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Fasakin OW, Awosika A, Ogunsanya ST, Benson IO, Olopoda AI. Anti-hypertensive effect of enriched white melon seed protein concentrate biscuit on sodium fluoride exposed rats. World J Exp Med 2025; 15:105798. [DOI: 10.5493/wjem.v15.i2.105798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Revised: 03/12/2025] [Accepted: 03/24/2025] [Indexed: 04/16/2025] Open
Abstract
BACKGROUND 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.
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Affiliation(s)
- Olamide Wilson Fasakin
- Department of Biomedical Technology, Federal University of Technology, Akure 234034, Nigeria
| | - Ayoola Awosika
- College of Medicine, University of Illinois, Chicago, Peoria, IL 61601, United States
| | | | | | - Akinyode Isaac Olopoda
- Department of Biochemistry, Federal University of Technology, Akure 234034, Ondo, Nigeria
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2
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Elimam H, El-Say KM, Ahmed TA, Marleau S, El-Khayat Z, El-Banna M, Hussein J. Nanoformulation of valsartan-loaded tablet attenuates L-NAME-induced hypertension: role of Nrf2/PPARγ/AT1 signaling pathway. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025:10.1007/s00210-025-03993-4. [PMID: 40137963 DOI: 10.1007/s00210-025-03993-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Accepted: 02/26/2025] [Indexed: 03/29/2025]
Abstract
Hypertension is the most common entity globally, marked by high prevalence and heterogeneous pathophysiology. Oxidative stress is a crucial area of investigation among potential etiologies. We examined the hypothesis that blocking the angiotensin type 1 (AT1) receptor with valsartan (VST) in self-nanoemulsifying delivery systems (SNEDS) and loads in liquisolid tablets (LST-1) or valsartan and hydrochlorothiazide (VST/HCTZ) in SNEDS and loads in liquisolid tablets (LST-2) in comparison with non-SNEDS liquisolid tablets (DCT-3 and DCT-4) would lead to an improvement in hypertension management. The present study aims to explore the molecular mechanisms underlying their effect in N(G)-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats. Male Sprague-Dawley rats were given L-NAME (40 mg/kg/day) orally for three weeks to inhibit the endogenous synthesis of nitric oxide (NO). Concurrent treatment with VST or VST/HCTZ liquisolid tablets (20 mg/kg/day for three weeks) resulted in lowering blood pressure (BP), reversing the L-NAME-induced serum NO suppression, enhancing lipid profile, and improving oxidative status. The antioxidant defense of paraoxonase was significantly increased in the LST-1- and LST-2-treated rats compared to the L-NAME-treated rats by 135% and 90%, respectively. Furthermore, SNEDS-loaded VST or SNEDS-loaded VST/HCTZ liquisolid tablets significantly lowered the elevated level of AT1 (P < 0.05), showed a marked Nrf2 expression (P < 0.01) and overexpressed PPARγ (P < 0.05), and suppressed iNOS expression (P < 0.0001). These results highlight the remarkable benefits of the novel formula, "SNEDS-loaded VST and SNEDS-loaded VST/HCTZ," as an alternative therapy in treating hypertension and its complications.
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Affiliation(s)
- Hanan Elimam
- Department of Biochemistry, Faculty of Pharmacy, University of Sadat City, Sadat City, 32897, Egypt.
| | - Khalid M El-Say
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Tarek A Ahmed
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Sylvie Marleau
- Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - Zakaria El-Khayat
- Department of Medical Biochemistry, National Research Centre, Giza, Egypt
| | - Mona El-Banna
- Department of Medical Biochemistry, National Research Centre, Giza, Egypt
| | - Jihan Hussein
- Department of Medical Biochemistry, National Research Centre, Giza, Egypt
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3
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Chen YT, Cheng HM. Age- and Blood Pressure-Dependent Form Factors: Reevaluating Arterial Waveforms and Blood Pressure Assessment. J Am Heart Assoc 2025; 14:e041118. [PMID: 40079313 DOI: 10.1161/jaha.125.041118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2025]
Affiliation(s)
- Yung-Te Chen
- Department of Internal Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - Hao-Min Cheng
- Division of Faculty Development, Department of Medical Education Taipei Veterans General Hospital Taipei Taiwan
- Division of Evidence-Based Medicine Taipei Veterans General Hospital Taipei Taiwan
- College of Medicine National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan
- Institute of Public Health and Community Medicine Research Centre, National Yang Ming Chiao Tung University School of Medicine Taipei Taiwan
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Chemla D, Jozwiak M, Millasseau S, Attal P. Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis. J Am Heart Assoc 2025; 14:e037064. [PMID: 40079342 DOI: 10.1161/jaha.124.037064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 12/31/2024] [Indexed: 03/15/2025]
Abstract
BACKGROUND Mean aortic pressure (MAP) plays a pivotal role in both cardiovascular dynamics and the noninvasive estimation of systolic aortic pressure. MAP can be estimated by adding a fraction of the pulse pressure (PP) to the diastolic aortic pressure, known as the form factor (FF=100×[MAP-diastolic aortic pressure]/PP). A 41.2% FF is recommended, yet this single value may not adequately account for age- and pressure-related changes in both pressure waveform and central-to-peripheral pulse pressure amplification (pulse pressure amplification=peripheral PP/central PP=central FF/peripheral FF). METHODS AND RESULTS This secondary analysis included data extracted from 11 high-fidelity invasive pressure studies. Individual data on age, high-fidelity systolic aortic pressure, diastolic aortic pressure, and time-averaged MAP were reanalyzed to calculate FF values and assess the influence of age and central hypertension on FF. The pooled data included 320 adults, comprising our own database (n=139). Among them, 97 subjects were initially categorized as "normal," 82 with hypertension, and 141 with diverse cardiac conditions (median age, 48 years; MAP, 102 mm Hg). The FF value (mean, 44%) decreased with age (r2=0.29, P<0.0001). A value of 50% was most appropriate for the youngest subjects, while FF tended toward 40% in older subjects. FF was lower in subjects with central hypertension (systolic aortic pressure/diastolic aortic pressure ≥130/90 mm Hg; n=169) compared with those without. In both groups, FF decreased with age, showing similar slopes for the FF-age relationship. CONCLUSIONS Aortic FF decreased with age and was lower in subjects with central hypertension. Unlike applying a fixed FF, this decline aligned with pathophysiological changes in pressure waveform and pulse pressure amplification, with potential implications for improving MAP estimation.
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Affiliation(s)
- Denis Chemla
- INSERM UMRS 999, Cardiovascular Physiology Department Hôpital Marie Lannelongue Le Plessis-Robinson France
| | - Mathieu Jozwiak
- Service de Médecine Intensive Réanimation CHU de Nice Nice France
- UR2CA, Unité de Recherche Clinique Côte d'Azur Univ. Côte d'Azur Nice France
| | | | - Pierre Attal
- Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel
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Rooi D, Kruger R, van Vuren EJ, Breet Y. Non-modifiable and Modifiable Risk Factors in Vascular Ageing Extremes: The African-PREDICT Study. Artery Res 2024; 30:19. [DOI: 10.1007/s44200-024-00063-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 10/21/2024] [Indexed: 01/04/2025] Open
Abstract
Abstract
Background
Cardiovascular risk factors accelerate vascular ageing beyond chronological age, hence early vascular ageing (EVA). Carotid to femoral pulse wave velocity (cfPWV) is a measure of vascular ageing and is used to identify EVA and supernormal vascular ageing (SUPERNOVA). Vascular ageing is not completely understood in African populations. Therefore, we aimed to phenotype young South African adults stratified by cfPWV extremes in terms of non-modifiable and modifiable risk factors. This study included 1133 young adults (mean age: 24.5 years). We measured cfPWV using applanation tonometry. Body composition measures, self-reported 24-h dietary intake, smoking and alcohol consumption were included. Fasting blood samples were analysed for biochemical risk factors. Three groups based on cfPWV percentiles were compared and included SUPERNOVA (≤ 10th percentile), average vascular ageing (AVA, between 10 to 90th percentile) and EVA (≥ 90th percentile).
