Homocysteine – relation to hypertension, age and smoking in patients with newly diagnosed essential hypertension

Introduction. An elevated circulating concentration of homocysteine is associated with an increased risk of coronary, cerebral, and peripheral vascular disease. The purpose of this study was to determine the concentrations of homocysteine in the patients with newly diagnosed essential hypertension and healthy subjects and to analyze the correlation between homocysteine level and the other parameters (age, blood pressure, smoking).Material and methods. The study group consisted of 18 patients with essential hypertension, 4 women and 14 men (mean age 43 ± 16 years) and 15 healthy volunteers, 8 women and 7 men (mean age 47 ± 10 years). Serum homocysteine was analyzed by FPIA method (Fluorescence Polarization Immunoassay).Results. The patients with essential hypertension had significantly higher homocysteine concentration compared to control group. No correlation was observed between homocysteine levels and age, diastolic, systolic blood pressure in subjects with essential hypertension. In healthy volunteers, only a correlation between age and homocysteine concentration was found.

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Raised Serum Homocysteine Level is Associated with Hypertension

Bangladesh Journal of Medical Biochemistry ◽

10.3329/bjmb.v11i1.39764 ◽

2019 ◽

Vol 11 (1) ◽

pp. 22-25

Author(s):

S Biswas ◽

R Haque ◽

N Uddin ◽

AR Saha ◽

K Sultan ◽

...

Keyword(s):

Homocysteine Level ◽

Elevated Serum ◽

Cross Sectional ◽

Homocysteine Concentration ◽

National Health Care ◽

Medical College ◽

Serum Homocysteine ◽

Increased Risk ◽

Clinical Measurements ◽

Group Serum

An elevated serum homocysteine concentration is associated with an increased risk of coronary, cerebral, and peripheral vascular disease. The objective of the study was to evaluate the association of serum homocysteine level with hypertension (HTN). This cross sectional analytical study was conducted at Sir Salimullah Medical College & Mitford Hospital and National Health Care Network Dhaka, Bangladesh over a duration of 21 months from July 2012 to May 2014. Fifty HTN patients were included as study subjects and age and sex matched fifty non-HTN healtlhy controls were included. All the clinical measurements were taken and serum Hcy was measured for all study subjects. In this study, females were predominant in both groups, mean age of the HTN patients was 41.0±5.6 years and non-HTN healthy subjects was 38.2±5.2 years. BMI and FBG were found higher in HTN group than that of non-HTN group but the differences were not statistically significant. Systolic and diastolic BP were found significantly higher in HTN group than that of non-HTN group. Serum Hcy level was significantly higher in HTN group (19.93±4.12 μmol/L) than that of non-HTN group (13.20±1.88 μmol/L). This study depicted that serum Hcy had significant correlation with SBP and DBP in HTN. In conclusion, it was seen that elevated serum Hcy level is associated with hytpertension. Bangladesh J Med Biochem 2018; 11(1): 22-25

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A STUDY OF SERUM URIC ACID LEVELS IN NEWLY DIAGNOSED CASES OF ESSENTIAL HYPERTENSION

10.36106/ijsr/6735804 ◽

2021 ◽

pp. 72-74

Author(s):

Deepak Jain ◽

Ajith Thomas ◽

Rajinder Singh Gupta

Keyword(s):

Blood Pressure ◽

Uric Acid ◽

Essential Hypertension ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Serum Uric Acid ◽

