BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),...BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),prediabetes,and mortality that are associated with hypertensive disorders of pregnancy.METHODS This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes,especially T2DM,prediabetes and mortality,related to hypertensive disorders of pregnancy in females aged 21-45.Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation.Propensity score matching was applied to balance covariates such as gestational diabetes,polycystic ovarian syndrome,chronic kidney disease,hy-perlipidemia,overweight/obesity,nicotine dependence,alcohol abuse,and healthcare utilization.This ensured comparability between groups and reduced potential confounding in outcome evaluation.RESULTS This study included 318544 females aged 21-45 with and without PIH.Females with PIH had higher risks of T2DM[hazard ratio(HR):1.907,95%confidence interval(CI):1.821-1.998),prediabetes(HR:1.610,95%CI:1.537-1.687),and mortality(HR:1.501,95%CI:1.361-1.655)over a follow-up of up to 18 years.Incidence rates for T2DM,prediabetes,and mortality were 3.2%,2.7%,and 0.6%,respectively.Subgroup analyses showed that the presence of gestational hypertension,preeclampsia,and eclampsia increased risks across all outcomes.Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality.Preventative aspirin use during pregnancy did not reduce the risks of T2DM,prediabetes,or mortality among those with PIH.CONCLUSION PIH significantly increases the long-term risks of T2DM,prediabetes,and mortality,highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.展开更多
Background:Hypertensive disorders of pregnancy(HDP)stands as a significant contributor to adverse maternal and fetal outcomes worldwide.However,current biomarkers lack specificity in distinguishing HDP from chronic hy...Background:Hypertensive disorders of pregnancy(HDP)stands as a significant contributor to adverse maternal and fetal outcomes worldwide.However,current biomarkers lack specificity in distinguishing HDP from chronic hypertension.Hence,we employed proteome-wide Mendelian randomization(MR)and colocalization analysis to decipher sensitive and specific markers for HDP via integrating multi-omics data.Methods:Genetic associations for plasma proteins were obtained from large-scale proteomic studies(e.g.,Iceland,Fenland,and UK Biobank).The summarized GWAS data of HDP and hypertension were acquired from the FinnGen consortium.A proteome-wide Mendelian randomization(MR)study was then implemented to identify the causal role of plasma proteins in HDP and hypertension.The results were further confirmed by transcriptome-wide association studies(TWAS)and colocalization analyses.Results:Proteome-wide MR identified 13 plasma proteins with potential causal links to HDP.Among them,peroxisomal acyl-coenzyme A oxidase 1(ACOX1)and glycine N-methyltransferase(GNMT)were classified as highly sensitive and specific markers differentiating from hypertension by integrating multi-omics evidence from expression quantitative trait loci(eQTL),protein quantitative trait loci(pQTL)and colocalization analyses.ACOX1 was identified as a risk factor,whereas GNMT demonstrated a protective effect.Enrichment analysis and protein-protein interaction(PPI)network mapping offered insights into underlying biological pathways.Conclusion:This study establishes the causal associations between 13 identified proteins and HDP,nominates that ACOX1 and GNMT are highly sensitive and specific markers for HDP distinguished from hypertension.Our findings offer valuable insights into the pathogenesis of HDP,paving the path for novel strategies in diagnosis and prevention.展开更多
AIM:To analyze whether alterations of voxel mirror homology connectivity(VMHC)values,as determined by resting-state functional magnetic resonance imaging(rsfMRI),occur in cerebral regions of patients with hypertensive...AIM:To analyze whether alterations of voxel mirror homology connectivity(VMHC)values,as determined by resting-state functional magnetic resonance imaging(rsfMRI),occur in cerebral regions of patients with hypertensive retinopathy(HR)and to determine the relationship between VMHC values and clinical characteristics in patients with HR.METHODS:Twenty-one patients with HR and 21 agematched healthy controls(HCs)were assessed by rsfMRI scanning.The functional connectivity between the hemispheres of the cerebrum was assessed by measuring VMHC,with the ability of VMHC to distinguish between the HR and HC groups assessed using receiver operating characteristic(ROC)curve analysis.Differences in the demographic and clinical characteristics of the HR and HC groups were analyzed by independent sample t-tests.The relationship between average VMHC in several brain areas of HR patients and clinical features was determined using Pearson correlation analysis.RESULTS:Mean VMHC values of the bilateral cuneus gyrus(BA19),bilateral middle orbitofrontal gyrus(BA47),bilateral middle temporal gyrus(BA39)and bilateral superior medial frontal gyrus(BA9)were lower in the HR than in the HC group.CONCLUSION:VMHC values can predict the development of early HR,prevent the transformation of hypertensive microangiopathy,and provide useful information explaining the changes in neural mechanism associated with HR.展开更多
Hypertension,a prevalent condition among older adults,has been identified as a risk factor for cognitive decline.Nutritional status is a pivotal factor in preserving cognitive function in hypertensive older adults.Nut...Hypertension,a prevalent condition among older adults,has been identified as a risk factor for cognitive decline.Nutritional status is a pivotal factor in preserving cognitive function in hypertensive older adults.Nutritional psychiatry underscores the significance of anti-inflammatory diets in promoting mental and cognitive health.This article examined the mechanisms by which body mass index,serum hemoglobin,serum albumin,and alkaline phosphatase levels predict cognitive function in hypertensive older adults.Nutrition emerges as a modifiable factor that can be targeted to maintain cognitive function in these patients.展开更多