Results
Chronological age, male sex, smoking, alcohol use, and blood pressure were incrementally higher across PWV groups (all p trend ≤ 0.007). Black ethnicity was higher (p = 0.038) in the SUPERNOVA group. In exploratory factor analysis, a factor pattern including mean arterial pressure and fasting glucose showed beneficial odds (OR 0.62, p = 0.002) for SUPERNOVA and higher likelihood (OR 2.10, p < 0.001) for EVA. Another factor pattern of socio-economic status and total dietary fat showed lower odds (OR 0.64, p = 0.003) for EVA.
Conclusion
Poor lifestyle behavioural risk factors seem detrimental in the EVA group conferring a possible higher risk of future CVD.
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Stankute I, Dulskiene V, Kuciene R. Associations between Changes in Body Weight Status and High Blood Pressure among Lithuanian Children and Adolescents during the COVID-19 Pandemic: A Retrospective Cohort Study. Nutrients 2024; 16:3256. [PMID: 39408222 PMCID: PMC11479103 DOI: 10.3390/nu16193256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/17/2024] [Accepted: 09/24/2024] [Indexed: 10/20/2024] Open
Abstract
(1) Background: High blood pressure (HBP), overweight, and obesity are common, growing public health problems worldwide. The aim of this study was to evaluate associations between changes in body weight status and HBP among Lithuanian children and adolescents during the COVID-19 pandemic. (2) Methods: In this study, we analysed data on blood pressure and anthropometric measurements of 2430 children and adolescents aged 8-18 years, who participated in both the baseline study conducted before the COVID-19 pandemic (from November 2019 to March 2020) and the follow-up study during the COVID-19 pandemic (from November 2021 to April 2022). Multivariate logistic regression analysis was used to estimate the associations between changes in weight status categories and HBP. (3) Results: At baseline, 17.1% of the subjects had overweight, 5.9% had obesity, 5.6% had abdominal obesity, and 23.7% had HBP, whereas at the follow-up, these percentages increased to 20.1%, 8.2%, 6.8%, and 27.4%, respectively. Compared to schoolchildren who maintained normal weight from baseline to the follow-up period, subjects who newly developed overweight/obesity and those who remained with persistent overweight/obesity had increased odds of HBP, with adjusted odds ratios (aORs) of 1.95 (p < 0.001) and 2.58 (p < 0.001), respectively. In subjects who transitioned from overweight/obesity to normal weight, the odds of HBP were slightly increased, with an aOR of 1.14 (p = 0.598), but the change was not statistically significant (p > 0.05). (4) Conclusions: This study observed an increase in the prevalence of overweight, obesity, and HBP among schoolchildren during the COVID-19 pandemic. The study also suggested that changes from normal body weight status at baseline to overweight/obesity during follow-up, especially persistent overweight/obesity, were associated with higher odds of HBP in Lithuanian children and adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Ieva Stankute
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, LT-50162 Kaunas, Lithuania; (V.D.); (R.K.)
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Zuin M, Henkin S, Harder EM, Piazza G. Optimal hemodynamic parameters for risk stratification in acute pulmonary embolism patients. J Thromb Thrombolysis 2024; 57:918-928. [PMID: 38762710 DOI: 10.1007/s11239-024-02998-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 05/20/2024]
Abstract
Hemodynamic assessment of patients with pulmonary embolism (PE) remains a fundamental component of early risk stratification that in turn, influences subsequent monitoring and therapeutic strategies. The current body of literature and international evidence-based clinical practice guidelines focus mainly on the use of systolic blood pressure (SBP). The accuracy of this single hemodynamic parameter, however, and its optimal values for the identification of hemodynamic instability have been recently questioned by clinicians. For example, abnormal SBP or shock index may be a late indicator of adverse outcomes, signaling a patient in whom the cascade of hemodynamic compromise is already well underway. The aim of the present article is to review the current evidence supporting the use of SBP and analyze the potential integration of other parameters to assess the hemodynamic stability, impending clinical deterioration, and guide the reperfusion treatment in patients with PE, as well as to suggest potential strategies to further investigate this issue.
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Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, Ferrara, 44124, Italy.
| | | | - Eileen M Harder
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory Piazza
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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8
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Rooi D, Botha-Le Roux S, Breet Y. Perfusion and pulsatile pressure: their relationship with target organ damage in the African-PREDICT study. BMC Cardiovasc Disord 2024; 24:399. [PMID: 39090575 PMCID: PMC11293048 DOI: 10.1186/s12872-024-04071-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Hypertension is the leading risk factor for subclinical target-organ damage (TOD) and cardiovascular disease (CVD). Little is known about the relationship between different pressure measures and subclinical TOD, especially in young populations. We compared the strength of associations of subclinical TOD markers with perfusion and pulsatile pressure in young adults. METHODS A total of 1 187 young adults from the African-PREDICT study were included. Ambulatory mean arterial pressure (MAP) and pulse pressure (PP) was obtained. Markers of subclinical TOD were measured and included left ventricular mass index (LVMi), carotid intimamedia thickness (cIMT), carotidfemoral pulse wave velocity (cfPWV), central retinal arteriolar equivalent (CRAE) and albumin to creatinine ratio (ACR). RESULTS Measures of sub-clinical TOD (cIMT, cfPWV and CRAE), associated stronger with perfusion pressure (all p < 0.001) than pulsatile pressure in unadjusted models. Stronger associations were found between cfPWV (adjusted R2 = 0.26), CRAE (adjusted R2 = 0.12) and perfusion pressure (all p ≤ 0.001) than pulsatile pressure independent of several non-modifiable and modifiable risk factors. CONCLUSIONS In young, healthy adults, perfusion pressure is more strongly associated with subclinical TOD markers than pulsatile pressure. These findings contribute to the understanding of the development of early cardiovascular changes and may guide future intervention strategies.
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Affiliation(s)
- Donavan Rooi
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X 1290, Potchefstroom, 2520, South Africa
| | - Shani Botha-Le Roux
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X 1290, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Yolandi Breet
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X 1290, Potchefstroom, 2520, South Africa.
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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9
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Jimenez R, Yurk D, Dell S, Rutledge AC, Fu MK, Dempsey WP, Abu-Mostafa Y, Rajagopal A, Brinley Rajagopal A. Resonance sonomanometry for noninvasive, continuous monitoring of blood pressure. PNAS NEXUS 2024; 3:pgae252. [PMID: 39081785 PMCID: PMC11287871 DOI: 10.1093/pnasnexus/pgae252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/10/2024] [Indexed: 08/02/2024]
Abstract
Cardiovascular disease is the leading cause of death worldwide. Existing methods for continuous, noninvasive blood pressure (BP) monitoring suffer from poor accuracy, uncomfortable form factors, or a need for frequent calibration, limiting their adoption. We introduce a new framework for continuous BP measurement that is noninvasive and calibration-free called resonance sonomanometry. The method uses ultrasound imaging to measure both the arterial dimensions and artery wall resonances that are induced by acoustic stimulation, which offers a direct measure of BP by a fully determined physical model. The approach and model are validated in vitro using arterial mock-ups and then in multiple arteries in human subjects. This approach offers the promise of robust continuous BP measurements, providing significant benefits for early diagnosis and treatment of cardiovascular disease.
