Abstract 139: Vascular Endothelin-1 Activity Increases with Age in Hypertensive Patients

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Andrew E Berdy ◽  
Vijaywant Brar ◽  
Julio A Panza ◽  
Umberto Campia
Keyword(s):  
Essential Hypertension ◽  
Repeated Measures ◽  
Disease Risk ◽  
Population Aging ◽  
Pearson Correlation ◽  
Cardiovascular Disease Risk ◽  
Prospective Clinical Study ◽  
Hypertensive Patients ◽  
Association Analyses ◽  
Endothelin 1

Background: Vascular endothelin-1 (ET-1) dependent vasoconstriction is elevated in patients with hypertension. The effect of increasing age on ET-1 activity is unknown. This study investigated the hypothesis that age is directly associated with ET-1 activity in hypertensive patients. Methods: Retrospective analysis of data collected in a prospective clinical study that investigated vascular ET-1 activity in patients with essential hypertension (BP>140/90mmHg). Endothelin-1 activity was expressed as forearm blood flow (FBF) responses as measured by strain-gauge plethysmography during the intra-arterial infusion of the selective endothelin type-A receptor antagonist BQ-123 (100 nmol/min) for 60 minutes. Changes in FBF from baseline in response to BQ-123 were assessed by one-way ANOVA for repeated measures. Association analyses were performed with use of the Pearson correlation coefficient. Results: Data from 40 patients were included in the current analyses. The baseline characteristics of the study population are reported in the table. Infusion of BQ-123 induced a significant increase in FBF from baseline (p<0.001). The percent increase in FBF from baseline at 60 minutes of BQ-123 infusion was significantly directly associated with age (r=0.435; p=0.006), but not with blood pressure, parameters of glucose and lipid metabolism, markers of endothelial activation, and adipocytokine levels (p=NS for all). Conclusions: In patients with essential hypertension, ET-1 activity is directly associated with age. Our findings suggest that, in this population, aging may contribute to vascular damage and cardiovascular disease risk through an enhanced activation of the ET-1 system. Further study is needed to elucidate the mechanisms underlying the association between age and vascular ET-1 activity.

4328Short-term effects of dapagliflozin versus canagliflozin on acute decompensated heart failure in patients with type 2 diabetes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Nakagaito ◽  
S Joho ◽  
R Ushijima ◽  
M Nakamura ◽  
T Hirai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Glucose ◽  
Repeated Measures ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Fasting Blood Glucose ◽  
Urine Volume ◽  
P Value ◽  
Urine Glucose

