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Biomedicine & Pharmacotherapy =... Apr 2024This study investigated whether sacubitril/valsartan or valsartan are able to prevent left ventricular (LV) fibrotic remodelling and dysfunction in two experimental...
Effect of sacubitril/valsartan on the hypertensive heart in continuous light-induced and lactacystin-induced pre-hypertension: Interactions with the renin-angiotensin-aldosterone system.
This study investigated whether sacubitril/valsartan or valsartan are able to prevent left ventricular (LV) fibrotic remodelling and dysfunction in two experimental models of pre-hypertension induced by continuous light (24 hours/day) exposure or by chronic lactacystin treatment, and how this potential protection interferes with the renin-angiotensin-aldosterone system (RAAS). Nine groups of three-month-old male Wistar rats were treated for six weeks as follows: untreated controls (C), sacubitril/valsartan (ARNI), valsartan (Val), continuous light (24), continuous light plus sacubitril/valsartan (24+ARNI) or valsartan (24+Val), lactacystin (Lact), lactacystin plus sacubitil/valsartan (Lact+ARNI) or plus valsartan (Lact+Val). Both the 24 and Lact groups developed a mild but significant systolic blood pressure (SBP) increase, LV hypertrophy and fibrosis, as well as LV systolic and diastolic dysfunction. Yet, no changes in serum renin-angiotensin were observed either in the 24 or Lact groups, though aldosterone was increased in the Lact group compared to the controls. In both models, sacubitril/valsartan and valsartan reduced elevated SBP, LV hypertrophy and fibrosis and attenuated LV systolic and diastolic dysfunction. Sacubitril/valsartan and valsartan increased the serum levels of angiotensin (Ang) II, Ang III, Ang IV, Ang 1-5, Ang 1-7 in the 24 and Lact groups and reduced aldosterone in the Lact group. We conclude that both continuous light exposure and lactacystin treatment induced normal-to-low serum renin-angiotensin models of pre-hypertension, whereas aldosterone was increased in lactacystin-induced pre-hypertension. The protection by ARNI or valsartan in the hypertensive heart in either model was related to the Ang II blockade and the protective Ang 1-7, while in lactacystin-induced pre-hypertension this protection seems to be additionally related to the reduced aldosterone level.
Topics: Rats; Animals; Male; Renin-Angiotensin System; Renin; Aldosterone; Prehypertension; Tetrazoles; Rats, Wistar; Valsartan; Hypertension; Biphenyl Compounds; Heart Failure; Hypertrophy, Left Ventricular; Drug Combinations; Fibrosis; Stroke Volume; Acetylcysteine; Aminobutyrates
PubMed: 38461685
DOI: 10.1016/j.biopha.2024.116391 -
Journal of Human Hypertension May 2018In Bangladesh, morbidity and mortality due to non-communicable diseases (NCDs) has increased over the last few decades. Hypertension is an important risk factor for...
In Bangladesh, morbidity and mortality due to non-communicable diseases (NCDs) has increased over the last few decades. Hypertension is an important risk factor for NCDs, specifically cardiovascular disease. The objective of this study was to assess prevalence and risk factors for hypertension and pre-hypertension among adults in Bangladesh. Data for this analysis were collected during the national NCD Risk Factor Survey of Bangladesh conducted in 2010 from a representative sample of men and women, aged 25 years or above. The survey adopted a multistage, geographically clustered, probability-based sampling approach. WHO STEPS questionnaire was used to collect data on demographics, behavioral risk factors, and physical measurements. Overall, 20% of the study population were hypertensive at study measurement. The prevalence of hypertension increased with age and body mass index (BMI). Twelve percent of the population were previously diagnosed with hypertension. Among these individuals, nearly half were not taking any medications to control their hypertension. Additionally, the prevalence of pre-hypertension was 43%, with higher levels among males, older age groups, and those with higher education, higher wealth index and high BMI. Predictors of hypertension, included older age, high BMI, and diabetes comorbidity. Based on this study, we estimate that 1 out of 5 Bangladeshi adults have hypertension. The risk of hypertension increases with older age and high BMI. Additionally, prevalence of pre-hypertension is high in Bangladesh in both rural and urban areas. Findings from this study can be used to inform public health programming to control the spread of NCDs in Bangladesh.