This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy(HDP),covering epidemiology,potential mechanisms,and management strategies.HDP is the second leading cause ...This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy(HDP),covering epidemiology,potential mechanisms,and management strategies.HDP is the second leading cause of maternal and perinatal morbidity and mortality,encompassing subtypes such as gestational hypertension,preeclampsia,and eclampsia.Research indicates that anxiety is closely associated with the occurrence of HDP,potentially influencing blood pressure regulation and vascular function through neuroendocrine,inflammatory,genetic,and gut microbiota effects.Epidemiological data show that anxiety is prevalent during pregnancy and is linked to an increased risk of HDP.Biological mechanism studies reveal that anxiety can increase the risk of HDP by activating the hypothalamic-pituitary-adrenal axis,promoting inflammation,and affecting gut microbiota.In terms of treatment and management,psychological interventions(such as relaxation training,yoga,and mindfulness meditation)and pharmacological treatments(such as labetalol and nifedipine)play important roles in alleviating anxiety and improving the prognosis of HDP.Additionally,multidisciplinary collaboration and long-term postpartum follow-up are crucial for reducing the long-term risk of cardiovascular diseases.Despite significant progress in research on anxiety and HDP,many issues still require further exploration,including in-depth mechanism studies,optimization of clinical interventions,improvement of multidisciplinary collaboration models,long-term follow-up studies,and the impact of cultural and social factors.展开更多
Background:Hypertensive nephropathy remains a leading cause of end-stage renal disease with limited targeted therapies.Methods:We conducted a bibliometric analysis(1992-2024)of 440 basic studies from 7 databases,using...Background:Hypertensive nephropathy remains a leading cause of end-stage renal disease with limited targeted therapies.Methods:We conducted a bibliometric analysis(1992-2024)of 440 basic studies from 7 databases,using VOSviewer and R to quantify research evolution.Intervention modalities,signaling pathways,and mechanisms were innovatively extracted.Results:Quantified analysis revealed a distinct temporal evolution:early research was dominated by TGF-βsignaling,while starting from 2015,the focus of the research turned to podocyte-targeted studies.Traditional Chinese medicine compounds emerged as the predominant intervention,yet standardization deficits persisted across 73 formulas.Despite limited human pathological concordance,Spontaneously hypertensive rats models were utilized in most studies.Critically,only a few podocyte-focused therapeutics advanced to clinical trials,primarily hindered by species-specific Transient receptor potential channel expression divergence and mesenchymal stem cells renal delivery.Conclusion:Podocyte protection and standardized traditional Chinese medicine are potential translational targets,but there is a lack of reliable clinical trials for clinical verification.展开更多
Objective:To analyze the value of continuous care for patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 80 patients with HICH who visited our hospital from January 2024 to December 2024 were...Objective:To analyze the value of continuous care for patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 80 patients with HICH who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into two groups.The observation group received continuous care,while the control group received routine care.The Functional Independence Measure(FIM),Symptom Checklist-90(SCL-90),and complications were compared between the two groups.Results:The FIM score of the observation group was higher than that of the control group(P<0.05).The SCL-90 score of the observation group was lower than that of the control group(P<0.05).The incidence of HICH complications in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of continuous care in HICH nursing can enhance patients’independent living skills outside the hospital,optimize their psychosocial adaptation,and is safe and efficient.展开更多
Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital f...Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.展开更多
Objective:To analyze the therapeutic effect of ZhenGan XiFeng Decoction in patients with hypertensive intracerebral hemorrhage(HICH)in the acute phase.Methods:Fifty-seven patients with HICH in the acute phase who visi...Objective:To analyze the therapeutic effect of ZhenGan XiFeng Decoction in patients with hypertensive intracerebral hemorrhage(HICH)in the acute phase.Methods:Fifty-seven patients with HICH in the acute phase who visited the hospital from April 2024 to March 2025 were selected as samples and randomly divided into two groups.Group A received combined therapy with ZhenGan XiFeng Decoction,while Group B received conventional treatment.The efficacy,blood pressure,and symptom scores were compared between the two groups.Results:The effective rate of HICH patients in Group A was higher than that in Group B(P<0.05).The SBP and DBP indicators of HICH patients in Group A were lower than those in Group B(P<0.05).The symptom scores of HICH patients in Group A were lower than those in Group B(P<0.05).Conclusion:The use of ZhenGan XiFeng Decoction in the treatment of acute HICH can enhance the effect of HICH management,stabilize blood pressure,and also relieve HICH-related symptoms.展开更多
In Ivory Coast, arterial hypertension is 20.4% prevalent, with a high mortality rate. However, proper use of antihypertensive drugs can reduce the risks of morbidity and mortality associated with the disease. The aim ...In Ivory Coast, arterial hypertension is 20.4% prevalent, with a high mortality rate. However, proper use of antihypertensive drugs can reduce the risks of morbidity and mortality associated with the disease. The aim of this study was to determine the pattern of antihypertensive drugs in an urban population in Abidjan. To this end, a retrospective descriptive study was conducted. Data were collected from the consumption histories of several pharmacies in the Abobo commune of Abidjan between March and August 2020. Drugs available in pharmacies and containing one or more active ingredients in the ATC classification of antihypertensives were included. A total of 1082 sales of antihypertensives were recorded, with 53% of medicines containing a single molecule and 46% containing combinations of two molecules. Antihypertensives containing one active compound showed a high proportion of diuretics (28.7%), followed by calcium antagonists (20.35%) and beta-blockers (19.13%). The combination of ACE inhibitors and calcium antagonists was sold at 34.71%, with the combination of calcium antagonists/ACE inhibitors + diuretics (45.46%) in the two and three-molecule classes respectively. All in all, the study showed the patients were satisfied with the use of antihypertensives, with furosemide and the amlodipine/perindopril combination at the top of the list.展开更多
Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benef...Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.展开更多
BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes ...BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive population.METHODS Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of 2018.Longitudinal changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal group.To examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%CI.RESULTS The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the sample.Over the course of a mean follow-up of 4.8 years,143 ischemic strokes happened.When normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et al.Dyslipidemia changed and ischemic stroke WJCC https://www.wjgnet.com 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),respectively.CONCLUSION In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.展开更多