Abstract Background The CANVAS program and DECLERE-TIMI 58 reported that SGLT2i had been demonstrated to reduce hospitalization for heart failure (HF) in type 2 diabetic mellitus (T2DM) patients with high cardiovascular disease risk. However, it remains unclear whether the effectiveness of SGLT2i on acute decompensated HF is also observed in T2DM patients irrespective of acting types of SGLT2i. Methods In this single center, open-label, prospective study, fifty-eight T2DM patients hospitalized due to decompensated HF were enrolled (mean age 73 years, HbA1c 7.2%). After treatment for HF, 5mg/day of dapagliflozin (n=24, from February 2016 to February 2017) or 100mg/day of canagliflozin (n=34, from March 2017 to July 2018) was administered and clinical parameters about HF and T2DM were followed for 7 days. Statistical comparison of parameters between groups taking dapagliflozin or canagliflozin was performed using the two-way repeated measures analysis of variance (MANOVA). Results In both groups, urine glucose excretion increased significantly after administration of SGLT2i. Fasting blood glucose level tended to be decreased in both groups. Urine volume increased significantly one day after administration of SGLT2i, and returned to the baseline after one week in both groups. Interestingly, urine volume one day after administration of SGLT2i tended to increase more in the group taking canagliflozin than in the group taking dapagliflozin (interaction P value = 0.088). Importantly, plasma BNP levels and Nt-proBNP levels were decreased significantly in both groups. Parameters before and after treatment Baseline Day 7 (Day 1) P value Interaction P value Fasting blood glucose, mg/dL All 137±57 122±51 0.013 0.900 Dapa 144±64 133±53 0.089 Cana 128±64 118±40 0.069 log BNP All 5.31±1.11 4.91±1.09 <0.001 0.102 Dapa 5.48±1.04 4.94±1.00 <0.001 Cana 5.20±1.15 4.89±1.16 <0.001 log Nt-proBNP All 7.25±1.35 6.96±1.41 <0.001 0.735 Dapa 7.54±1.16 7.22±1.25 0.048 Cana 7.04±1.45 6.79±1.50 0.005 Urine volume (Day 1), mL/24h All 1218±523 1584±614 <0.001 0.088 Dapa 1261±564 1486±568 0.038 Cana 1186±498 1654±644 <0.001 Urine volume (Day 7), mL/24h All 1218±523 1305±408 0.128 0.428 Dapa 1261±564 1295±468 0.700 Cana 1186±498 1313±367 0.097 Urine glucose, g/24h All 1.6±5.5 23.7±23.5 <0.001 0.330 Dapa 1.7±6.8 20.3±21.7 <0.001 Cana 1.5±4.6 26.0±24.7 <0.001 Conclusion SGLT2i are useful for correcting volume overload and recovering from the decompensated state in HF patients with T2DM irrespective of acting types of SGLT2i.

scholarly journals Risk-Factor Clustering and Cardiovascular Disease Risk in Hypertensive Patients

2007 ◽  
Vol 20 (6) ◽  
pp. 599-607 ◽  
Author(s):  
D WEYCKER ◽  
G NICHOLS ◽  
M OKEEFFEROSETTI ◽  
J EDELSBERG ◽  
Z KHAN ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Hypertensive Patients

Diagnosis, assessment, and treatment of essential hypertension

2010 ◽  
pp. 3039-3057
Author(s):  
Bryan Williams ◽  
John D. Firth
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Subsequent Treatment ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Assessment And Treatment

Essential hypertension is almost invariably symptomless, and usually detected by routine screening or opportunistic measurement of blood pressure. Key questions to answer in the assessment of a person presenting with an elevated blood pressure are: (1) Do they have hypertension, i.e. is the blood pressure persistently elevated? (2) Are there any associated clinical features that might warrant further evaluation to exclude secondary causes of hypertension? (3) Are there factors that might be contributing to an elevated blood pressure, including lifestyle or dietary factors or concomitant medication? (4) Is there any associated target organ damage or comorbidity that influences the overall cardiovascular disease risk and subsequent treatment of the patient?...

scholarly journals Differential insulin sensitivity of NMR-based metabolomic measures in a two-step hyperinsulinemic euglycemic clamp study

Metabolomics ◽  
2021 ◽  
Vol 17 (6) ◽  
Author(s):  
Wenyi Wang ◽  
Ko Willems van Dijk ◽  
Carolien A. Wijsman ◽  
Maarten P. Rozing ◽  
Simon P. Mooijaart ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Insulin Infusion ◽  
Low Dose ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
High Dose ◽  
Mixed Effect ◽  
Euglycemic Clamp ◽  
Hyperinsulinemic Euglycemic Clamp ◽  
Branched Chain

