillation. Furthermore, attributable risk studies have shown that a history of hypertension contributes to up to 24% of incident atrial fibrillation. New data suggest that even early forms of hypertension (prehypertension and aortic stiffness) are associated with an increased risk of atrial fibrillation development. Hypertension and prehypertension are therefore critical mediators for the development of atrial fibrillation. Mechanisms for the association between hypertension and atrial fibrillation include diffuse electro-structural changes to the left atrium, driven by the haemodynamic and neurohormonal influences of hypertension and other, frequently coexisting, cardiovascular risk factors. Management of hypertension in atrial fibrillation should focus not only on blood pressure reduction but also on a comprehensive risk factor modification strategy. Such strategies have been shown to be associated with significant improvements in atrial fibrillation symptom burden as well as improved arrhythmia-free survival and reversal of the progression of atrial fibrillation. These strategies should focus on dietary modifications as well as prescribed exercise programmes involving a multidisciplinary team and patient-centred atrial fibrillation care. Risk factor management, supplemented by antihypertensive medications as needed, provides the optimum strategy for improving outcomes and even reversing the natural progression of atrial fibrillation in patients with hypertension.
Topics: Humans; Atrial Fibrillation; Prehypertension; Hypertension; Antihypertensive Agents; Heart Atria; Risk Factors
PubMed: 36204994
DOI: 10.1097/HJH.0000000000003278