Association of Liver Transaminase Levels and Long-Term Blood Pressure Variability in Military Young Males: The CHIEF Study

Background: An inverse relationship of serum liver transaminases and mortality might be due to better blood pressure control in hypertensive patients. Whether it holds true regarding such an association for long-term blood pressure variability (BPV) in those without antihypertensive therapy is unclear. Methods: A population of 1112 military males without antihypertensive medications, aged 32 years, was collected from a retrospective longitudinal study in Taiwan. Serum liver aspartate and alanine transaminase (AST and ALT) levels were obtained from a 12 h-fast blood sample of each participant. BPV was assessed by standard deviation (SD) and average real variability (ARV) of systolic and diastolic blood pressure (SBP and DBP), respectively across 4 visits during the study period (2012–2014, 2014–2015, 2015–2016, and 2016–2018). Multivariable linear regression analysis was utilized to determine the association adjusting for demographics, anthropometric indexes, SBP, DBP, and lipid profiles. Results: In the unadjusted model, ALT was significantly and positively correlated with SDDBP and ARVDBP (β (standard errors) = 0.36 (0.16) and 0.24 (0.12), respectively), and so was AST (β = 0.19 (0.08) and 0.14 (0.06), respectively). All the associations were insignificant with adjustments. However, ALT was significantly and negatively correlated with SDSBP and ARVSBP (β = −0.35 (0.14) and −0.25 (0.11), respectively) and so was AST (β = −0.14 (0.07) and −0.12 (0.06), respectively) with adjustments. Conclusion: Our findings suggested that serum liver transaminases were negatively correlated with long-term systolic BPV in young male adults without antihypertensive therapy, and the clinical relevance needs further investigations.

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Abstract P120: Association Of Liver Transaminase Levels And Long-term Blood Pressure Variability In Military Young Males In Taiwan

Hypertension ◽

10.1161/hyp.76.suppl_1.p120 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Gen-min Lin ◽

Pang-yen Liu

Keyword(s):

Blood Pressure ◽

Lower Risk ◽

Blood Pressure Variability ◽

Smoking Status ◽

Linear Regression Analysis ◽

Elevated Serum ◽

Young Male ◽

Liver Transaminase ◽

Young Males

Background: Elevated serum liver transaminases (AST and ALT), highly related to metabolic disorders, are paradoxically associated with lower risk of cardiovascular disease (CVD) and mortality. Blood pressure variability (BPV), a risk factor of CVD, has not been examined the relationship with serum liver transaminase. Methods: A prospective cohort of 1,112 military males, aged 32.2 years was collected in Taiwan. Serum AST and ALT were obtained from a 12 hour-fast blood sample of each participant. BPV was assessed by standard deviation (SD) and average real variability (ARV) of systolic and diastolic blood pressure (SBP and DBP), respectively across 4 visits during the study period (2012-14, 2014-15, 2015-16, and 2016-18). Multivariable linear regression analysis was used to determine the association adjusting for age, body mass index, SBP, DBP, lipid profiles, physical activity, alcohol and smoking status. Results: In the unadjusted model, serum ALT were positively correlated with SD DBP and ARV DBP (β (SE) =0.36 (0.16) and 0.24 (0.12), respectively), and so were AST (β= 0.19 (0.08) and 0.14 (0.06), respectively). However, all the associations were insignificant with adjustments. By contrast, the associations with systolic BPV were initially insignificant in the unadjusted model. With adjustments, serum ALT were negatively correlated with SD SBP and ARV SBP (β= -0.34 (0.16) and -0.24 (0.12), respectively) and so were AST (β= -0.14 (0.07) and -0.11 (0.06), respectively). Conclusion: Our findings suggest that liver transaminase levels were negatively correlated with long-term systolic BPV in young male adults, possibly accounting for the lower risk of CVD in previous studies.