Topics: Adult; Aged; Antihypertensive Agents; Bangladesh; Cross-Sectional Studies; Female; Humans; Hypertension; Male; Middle Aged; Prehypertension; Prevalence; Risk Factors
PubMed: 29230005
DOI: 10.1038/s41371-017-0018-x -
Hypertension (Dallas, Tex. : 1979) Mar 2018Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitus is characterized by a relatively rapid increase...
Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitus is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during the development of hypertension in patients with or without diabetes mellitus using data from the MCDS (Mexico City Diabetes Study; a population-based study of diabetes mellitus in Hispanic whites) and in the FOS (Framingham Offspring Study, a community-based study in non-Hispanic whites) during a 7-year follow-up. Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS, odds ratio, 3.14; 95% confidence interval, 2.17-4.54) independently of sex, age, body mass index, and familial diabetes mellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus (in FOS, odds ratio, 3.33; 95% CI, 2.50-4.44). In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mm Hg for systolic BP within 3.5 years (in MCDS). In comparison with the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall, results were similar in the 2 ethnic groups. We conclude that (1) development of hypertension and diabetes mellitus track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent of progression to 2 respective disease states.
Topics: Adult; Age Distribution; Blood Glucose; Blood Pressure Determination; Cohort Studies; Comorbidity; Diabetes Mellitus, Type 2; Female; Humans; Hypertension; Logistic Models; Longitudinal Studies; Male; Mexico; Middle Aged; Multivariate Analysis; Prediabetic State; Prehypertension; Prognosis; Risk Assessment; Sex Distribution; Survival Rate
PubMed: 29335249
DOI: 10.1161/HYPERTENSIONAHA.117.10546 -
Journal of Clinical Hypertension... May 2011Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults....
Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre-hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C-reactive protein, LVM/height(2.7) (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre-hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre-hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre-hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre-hypertension is associated with cardiovascular target organ damage in adolescents and young adults.
Topics: Adolescent; Blood Flow Velocity; Blood Pressure; Carotid Arteries; Child; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Echocardiography; Elasticity; Female; Humans; Hypertrophy, Left Ventricular; Male; Obesity; Prehypertension; Tunica Intima; Tunica Media; Ultrasonography; Vascular Resistance; Young Adult
PubMed: 21545394
DOI: 10.1111/j.1751-7176.2011.00471.x -
Hypertension (Dallas, Tex. : 1979) Jan 2019In 2017, the American Academy of Pediatrics issued a new clinical practice guideline for defining hypertension in children as an update to the previous Fourth Report...
In 2017, the American Academy of Pediatrics issued a new clinical practice guideline for defining hypertension in children as an update to the previous Fourth Report guidelines issued in 2004. Prevalence of confirmed pediatric hypertension in children has ranged from 2% to 4% based on previous guidelines yet it is unknown what the prevalence is under the new guideline. We estimated the prevalence of elevated blood pressure, stage 1, and stage 2 hypertension by the new American Academy of Pediatrics guideline in our school-based blood pressure screening program. New prevalence estimates were compared with Fourth Report prevalence estimates in the same population by sex, age, and height factors. In 22 224 students aged 10 to 17 years screened in school as part of the Houston Pediatric and Hypertension Program at the University of Texas McGovern Medical School, the prevalence of elevated blood pressure (previously called prehypertension) increased from 14.8% by Fourth Report to 16.3% by the new American Academy of Pediatrics guideline. This increase in elevated blood pressure resulted from differential classification changes in younger and older children. Prevalence of confirmed hypertension remains at 2% to 4% in this population, however shorter children <13 years old and taller, older children 13+ years old are systematically more likely to be diagnosed with hypertension by new guidelines.
Topics: Adolescent; Blood Pressure; Blood Pressure Determination; Body Height; Body Mass Index; Child; Female; Humans; Hypertension; Male; Pediatrics; Prehypertension; Prevalence; Risk Factors; United States
PubMed: 30571555
DOI: 10.1161/HYPERTENSIONAHA.118.11673 -
Epidemiology and Health 2018The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.
OBJECTIVES
The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.
METHODS
In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.