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Affiliation(s)
- Raymond Jimenez
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
| | - Dominic Yurk
- Department of Electrical Engineering, California Institute of Technology, 1200 East California Blvd, Pasadena, CA 91125, USA
| | - Steven Dell
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
| | - Austin C Rutledge
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
| | - Matt K Fu
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
| | - William P Dempsey
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
| | - Yaser Abu-Mostafa
- Department of Electrical Engineering, California Institute of Technology, 1200 East California Blvd, Pasadena, CA 91125, USA
| | - Aditya Rajagopal
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
- Department of Electrical Engineering, California Institute of Technology, 1200 East California Blvd, Pasadena, CA 91125, USA
- Department of Biomedical Engineering, University of Southern California, 3650 McClintock Ave, Los Angeles, CA 90089, USA
| | - Alaina Brinley Rajagopal
- Esperto Medical, Inc., 300 Spectrum Center Drive, Suite 400, Irvine, CA 92618, USA
- Department of Electrical Engineering, California Institute of Technology, 1200 East California Blvd, Pasadena, CA 91125, USA
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10
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Jozwiak M, Millasseau S, Teboul J, Lombardi R, Devanlay R, Umbdenstock E, Morand L, Dellamonica J, Chemla D. Value and Variability of Pulse Shape Indicator for Estimating Mean Arterial Pressure in the Radial and Femoral Arteries. J Am Heart Assoc 2024; 13:e031969. [PMID: 38240278 PMCID: PMC11056177 DOI: 10.1161/jaha.123.031969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/18/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND The form factor (FF) is a pulse shape indicator that corresponds to the fraction of pulse pressure added to diastolic blood pressure to estimate the time-averaged mean arterial pressure (MAP). Our invasive study assessed the FF value and variability at the radial and femoral artery levels and evaluated the recommended fixed FF value of 0.33. METHODS AND RESULTS Hemodynamically stable patients were prospectively included in 2 intensive care units. FF was documented at baseline and during dynamic maneuvers. A total of 632 patients (64±16 years of age, 66% men, MAP=81±14 mm Hg) were included. Among them, 355 (56%) had a radial catheter and 277 (44%) had a femoral catheter. The FF was 0.34±0.06. In multiple linear regression, FF was influenced by biological sex (P<0.0001) and heart rate (P=0.04) but not by height, weight, or catheter location. The radial FF was 0.35±0.06, whereas the femoral FF was 0.34±0.05 (P=0.08). Both radial and femoral FF were higher in women than in men (P<0.05). When using the 0.33 FF value to estimate MAP, the error was -0.4±4.0 mm Hg and -0.1±2.9 mm Hg at the radial and femoral level, respectively, and the MAP estimate still demonstrated high accuracy and good precision even after changes in norepinephrine dose, increase in positive end-expiratory pressure level, fluid administration, or prone positioning (n=218). CONCLUSIONS Despite higher FF in women and despite interindividual variability in FF, using a fixed FF value of 0.33 yielded accurate and precise estimations of MAP. This finding has potential implications for blood pressure monitoring devices and the study of pulse wave amplification.
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Affiliation(s)
- Mathieu Jozwiak
- Service de Médecine Intensive Réanimation CHU de NiceNiceFrance
- UR2CA, Unité de Recherche Clinique Côte d’Azur, Université Côte d’AzurNiceFrance
| | | | - Jean‐Louis Teboul
- AP‐HP, Hôpitaux universitaires Paris‐Sud, Hôpital de Bicêtre, service de Médecine Intensive Réanimation médicaleLe Kremlin‐BicêtreFrance
| | - Romain Lombardi
- Service de Médecine Intensive Réanimation CHU de NiceNiceFrance
- UR2CA, Unité de Recherche Clinique Côte d’Azur, Université Côte d’AzurNiceFrance
| | - Raphaël Devanlay
- Service de Médecine Intensive Réanimation CHU de NiceNiceFrance
- UR2CA, Unité de Recherche Clinique Côte d’Azur, Université Côte d’AzurNiceFrance
| | - Emilien Umbdenstock
- Service de Médecine Intensive Réanimation CHU de NiceNiceFrance
- UR2CA, Unité de Recherche Clinique Côte d’Azur, Université Côte d’AzurNiceFrance
| | - Lucas Morand
- Service de Médecine Intensive Réanimation CHU de NiceNiceFrance
- UR2CA, Unité de Recherche Clinique Côte d’Azur, Université Côte d’AzurNiceFrance
| | - Jean Dellamonica
- Service de Médecine Intensive Réanimation CHU de NiceNiceFrance
- UR2CA, Unité de Recherche Clinique Côte d’Azur, Université Côte d’AzurNiceFrance
| | - Denis Chemla
- INSERM UMRS 999, Hôpital Marie LannelongueLe Plessis‐RobinsonFrance
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11
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Chemla D, Jozwiak M. Commentary: Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records. Front Cardiovasc Med 2023; 10:1295467. [PMID: 38169777 PMCID: PMC10758428 DOI: 10.3389/fcvm.2023.1295467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Denis Chemla
- INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service de Médecine Intensive Réanimation CHU de Nice, Nice, France
| | - Mathieu Jozwiak
- Service de Médecine Intensive Réanimation CHU de Nice, Nice, France
- UR2CA, Unité de Recherche Clinique Côte D'Azur, Université Côte D’Azur, Nice, France
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12
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Sakuma S, Nogawa K, Watanabe Y, Sakurai M, Nishijo M, Ishizaki M, Morikawa Y, Kido T, Nakagawa H, Suwazono Y. Effect of renal tubular damage on non-cancer mortality in the general Japanese population living in cadmium non-polluted areas. J Appl Toxicol 2023; 43:1849-1858. [PMID: 37460094 DOI: 10.1002/jat.4518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 11/10/2023]
Abstract
This study aimed to clarify the cause-effect relationship between renal tubular damage and non-cancer mortality in the general Japanese population. We conducted a 19-year cohort study including 1110 men and 1,03 women who lived in three cadmium-non-polluted areas in 1993 or 1994. Mortality risk ratios based on urinary β2-microglobulin (β2MG) and N-acetyl-β-glucosaminidase (NAG) concentrations were estimated for specific non-cancer diseases using the Fine and Gray competing risks regression model. In men, continuous urinary NAG (+1 μg/g cre) concentrations were significantly correlated with increased mortality caused by diseases of the respiratory system (hazard ratio (HR): 1.09, 95% confidence interval (CI): 1.03-1.15). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortalities caused by kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00-1.03), renal diseases (HR: 1.01, 95% CI: 1.00-1.03), renal failure (HR: 1.02, 95% CI: 1.00-1.03), and external causes of mortality (HR: 1.01, 95% CI: 1.00-1.02). In women, urinary NAG (+1 μg/g cre) concentrations were significantly associated with increased mortality caused by ischemic heart diseases (HR: 1.02, 95% CI: 1.00-1.04) and kidney and urinary tract diseases (HR: 1.01, 95% CI: 1.00-1.04). Urinary β2MG (+100 μg/g cre) concentrations were significantly correlated with increased mortality caused by cardiovascular diseases (HR: 1.01, 95%CI: 1.00-1.02), ischemic heart diseases (HR: 1.01, 95%CI: 1.00-1.02), and kidney and urinary tract diseases (HR: 1.02, 95% CI: 1.01-1.03). The present study indicates that renal tubular damage was significantly related to several non-cancer disease causes of mortality in Japan's general population living in cadmium-non-polluted areas.