Control Group ◽

Newly Diagnosed ◽

The Mean ◽

And Control

Background: The association of raised serum uric acid levels with various cardiovascular risk factors has often led to the debate of whether raised serum uric acid levels could be an independent risk factor in essential hypertension. Hence, the present study was conducted for assessing the serum uric acid levels in cases of essential hypertension and comparing them with normal healthy, non-hypertensive controls. Materials & Methods: Sixty patients visiting in the department of general medicine, MMIMSR with newly diagnosed cases of essential hypertension [according to the Indian guidelines on Hypertension(IGH) III-2013] , fullling the inclusion criteria and after verifying the exclusion criteria were nally taken up for the study. Sixty controls of age and sex matched were taken from the same catchment area. Results: The mean age of the subjects of the essential hypertension group and control group was found to be 45.75 years and 47.8 years respectively. Mean systolic blood pressure and diastolic blood pressure among the subjects of the essential hypertension group was 161.3 and 102.3 mm of Hg. Mean systolic blood pressure and diastolic blood pressure among the subjects of the control group was 116.8 and 77.4 mm of Hg. Mean serum uric acid levels among the subjects of the essential hypertension group and control group was found to be 6.45 mg/dL and 5.57 mg/dLrespectively. Signicant results were obtained while comparing the mean serum uric acid levels among the subjects of the essential hypertension group and the control group. Hyperuricemia was present in 38.33 percent of the patients (23 patients) of the essential hypertension group and 13.33 percent of the patients (8 patients) of the control group. Signicant results were obtained while comparing the prevalence of hyperuricemia in between the two study groups.Conclusion: An independent relationship of elevated serum uric acid levels with hypertension and indicates the signicance of maintaining normal serum uric acid concentration to prevent hypertension.

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Bilateral sphenopalatine ganglion block reduces blood pressure and blood pressure variability in never treated patients with essential hypertension

European Heart Journal ◽

10.1093/ehjci/ehaa946.2786 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

H Triantafyllidi ◽

C Arvaniti ◽

D Benas ◽

A Schoinas ◽

D Voutsinos ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Blood Pressure Variability ◽

Control Group ◽

Sham Operation ◽

Study Group ◽

Sphenopalatine Ganglion ◽

Night Time ◽

Hypertensive Patients ◽

Increased Risk

Abstract Background Sphenopalatine ganglion (SPG) area is connected through sympathetic fibers with the central nervous system. It is already known that SPG infiltration by lidocaine reduced blood pressure in naïve hypertensive patients. Blood pressure variability (BPV) has been associated with an increased risk of cardiovascular events and mortality, independently of elevated BP levels. We aimed to study the effect of SPG block in BPV in never treated patients with stage I–II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 47 newly diagnosed and never treated hypertensive patients (study group, mean age 50±12 years, 31 men) and a sham operation with water for injection in 11 patients (control group, mean age 51±12 years, 8 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring (ABPM) prior and a month after the SPG block in order to estimate any differences in BP parameters derived from ABPM (BP, BPV). We defined as responders to SBG block those patients with a 24h average SBP decrease >5 mmHg. Results We noticed the following significant differences in the study group: a. 24h average DBP and daytime DBP were reduced by 1.6±5 mmHg (p=0.04) and 1.9±5 mmHg (p=0.01) respectively and b. systolic BPV during daytime (11±2 mmHg vs. 10±2 mmHg, p<0.05). Interestingly, in the responders group (14/47, 30%, 9 men, age = 47±8 mmHg) and a month after SPG block we noticed that: a. 24h average, daytime, night-time SBP and 24h average, daytime, night-time DBP were reduced by 9±4 mmHg (p<0.001), 9±3 mmHg (p<0.001), 7±7 mmHg (p=0.002) and 6.5±3 mmHg (p<0.001), 6.5±3 mmHg (p<0.001), 4±7 mmHg (p=0.02), respectively and b. systolic BPV during daytime (13±2 mmHg vs. 9±2 mmHg, p=0.01). No differences regarding BPV were found in the non-responders and the sham operation group. Conclusions SPG block is a promising, minimally invasive option of significant BP and BPV decrease in never treated hypertensive patients, especially during daytime activities when SNS is activated. It acts probably through SNS modulation. Since its effect is only anesthetic and non-permanent, SPG block might permit the selection of the hypertensive patients with an activated SNS before any other invasive antihypertensive procedure. SPG block reduces BP variability Funding Acknowledgement Type of funding source: None

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Effect of Losartan and Atenolol on heart rate variability in newly diagnosed essential hypertensive patient

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v6i2.29135 ◽

2016 ◽

Vol 6 (2) ◽

pp. 161

Author(s):