In the present study,we aimed to investigate the clinical potential of sacubitril/valsartan compared with valsartan in patients with newly diagnosed hypertensive acute heart failure(H-AHF).A total of 63 patients were ...In the present study,we aimed to investigate the clinical potential of sacubitril/valsartan compared with valsartan in patients with newly diagnosed hypertensive acute heart failure(H-AHF).A total of 63 patients were retrospectively enrolled from our hospital,with 32 patients assigned to the sacubitril/valsartan group and 31 patients to the valsartan group.Clinical characteristics,laboratory examinations,and echocardiographic data at baseline,during hospitalization,and follow-up were collected to assess.The results demonstrated that patients treated with sacubitril/valsartan achieved better control of systolic and diastolic blood pressures than those treated with valsartan.Sacubitril/valsartan also resulted in more significant reductions in N-terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity troponin I(hs-TnI),and creatinine,as well as an increase in estimated glomerular filtration rate(eGFR).Moreover,sacubitril/valsartan significantly improved left ventricular ejection fraction(LVEF),the E/e'ratio[the ratio between the early diastolic filling velocity(E-wave)and early diastolic mitral annular velocity(E')],and reduced left atrial dimension(LAD)and left ventricular mass index(LVMI).Additionally,sacubitril/valsartan might offer potential benefits in managing cardiac arrhythmias such as atrial fibrillation,ventricular or supraventricular premature beats,and left bundle branch block(LBBB).No fatal or nonfatal adverse effects were observed in the sacubitril/valsartan group,although one patient in the valsartan group experienced angioedema.In conclusion,after short-term administration,sacubitril/valsartan proved to be more effective than valsartan in lowering blood pressure,improving cardiac function and remodeling,and enhancing biomarker profiles.Furthermore,it had favorable effects on renal function and cardiac arrhythmias in newly diagnosed H-AHF patients.展开更多
Hypertension is one of the most prevalent cardiovascular diseases,and autophagy is known to play a significant role in the pathogenesis and progression of cardiovascular conditions.This study aimed to evaluate the eff...Hypertension is one of the most prevalent cardiovascular diseases,and autophagy is known to play a significant role in the pathogenesis and progression of cardiovascular conditions.This study aimed to evaluate the effects of Huanglian Jiedu decoction(HLJDD)on myocardial mitochondrial autophagy in spontaneously hypertensive rats(SHRs)and to further explore the relationship between autophagy,myocardial remodeling,and injury.The SHRs were randomly assigned to five groups:the model group,the HLJDD low-dose group,the HLJDD medium-dose group,the HLJDD high-dose group,and a positive control group treated with captopril.Additionally,a blank control group was established using Wistar Kyoto(WKY)rats,with 10 rats in each group.The model and blank control groups were administered an equivalent volume of physiological saline via oral gavage,while the treatment groups received their respective doses of HLJDD or captopril by oral gavage.Following the treatments,various parameters were assessed,including blood pressure(systolic,diastolic,and mean arterial pressure),mitochondrial swelling and membrane potential,free ATPase activity,as well as the mRNA and protein levels of autophagy-related factors.The results showed that HLJDD significantly reduced blood pressure(systolic,diastolic,and mean arterial pressure)in SHR rats.Moreover,it enhanced mitochondrial swelling and membrane potential,increased mitochondrial ATPase activity,and decreased the mRNA and protein expression levels of autophagy-related genes(AKT,mTOR,Beclin-1,and LC3-II)in SHRs.The findings of this study suggested that HLJDD could effectively ameliorate myocardial tissue injury in SHRs,and its protective effects on the heart might be attributed to the reduction of autophagy in cardiomyocyte mitochondria.This provided insights into the potential therapeutic use of HLJDD in managing hypertension-induced myocardial injury and remodeling.展开更多
BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and...BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.展开更多
BACKGROUND Hypertension is a chronic cardiovascular disease characterized by persistently elevated arterial blood pressure.It is not only a significant risk factor for cardio-vascular and cerebrovascular diseases(such...BACKGROUND Hypertension is a chronic cardiovascular disease characterized by persistently elevated arterial blood pressure.It is not only a significant risk factor for cardio-vascular and cerebrovascular diseases(such as myocardial infarction and stroke)but also closely related to multiple organ damages(such as kidney disease and retinopathy),imposing a heavy health and economic burden on individuals and society.AIM To investigate the expression differences and relationships of endothelin-1(ET-1),interleukin-6(IL-6),stem cell factor(SCF),and its receptor(c-kit)in hypertensive patients with or without depression.METHODS A retrospective analysis was conducted on the clinical data of 163 hypertensive patients admitted to our hospital from March 2022 to January 2024.Based on the presence of depression,patients were divided into Group A(n=77,with depre-ssion)and Group B(n=86,without depression).Serum levels of ET-1 and IL-6 were measured using radioimmunoassay,while serum levels of SCF and c-kit were measured using ELISA.The differences in ET-1,IL-6,SCF,and c-kit levels between Groups A and B were compared.Additionally,the differences in these biomarkers among patients with varying degrees of depression in Group A were analyzed.Pearson correlation analysis was used to examine the relationship between ET-1,IL-6,SCF,c-kit levels,and Hamilton depression rating scale(HAMD)scores.Multivariate logistic regression analysis was performed to identify factors influencing hypertension with depression.The diagnostic efficacy of individual and combined biomarkers was analyzed using receiver operating characteristic(ROC)curves.Comparative statistical analysis of the area under the curve(AUC)values was performed using DeLong’s test to assess the superiority of combined biomarker detection.RESULTS The levels of ET-1 and IL-6 in Group A were significantly higher than those in Group B,while the levels of SCF and c-kit were significantly lower in Group A compared to Group B(P<0.05).In the severe depression subgroup,ET-1 and IL-6 levels were higher than those in the mild-to-moderate depression subgroup,while SCF and c-kit levels were lower(P<0.05).Pearson correlation analysis showed that ET-1 and IL-6 levels were positively correlated with HAMD scores(r=0.442,0.463,P<0.05),while SCF and c-kit levels were negatively correlated with HAMD scores(r=-0.429,-0.394,P<0.05).Multivariate logistic regression analysis revealed that high ET-1,high IL-6,low SCF,and low c-kit were independent influencing factors for hypertension with depression(P<0.05).ROC analysis revealed AUCs of 0.746(ET-1),0.801(IL-6),0.732(SCF),0.779(c-kit),and 0.884(combination).The combined diagnosis demonstrated significantly higher AUC than individual markers(DeLong's test,P<0.01),with superior sensitivity(90.24%)and specificity(85.37%).CONCLUSION Compared to patients with hypertension alone,patients with hypertension and depression exhibited higher serum levels of ET-1 and IL-6 and lower levels of SCF and c-kit.High ET-1,high IL-6,low SCF,and low c-kit were inde-pendent influencing factors for hypertension with depression.The combination of ET-1,IL-6,SCF,and c-kit demonstrated significant diagnostic value for hypertension with depression.展开更多
OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A ...OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A total of 64 male SHRs were divided into four groups:model,sham-operated(Sham),electroacupuncture(EA),and N-methyl-D-aspartate receptor antagonist and electroacupuncture(NRA+EA).In addition,16 Wistar-Kyoto rats were used as controls.PVN stereotaxic surgery was performed in both the Sham and NRA+EA groups,while the EA and NRA+EA groups received 14 d of electroacupuncture.Blood pressure(BP)and heart rate(HR)were measured the day before the intervention and every other day.After 14 d of intervention,the rats in each group were tested for renal sympathetic nerve activity(RSNA).The associated factor levels were determined using Western blotting,reverse transcription-polymerase chain reaction(RTPCR),enzyme-linked immunosorbent assay(ELISA)and immunofluorescence assays.RESULTS:In comparison to the model group,the EA and NRA+EA groups had significantly lower BP,HR,and RSNA(P<0.01).The expression of N-methyl-Daspartate receptor(NMDAR),angiotensin II(Ang II),angiotensin II type 1(AT1),tumor necrosis factor-α,interleukin-1β,norepinephrine and arginine vasopressin was significantly lower in the EA and NRA+EA groups(P<0.01).Moreover,the antihypertensive effect of NRA+EA group outperformed to the EA group.CONCLUSIONS:Electroacupuncture effectively reduced the BP and sympathetic nerve excitability in SHRs.The mechanism was linked to the inhibition of NMDARmediated Ang II/AT1 and the inflammatory response in PVN.展开更多
Objective:To analyze the risk factors of anxiety in young hypertensive patients and build a prediction model to provide a scientific basis for clinical diagnosis and treatment.Methods:According to the research content...Objective:To analyze the risk factors of anxiety in young hypertensive patients and build a prediction model to provide a scientific basis for clinical diagnosis and treatment.Methods:According to the research content,young hypertensive patients admitted to the hospital from January 2022 to December 2024 were selected as the research object and at least 950 patients were included according to the sample size calculation.According to the existence of anxiety,950 patients were divided into control group(n=650)and observation group(n=300),and the clinical data of all patients were collected for univariate analysis and multivariate Logistic regression analysis to get the risk factors of hypertension patients complicated with anxiety in.All patients were randomly divided into a training set(n=665)and a test set(n=285)according to the ratio of 7:3,and the evaluation efficiency of different prediction models was obtained by using machine learning algorithm.To evaluate the clinical application effect of the prediction model.Results:(1)Univariate analysis showed that age,BMI,education background,marital status,smoking,drinking,sleep disorder,family history of hypertension,history of diabetes,history of hyperlipidemia,history of cerebral infarction,and TC were important risk factors for young hypertensive patients complicated with anxiety.(2)Multivariate Logistic regression analysis showed that hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors for young hypertensive patients complicated with anxiety.(3)Extra Trees has the highest predictive power for young people with hypertension complicated with anxiety,while Decision-Tree has the lowest predictive power.Conclusion:Hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors that affect the anxiety of young hypertensive patients.Extra Trees model has the best prediction efficiency among different groups of models.展开更多
Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A sea...Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.展开更多
Sodium fluoride(NaF)is a daily necessity consumed as the major ingredient of fluorinated drinking water,milk,salts,mouthwashes,toothpaste,and dentistry medications.However,the use of NaF products has also been associa...Sodium fluoride(NaF)is a daily necessity consumed as the major ingredient of fluorinated drinking water,milk,salts,mouthwashes,toothpaste,and dentistry medications.However,the use of NaF products has also been associated with increased fluoride anion distribution in the body,leading to hypertension.AIM This study evaluated the antihypertensive effect of sweet orange peels-enriched white melon seed protein concentrate(WSP)biscuit meal in eight-week-old albino rats exposed to NaF for 14 days.METHODS Forty-two(42)male Wistar albino rats were assigned at random into 7 groups of 6 rats per group(control group and six experimental groups).The experimental groups received various treatments that lasted for two weeks.Twenty-four hours after the last administration,hemodynamic parameters were evaluated,rats were sacrificed,blood samples were collected,and the heart was harvested.Blood serum was assessed for cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),and lactate dehydrogenase(LDH).At the same time,the heart homogenate was assayed for angiotensin-1 converting enzyme(ACE)activity,proinflammatory cytokines,nitric oxide concentrations,and antioxidant status.Cardiac tissues were stained with Hematoxylin and Eosin,Masson’s Trichrome,and cTnI.Also,the safety of the WSP biscuit diet was evaluated.RESULTS Results obtained showed that NaF administration elevated the collagen content of cardiac tissues,activities of ACE,and concentrations of cTnI,CK-MB,LDH,tumor necrosis factor-alpha,and interleukin 1 beta,while there was a reduction in the concentration of nitric oxide and antioxidants;however,their alterations were significantly prevented in WSP-biscuit-fed rats.The WSP biscuit meal is safe for consumption and possesses dose-dependent antihypertensive ability at 10%and 20%inclusion.CONCLUSION The WSP biscuit diet may be recommended in diet formulation for the management of individuals or communities that are predisposed to NaF contaminations.展开更多
基金Supported by Chung Shan Medical University,No.CSMU-INT-113-14.