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Affiliation(s)
- Sayaka Sakuma
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaru Sakurai
- Department of Hygiene, Kanazawa Medical University, Ishikawa, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Masao Ishizaki
- Department of Hygiene, Kanazawa Medical University, Ishikawa, Japan
| | - Yuko Morikawa
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, Ishikawa, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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13
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Kuciene R, Dulskiene V. Associations between tri-ponderal mass index, body mass index, and high blood pressure among children and adolescents: a cross-sectional study. Sci Rep 2023; 13:18148. [PMID: 37875577 PMCID: PMC10598122 DOI: 10.1038/s41598-023-45432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
High blood pressure (HBP) and obesity are major public health issues globally. The aim of the study was to evaluate the associations between tri-ponderal mass index (TMI) and body mass index (BMI) and HBP and to determine which anthropometric parameters may best predict HBP among Lithuanian children and adolescents aged 7-18 years. This cross-sectional study included 3710 Lithuanian children and adolescents aged 7-18 (52.7% boys and 47.3% girls). Each subject's height, weight, and other anthropometric parameters, as well as blood pressure were measured according to standardized protocols; subsequently, TMI and BMI were calculated. The prevalence of HBP was 27% (the prevalence of elevated BP and hypertension was 13.7% and 13.3%, respectively), significantly higher for boys than for girls. The Pearson correlation coefficients between the BMI z-score and BP were higher than those between the TMI z-score and BP. In both sexes combined, the adjusted odds ratios (aOR) for HBP were increased significantly with increasing quartiles of TMI and BMI as compared to the first quartile (Q1) (Q2: aOR = 1.37 and aOR = 1.69; Q3: aOR = 2.10 and aOR = 2.27; Q4: aOR = 3.95 and aOR = 4.91, respectively). Significant associations also were observed between overweight and obesity (defined according to two methods: age- and sex-specific TMI percentiles and IOTF criteria) among boys and girls separately. BMI presented a higher area under the curve value than TMI for predicting HBP in children and adolescents. The findings of the study suggest that BMI and TMI are significantly associated with HBP. However, BMI is a better predictor for HBP than TMI among Lithuanian children and adolescents aged 7-18 years.
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Affiliation(s)
- Renata Kuciene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50162, Kaunas, Lithuania.
| | - Virginija Dulskiene
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu 15, 50162, Kaunas, Lithuania
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14
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Wohlwend NF, Grossmann K, Aeschbacher S, Weideli OC, Telser J, Risch M, Conen D, Risch L. The Association of suPAR with Cardiovascular Risk Factors in Young and Healthy Adults. Diagnostics (Basel) 2023; 13:2938. [PMID: 37761305 PMCID: PMC10530210 DOI: 10.3390/diagnostics13182938] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The soluble urokinase plasminogen activator receptor (suPAR), as a correlate of chronic low-grade inflammation, may be used to predict individual cardiovascular risk. Since chronic low-grade inflammation is thought to be associated with the development of cardiovascular disease, this study aimed to evaluate if suPAR plasma levels are correlated with cardiovascular risk factors in young and healthy adults (aged 25-41 years). Consequently, data from the GAPP (genetic and phenotypic determinants of blood pressure and other cardiovascular risk factors) study were used to investigate suPAR plasma levels in relation to the following cardiovascular risk factors and laboratory parameters: BMI, physical activity, alcohol consumption, smoking status, blood pressure parameters, glucose status, and lipid levels. Additionally, suPAR was compared to the healthy lifestyle score and the Framingham score representing the overall cardiovascular risk profile. These associations were assessed using two different statistical approaches. Firstly, all cardiovascular risk factors and scores were compared amongst sex-specific suPAR plasma levels with ANOVA analysis. Secondly, sex-specific multivariable linear regressions were performed. Female participants had higher plasma suPAR levels than male participants (1.73 ng/mL versus 1.50 ng/mL; p < 0.001). A significant inverse correlation between suPAR plasma levels and HDL cholesterol was found in men (p = 0.001) and women (p < 0.001). Furthermore, male (p < 0.001) and female participants (p < 0.001) who smoked showed significantly higher plasma levels of suPAR (p < 0.001). For male participants, an inverse correlation of the healthy lifestyle score with suPAR plasma levels (p = 0.001) and a positive correlation of the Framingham score with suPAR plasma levels (p < 0.001) were detected. In women, no such correlation was found. The cholesterol levels (p = 0.001) and HbA1c (p = 0.008) correlated significantly with plasma suPAR levels in female participants. suPAR plasma levels were found to be strongly associated with certain cardiovascular risk factors; however, sex-specific differences were found. These sex-specific differences might be explained by the higher prevalence of cardiovascular risk factors in men resulting in a stronger correlation of suPAR as a marker of low-grade inflammation, since the existence of the risk factors already led to subclinical damage in men. Further research on suPAR levels in an older study population is needed.
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Affiliation(s)
| | - Kirsten Grossmann
- Dr. Risch Medical Laboratory, 9490 Vaduz, Liechtenstein
- Faculty of Medical Sciences, Private University in the Principality of Liechtenstein, 9495 Triesen, Liechtenstein
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, Division Cardiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - Ornella C. Weideli
- Dr. Risch Medical Laboratory, 9490 Vaduz, Liechtenstein
- Soneva Fushi, Boduthakurufaanu Magu, Male 20077, Maldives
| | - Julia Telser
- Dr. Risch Medical Laboratory, 9490 Vaduz, Liechtenstein
- Faculty of Medical Sciences, Private University in the Principality of Liechtenstein, 9495 Triesen, Liechtenstein
| | - Martin Risch
- Dr. Risch Medical Laboratory, 9490 Vaduz, Liechtenstein
- Division of Laboratory Medicine, Cantonal Hospital Graubünden, 7007 Chur, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, ON L8L 2X2, Canada
| | - Lorenz Risch
- Dr. Risch Medical Laboratory, 9490 Vaduz, Liechtenstein
- Faculty of Medical Sciences, Private University in the Principality of Liechtenstein, 9495 Triesen, Liechtenstein
- Department of Laboratory Medicine, Institute of Clinical Chemistry, Inselspital Bern University Hospital, University of Berne, 3012 Berne, Switzerland
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15
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Ademosun A, Ojueromi O, Peace O, Oboh G. Cardiomodulatory and Antioxidative Potentials of Almond-Citrus Peel Fortified Shortbread in High Fat Diet/L-NAME-Induced Hyperlipidemic-Hypertensive Rats. J Med Food 2023; 26:586-594. [PMID: 37594561 DOI: 10.1089/jmf.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
In folk medicine, the almond nut (Terminalia catappa) and orange peel (Citrus sinensis) are cost-effective sources of nutraceutical utilized in the treatment of degenerative diseases. Hyperlipidemia and hypertension are two pathological conditions implicated in cardiovascular disorders. This study sought to evaluate the cardiomodulatory effect of almond-citrus peel fortified shortbread in hyperlipidemic-hypertensive rats induced by high fat diet and Nω-nitro-l-arginine methyl ester. The experimental animals were divided into eight groups. The experimental rats were fed with shortbread supplemented with almond and citrus peel at varying inclusions of 0.2% citrus, 50% almond, and almond (50%)- citrus (0.2%) for 21 days. The mean arterial blood pressure (MABP), systolic blood pressure (SBP), and lipid profile of the experimental rats were measured. Thereafter, the activities of angiotensin-1-converting enzyme (ACE), arginase, malondialdehyde (MDA), phosphodiesterase-5, nitric oxide (NO), and antioxidant indices were evaluated. The result showed significant elevation in SBP, MABP, blood cholesterol, triglyceride, ACE, arginase, activities, and MDA levels in the heart tissue of the untreated rats. In contrast, the antioxidant status and NO level were significantly decreased in the untreated groups. Remarkably, the treatment with almond-citrus peel fortified shortbread and the individual effect of almond (50%) and citrus peel (0.2%) all reversed these trends in the hyperlipidemic-hypertensive rats. Intriguingly, the blend of almond (50%)-citrus peel (0.2%) fortified shortbread showed the best antioxidative and cardioprotective effect. The results suggest that almond and citrus peel offer potentials as therapeutic agent in the prevention and management of hyperlipidemia and hypertension.