Shamima Sultana ◽

Shelina Begum ◽

Sultana Ferdousi

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Heart Rate Variability ◽

Essential Hypertension ◽

Antihypertensive Drugs ◽

Control Group ◽

Newly Diagnosed ◽

Hypertensive Patients ◽

Group B ◽

Mean Heart Rate

Background: Essential hypertension is associated with altered autonomic function. Essential hypertension is treated with drugs which modify the sympatho-parasympathetic balance. Losartan (angioteosin II receptor blocker) and atenolol (beta blocker) is commonly used antihypertensive drugs.Objective: To evaluate the effect of antihypertensive drugs on heart rate variability (HRV) in patients with essential hypertension.Methods: This prospective observational study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from July 2012 to June 2013 on 120 newly diagnosed hypertensive patients without any medication (group B, age 30-55 years). They were selected from the Out Patients Department (OPD) of cardiology, BSMMU, Dhaka. Age, sex and BMI matched 60 apparently healthy norrnotensive subjects were also studied as control (group A). Based on treatment, these study subjects were divided into two groups (BI and B2). Group B1a included 60 patients received Josartan 50 mg daily and B2a included 60 patients received atenolol 50mg daily. They were observed once before the treatment (B1a & B2a), after 3 months medication (B1b & B2b) and after 6 months medication (B1c & B2c). For assessing HRV, Mean heart rate, Mean R-R interval, Max/Min R-R interval, SDNN, RMSSD were recorded by a polyrite. Data were compared among before treatment, after 3 months treatment and after 6 months treatment. For statistical analysis ANOVA, independent sample't' test and paired sample 't' test were performed. Results: Mean resting pulse rate, mean heart rate, systolic blood pressure, diastolic blood pressure were significantly higher and mean R-R interval, Max/Min R-R interval, SDNN, RMSSD were significantly lower in newly diagnosed hypertensive patients in comparison with that of healthy normotensive subjects and after treatment. Jn both groups SDNN, RMS SD, mean R-R interval were found significantly higher after 6 months of treatment compared to their values after 3 months treatment. Again these values were found close to the values in normotensive subjects. In addition, mean heart rate was found significantly lower in atenolol treated patients than those of controls. Again in atenolol group these values were found significanLly higher than the corresponding values in losartan treated patients after 6 months treatment. Conclusion: Reduced cardiac vagal tone occurs in newly diagnosed hypertensive patients which is improved by both losartan and atenolol and in particular atenolol was found more effective.

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Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

Revista de Chimie ◽

10.37358/rc.18.6.6366 ◽

2018 ◽

Vol 69 (6) ◽

pp. 1550-1553

Author(s):

Rosana Manea ◽

Bianca Elena Popovici ◽

Carmen Daniela Neculoiu ◽

Dan Minea ◽

Alina Calin

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Carotid Artery ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Diagnostic Methods ◽

Control Group ◽

Study Group ◽

Media Thickness ◽

Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

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Association of Serum Homocysteine Level and Interstitial Lung Disease in Systemic Sclerosis: A Case-control Study

Current Rheumatology Reviews ◽

10.2174/1573397114666180628162907 ◽

2018 ◽

Vol 15 (1) ◽

pp. 74-78

Author(s):

Mohammadali Nazarinia ◽

Asghar Zare ◽

Mohammad javad Fallahi ◽

Mesbah Shams

Keyword(s):

Systemic Sclerosis ◽

Healthy Subjects ◽

Case Control Study ◽

Homocysteine Level ◽

Case Control ◽

Control Group ◽

Lung Involvement ◽

Serum Homocysteine ◽

The Mean ◽

Control Study

Background:Systemic sclerosis is a disorder of connective tissue with unknown cause, affecting the skin and internal organs, characterized by fibrotic changes.Objective:To determine the correlation between serum homocysteine level and interstitial lung involvement in systemic sclerosis. Materials and Methods: In this case – control study, 59 patients who fulfilled the ACR/EULAR classification criteria for systemic sclerosis and were referred to Hafez Hospital of Shiraz, Iran, were included as the case group. Fifty nine healthy subjects were involved as the control group. Patients were divided into two groups based on interstitial lung involvement and two subtypes, diffuse and limited type. Serum homocysteine, vitamin B12, and folate levels compared between the controls, and cases groups.Results:Of 59 case and control group, 53 (%89.8) were female and the mean age did not differ in both groups (P=0.929). Thirty five (%59.3) patients had interstitial lung involvement and 38(%64.4) had diffuse cutaneous systemic sclerosis. The mean serum homocysteine level was 13.9±6.3 µmol/L in the case and 13.7±9.2 µmol/L in the control group (P=0.86). The mean serum homocysteine level did not differ between the patients with and without interstitial lung involvement (P=0.52). The patients with lung involvement was older than those without lung involvement (P=0.004). Lung disease was more common in diffuse type (P=0.014).Conclusion:In our study, serum homocysteine level did not differ between the patients and healthy subjects. Also, there was no correlation between serum homocysteine level and lung involvement, but lung involvement was more common in older patients and also diffuse subtype.

