Patterns of lipid profile abnormalities in hypertensive patients and normotensive subjects: a cross-sectional observational study

Background: It is a well-known fact that hypertension and altered lipid profile or dyslipidaemia are leading risk factors for cardiovascular diseases. The coexistence of these two conditions has remained an interesting matter, among cardiologists and researchers alike. In this study, we analysed the serum lipid patterns of hypertensive patients and normotensive control subjects.Methods: This cross-sectional observational study was conducted in a tertiary healthcare and teaching center of Northwestern India during the period of 2010 and 2011. The study comprised of 100 hypertensive patients and 100 normotensive control subjects. Data were collected regarding demographic details, past medical/drug history and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL).Results: A total of 200 subjects with the age above 20 years were enrolled in the study. The mean BMI in hypertensive patients (24.14±2.15 kg/m2) was significantly higher than normotensive subjects (22.60±2.62 kg/m2) (p<0.05). When we compared the mean of TC and TG among the hypertensive patients and normotensive subjects, highly significant differences were obtained (p<0.001). The significant decline in mean HDL level was observed in hypertensive patients than normotensive subjects (40.41±4.57 versus 44.64±5.97, p<0.005).Conclusions: The dyslipidaemia has been more evident among hypertensive patients. Hence, the measurement of blood pressure and lipid profile are of great importance to prevent cardiovascular diseases, stroke and other comorbidities.

Polypharmacy in the Management of Arterial Hypertension—Friend or Foe?

Background and Objectives: Polypharmacy is associated with drug–drug or food–drug interactions that may pose treatment difficulties. The objective of the study was to investigate the use of polypharmacy in hypertensive patients hospitalized in the Internal Medicine Clinic of a European referral hospital. Materials and Methods: We conducted a retrospective chart review study on patients identified by a database search of discharge diagnoses to assess the use of polypharmacy and identify potential drug-drug and food-drug interactions. Results: In total, 166 hypertensive patients (68.46 ± 12.70 years, range 42–94 years) were compared to 83 normotensive subjects (67.82 ± 14.47 years, range 22–94 years) who were hospitalized in the clinic during the same period. Polypharmacy was more common in hypertensive versus normotensive subjects (p = 0.007). There were no differences in terms of age, as well as major (0.44 ± 0.77 versus 0.37 ± 0.73 interactions/patient, p = 0.52) and minor (1.25 ± 1.50 versus 1.08 ± 1.84 interactions/patient, p = 0.46) drug–drug interactions between patients with and without hypertension. The mean number of drug–drug interactions (6.55 ± 5.82 versus 4.93 ± 5.59 interactions/patient, p = 0.03), moderate drug–drug interactions (4.94 ± 4.75 versus 3.54 ± 4.17, p = 0.02) and food–drug interactions (2.64 ± 1.29 versus 2.02 ± 1.73, p = 0.00) was higher in patients with hypertension versus their counterparts. Conclusions: The present study reinforces that polypharmacy is a serious concern in hypertensive patients, as reflected by the high number of potentially harmful drug–drug or food–drug interactions. We recorded higher numbers of comorbidities, prescribed drugs, and moderate drug–drug/food–drug interactions in hypertensive versus normotensive patients. A strategy to evaluate the number of discharge medications and reduce drug–drug interactions is essential for the safety of hypertensive patients.

Associations of Serum Uromodulin and Its Genetic Variants With Blood Pressure and Hypertension in Chinese Adults

Background: Uromodulin, also named Tamm Horsfall protein, has been associated with renal function and regulation of sodium homeostasis. We aimed to examine the associations of serum uromodulin levels and its genetic variants with longitudinal blood pressure (BP) changes and hypertension incidence/risk.Methods: A total of 514 participants from the original Baoji Salt-Sensitive Study cohort were genotyped to examine the associations of genetic variations in uromodulin gene with the longitudinal BP changes and the incidence of hypertension over 8 years of follow-up. In addition, 2,210 subjects from the cohort of Hanzhong Adolescent Hypertension Study were used to investigate the relationships between serum uromodulin levels and the risk of hypertension.Results: SNPs rs12917707 and rs12708631 in the uromodulin gene were significantly associated with the longitudinal BP changes over 8 years of follow-up. SNP rs12708631 was significantly associated with the incidence of hypertension over 8 years. In addition, gene-based analyses supported the associations of uromodulin gene with the longitudinal BP changes and hypertension incidence in Baoji Salt-Sensitive Study cohort. Furthermore, serum uromodulin levels in the hypertensive subjects were lower than in the normotensive subjects (25.5 ± 1.1 vs. 34.7 ± 0.7 ng/mL). Serum uromodulin levels decreased gradually as BP levels increased (34.6, 33.2, 27.8, and 25.0 ng/mL for subjects with normotension, high-normal, grade 1 hypertension, and grade 2 hypertension, respectively). Serum uromodulin was significantly associated with the lower risk of hypertension [0.978 (0.972–0.984)] in Hanzhong Adolescent Hypertension Study cohort.Conclusion: This study shows that uromodulin is associated with blood pressure progression and development of hypertension.