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Affiliation(s)
- Ayokunle Ademosun
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Opeyemi Ojueromi
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Olukorede Peace
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Ganiyu Oboh
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
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16
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Craig A, Ware LJ, Mapanga W, Norris SA. A comparison of paediatric hypertension clinical practice guidelines and their ability to predict adult hypertension in an African birth cohort. J Hum Hypertens 2023; 37:455-462. [PMID: 35701669 PMCID: PMC10256606 DOI: 10.1038/s41371-022-00709-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/02/2022] [Accepted: 05/27/2022] [Indexed: 11/08/2022]
Abstract
It remains unclear which paediatric hypertension clinical practice guideline (CPG) should be applied in an African population. We, therefore, aimed to compare commonly used CPG (2017 AAP, 2016 ESH, 2004 Fourth Report) developed in high-income countries for use in South African children at four paediatric ages (children: 5 years, 8 years; adolescents: 13 years, 17 years) to determine which best predicts elevated blood pressure (BP) in adulthood (22 years, 28 years). Moreover, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each specific paediatric CPG was calculated across the age points. The 2017 AAP definition identified more children and adolescents with hypertension when compared to the 2004 Fourth Report and 2016 ESH guidelines. In computed hazards ratios, ages 8 years to 17 years, all three paediatric CPG significantly predicted the risk of elevated BP in young adulthood (p ≤ 0.032). However, sensitivity to predict elevated BP at age 22 years for all CPG was generally low (17.0%-33.0%) with higher specificity (87.4%-93.1%). Sensitivity increased at age 28 years (51.4%-70.1%), while specificity decreased (52.8%-65.1%). Both PPV and NPV at both adult age points varied widely (17.9%-79.9% and 29.3%-92.5% respectively). The performance of these paediatric CPG in terms of AUC were not optimal at both adult age points, however, the 2017 AAP definition at age 17 years met an acceptable level of performance (AUC = 0.71). Our results, therefore, highlight the need for more research to examine if an African-specific CPG would better identify high-risk children to minimise their trajectory towards adult hypertension.
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Affiliation(s)
- A Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
| | - L J Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - W Mapanga
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - S A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Health and Human Development, University of Southampton, Southampton, UK
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17
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Xuan Y, Barry C, De Souza J, Wen JH, Antipa N, Moore AA, Wang EJ. Ultra-low-cost mechanical smartphone attachment for no-calibration blood pressure measurement. Sci Rep 2023; 13:8105. [PMID: 37248245 DOI: 10.1038/s41598-023-34431-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/29/2023] [Indexed: 05/31/2023] Open
Abstract
We propose an ultra-low-cost at-home blood pressure monitor that leverages a plastic clip with a spring-loaded mechanism to enable a smartphone with a flash LED and camera to measure blood pressure. Our system, called BPClip, is based on the scientific premise of measuring oscillometry at the fingertip to measure blood pressure. To enable a smartphone to measure the pressure applied to the digital artery, a moveable pinhole projection moves closer to the camera as the user presses down on the clip with increased force. As a user presses on the device with increased force, the spring-loaded mechanism compresses. The size of the pinhole thus encodes the pressure applied to the finger. In conjunction, the brightness fluctuation of the pinhole projection correlates to the arterial pulse amplitude. By capturing the size and brightness of the pinhole projection with the built-in camera, the smartphone can measure a user's blood pressure with only a low-cost, plastic clip and an app. Unlike prior approaches, this system does not require a blood pressure cuff measurement for a user-specific calibration compared to pulse transit time and pulse wave analysis based blood pressure monitoring solutions. Our solution also does not require specialized smartphone models with custom sensors. Our early feasibility finding demonstrates that in a validation study with N = 29 participants with systolic blood pressures ranging from 88 to 157 mmHg, the BPClip system can achieve a mean absolute error of 8.72 and 5.49 for systolic and diastolic blood pressure, respectively. In an estimated cost projection study, we demonstrate that in small-batch manufacturing of 1000 units, the material cost is an estimated $0.80, suggesting that at full-scale production, our proposed BPClip concept can be produced at very low cost compared to existing cuff-based monitors for at-home blood pressure management.
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Affiliation(s)
- Yinan Xuan
- Electrical and Computer Engineering Department, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
- The Design Lab, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
| | - Colin Barry
- Electrical and Computer Engineering Department, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- The Design Lab, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Jessica De Souza
- Electrical and Computer Engineering Department, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- The Design Lab, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Jessica H Wen
- Department of Medicine, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Nick Antipa
- Electrical and Computer Engineering Department, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Alison A Moore
- Department of Medicine, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- The Design Lab, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
| | - Edward J Wang
- Electrical and Computer Engineering Department, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
- The Design Lab, UC San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
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18
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Xuan Y, Barry C, De Souza J, Wen J, Antipa N, Moore A, Wang E. Ultra-low-cost Mechanical Smartphone Attachment for No-Calibration Blood Pressure Measurement. RESEARCH SQUARE 2023. [PMID: 36909577 PMCID: PMC10002832 DOI: 10.21203/rs.3.rs-2561946/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
We propose BPClip, a less than $ 1 USD blood pressure monitor that leverages a plastic clip with a spring-loaded mechanism to enable any smartphone with a flash LED and a camera to measure blood pressure. Unlike prior approaches, our system measured systolic, mean, and diastolic blood pressure using oscillometric measurements that avoid cumbersome per-user calibrations and does not require specialized smartphone models with custom sensors.
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19
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Qiu S, Zhang YT, Lau SK, Zhao N. Scenario Adaptive Cuffless Blood Pressure Estimation by Integrating Cardiovascular Coupling Effects. IEEE J Biomed Health Inform 2023; 27:1375-1385. [PMID: 37015611 DOI: 10.1109/jbhi.2022.3227235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Adding cuffless blood pressure (BP) measurement function to wearable devices is of great value in the fight against hypertension. The widely used arterial pulse transit time (PTT)-based method for BP monitoring relies primarily on vascular status-determined BP models and typically exhibits degraded performance over time and is sensitive to measurement procedures. Developing alternative methods with improved accuracy and adaptability to various application scenarios is highly desired for cuffless BP measurement. In this work, we proposed a pattern-fusion (PF) method that incorporates cardiovascular coupling effects in the vascular model by combining three calculation modules - cardiac parameter extraction module, cardiac parameter-to-BP mapping module, and BP regulation module. Specifically, the first module combines feedforward, feedback, and propagation modes to model different modulation functions of a cardiovascular system and is responsible for extracting BP-related features from electrocardiography (ECG) and photoplethysmography (PPG) signals; the cardiac parameter-to-BP mapping module is used to map cardiac parameters into mean blood pressure (MBP) by fusing different features; finally, the BP regulation module recovers accurate systolic BP (SBP) and diastolic BP (DBP) from given MBP. With the concerted use of these three modules, the pattern fusion method consistently demonstrates excellent BP prediction accuracy in a variety of measurement scenarios and durations, exhibiting SBP/DBP mean absolute error (MAE) of 3.65/4.56 mmHg for the short-term (<10 mins) continuous measurement dataset, SBP/DBP MAE of 6.84/3.81 mmHg for the medium-term (avg. > 20 hours) continuous measurement dataset, and SBP/DBP MAE of 6.24/3.65 mmHg for the long-term (>1 month) intermittent measurement dataset.