Abstract Background Insulin is the key regulator of glucose metabolism, but it is difficult to dissect direct insulin from glucose-induced effects. We aimed to investigate the effects of hyperinsulemia on metabolomic measures under euglycemic conditions in nondiabetic participants. Methods We assessed concentrations of 151 metabolomic measures throughout a two-step hyperinsulinemic euglycemic clamp procedure. We included 24 participants (50% women, mean age = 62 [s.d. = 4.2] years) and metabolomic measures were assessed under baseline, low-dose (10 mU/m2/min) and high-dose (40 mU/m2/min) insulin conditions. The effects of low- and high-dose insulin infusion on metabolomic measures were analyzed using linear mixed-effect models for repeated measures. Results After low-dose insulin infusion, 90 metabolomic measures changed in concentration (p < 1.34e−4), among which glycerol (beta [Confidence Interval] =  − 1.41 [− 1.54, − 1.27] s.d., p = 1.28e−95) and three-hydroxybutyrate (− 1.22 [− 1.36, − 1.07] s.d., p = 1.44e−61) showed largest effect sizes. After high-dose insulin infusion, 121 metabolomic measures changed in concentration, among which branched-chain amino acids showed the largest additional decrease compared with low-dose insulin infusion (e.g., Leucine, − 1.78 [− 1.88, − 1.69] s.d., P = 2.7e−295). More specifically, after low- and high-dose insulin infusion, the distribution of the lipoproteins shifted towards more LDL-sized particles with decreased mean diameters. Conclusion Metabolomic measures are differentially insulin sensitive and may thus be differentially affected by the development of insulin resistance. Moreover, our data suggests insulin directly affects metabolomic measures previously associated with increased cardiovascular disease risk.

scholarly journals Leisure-Time Physical Activity and Cardiovascular Disease Risk Among Hypertensive Patients: A Longitudinal Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiqing Li ◽  
Zhentang Zhang ◽  
Shucheng Si ◽  
Fuzhong Xue
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Leisure Time ◽  
Disease Risk ◽  
Leisure Time Physical Activity ◽  
Cox Model ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk ◽  
Hypertensive Patients ◽  
Longitudinal Cohort

Objective: Few studies estimated the effect of leisure-time physical activity (LTPA) on cardiovascular disease (CVD) risk among hypertensive patients in a longitudinal cohort. This study aims to evaluate the association between LTPA and CVD in a longitudinal management cohort of hypertensive patients.Methods: A total of 58,167 hypertensive patients without baseline CVD from a longitudinal cohort were included in this study. LTPA and other covariates were measured at the follow-up four times annually. The primary outcome was CVD events. The association between LTPA and CVD was assessed by the marginal structure model (MSM) and Cox model with adjustment for age, gender, body mass index (BMI), smoking, drinking, diabetes, hyperlipidemia, and antihypertensive medication. The restricted cubic spline and segmented regression were used to assess the dose–response relationship between LTPA and CVD.Results: We recorded 16,332 CVD events; crude incidence of CVD were 89.68, 80.39, 62.64, and 44.04 per 1,000 person-years for baseline 0, 1–150, 151–300, and &gt;300 min/week LTPA, respectively. Compared with inactive LTPA, the adjusted hazard ratios (HRs) estimated by Cox model and MSM-Cox model for CVD associated with 1–150,151–300, and 300 min/week LTPA were 0.85 (95% CI, 0.83–0.88), 0.67 (95% CI, 0.64–0.71), 0.47 (95% CI, 0.44–0.51), and 0.83 (95% CI, 0.76–0.91), 0.58 (95% CI, 0.52–0.63), and 0.39 (95% CI, 0.35–0.44), respectively. Per 60 min/week increase in LTPA was associated with a 13% reduction in CVD risk. LTPA breakpoint was 417 min/week for CVD. Before and after the break-point, the slopes of the piecewise-linear relationship between LTPA and CVD risk were −0.0017 and −0.0003, respectively.Conclusion: LTPA was more strongly associated with the CVD risk than that estimated by conventional analyses based on baseline LTPA; 417 min/week is a breakpoint, after which the incremental health benefits on CVD prevention obtained from the increase in LTPA are much less than before.