Evaluation and Comparison of Stress Status between Hypertensive and Normotensive Subjects

Hypertension is a prevalent life style disease that causes cardiovascular diseases associated mortality worldwide. Being a devastating endemic, hypertension require special emphasis to be studied for its complications and consequences. Existing literatures provide robust evidences of the disastrous effects of hypertension on psychological stress separately, but there are least evidences comparing the same between hypertensive and normotensive adults. This study mainly concentrates on the effect of hypertension on stress levels and its comparison between hypertensive and normotensive individuals. Objective: To identify the differences of stress status among hypertensive and normotensive individuals. Methods: A CASE and a CONTROL group each constituting with a sample of 44 subjects between the age group 25-65 years were recruited in the study. The stress status of the study group was assessed by the Perceived Stress Scale (PSS). Data were statistically analyzed using SPSS (Version 20.0). Descriptive statistics were presented as frequencies, percentages and mean± S.D. Statistical differences between the stress status of case and control groups were conducted by Independent Sample T-test. Results: Majority (54.5%) of the hypertensive patients belonged to the age group of 56-65 years. The average Perceived Stress Scale (PSS) Scores of the case group were 26.68±6.03 and that of the control group were 10.43±6.57. The differences between the Average PSS scores of the case and control groups were found to be highly statistically significant (P-0.00). Conclusions: Hypertensive cases recruited for the study had moderate and high levels of stress when compared to the normotensive controls of the same age- group (25-65years). Key words: Hypertension; Normotension; Stress Status; Perceived Stress Scale.

Sex differences in the lung ACE/ACE2 balance in hypertensive rats

The ACE/Ang II and ACE2/Ang-(1-7) pathways are coexpressed in most tissues. The balance between these pathways determines, at least in part, whether tissue damage will occur in response to pathological stimuli. This study tested the hypothesis that male sex and high blood pressure are associated with ACE/ACE2 imbalance in the lungs. Experiments were conducted in male and female Wistar rats and spontaneously hypertensive rats (SHRs). Lung ACE and ACE2 gene expression was also evaluated in normotensive and hypertensive humans using the Genotype-Tissue Expression (GTEx) project. Compared to Wistar rats and female SHRs, male SHRs displayed reduced lung ACE2 mRNA, ACE2 protein abundance and ACE2 activity, and increased Ang II concentration. Lung ACE mRNA levels were higher in male SHRs than in Wistar rats, whereas lung ACE protein abundance and activity were similar among the four groups of rats. Lung Ang-(1-7) concentration was higher in female than in male SHRs (89 ± 17 vs. 43 ± 2 pg/g, P &lt; 0.05). Lung ACE to ACE2 mRNA expression in hypertensive patients was significantly higher than that in normotensive subjects. Taken together, these results demonstrate that male hypertensive rats display imbalance between the ACE/Ang II and ACE2/Ang-(1-7) pathways in the lungs mainly attributable to ACE2 downregulation. Further studies should be conducted to investigate whether this imbalance between ACE/ACE2 may promote and accelerate lung injury in respiratory infections, including COVID-19.

Influence of Gender on Total Serum Creatine Kinase and Creatine Kinase-Mb Levels of Nigerian Hypertensives