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20
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Gupta S, Singh A, Sharma A. Exploiting moving slope features of PPG derivatives for estimation of mean arterial pressure. Biomed Eng Lett 2023; 13:1-9. [PMID: 36711158 PMCID: PMC9873885 DOI: 10.1007/s13534-022-00247-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/24/2022] [Accepted: 09/17/2022] [Indexed: 02/01/2023] Open
Abstract
Monitoring Mean Arterial Pressure (MAP) helps calculate the arteries' flow, resistance, and pressure. It allows doctors to check how well the blood flows through our body and reaches all major organs. Photoplethysmogram technology is gaining momentum and popularity in smart wearable devices to monitor cuff-less blood pressure (BP). However, the performance reliability of the existing PPG-based BP estimation devices is still poor. Inaccuracy in estimating systolic and diastolic blood pressure leads to an overall imprecision in resultant MAP values. Hence, there is a need for robust and reliable MAP estimation algorithms. This work exploits the moving slope features of PPG contour in its first and second derivatives that directly correlate with MAP and does not require estimating systolic and diastolic blood pressure values. The proposed approach is evaluated using two different data sets (i.e., MIMIC-I and MIMIC-II) to demonstrate the robustness and reliability of the work for personalized non-invasive BP monitoring devices to estimate MAP directly. A mean absolute error of 1.28 mmHg and a standard deviation of 2.50 mmHg is obtained with MIMIC-II data-set using GridSearchCV random forest regressor that outperformed most of the existing related works.
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Affiliation(s)
| | - Anurag Singh
- IIIT Naya Raipur, Raipur, Chhattisgarh 493661 India
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21
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Arab A, Khorvash F, Karimi E, Hadi A, Askari G. Associations between adherence to Mediterranean dietary pattern and frequency, duration, and severity of migraine headache: A cross-sectional study. Nutr Neurosci 2023; 26:1-10. [PMID: 34870564 DOI: 10.1080/1028415x.2021.2009162] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The present study was conducted to explore the association between adherence to Mediterranean dietary pattern and migraine headache features including frequency, duration, and severity, as well as patients' migraine-related disabilities among the Iranian population diagnosed with migraine. METHODS In the present cross-sectional study on 262 migraine patients aged 20-50 years old, a validated 168-item, food frequency questionnaire was used to assess the dietary intakes of participants. The Mediterranean diet score was calculated for each subject using nine pre-defined dietary components and ranged from 0-9. The headache severity, duration, frequency, migraine headache index score (MHIS), and headache impact test-6 (HIT-6) were measured using related questionnaires. RESULTS After controlling for potential confounders, Mediterranean diet tended to be associated with lower headache frequency (β = -1.74, 95% CI: -3.53,0.03) and duration (β = -0.28, 95% CI: -0.59, -0.02) and was significantly associated with lower MHIS (β = -29.32, 95% CI: -51.22, -7.42), and HIT-6 score (β = -2.86, 95% CI: -5.40, -0.32) for those in the highest category of Mediterranean diet scores compared to the lowest category. A subgroup analysis of women also revealed a negative association between Mediterranean diet and headaches frequency (β = -2.30, 95% CI: -4.27, -0.32), duration (β = -0.42, 95% CI: -0.78, -0.07), scores of MHIS (β = -47.44, 95% CI: -71.90, -22.99), and HIT-6 (β = -3.45, 95% CI: -6.29, -0.61), after controlling for potential confounders. CONCLUSIONS The present study suggests that adherence to the Mediterranean dietary pattern is associated with lower headache frequency, duration, MHIS, and HIT-6 score.
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Affiliation(s)
- Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Khorvash
- Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Karimi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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22
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Martocchia A, Piccoli C, Notarangelo MF, Bentivegna E, Sergi D, Luciani M, Barlattani M, Sesti G, Martelletti P. A bedside ultrasound protocol to the measurement of the systemic vascular resistances: Preliminary results in the patients with sepsis. Clin Hemorheol Microcirc 2023; 83:163-169. [PMID: 36404539 DOI: 10.3233/ch-221613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The use of the ultrasound (US) bedside examination is increasing for the detailed evaluation of the hemodynamic parameters, allowing the physicians to set the appropriate therapeutic strategies with greater precision. OBJECTIVE The aim of this study is to evaluate the hemodynamic parameters (the cardiac output or CO, the central venous pressure or CVP and the systemic vascular resistance or SVR) in the patients with sepsis, by using a bedside US approach. METHODS We consecutively enrolled n.82 patients of S.Andrea Hospital (n.47 with sepsis and n.35 without sepsis), examining the hemodynamic parameters by a bedside US evaluation. RESULTS The incidence of sepsis was more than 50% of cases. The patients with sepsis presented higher comorbidity and polypharmacy (p < 0.01, p < 0.001), with increased creatinine (p < 0.001) and consequent esteemed glomerular filtration rate (p < 0.01), C-reactive protein (p < 0.01), SOFA (Sepsis-related Organ Failure Assessment) score (p < 1.58×10-7) and reduced SVR (p < 0.05). The SOFA score was inversely related to the SVR (p < 0.05). CONCLUSIONS To our best knowledge, this is the first study with a bedside US protocol to measure SVR, beyond the abdominal and cardiac qualitative evaluation.
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Affiliation(s)
- Antonio Martocchia
- Emergecy Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | - Cinzia Piccoli
- Emergecy Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | | | - Enrico Bentivegna
- Emergecy Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | - Daniela Sergi
- Radiology Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | - Michelangelo Luciani
- Emergecy Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | - Michela Barlattani
- Internal Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | - Giorgio Sesti
- Internal Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
| | - Paolo Martelletti
- Emergecy Medicine Unit, Sapienza University of Rome, S.Andrea Hospital, Rome, Italy
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23
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Fernández-Aparicio Á, Perona JS, Schmidt-RioValle J, Montero-Alonso MA, Navarro-Pérez CF, González-Jiménez E. cMetS Based on Z-Scores as an Accurate and Efficient Scoring System to Determine Metabolic Syndrome in Spanish Adolescents. J Pers Med 2022; 13:jpm13010010. [PMID: 36675671 PMCID: PMC9865991 DOI: 10.3390/jpm13010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/30/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
The definition of metabolic syndrome (MetS) based on dichotomous cut-off points is efficient in the adult population. However, to date, there is no international consensus on how to define MetS in the pediatric population. For that reason, a continuous MetS score (cMetS) has been proposed for the pediatric population. However, despite multiple attempts, cMetS has not been fully validated as there is no agreement about the most accurate score to calculate it. The purpose of the present study was to compare the validity of different scores (three siMS scores, z-score, principal components analysis (PCA), the sum of PCA, and confirmatory factor analysis) to calculate cMetS and determine MetS in Spanish adolescents. There were 981 subjects, ranging 11-16 years old, recruited for this cross-sectional study. Seven different approaches to pediatric cMetS scores were calculated. All cMetS scores calculated strongly correlated with each other, especially siMS scores. The area under the curve obtained from receiving operating characteristic curves was particularly elevated for z-scores 0.81 (95% CI: 0.784-0.838), showing a specificity of 64.4%. Our study shows that cMetS based on z-scores is accurate and efficient to be used for research instead of the dichotomized definition of MetS in adolescents; and cMetS based on siMS scores is useful for clinical practice.