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Hyperhomocysteinaemia in Behçet's Disease

Biochemistry Research International ◽

10.1155/2010/361387 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Amira Hamzaoui ◽

Olfa Harzallah ◽

Rim Klii ◽

Silvia Mahjoub

Keyword(s):

Behçet’S Disease ◽

Behcet’S Disease ◽

Homocysteine Level ◽

Behçet's Disease ◽

Negative Control Group ◽

Negative Control ◽

Control Group ◽

Behcet's Disease ◽

Homocysteine Concentration ◽

Significant Difference

Objectives. The aim of this study was to investigate if hyperhomocysteinaemia is a contributive risk factor for the pathogenesis and the activity of Behçet's disease (BD).Design and Methods. Fifty four patients fullfiling the criteria of the International Study Group for BD were enrolled. Fifty healthy volunteers matched for age and sex with the BD group were included as a negative control group. Patients, with any condition that might affect plasma homocysteine concentration, were excluded.Results. Mean serum homocysteine concentration was significantly higher in patients with BD than in the healthy controls (), in patients with active disease (), and in masculine gender (). There was no significant difference between homocysteine level and clinical involvement.Conclusions. We demonstrated that plasma total homocysteine level (tHcy) is increased in BD and correlated with disease activity. No association was found between homocysteine levels and clinical involvement.

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Abstract 17638: Systemic Cardiovascular Effects of Intravenous Urocortin 2 and Urocortin 3 in Patients with Heart Failure and Healthy Volunteers

Circulation ◽

10.1161/circ.130.suppl_2.17638 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Colin G Stirrat ◽

Sowmya Venkatasubramanian ◽

Tania Pawade ◽

Andrew Mitchell ◽

Anoop Shah ◽

...

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Cardiac Index ◽

Healthy Volunteers ◽

Diastolic Blood Pressure ◽

Cardiovascular Effects ◽

Peripheral Vascular ◽

Patients With Heart Failure ◽

Group A ◽

Urocortin 3

Introduction: Urocortin 2 (UCN 2) and urocortin 3 (UCN 3) are endogenous peptide hormones with an emerging role in the pathophysiology and treatment of heart failure. For the first time, we examined the systemic cardiovascular effects of both UCN 2 and UCN 3 in healthy volunteers and patients with heart failure. Methods: Seven healthy volunteers (Group A) and nine patients with stable chronic heart failure (Group B, New York Heart Association class II and III, left ventricular ejection fraction <35%) on optimal medical therapy underwent non-invasive oscillometric sphygmomanometry and impedance cardiography during incremental intravenous infusions of sodium nitroprusside (0.15/0.5/1.5 μg/kg/min), UCN 2 (0.16/0.48/1.6 μg/min), UCN 3 (5/15/50 μg/min) and saline placebo in a randomised double blind two-way cross over study. Results: Other than diastolic blood pressure (78 vs 72 mmHg for Group A and B respectively, p<0.05), haemodynamic variables were similar at baseline of each infusion and were unchanged by saline placebo infusion (p>0.05 for all). SNP, UCN2 and UCN 3 infusions increased heart rate and cardiac index, and reduced systolic and diastolic blood pressure and peripheral vascular resistance index (PVRI) in both healthy volunteers and patients with heart failure (p<0.05 for all; see Figure 1). There were no significant differences in the changes in cardiac index or PVRI between healthy volunteers and patients with heart failure during either UCN 2 or UCN 3 infusions (p>0.05). Conclusion: Intravenous UCN 2 and especially UCN 3 increase cardiac output and reduce peripheral vascular resistance. This favourable haemodynamic profile suggests that UCN 2 and UCN 3 hold exciting therapeutic potential for the treatment of acute heart failure.

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Association of Serum Homocysteine Level with Migraine in Adults

Bangladesh Journal of Neuroscience ◽

10.3329/bjn.v33i2.57521 ◽

2017 ◽

Vol 33 (2) ◽

pp. 76-82

Author(s):

Md Monirul Islam ◽

Md Ahsan Habib ◽

Md Rafiqul Islam ◽

Hasan Zahirur Rahman ◽

Abu Nasir Rizvi ◽

...