scholarly journals LIFESTYLE PHYSICAL ACTIVITY IN OLDER WOMEN: ASSOCIATIONS OF CHANGE, SELF-EFFICACY, AND WELL-BEING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S171-S171
Author(s):  
Leanne L Lefler ◽  
Shelly Y Lensing ◽  
Kimberly K Garner
Keyword(s):  
Physical Activity ◽  
Clinical Trial ◽  
Older Women ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Social Role ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Well Being ◽  
Lifestyle Physical Activity

Abstract Reduction of cardiovascular disease risk in undeserved populations, such as older women, is a top priority of the U.S. Our innovative trial tested a new approach to PA promotion for older women—motivational interviewing (MI), shifting the paradigm from structured exercise to self-selected activities. We present data comparing stage of change (SOC), self-efficacy for exercise (SEE), and well-being: 8 dimensions (physical, social, role limitations, emotional, general mental health, vitality, health perceptions and pain) and associations with physical activity outcomes in the Lifestyle Physical Activity for Women (LPAW) clinical trial. Methods: 106 women, &gt; 60 years old, who did not engage in regular PA, and were not frail, participated in a clinical trial of a tailored MI intervention to increase PA. We report baseline, 3 and 6 month repeated measures and PA associations with SOC, SEE, and well-being (SF36). Results: Of 106 women, 36% were Black and 63% White, with a mean age of 69. Significant improvement in SOC in both arms noted but the proportion in action/maintenance was significantly higher in the PA arm at 3 mos (78% vs. 55%, P=0.045) and 6 mos (79% vs. 50%, P= 0.019). A decrease in SEE for control (p=.001), but not for PA arm (p=.45); at 6 months, The PA arm had greater SEE compared to control. There were significant arm difference for physical component scores of SF36 (p=.02), but not for mental scores. Associations with PA will be tabulated. Conclusions: Preliminary results support the PA intervention, more data to be presented.

scholarly journals Biochemical verification of smoking cessation and the role of endothelin‐1: Impact on cardiovascular disease risk

2019 ◽  
Vol 33 (S1) ◽  
Author(s):  
Martha S Tingen ◽  
Samantha J Sojourner ◽  
Matthew A Tucker ◽  
Cassandra C Derella ◽  
Ryan A Harris
Keyword(s):  
Cardiovascular Disease ◽  
Smoking Cessation ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Endothelin 1

scholarly journals Prevalence of other associated risk factors of Cardiovascular Disease among Hypertensive patients in Eastern Nepal

2014 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Buna Bhandari ◽  
Mahesh Bhattarai ◽  
Manjul Bhandari ◽  
Anup Ghimire ◽  
Paras Kumar Pokharel
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Physically Active ◽  
Hypertensive Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Associated Risk Factors

Background and Aims : Cardiovascular disease is the leading cause of death worldwide. Hypertension is one of the most important risk factors for Cardiovascular Diseases which cause 45% of global cardiovascular morbidity and mortality. Hypertension, along with other risk factors such as smoking, diabetes and obesity, is an emerging epidemic in many developing countries. This study aimed to find out the prevalence of other associated conventional risk factors of cardiovascular disease among hypertensive patients. Methods: Community based cross sectional study was conducted among 154 hypertensive patients over age 35yrs in Dharan Municipality. Data were collected by face to face interview method using structured questionnaire then analyzed by using descriptive and inferential statistics. Results: Around 29% hypertensive patients were between the age of 45 – 55 yrs and above 65 years. Prevalence of obesity was significantly higher 70.8%. Similarly, 46.8% had habit of taking high salt diet and 58.4% were taking high fat diet. Likewise, less physically active people were 58.4% and 64.9% were consuming alcohol regularly. Whereas 42.9% were smoker and 48.7% had stressful life. Moreover, this study also showed 46.1% had uncontrolled blood pressure in this hypertensive group. Conclusion: Cardiovascular Disease risk factors are highly prevalent among the hypertensive patients in this study. DOI: http://dx.doi.org/10.3126/njh.v11i1.10978 Nepalese Heart Journal 2014;11(1): 27-31

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