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Affiliation(s)
- Ángel Fernández-Aparicio
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, 52005 Melilla, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
| | - Javier S. Perona
- Department of Food and Health, Instituto de la Grasa-CSIC, Campus of the University Pablo de Olavide, 41013 Seville, Spain
| | - Jacqueline Schmidt-RioValle
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Correspondence: ; Tel.: +34-958-243-495
| | - Miguel A. Montero-Alonso
- Department of Statistics and O.I., Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - Carmen Flores Navarro-Pérez
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | - Emilio González-Jiménez
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
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Oguntuase SO, Fasakin OW, Oyeleye SI, Oboh G. Effects of dietary inclusion of Bambara groundnut and sweet orange peels on streptozotocin/HFD type-2 induced diabetes mellitus complications and related biochemical parameters. J Food Biochem 2022; 46:e14373. [PMID: 35933697 DOI: 10.1111/jfbc.14373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/07/2022] [Accepted: 07/22/2022] [Indexed: 12/29/2022]
Abstract
The effects of dietary inclusion of Bambara groundnut and sweet orange peels composite bread on low-dose streptozotocin and high-fat diet (HFD)-induced type-2 diabetes mellitus (T2D) complications was evaluated in the present study. Male experimental rats-induced T2D were administered with acarbose (standard) and fed with Bambara groundnut and sweet orange peels composite bread for a period of 14 days while monitoring their blood glucose levels. More so, the activities of angiotensin-I-converting enzyme (ACE), serum aspartate aminotransferase, alkaline phosphatase, and alanine aminotransferase activities, as well as nitric oxide (NO), reactive oxygen species (ROS), albumin, total bilirubin, creatinine, urea, and uric acid serum concentrations were assayed for. Diabetic untreated rats showed disorders in ACE, AST, ALT, and ALP activities, and NO, ROS, glucose, albumin, bilirubin, creatinine, urea, uric acid levels, as well as lipid profiles. Interestingly, these disorders were significantly ameliorated in composite bread diet-fed rats in comparison to the diabetic untreated rats. Meanwhile, the presence of polyphenols in the Bambara groundnut and sweet orange peels composite bread diet could have aided the amelioration of these metabolic disorders after the 14th day of administration. Finally, it was proposed that the ability of Bambara groundnut-wheat and sweet orange peel composite bread to treat T2D and its complications makes it a more successful therapy than medications that just target one of the diseased states. PRACTICAL APPLICATIONS: Diabetes mellitus is a global and chronic disease that presently affects 536.6 million people alongside 1.5 million deaths directly attributed to it yearly. Several drug and medicinal agents have been employed for the management of diabetes but those drugs are mostly limited to the management of diabetes while the associated complications are most untreated, while drugs that can manage diabetes and its related complications mostly come at high prices. Therefore, there is an urgent need to evaluate legumes, such as Bambara groundnut, with proven therapeutic potential in the management of diabetes and its complications. However, the Bambara groundnut takes a long period to prepare for a meal, therefore including it in a ready-to-eat product will not only improve its acceptability but also add to economic improvement. Furthermore, adding a waste product, sweet orange peels, will both add flavor and source of additional antioxidant attributes.
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Affiliation(s)
| | | | | | - Ganiyu Oboh
- Department of Biochemistry, Federal University of Technology, Akure, Nigeria
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25
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Gu JK, Charles LE, Allison P, Violanti JM, Andrew ME. Association Between the Metabolic Syndrome and Retinal Microvascular Diameters Among Police Officers. J Occup Environ Med 2022; 64:748-753. [PMID: 35732034 PMCID: PMC10278538 DOI: 10.1097/jom.0000000000002569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We examined the associations of the metabolic syndrome severity score (MSSS) and the metabolic syndrome (MetSyn) components with central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). METHODS Participants in this cross-sectional study were 253 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study (2011-2014). The MSSS is a z -score that represents the severity of MetSyn and was estimated using a sex/race-specific equation and the five MetSyn components. Associations of MSSS and the MetSyn with CRAE/CRVE were obtained using linear regression models or analysis of covariance. RESULTS For every 1-standard deviation of MSSS, CRAE decreased by 2.3 μm (SE = 1.2, P = 0.0262) and CRVE increased by 3.4 μm (SE = 1.6, P = 0.0308) after adjusting for confounders. CONCLUSIONS Officers with higher MSSS had narrower (ie, worse) arteriolar diameters and wider (ie, worse) venular diameters.
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Affiliation(s)
- Ja K Gu
- From the Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia (Gu, Dr Charles, Dr Allison, Dr Andrew); Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, New York (Dr Violanti)
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26
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Geddes JR, Ottesen JT, Mehlsen J, Olufsen MS. Postural orthostatic tachycardia syndrome explained using a baroreflex response model. J R Soc Interface 2022; 19:20220220. [PMID: 36000360 PMCID: PMC9399868 DOI: 10.1098/rsif.2022.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Patients with postural orthostatic tachycardia syndrome (POTS) experience an excessive increase in heart rate (HR) and low-frequency (∼0.1 Hz) blood pressure (BP) and HR oscillations upon head-up tilt (HUT). These responses are attributed to increased baroreflex (BR) responses modulating sympathetic and parasympathetic signalling. This study uses a closed-loop cardiovascular compartment model controlled by the BR to predict BP and HR dynamics in response to HUT. The cardiovascular model predicts these quantities in the left ventricle, upper and lower body arteries and veins. HUT is simulated by letting gravity shift blood volume (BV) from the upper to the lower body compartments, and the BR control is modelled using set-point functions modulating peripheral vascular resistance, compliance, and cardiac contractility in response to changes in mean carotid BP. We demonstrate that modulation of parameters characterizing BR sensitivity allows us to predict the persistent increase in HR and the low-frequency BP and HR oscillations observed in POTS patients. Moreover, by increasing BR sensitivity, inhibiting BR control of the lower body vasculature, and decreasing central BV, we demonstrate that it is possible to simulate patients with neuropathic and hyperadrenergic POTS.
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Affiliation(s)
- Justen R. Geddes
- Department of Mathematics, North Carolina State University, Raleigh, NC 27695, USA
| | - Johnny T. Ottesen
- Department of Science and Environment and Centre for Mathematical Modeling – Human Health and Disease, Roskilde University, Roskilde, Denmark
| | - Jesper Mehlsen
- Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen, Denmark
| | - Mette S. Olufsen
- Department of Mathematics, North Carolina State University, Raleigh, NC 27695, USA
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Brierley ML, Smith LR, Chater AM, Bailey DP. A-REST (Activity to Reduce Excessive Sitting Time): A Feasibility Trial to Reduce Prolonged Sitting in Police Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159186. [PMID: 35954543 PMCID: PMC9368451 DOI: 10.3390/ijerph19159186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/12/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the acceptability and feasibility of a theory-derived sedentary workplace intervention for police office staff. Twenty-four staff participated in an 8-week intervention (single arm, pre-post design) incorporating an education session, team competition with quick response (QR) codes, team trophy, weekly leaderboard newsletters, a self-monitoring phone app, and electronic prompt tools. The intervention supported participants to reduce and break up their sitting time with three minutes of incidental movement every 30 min at work. Feasibility and acceptability were assessed using mixed methods via the RE-AIM QuEST and PRECIS-2 frameworks. The intervention was highly pragmatic in terms of eligibility, organisation, adherence, outcome, and analysis. It was slightly less pragmatic on recruitment and setting. Delivery and follow-up were more explanatory. Reach and adoption indicators demonstrated feasibility among police staff, across a range of departments, who were demographically similar to participants in previous office-based multi-component interventions. The intervention was delivered mostly as planned with minor deviations from protocol (implementation fidelity). Participants perceived the intervention components as highly acceptable. Results showed improvements in workplace sitting and standing, as well as small improvements in weight and positive affect. Evaluation of the intervention in a fully powered randomised controlled trial to assess behaviour and health outcomes is recommended.