Keyword(s):

Migraine With Aura ◽

Homocysteine Level ◽

Primary Headache ◽

Headache Disorder ◽

Mean Value ◽

Control Group ◽

Case Group ◽

Close Link ◽

Serum Homocysteine ◽

The Mean

Background: Migraine is the second most common primary headache disorder that has close link to the neurovascular system. The exact pathogenesis of migraine is still not fully understood but several possible theories have been proposed. Hyperhomocysteinemia is one of the coincidental factors whose association with migraine is yet in obscure. Methods: This case control study was conducted in the department of Neurology, Bangabandhu Sheikh Mujib Medical University, Dhaka. A total of 65 patients, who were diagnosed as migraine (with aura or without aura) according to ICHD-3 criteria, were considered as case group and another 65 patients (age and sex matched) with headache other than migraine were considered as control group. Serum homocysteine levels were estimated for both groups and other relevant investigations were done in selective cases. Comparison of serum homocysteine levels between two groups were done to see association of serum homocysteine level with migraine in adults. Results: A total of 50 women and 15 men with mean age of 31 (±10.41) years and 50 women and 15 men with mean age of 33 (±10.91) years constituted case and control groups, respectively. The mean (±SD) serum homocysteine level in case group 10.71 (±4.16) ìmol/L was significantly higher than control group 7.62 (±2.26) ìmol/L, (P <0.001).The mean value of serum homocysteine level in migraine without aura (MWOA) patients 11.87 (±4.18) ìmol/L was found significantly higher than migraine with aura (MWA) patients 8.23 (±1.51) ìmol/L, (p<0.05). There was no significant correlation between severity of migraine headache and frequency of migraine attack with serum homocysteine level. Conclusion: Serum homocysteine level was found significantly higher in migraineurs than non-migraineurs. Bangladesh Journal of Neuroscience 2017; Vol. 33 (2): 76-82

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Influence of Mindfulness and Relaxation on Treatment of Essential Hypertension: Meta-Analysis

Journal of Healthcare Engineering ◽

10.1155/2021/2272469 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Fushun Zhang ◽

Yuanyuan Zhang ◽

Nan Jiang ◽

Qiao Zhai ◽

Juanjuan Hu ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Systolic Blood Pressure ◽

Publication Bias ◽

Effect Size ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Control Group ◽

Effect Model

Background. Some studies published previously have shown a strong correlation between hypertension and psychological nature including impulsion emotion or mindfulness and relaxation temperament, among which mindfulness and relaxation temperament might have a benign influence on blood pressure, ameliorating the hypertension. However, the conclusion was not confirmed. Objective. The meta-analysis was performed to investigate the influence of mindfulness and relaxation on essential hypertension interventions and confirm the effects. Methods. Systematic searches were conducted in common English and Chinese electronic databases (i.e., PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, Cochrane Library, and Chinese Biomedical Literature Database) from 1980 to 2020. A meta-analysis including 5 studies was performed using Rev Man 5.4.1 software to estimate the influence of mindfulness and relaxation on blood pressure, ameliorating the hypertension. Publication bias and heterogeneity of samples were tested using a funnel plot. Studies were analyzed using either a random-effect model or a fixed-effect model. Results. All the 5 studies investigated the influence of mindfulness and relaxation on diastolic and systolic blood pressure, with total 205 participants in the control group and 204 in the intervention group. The random-effects model (REM) was used to calculate the pooled effect for mindfulness and relaxation on diastolic blood pressure (I2 = 0%, t2 = 0.000, P = 0.41 ). The random pooled effect size (MD) was 0.30 (95% CI = −0.81–1.42, P = 0.59 ). REM was used to calculate the pooled effect for mindfulness and relaxation on systolic blood pressure (I2 = 49%, t2 = 3.05, P = 0.10 ). The random pooled effect size (MD) was −1.05 (95% CI = −3.29–1.18, P = 0.36 ). The results of this meta-analysis were influenced by publication bias to some degree. Conclusion. All the results showed less influence of mindfulness and relaxation might act on diastolic or systolic blood pressure, when mindfulness and relaxation are used to intervene in treating CVD and hypertension.

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