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Physical Fitness and Long-term Blood Pressure Variability in Young Male Military Personnel

Current Hypertension Reviews ◽

10.2174/1573402115666191023111351 ◽

2020 ◽

Vol 16 (2) ◽

pp. 156-160 ◽

Cited By ~ 2

Author(s):

Gen-Min Lin ◽

Kun-Zhe Tsai ◽

Chin-Sheng Lin ◽

Chih-Lu Han

Keyword(s):

Blood Pressure ◽

Physical Fitness ◽

Military Personnel ◽

Blood Pressure Variability ◽

Young Male ◽

The Elderly ◽

Average Real Variability ◽

The Right ◽

Run Test

Aims: The aim of this study is to investigate the association of physical fitness with longterm Blood Pressure Variability (BPV) in young male adults. Methods: 1,112 healthy military males, aged 18-40 years (mean age, 32 years), in Taiwan were included for the current analysis. Resting blood pressures were measured over the right upper arm in a sitting position every two years from 2012 to 2018 (2012-14, 2014-15, 2015-16, 2016-18). Long-term BPV by Standard Deviation (SDSBP and SDDBP) and Average Real Variability (ARVSBP and ARVDBP) were assessed across 4 visits during the study period. Aerobic fitness was evaluated by the time taken for a 3000-meter run test, and anaerobic fitness was evaluated by the number of 2-minute sit-ups and 2-minute push-ups. Results: After adjusting the systolic and diastolic blood pressure, the time for a 3000-meter run was associated with ARVSBP, SDSBP, and SDDBP (β [SE]: 0.007 [0.002], 0.004 [0.002], and 0.005 [0.002], respectively, all p <0.05) but not with ARVDBP. In addition, the number of 2-minute sit-ups was inversely associated with ARVSBP (β [SE]: -0.041 [0.017], p =0.01) but not with ARVDBP, SDSBP, and SDDBP. There was no association of the number of 2-minute push-ups with the BPV indexes. After additionally adjusting the age, body mass index, and other covariates, all the associations were found to be not significant. Conclusion: It was found that there was no association of physical fitness with long-term BPV in young male military personnel. Previous studies have shown no association with cardiorespiratory fitness in the elderly. This study further increased the knowledge of a null association between anaerobic fitness and long-term BPV.

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P1806OUTCOMES OF PEDIATRIC RENOVASCULAR HYPERTENSON: A SINGLE-CENTER EXPERIENCE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1806 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Jiwon Jung ◽

Joo Hoon Lee ◽

Kun suk Kim ◽

Young Seo Park

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Blood Pressure Control ◽

Antihypertensive Agents ◽

Good Control ◽

Pressure Control ◽

Renovascular Disease ◽

Antihypertensive Medications

Abstract Background and Aims Renovascular disease is rare but important treatable cause of secondary hypertension in children. We aimed to evaluate the clinical presentations and long-term outcomes of pediatric patients with renovascular hypertension (RVH). Method We retrospectively reviewed medical records of patients with renovascular disease at our center between 1994 and 2019. Clinical courses including status of hypertension control with preservation of renal function during follow up were evaluated. Results 20 patients were diagnosed with RVH. 50 % (n = 10) were male, and median age at diagnosis was 10.1 (range 1.3 – 17.2) years, and median follow up period was 8.7 (range 0.1 – 24.6) years. 50 % (n = 10) presented with incidently detected high blood pressure (8 patients without symptoms, one with headache, and the other one with proteinuria), 25 % (n = 5) first admitted due to heart failure symptoms, and the rest (25 %, n = 5) presented with neurologic symptoms including seizure or paraplegia. Majority had no underlying disease except for 3 patients with Moyamoya disease. 80 % (n = 16) had unilateral renovascular stenosis. All patients showed elevated basal random renin activity (median 20.0, range 2.5 – 62.1 ng/ml/hr), and 45 % (n = 9) patients showed elevated basal random aldosterone level (median 822, range 266 – 2440 pg/ml). All patients needed antihypertensive medications for blood pressure control; 35 % (n = 7) of patients gained good control of blood pressure only with antihypertensive agents including angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), 40 % (n = 8) of patients who underwent percutaneous transluminal angioplasty all still needed antihypertensive agents including ACEI for blood pressure control. 20 % (n = 4) of the patients initially showed profoundly low relative function of involved kidney on diuretic scan, leading to nephrectomy. Three of these patients with nephrectomy successfully discontinued all antihypertensive agent gaining good control of blood pressure. The remaining one patient showed progressive deterioration of relative function on the involved side of kidney during 13 years, ended up with nephrectomy, but couldn’t discontinue ACEI. Glomerular filtration rate (GFR) was within normal range for all patients at diagnosis. For patients without nephrectomy, mean relative function of the involved kidney on diuretic scan was 33.5 ± 11.4 % at diagnosis. There was no significant change or deterioration of relative renal function during a mean follow up period of 10 ± 8 (median 11.5, range 0 – 19.5) years, although they all used ACEI/ARB. All patients including patients with nephrectomy showed normal GFR with a mean of 114.1 ± 19.5 ml/min/1.73 m2 at the last follow up. Conclusion Antihypertensive medications including ACEI and ARB were safely used with no further deterioration of the renal function of the involved side with or without angioplasty. Pediatric RVH is well managed with preserved renal function in long-term follow up.