文摘BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),prediabetes,and mortality that are associated with hypertensive disorders of pregnancy.METHODS This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes,especially T2DM,prediabetes and mortality,related to hypertensive disorders of pregnancy in females aged 21-45.Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation.Propensity score matching was applied to balance covariates such as gestational diabetes,polycystic ovarian syndrome,chronic kidney disease,hy-perlipidemia,overweight/obesity,nicotine dependence,alcohol abuse,and healthcare utilization.This ensured comparability between groups and reduced potential confounding in outcome evaluation.RESULTS This study included 318544 females aged 21-45 with and without PIH.Females with PIH had higher risks of T2DM[hazard ratio(HR):1.907,95%confidence interval(CI):1.821-1.998),prediabetes(HR:1.610,95%CI:1.537-1.687),and mortality(HR:1.501,95%CI:1.361-1.655)over a follow-up of up to 18 years.Incidence rates for T2DM,prediabetes,and mortality were 3.2%,2.7%,and 0.6%,respectively.Subgroup analyses showed that the presence of gestational hypertension,preeclampsia,and eclampsia increased risks across all outcomes.Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality.Preventative aspirin use during pregnancy did not reduce the risks of T2DM,prediabetes,or mortality among those with PIH.CONCLUSION PIH significantly increases the long-term risks of T2DM,prediabetes,and mortality,highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.
基金supported by grants from the Natural Science Foundation of Gansu Province(24JRRA937 and 25JRRA1234)grants from the National Natural Science Foundation of China(82360469)+1 种基金Scientific research projects in the health industry of Gansu Province(GSWSKY2025-23)Research Project for Introduced Talents of Northwest Minzu University(xbmuyjrc2023020).
文摘Background:Hypertensive disorders of pregnancy(HDP)stands as a significant contributor to adverse maternal and fetal outcomes worldwide.However,current biomarkers lack specificity in distinguishing HDP from chronic hypertension.Hence,we employed proteome-wide Mendelian randomization(MR)and colocalization analysis to decipher sensitive and specific markers for HDP via integrating multi-omics data.Methods:Genetic associations for plasma proteins were obtained from large-scale proteomic studies(e.g.,Iceland,Fenland,and UK Biobank).The summarized GWAS data of HDP and hypertension were acquired from the FinnGen consortium.A proteome-wide Mendelian randomization(MR)study was then implemented to identify the causal role of plasma proteins in HDP and hypertension.The results were further confirmed by transcriptome-wide association studies(TWAS)and colocalization analyses.Results:Proteome-wide MR identified 13 plasma proteins with potential causal links to HDP.Among them,peroxisomal acyl-coenzyme A oxidase 1(ACOX1)and glycine N-methyltransferase(GNMT)were classified as highly sensitive and specific markers differentiating from hypertension by integrating multi-omics evidence from expression quantitative trait loci(eQTL),protein quantitative trait loci(pQTL)and colocalization analyses.ACOX1 was identified as a risk factor,whereas GNMT demonstrated a protective effect.Enrichment analysis and protein-protein interaction(PPI)network mapping offered insights into underlying biological pathways.Conclusion:This study establishes the causal associations between 13 identified proteins and HDP,nominates that ACOX1 and GNMT are highly sensitive and specific markers for HDP distinguished from hypertension.Our findings offer valuable insights into the pathogenesis of HDP,paving the path for novel strategies in diagnosis and prevention.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203).
文摘AIM:To analyze whether alterations of voxel mirror homology connectivity(VMHC)values,as determined by resting-state functional magnetic resonance imaging(rsfMRI),occur in cerebral regions of patients with hypertensive retinopathy(HR)and to determine the relationship between VMHC values and clinical characteristics in patients with HR.METHODS:Twenty-one patients with HR and 21 agematched healthy controls(HCs)were assessed by rsfMRI scanning.The functional connectivity between the hemispheres of the cerebrum was assessed by measuring VMHC,with the ability of VMHC to distinguish between the HR and HC groups assessed using receiver operating characteristic(ROC)curve analysis.Differences in the demographic and clinical characteristics of the HR and HC groups were analyzed by independent sample t-tests.The relationship between average VMHC in several brain areas of HR patients and clinical features was determined using Pearson correlation analysis.RESULTS:Mean VMHC values of the bilateral cuneus gyrus(BA19),bilateral middle orbitofrontal gyrus(BA47),bilateral middle temporal gyrus(BA39)and bilateral superior medial frontal gyrus(BA9)were lower in the HR than in the HC group.CONCLUSION:VMHC values can predict the development of early HR,prevent the transformation of hypertensive microangiopathy,and provide useful information explaining the changes in neural mechanism associated with HR.
文摘Hypertension,a prevalent condition among older adults,has been identified as a risk factor for cognitive decline.Nutritional status is a pivotal factor in preserving cognitive function in hypertensive older adults.Nutritional psychiatry underscores the significance of anti-inflammatory diets in promoting mental and cognitive health.This article examined the mechanisms by which body mass index,serum hemoglobin,serum albumin,and alkaline phosphatase levels predict cognitive function in hypertensive older adults.Nutrition emerges as a modifiable factor that can be targeted to maintain cognitive function in these patients.