RESULTS
The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.
CONCLUSIONS
Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Topics: Adult; Diabetes Mellitus; Female; Humans; Incidence; Iran; Male; Middle Aged; Models, Statistical; Prehypertension; Prospective Studies; Risk
PubMed: 30056646
DOI: 10.4178/epih.e2018026 -
Journal of the American College of... Jun 2012The purpose of this study is to better understand the origins and progression of pre-hypertension.
OBJECTIVES
The purpose of this study is to better understand the origins and progression of pre-hypertension.
BACKGROUND
Pre-hypertension is a risk factor for progression to hypertension, cardiovascular disease, and increased mortality. We used a cross-sectional twin study design to examine the role of heredity in likely pathophysiological events (autonomic or hemodynamic) in pre-hypertension.
METHODS
Eight hundred twelve individuals (337 normotensive, 340 pre-hypertensive, 135 hypertensive) were evaluated in a sample of twin pairs, their siblings, and other family members. They underwent noninvasive hemodynamic, autonomic, and biochemical testing, as well as estimates of trait heritability (the percentage of trait variance accounted for by heredity) and pleiotropy (the genetic covariance or shared genetic determination of traits) by variance components.
RESULTS
In the hemodynamic realm, an elevation of cardiac contractility prompted increased stroke volume, in turn increasing cardiac output, which elevated blood pressure into the pre-hypertension range. Autonomic monitoring detected an elevation of norepinephrine secretion plus a decline in cardiac parasympathetic tone. Twin pair variance components documented substantial heritability as well as joint genetic determination for blood pressure and the contributory autonomic and hemodynamic traits. Genetic variation at a pathway locus also indicated pleiotropic effects on contractility and blood pressure.
CONCLUSIONS
Elevated blood pressure in pre-hypertension results from increased cardiac output, driven by contractility as well as heart rate, which may reflect both diminished parasympathetic and increased sympathetic tone. In the face of increased cardiac output, systemic vascular resistance fails to decline homeostatically. Such traits display substantial heritability and shared genetic determination, although by loci not yet elucidated. These findings clarify the role of heredity in the origin of pre-hypertension and its autonomic and hemodynamic pathogenesis. The results also establish pathways that suggest new therapeutic targets for pre-hypertension, or approaches to its prevention.
Topics: Adult; Blood Pressure; Calcium Channels, L-Type; Cardiac Output; Cross-Sectional Studies; Disease Progression; Female; Hemodynamics; Humans; Male; Myocardial Contraction; Norepinephrine; Prehypertension; Stroke Volume; Vascular Resistance
PubMed: 22676942
DOI: 10.1016/j.jacc.2012.02.040 -
Tropical Medicine & International... Nov 2018To determine risk factors of pre-hypertension and hypertension in a cohort of 1247 rural Tanzanian women before conception.
OBJECTIVES
To determine risk factors of pre-hypertension and hypertension in a cohort of 1247 rural Tanzanian women before conception.
METHODS
Demographic and socioeconomic data, anthropometric measurements, past medical and obstetric history and other risk factors for pre-hypertension and hypertension were collected using a structured questionnaire. Multiple logistic regression analysis was used to evaluate the associations between anthropometric indices and other risk factors of pre-hypertension and hypertension. The predictive power of different anthropometric indicators for identification of pre-hypertension and hypertension patients was determined by Receiver Operating Characteristic curves (ROC).
RESULTS
The median (range) age was 28.0 (18-40) years. The age-standardised prevalences of pre-hypertension and hypertension were 37.2 (95% CI 34.0-40.6) and 8.5% (95%CI 6.7-10.8), respectively. Of hypertensive patients (n = 98), only 20 (20.4%) were aware of their condition. In multivariate analysis, increasing age, obesity and haemoglobin levels were significantly associated with pre-hypertension and hypertension.
CONCLUSION
Despite a low prevalence of hypertension, over one third of the women had pre-hypertension. This poses a great challenge ahead as pre-hypertensive women may progress into hypertension as they grow older without appropriate interventions. Obesity was the single most important modifiable risk factor for pre-hypertension and hypertension.