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Metabolic biomarkers and long-term blood pressure variability in military young male adults

World Journal of Clinical Cases ◽

10.12998/wjcc.v8.i11.2246 ◽

2020 ◽

Vol 8 (11) ◽

pp. 2246-2254

Author(s):

Yu-Kai Lin ◽

Pang-Yen Liu ◽

Chia-Hao Fan ◽

Kun-Zhe Tsai ◽

Yen-Po Lin ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Young Male ◽

Metabolic Biomarkers

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DYNAMICS OF FUNCTIONAL STATE OF KIDNEYS IN PATIENTS WITH RESISTANT HYPERTENSION AND CHRONIC KIDNEY DISEASE ACCORDING TO LONG-TERM FOLLOW-UP

International Medical Journal ◽

10.37436/2308-5274-2020-4-1 ◽

2020 ◽

pp. 5-11

Author(s):

O. O. Matova ◽

K. I. Serbeniuk ◽

L. V. Bezrodna ◽

V. B. Bezrodnyi ◽

V. V. Radchenko

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Antihypertensive Therapy ◽

Functional State ◽

Resistant Hypertension ◽

Pressure Control

Resistant hypertension and chronic kidney disease are closely related from a pathogenetic and clinical point of view. To study the dynamics of functional state of kidneys and as well as to identify the predictors of its improvement, 117 patients with resistant hypertension were examined. Dynamic follow−up of patients included monitoring of antihypertensive therapy, blood pressure, biochemical and humoral parameters during 3, 6 and 36 months of treatment. The findings have shown that a significant long−term improvement in blood pressure control in the patients with chronic kidney disease improves their function and also has a nephroprotective effect in patients without any signs of renal damage. The established prognostic value of the higher initial creatinine content for the improvement of renal function in patients with resistant hypertension is stipulated with a positive effect of antihypertensive therapy on the glomerular filtration rate dynamics. The close association between improved renal function and lower baseline levels of interleukin 6 as well as an active renin in the blood may indicate a role for systemic inflammation and renin−angiotensin−aldosterone system activity in the renal dysfunction development. Prolonged improvement in blood pressure control in the patients with resistant hypertension without diabetes is associated with a stable level of urinary albumin excretion, whereas in patients with diabetes, an albuminuria increases over time. The study concluded that independent predictors of improved renal function in patients with resistant hypertension are higher baseline creatinine and lower glomerular filtration rate, lower concentrations of interleukin 6, active renin and plasma potassium. Key words: resistant arterial hypertension, chronic kidney disease, functional state of kidneys, antihypertensive therapy.