文摘This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy(HDP),covering epidemiology,potential mechanisms,and management strategies.HDP is the second leading cause of maternal and perinatal morbidity and mortality,encompassing subtypes such as gestational hypertension,preeclampsia,and eclampsia.Research indicates that anxiety is closely associated with the occurrence of HDP,potentially influencing blood pressure regulation and vascular function through neuroendocrine,inflammatory,genetic,and gut microbiota effects.Epidemiological data show that anxiety is prevalent during pregnancy and is linked to an increased risk of HDP.Biological mechanism studies reveal that anxiety can increase the risk of HDP by activating the hypothalamic-pituitary-adrenal axis,promoting inflammation,and affecting gut microbiota.In terms of treatment and management,psychological interventions(such as relaxation training,yoga,and mindfulness meditation)and pharmacological treatments(such as labetalol and nifedipine)play important roles in alleviating anxiety and improving the prognosis of HDP.Additionally,multidisciplinary collaboration and long-term postpartum follow-up are crucial for reducing the long-term risk of cardiovascular diseases.Despite significant progress in research on anxiety and HDP,many issues still require further exploration,including in-depth mechanism studies,optimization of clinical interventions,improvement of multidisciplinary collaboration models,long-term follow-up studies,and the impact of cultural and social factors.
基金funded by National Natural Science Foundation of China,No.811734071The Fundamental Research Funds for the Central Universities(2023-JYB-XJSJJ043)The fifth batch of National TCM Clinical Outstanding Talents Training Program(National TCM Personnel Education Letter[2022]No.1)。
文摘Background:Hypertensive nephropathy remains a leading cause of end-stage renal disease with limited targeted therapies.Methods:We conducted a bibliometric analysis(1992-2024)of 440 basic studies from 7 databases,using VOSviewer and R to quantify research evolution.Intervention modalities,signaling pathways,and mechanisms were innovatively extracted.Results:Quantified analysis revealed a distinct temporal evolution:early research was dominated by TGF-βsignaling,while starting from 2015,the focus of the research turned to podocyte-targeted studies.Traditional Chinese medicine compounds emerged as the predominant intervention,yet standardization deficits persisted across 73 formulas.Despite limited human pathological concordance,Spontaneously hypertensive rats models were utilized in most studies.Critically,only a few podocyte-focused therapeutics advanced to clinical trials,primarily hindered by species-specific Transient receptor potential channel expression divergence and mesenchymal stem cells renal delivery.Conclusion:Podocyte protection and standardized traditional Chinese medicine are potential translational targets,but there is a lack of reliable clinical trials for clinical verification.
文摘Objective:To analyze the value of continuous care for patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 80 patients with HICH who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into two groups.The observation group received continuous care,while the control group received routine care.The Functional Independence Measure(FIM),Symptom Checklist-90(SCL-90),and complications were compared between the two groups.Results:The FIM score of the observation group was higher than that of the control group(P<0.05).The SCL-90 score of the observation group was lower than that of the control group(P<0.05).The incidence of HICH complications in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of continuous care in HICH nursing can enhance patients’independent living skills outside the hospital,optimize their psychosocial adaptation,and is safe and efficient.
文摘Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.
文摘Objective:To analyze the therapeutic effect of ZhenGan XiFeng Decoction in patients with hypertensive intracerebral hemorrhage(HICH)in the acute phase.Methods:Fifty-seven patients with HICH in the acute phase who visited the hospital from April 2024 to March 2025 were selected as samples and randomly divided into two groups.Group A received combined therapy with ZhenGan XiFeng Decoction,while Group B received conventional treatment.The efficacy,blood pressure,and symptom scores were compared between the two groups.Results:The effective rate of HICH patients in Group A was higher than that in Group B(P<0.05).The SBP and DBP indicators of HICH patients in Group A were lower than those in Group B(P<0.05).The symptom scores of HICH patients in Group A were lower than those in Group B(P<0.05).Conclusion:The use of ZhenGan XiFeng Decoction in the treatment of acute HICH can enhance the effect of HICH management,stabilize blood pressure,and also relieve HICH-related symptoms.
文摘In Ivory Coast, arterial hypertension is 20.4% prevalent, with a high mortality rate. However, proper use of antihypertensive drugs can reduce the risks of morbidity and mortality associated with the disease. The aim of this study was to determine the pattern of antihypertensive drugs in an urban population in Abidjan. To this end, a retrospective descriptive study was conducted. Data were collected from the consumption histories of several pharmacies in the Abobo commune of Abidjan between March and August 2020. Drugs available in pharmacies and containing one or more active ingredients in the ATC classification of antihypertensives were included. A total of 1082 sales of antihypertensives were recorded, with 53% of medicines containing a single molecule and 46% containing combinations of two molecules. Antihypertensives containing one active compound showed a high proportion of diuretics (28.7%), followed by calcium antagonists (20.35%) and beta-blockers (19.13%). The combination of ACE inhibitors and calcium antagonists was sold at 34.71%, with the combination of calcium antagonists/ACE inhibitors + diuretics (45.46%) in the two and three-molecule classes respectively. All in all, the study showed the patients were satisfied with the use of antihypertensives, with furosemide and the amlodipine/perindopril combination at the top of the list.
基金supported by the National Natural Science Foundation of China(82170375,U23A20395)1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University(ZYGD23021,23HXF-H009)Sichuan Science and Technology Program 2023NSFSC1645。
文摘Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.
文摘BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive population.METHODS Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of 2018.Longitudinal changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal group.To examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%CI.RESULTS The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the sample.Over the course of a mean follow-up of 4.8 years,143 ischemic strokes happened.When normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et al.Dyslipidemia changed and ischemic stroke WJCC https://www.wjgnet.com 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),respectively.CONCLUSION In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.
基金Key R&D Projects in Shandong Province(Grant No.2017G006029).