Topics: Adolescent; Adult; Cohort Studies; Cross-Sectional Studies; Female; Humans; Hypertension; Prehypertension; Prevalence; Risk Factors; Rural Population; Tanzania; Young Adult
PubMed: 30280462
DOI: 10.1111/tmi.13149 -
International Journal of Environmental... Jan 2024Hypertensive disorders of pregnancy (HDP) and pre-pregnancy hypertension contribute to maternal morbidity and mortality. We examined the association of HDP and...
Hypertensive disorders of pregnancy (HDP) and pre-pregnancy hypertension contribute to maternal morbidity and mortality. We examined the association of HDP and pre-pregnancy hypertension with subsequent venous thromboembolic (VTE) events. The retrospective cohort study included 444,859 women with ≥1 live, singleton birth in South Carolina (2004-2016). Hospital and emergency department visit and death certificate data defined incident VTE, HDP, and pre-pregnancy hypertension. Birth certificate data also defined the exposures. Adjusted Cox proportional hazards methods modeled VTE events risk. Of the cohort, 2.6% of women had pre-pregnancy hypertension, 5.8% had HDP, 2.8% had both pre-pregnancy hypertension and HDP (both conditions), and 88.8% had neither condition. The risk of incident VTE events within one year of delivery was higher in women with HDP (hazard ratio [HR] = 1.62, 95% confidence interval [CI]: 1.15-2.29) and both conditions (HR = 2.32, 95% CI: 1.60-3.35) compared to those with neither condition as was the risk within five years for women with HDP (HR = 1.35, 95% CI: 1.13-1.60) and for women with both conditions (HR = 1.82, 95% CI: 1.50-2.20). One- and five-year risks did not differ in women with pre-pregnancy hypertension compared to women with neither condition. Compared to non-Hispanic White (NHW) women with neither condition, the incident VTE event risk was elevated within five years of delivery for NHW (HR = 1.29, 95% CI: 1.02-1.63; HR = 1.59, 95% CI: 1.16-2.17) and non-Hispanic Black (NHB; HR = 1.51, 95% CI: 1.16-2.96; HR = 2.08, 95% CI: 1.62-2.66) women with HDP and with both conditions, respectively, and for NHB women with pre-pregnancy hypertension (HR = 1.50, 95% CI: 1.09-2.07). VTE event risk was highest in women with HDP, and the event rates were higher in NHB women than in NHW women in the same exposure group.
Topics: Pregnancy; Female; Humans; Venous Thromboembolism; Hypertension, Pregnancy-Induced; Retrospective Studies; Venous Thrombosis; Birth Certificates; Prehypertension
PubMed: 38248552
DOI: 10.3390/ijerph21010089 -
Revista Portuguesa de Cardiologia :... Oct 2017Systemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a...
INTRODUCTION
Systemic hypertension is one of the main risk factors for cardiovascular disease (CVD). Early diagnosis and treatment of hypertension in childhood can potentially have a significant impact on future adverse outcomes.
OBJECTIVE
To investigate the relationship of diastolic (DBP) and systolic blood pressure (SBP) with anthropometric data and area of residence of children in municipalities of Rio Grande do Sul state, Brazil.
METHODS
This is a cross-sectional study of 709 children between six and nine years of age. Blood pressure, weight, height and waist circumference (WC) were measured. Statistical tests had a maximum significance level of 5% (p≤0.05) and the software used was SPSS version 13.0.
RESULTS
Obesity was significantly associated with pre-hypertension, and stage 1 and 2 hypertension as assessed by DBP and SBP (≤0.05); high WC was significantly associated with a classification of pre-hypertension and stage 1 hypertension based on DBP and a classification of stage 1 and 2 hypertension based on SBP (≤0.01).
CONCLUSION
Children living in urban areas had significantly higher mean SBP than those living in rural areas. Those with high WC presented higher SBP and DBP compared to children with normal WC. Obese children showed higher mean SBP and DBP compared to those who were overweight or normal weight and mean SBP and DBP also increased with older age and higher mean body mass index and WC.
Topics: Blood Pressure; Brazil; Cardiovascular Diseases; Child; Cross-Sectional Studies; Female; Humans; Male; Prehypertension; Risk Factors
PubMed: 29054491
DOI: 10.1016/j.repc.2016.12.013