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Erythrocyte Indices and Long-term Blood Pressure Variability in Military Males

Cardiovascular & Haematological Disorders - Drug Targets ◽

10.2174/1871529x21666211214154545 ◽

2021 ◽

Vol 21 ◽

Author(s):

Shiue-Wei Lai ◽

Kun-Zhe Tsai ◽

Shen-Huei Wang ◽

Yu-Kai Lin ◽

Yen-Po Lin ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Linear Regression Analysis ◽

Microcytic Anemia ◽

Standard Errors ◽

Multivariate Linear Regression Analysis ◽

Erythrocyte Indices ◽

Young Males ◽

Relationship Of

Backgrounds: Severe microcytic anemia has been associated with BP changes. Aims and Objectives: Whether the erythrocyte indices are associated with long-term BPV is unknown. This study aimed to investigate the association of hemoglobin levels and erythrocyte size with long-term blood pressure variability (BPV) in young males. Methods: This study included 1,112 healthy military males, averaging 32 years of age, in Taiwan. All participants took a measurement of systolic and diastolic BP (SBP and DBP) every two-year from 2012 to 2018 (2012-14, 2014-15, 2015-16, 2016-18). Lev-els of hemoglobin and mean corpuscular volume (MCV) of erythrocytes were obtained at the first visit. Long-term BPV was assessed by the standard deviation (SD) and aver-age real variability (ARV). Multivariate linear regression analysis with adjustment for the baseline BP levels and other covariates was used to elucidate the association. Results: Hemoglobin levels were borderline positively correlated with SD DBP (β and standard errors = 0.016 (0.009), P =0.06). In those with hemoglobin levels of 10.0-13.9 g/dL, hemoglobin was negatively correlated with SDSBP (β= -0.039 (0.018), P =0.03). In contrast, MCV levels were borderline positively correlated with SDSBP (β =0.085 (0.052), P =0.09). In those with MCV levels <80 fL, MCV was positively correlated with SDSBP and ARVSBP (β= 0.445 (0.210) and 0.286 (0.149), p = 0.03 and 0.05, re-spectively). Conclusion: There were inconsistent patterns for the associations of erythrocyte indices with long-term BPV. We found a U-shaped relationship of hemoglobin levels with sys-tolic BPV, whereas there was a positive linear relationship of hemoglobin and MCV levels with diastolic BPV, respectively.

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Compliance with Antihypertensive Therapy after Renal Artery Stenting

Biological Research For Nursing ◽

10.1177/1099800403005001004 ◽

2003 ◽

Vol 5 (1) ◽

pp. 37-46 ◽

Cited By ~ 3

Author(s):

Bhagat K. Reddy ◽

David J. Kennedy ◽

William R. Colyer ◽

Mark W. Burket ◽

William J. Thomas ◽

...

Keyword(s):

Blood Pressure ◽

Renal Artery ◽

Systolic Blood Pressure ◽

Antihypertensive Therapy ◽

Blood Pressure Control ◽

Pressure Control ◽

Physical Symptoms ◽

Antihypertensive Medications ◽

Critical Determinant ◽

Improve Blood Pressure Control

Hypertension is an important clinical endpoint after renal artery revascularization for renal artery stenosis (RAS). Medication compliance is a critical determinant of blood pressure control. Although factors influencing compliance are known in essential hypertension, they have not been evaluated in studies investigating renal artery revascularization. The aim of this study was to assess the determinants of compliance to antihypertensive therapy in patients with RAS following renal artery stent placement (RASP). A cross-sectional study evaluating blood pressure, antihypertensive medications, quality of life, compliance, and determinants of compliance to antihypertensive therapy was undertaken in 112 patients undergoing RASP. Additionally, cardiovascular risk factors, antihypertensive medications, and cardiovascular history were reported. Self-reported compliance was 79% ± 24% (scale of 0% [none] to 100% [complete] compliance) in patients after RASP. Determinants of compliance by multivariate analysis included physical symptoms, which correlated negatively to compliance and included loss of appetite (r2 = 0.26, P < 0.0001), dizziness (r2 = 0.06, P < 0.01), and cough (r2 = 0.03, P < 0.05). Systolic blood pressure correlated positively with compliance (r2 = 0.03, P < 0.05). The number or class of antihypertensive medications did not influence compliance. Patients' physical symptoms and level of systolic blood pressure, rather than the number or class of medications, influence compliance in patients with continued hypertension after RASP. Attention to physical symptoms may help to improve blood pressure control in this population.

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