文摘In the present study,we aimed to investigate the clinical potential of sacubitril/valsartan compared with valsartan in patients with newly diagnosed hypertensive acute heart failure(H-AHF).A total of 63 patients were retrospectively enrolled from our hospital,with 32 patients assigned to the sacubitril/valsartan group and 31 patients to the valsartan group.Clinical characteristics,laboratory examinations,and echocardiographic data at baseline,during hospitalization,and follow-up were collected to assess.The results demonstrated that patients treated with sacubitril/valsartan achieved better control of systolic and diastolic blood pressures than those treated with valsartan.Sacubitril/valsartan also resulted in more significant reductions in N-terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity troponin I(hs-TnI),and creatinine,as well as an increase in estimated glomerular filtration rate(eGFR).Moreover,sacubitril/valsartan significantly improved left ventricular ejection fraction(LVEF),the E/e'ratio[the ratio between the early diastolic filling velocity(E-wave)and early diastolic mitral annular velocity(E')],and reduced left atrial dimension(LAD)and left ventricular mass index(LVMI).Additionally,sacubitril/valsartan might offer potential benefits in managing cardiac arrhythmias such as atrial fibrillation,ventricular or supraventricular premature beats,and left bundle branch block(LBBB).No fatal or nonfatal adverse effects were observed in the sacubitril/valsartan group,although one patient in the valsartan group experienced angioedema.In conclusion,after short-term administration,sacubitril/valsartan proved to be more effective than valsartan in lowering blood pressure,improving cardiac function and remodeling,and enhancing biomarker profiles.Furthermore,it had favorable effects on renal function and cardiac arrhythmias in newly diagnosed H-AHF patients.
基金The Shandong Provincial Key Project of TCM Science and Technology(Grant Nos.M-2023170,M-2022233)the Binzhou Medical College Student Innovation and Entrepreneurship Training Program(Grant Nos.X202410440414,X2024225030120)。
文摘Hypertension is one of the most prevalent cardiovascular diseases,and autophagy is known to play a significant role in the pathogenesis and progression of cardiovascular conditions.This study aimed to evaluate the effects of Huanglian Jiedu decoction(HLJDD)on myocardial mitochondrial autophagy in spontaneously hypertensive rats(SHRs)and to further explore the relationship between autophagy,myocardial remodeling,and injury.The SHRs were randomly assigned to five groups:the model group,the HLJDD low-dose group,the HLJDD medium-dose group,the HLJDD high-dose group,and a positive control group treated with captopril.Additionally,a blank control group was established using Wistar Kyoto(WKY)rats,with 10 rats in each group.The model and blank control groups were administered an equivalent volume of physiological saline via oral gavage,while the treatment groups received their respective doses of HLJDD or captopril by oral gavage.Following the treatments,various parameters were assessed,including blood pressure(systolic,diastolic,and mean arterial pressure),mitochondrial swelling and membrane potential,free ATPase activity,as well as the mRNA and protein levels of autophagy-related factors.The results showed that HLJDD significantly reduced blood pressure(systolic,diastolic,and mean arterial pressure)in SHR rats.Moreover,it enhanced mitochondrial swelling and membrane potential,increased mitochondrial ATPase activity,and decreased the mRNA and protein expression levels of autophagy-related genes(AKT,mTOR,Beclin-1,and LC3-II)in SHRs.The findings of this study suggested that HLJDD could effectively ameliorate myocardial tissue injury in SHRs,and its protective effects on the heart might be attributed to the reduction of autophagy in cardiomyocyte mitochondria.This provided insights into the potential therapeutic use of HLJDD in managing hypertension-induced myocardial injury and remodeling.
基金Supported by the Wuxi Science and Technology Plan Project Plan,No.BJ21008.
文摘BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.
文摘BACKGROUND Hypertension is a chronic cardiovascular disease characterized by persistently elevated arterial blood pressure.It is not only a significant risk factor for cardio-vascular and cerebrovascular diseases(such as myocardial infarction and stroke)but also closely related to multiple organ damages(such as kidney disease and retinopathy),imposing a heavy health and economic burden on individuals and society.AIM To investigate the expression differences and relationships of endothelin-1(ET-1),interleukin-6(IL-6),stem cell factor(SCF),and its receptor(c-kit)in hypertensive patients with or without depression.METHODS A retrospective analysis was conducted on the clinical data of 163 hypertensive patients admitted to our hospital from March 2022 to January 2024.Based on the presence of depression,patients were divided into Group A(n=77,with depre-ssion)and Group B(n=86,without depression).Serum levels of ET-1 and IL-6 were measured using radioimmunoassay,while serum levels of SCF and c-kit were measured using ELISA.The differences in ET-1,IL-6,SCF,and c-kit levels between Groups A and B were compared.Additionally,the differences in these biomarkers among patients with varying degrees of depression in Group A were analyzed.Pearson correlation analysis was used to examine the relationship between ET-1,IL-6,SCF,c-kit levels,and Hamilton depression rating scale(HAMD)scores.Multivariate logistic regression analysis was performed to identify factors influencing hypertension with depression.The diagnostic efficacy of individual and combined biomarkers was analyzed using receiver operating characteristic(ROC)curves.Comparative statistical analysis of the area under the curve(AUC)values was performed using DeLong’s test to assess the superiority of combined biomarker detection.RESULTS The levels of ET-1 and IL-6 in Group A were significantly higher than those in Group B,while the levels of SCF and c-kit were significantly lower in Group A compared to Group B(P<0.05).In the severe depression subgroup,ET-1 and IL-6 levels were higher than those in the mild-to-moderate depression subgroup,while SCF and c-kit levels were lower(P<0.05).Pearson correlation analysis showed that ET-1 and IL-6 levels were positively correlated with HAMD scores(r=0.442,0.463,P<0.05),while SCF and c-kit levels were negatively correlated with HAMD scores(r=-0.429,-0.394,P<0.05).Multivariate logistic regression analysis revealed that high ET-1,high IL-6,low SCF,and low c-kit were independent influencing factors for hypertension with depression(P<0.05).ROC analysis revealed AUCs of 0.746(ET-1),0.801(IL-6),0.732(SCF),0.779(c-kit),and 0.884(combination).The combined diagnosis demonstrated significantly higher AUC than individual markers(DeLong's test,P<0.01),with superior sensitivity(90.24%)and specificity(85.37%).CONCLUSION Compared to patients with hypertension alone,patients with hypertension and depression exhibited higher serum levels of ET-1 and IL-6 and lower levels of SCF and c-kit.High ET-1,high IL-6,low SCF,and low c-kit were inde-pendent influencing factors for hypertension with depression.The combination of ET-1,IL-6,SCF,and c-kit demonstrated significant diagnostic value for hypertension with depression.