Introduction: Hypertension is a long-term medical condition which when not detected and managed properly and on time often results to complications leading to disabilities and mortality. Gender has been known to affect the interpretation of some variables necessitating the need for gender-specific ranges. Objectives:This study evaluated total creatine kinase (CK) and creatine kinase-MB (CK-MB) isoenzyme activities of hypertensive subjects in Calabar, Nigeria and to assess if gender has influence on the activities of these enzymes. Methodology:One hundred and two participants were consecutively enrolled in this case control study. Serum total serum CK and CK-MB activity were evaluated in fifty one hypertensive and 51 normotensive subjects. The total CK levels were assessed using a spectrophotometric method while immunoinhibition method was used to determine the activity of CK-MB. Data was analyzed using Student’s t-test and Pearson’s correlation. Statistical significance was set at p<0.05. Results:The total creatine kinase activities of the hypertensives did not differ significantly from those of the normotensive controls (p = 0.428) while the serum CK-MB activities of the hypertensive subjects were significantly higher than those of the normotensive controls (p=0.000). The body mass index of the hypertensives was significantly higher than those of the normotensive subjects (p=0.030). Gender had no effect on the blood pressure, body mass index and levels of CK and CK-MB (p>0.05). There was also no significant correlation (p>0.05) between blood pressure, body mass index and the levels of CK and CK-MB. Conclusion:CK-MB activities were significantly higher in hypertensive subjects compared to normotensive controls. There were no gender specific differences in the CK-MB levels of male and female hypertensives. This cardiac marker should be included in the routine assessment of hypertensives and gender-specific considerations may not be necessary in the interpretation of the data.

Classification of Hypertensive and Normotensive Subjects Using Bilateral Differential Biopotential Signals

Hypertension or high blood pressure is a severe health issue in the modern world, especially in this pandemic scenario, that can cause many heart related diseases or even death, and it is increasing day by day. For this reason, a reliable, automatic and easy to use system for hypertensive subject detection is an important focus for the researchers. Biopotential signals can play a pivotal role in this regard. Though, few strategies were proposed based on electrocardiogram (ECG) or electrodermal (EDA) signals, but those require special circuitry, as well as trained persons. In this article, a method is proposed to classify hypertensive and normotensive subjects using differential biopotential signals. Neither special circuitry, nor much expertise is required for handling this system. It was assumed that progression of rest is dependent upon blood pressure. To serve the purpose, signals were acquired from both hypertensive and normotensive subjects bilaterally for 10 continuous minutes. Result of the random forest (RF) classification establishes that from the analysis of the progression of the bilaterally acquired differential biopotential signals, hypertensive subjects can be distinguished from normotensive subjects.

Longitudinal study on the effect of surgical weight loss on beat-to-beat blood pressure variability in patients undergoing bariatric surgery: a study protocol

IntroductionAlterations in linear and non-linear parameters of beat-to-beat blood pressure variability (BPV) have been shown to predict disease prognosis and distinguish between risk categories in various pathological conditions, independently of average blood pressure levels. Obesity places subjects at elevated risk of vascular diseases, including hypertension, resulting in serious cardiac, respiratory and cerebral events. However, little is known about the status of vascular dynamics in obese and morbidly obese adults.Methods and analysisIn this present quasi-experimental longitudinal study, changes in beat-to-beat BPV, using continuous, non-invasive blood pressure monitoring, in obese subjects undergoing bariatric surgery are characterised. The capacity of linear and non-linear measures of BPV to detect differences between hypertensive, prehypertensive and normotensive obese subjects prebariatric and postbariatric surgery are tested. Additionally, potential correlations between beat-to-beat BPV and age, body mass index, gender and comorbidities will be investigated. In parallel, the impact of the unsteady fluctuations of beat-to-beat blood pressure on the dynamic stresses imparted by blood flow on blood vessel walls will be explored. We expect to find altered BPV profiles in hypertensive and prehypertensive subjects as compared with normotensive subjects. We also expect to see differential normalisation in BPV profiles between hypertensive, prehypertensive and normotensive subjects over time.Ethics and disseminationThe study has been approved by the Institutional Review Board at the American University of Beirut (IRB ID: BIO-2018-0040). Study results will be made available to the public through publications in peer-reviewed journals and conference papers and/or presentations.

Hypertension With High Homocysteine Is Associated With Default Network Gray Matter Loss

Hypertension with high homocysteine (Hcy, ≥10 μmol/L) is also known as H-type hypertension (HHT) and proposed as an independent risk factor for stroke and cognitive impairment. Although previous studies have established the relationships among hypertension, Hcy levels, and cognitive impairment, how they affect brain neuroanatomy remains unclear. Thus, we aimed to investigate whether and to what extent hypertension and high Hcy may affect gray matter volume in 52 middle-aged HHT patients and 51 demographically matched normotensive subjects. Voxel-based morphological analysis suggested that HHT patients experienced significant gray matter loss in the default network. The default network atrophy was significantly correlated with Hcy level and global cognitive function. These findings provide, to our knowledge, novel insights into how HHT affects brain gray matter morphology through blood pressure and Hcy.