基金Doctoral Research Fund Project of Qilu Hospital of Shandong University(Qingdao):Mechanistic Study on the Improvement of Vertigo Caused by Posterior Circulation Ischemia by Acupuncture through Regulating Cerebral Blood Flow in Rats with Posterior Circulation Ischemia Vertigo(No.QDKY2023BS19)National Natural Science Foundation of China:From Microrna 9 Regulate P2X7 Receptor of Microglia in Paraventricular Nucleus of Hypothalamus to Explore the Effect of Electroacupuncture on Sympathetic Nerve Excitability in Spontaneously Hypertensive Rats(No.82074553)。
文摘OBJECTIVE:To investigate the mechanism of electroacupuncture of sympathetic nerve activity and blood pressure reduction in the hypothalamic paraventricular nucleus(PVN)of spontaneous hypertensive rats(SHRs).METHODS:A total of 64 male SHRs were divided into four groups:model,sham-operated(Sham),electroacupuncture(EA),and N-methyl-D-aspartate receptor antagonist and electroacupuncture(NRA+EA).In addition,16 Wistar-Kyoto rats were used as controls.PVN stereotaxic surgery was performed in both the Sham and NRA+EA groups,while the EA and NRA+EA groups received 14 d of electroacupuncture.Blood pressure(BP)and heart rate(HR)were measured the day before the intervention and every other day.After 14 d of intervention,the rats in each group were tested for renal sympathetic nerve activity(RSNA).The associated factor levels were determined using Western blotting,reverse transcription-polymerase chain reaction(RTPCR),enzyme-linked immunosorbent assay(ELISA)and immunofluorescence assays.RESULTS:In comparison to the model group,the EA and NRA+EA groups had significantly lower BP,HR,and RSNA(P<0.01).The expression of N-methyl-Daspartate receptor(NMDAR),angiotensin II(Ang II),angiotensin II type 1(AT1),tumor necrosis factor-α,interleukin-1β,norepinephrine and arginine vasopressin was significantly lower in the EA and NRA+EA groups(P<0.01).Moreover,the antihypertensive effect of NRA+EA group outperformed to the EA group.CONCLUSIONS:Electroacupuncture effectively reduced the BP and sympathetic nerve excitability in SHRs.The mechanism was linked to the inhibition of NMDARmediated Ang II/AT1 and the inflammatory response in PVN.
文摘Objective:To analyze the risk factors of anxiety in young hypertensive patients and build a prediction model to provide a scientific basis for clinical diagnosis and treatment.Methods:According to the research content,young hypertensive patients admitted to the hospital from January 2022 to December 2024 were selected as the research object and at least 950 patients were included according to the sample size calculation.According to the existence of anxiety,950 patients were divided into control group(n=650)and observation group(n=300),and the clinical data of all patients were collected for univariate analysis and multivariate Logistic regression analysis to get the risk factors of hypertension patients complicated with anxiety in.All patients were randomly divided into a training set(n=665)and a test set(n=285)according to the ratio of 7:3,and the evaluation efficiency of different prediction models was obtained by using machine learning algorithm.To evaluate the clinical application effect of the prediction model.Results:(1)Univariate analysis showed that age,BMI,education background,marital status,smoking,drinking,sleep disorder,family history of hypertension,history of diabetes,history of hyperlipidemia,history of cerebral infarction,and TC were important risk factors for young hypertensive patients complicated with anxiety.(2)Multivariate Logistic regression analysis showed that hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors for young hypertensive patients complicated with anxiety.(3)Extra Trees has the highest predictive power for young people with hypertension complicated with anxiety,while Decision-Tree has the lowest predictive power.Conclusion:Hypertension history,drinking history,coronary heart disease history,diabetes history,BMI,TC,and TG are important independent risk factors that affect the anxiety of young hypertensive patients.Extra Trees model has the best prediction efficiency among different groups of models.
基金the support provided by the 2D43 TW009883 D43 Post-Doctoral Program at the School of Nursing,University of Michigan,USA。
文摘Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.
文摘Sodium fluoride(NaF)is a daily necessity consumed as the major ingredient of fluorinated drinking water,milk,salts,mouthwashes,toothpaste,and dentistry medications.However,the use of NaF products has also been associated with increased fluoride anion distribution in the body,leading to hypertension.AIM This study evaluated the antihypertensive effect of sweet orange peels-enriched white melon seed protein concentrate(WSP)biscuit meal in eight-week-old albino rats exposed to NaF for 14 days.METHODS Forty-two(42)male Wistar albino rats were assigned at random into 7 groups of 6 rats per group(control group and six experimental groups).The experimental groups received various treatments that lasted for two weeks.Twenty-four hours after the last administration,hemodynamic parameters were evaluated,rats were sacrificed,blood samples were collected,and the heart was harvested.Blood serum was assessed for cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),and lactate dehydrogenase(LDH).At the same time,the heart homogenate was assayed for angiotensin-1 converting enzyme(ACE)activity,proinflammatory cytokines,nitric oxide concentrations,and antioxidant status.Cardiac tissues were stained with Hematoxylin and Eosin,Masson’s Trichrome,and cTnI.Also,the safety of the WSP biscuit diet was evaluated.RESULTS Results obtained showed that NaF administration elevated the collagen content of cardiac tissues,activities of ACE,and concentrations of cTnI,CK-MB,LDH,tumor necrosis factor-alpha,and interleukin 1 beta,while there was a reduction in the concentration of nitric oxide and antioxidants;however,their alterations were significantly prevented in WSP-biscuit-fed rats.The WSP biscuit meal is safe for consumption and possesses dose-dependent antihypertensive ability at 10%and 20%inclusion.CONCLUSION The WSP biscuit diet may be recommended in diet formulation for the management of individuals or communities that are predisposed to NaF contaminations.