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Affiliation(s)
- Marsha L. Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
| | - Lindsey R. Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
- Correspondence: ; Tel.: +44-(0)1895-266127
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Chen CH, Hsu CH, Chu LP, Chiu CH, Yang WC, Yu KW, Ye X. Acute Effects of Static Stretching Combined with Vibration and Nonvibration Foam Rolling on the Cardiovascular Responses and Functional Fitness of Older Women with Prehypertension. BIOLOGY 2022; 11:biology11071025. [PMID: 36101406 PMCID: PMC9312478 DOI: 10.3390/biology11071025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/26/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022]
Abstract
Simple Summary Thirty-seven percent of the US adult population have prehypertension, and a quarter to half of these over 65 years of age progress to hypertension in four years. Along with healthy diet, exercise or physical activity is one of the critical lifestyle factors for this population. General exercise recommendation or prescription to individuals who have cardiovascular risks is provided by organizations such as ACSM and AHA, but more detailed information and research are still needed. As the first component of any exercise program, finding the proper warm-up routine is important. We aimed to examine the acute immediate effects of three different warm-up protocols on cardiovascular responses and functional fitness testing in older women with prehypertension. Thirteen qualified subjects went through three protocols (static stretching with and without foam rolling, and stretching with vibration rolling) in three different sessions. Blood pressure was not altered only in the static stretching with foam rolling condition. Interestingly, adding the vibration component to the stretching increased the upper body flexibility and stretching. We therefore suggest the combination of static stretching with foam rolling as the safe and effective protocol for older women with prehypertension. Abstract We compared the effects of three warm-up protocols (static stretching (SS), static stretching with vibration foam rolling (SS + VFR), and static stretching with nonvibration foam rolling (SS + FR) on the blood pressure and functional fitness performance in older women with prehypertension. Thirteen older women went through different protocols in separate visits, and their systolic (SBP) and diastolic (DBP) blood pressure, heart rate, mean arterial pressure, brachial pulse pressure (BPP), functional fitness test (back scratch (BS), chair-sit-and-reach, 30 s arm curl (AC), 30 s chair stand, 2 min step, 8-foot up and go), and single-leg standing balance (SLB) were recorded. The SBP and BPP were significantly higher after SS and SS + VFR than after SS + FR. Both SS + FR and SS + VFR significantly improved the 2 min step, when compared with SS. Additionally, SS + VFR significantly improved the BS and AC performance. However, compared with SS and SS + FR, SS + VFR significantly reduced the SLB performance. Therefore, SS + FR may be a better warm-up protocol for older women in maintaining blood pressure. On the other hand, even though SS + VFR induced superior shoulder flexibility, aerobic endurance, and arm strength, it could impair balance.
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Affiliation(s)
- Che-Hsiu Chen
- Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Chin-Hsien Hsu
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung 41170, Taiwan; (C.-H.H.); (K.-W.Y.)
| | - Lee-Ping Chu
- Department of Orthopedics, China Medical University Hospital, Taichung 404332, Taiwan;
| | - Chih-Hui Chiu
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Wen-Chieh Yang
- Department of Physical Therapy, Hung Kuang University, Taichung 433304, Taiwan;
| | - Kai-Wei Yu
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung 41170, Taiwan; (C.-H.H.); (K.-W.Y.)
| | - Xin Ye
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
- Correspondence: ; Tel.: +1-860-768-5787
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Wang SY, Chiu CH, Hsu CH, Chou CC, Hsu SM, Shapu LB, Chao TC, Chen CH. Acute Effects of Wearing Different Surgical Face Masks during High-Intensity, Short-Rest Resistance Exercise on Cardiorespiratory and Pulmonary Function and Perceptual Responses in Weightlifters. BIOLOGY 2022; 11:biology11070992. [PMID: 36101371 PMCID: PMC9311899 DOI: 10.3390/biology11070992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022]
Abstract
This study investigated the effect of wearing a typical surgical mask (SM) or a three-dimensional (3D) SM (3DSM) during whole-body, high-intensity, short-rest resistance exercise on cardiorespiratory, respiratory, and perceptual comfort responses in weightlifters. Twenty elite weightlifters (6 women and 14 men; age = 24.1 ± 4.9 years; height: 167.45 ± 7.60 cm; body mass = 76.48 ± 19.86 kg) who participated in this study performed 3 resistance exercise sessions in a randomized order: (1) without a mask (NM), (2) while wearing a typical SM, and (3) while wearing a 3DSM. Resistance exercise consisted of a descending pyramid scheme starting at 10 repetitions, with a decrease of one repetition per set for the back squat, bench press, and deadlift, as fast as possible at 75% of the one-repetition maximum. Cardiorespiratory and pulmonary function and comfort were measured. Across all conditions, effective postexercise hypotension (PEH) was noted in terms of decreased systolic blood pressure (−4.64%), diastolic BP (−5.36%), mean arterial pressure (−5.02%), and ankle–brachial index (−6.84%). However, the heart rate (40.34%) and rate of pressure product (33.60%) increased, and no effects on pulmonary function were observed in the three conditions. The participants reported higher breathing resistance and tightness when wearing a typical SM than when wearing a 3DSM or no mask. Therefore, both wearing and not wearing a face mask during whole-body, high-intensity, short-rest resistance exercise promoted PEH and exerted no detrimental effect on pulmonary function. Coaches, trainers, and athletes should consider wearing a 3DSM during resistance exercise.
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Affiliation(s)
- Shin-Yuan Wang
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung 404401, Taiwan; (S.-Y.W.); (C.-H.C.)
| | - Chih-Hui Chiu
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung 404401, Taiwan; (S.-Y.W.); (C.-H.C.)
| | - Chin-Hsien Hsu
- Department of Leisure Industry Management, National Chi-Yi University of Technology, Taichung 411030, Taiwan
- Correspondence: (C.-H.H.); (C.-H.C.); Tel.: +886-4-2392-4505 (ext. #8306) (C.-H.H.); +886-4-2221-3108 (C.-H.C.)
| | - Chun-Chung Chou
- Physical Education Office, National Taipei University of Technology, Taipei 10608, Taiwan;
| | | | - Lu-Bi Shapu
- School of Physical & Health, Nanning Normal University, Nanning 530011, China;
| | - Tai-Chen Chao
- Sport Science Research Center, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Che-Hsiu Chen
- Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan
- Correspondence: (C.-H.H.); (C.-H.C.); Tel.: +886-4-2392-4505 (ext. #8306) (C.-H.H.); +886-4-2221-3108 (C.-H.C.)
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30
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Zhou S, Yao Y, Liu W, Yang J, Wang J, Hao L, Wang L, Xu L, Avolio A. Ultrasound-based method for individualized estimation of central aortic blood pressure from flow velocity and diameter. Comput Biol Med 2022; 143:105254. [PMID: 35093843 DOI: 10.1016/j.compbiomed.2022.105254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/10/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
Abstract
Central aortic blood pressure (CABP) is a better predictor for cardiovascular events than brachial blood pressure. However, direct CABP measurement is invasive. The objective of this paper is to develop an ultrasound-based method using individualized Windkessel (WK) models for non-invasive estimation of CABP. Three WK models (with two-, three- and four-element WK, named, WK2, WK3 and WK4, respectively) were created and the model parameters were individualized based on aortic flow velocity and diameter waveforms measured by ultrasound (US). Experimental data were acquired in 42 subjects aged 21-67 years. The CABP estimated by WK models was compared with the reference CABP obtained using a commercial system. The results showed that the overall performance of the WK3 and WK4 models was similar, outperforming the WK2 model. The estimated CABP based on WK3/WK4 model showed good agreement with the reference CABP: the absolute errors of systolic blood pressure (SBP), 2.4 ± 2.1/2.4 ± 2.0 mmHg; diastolic blood pressure (DBP), 1.4 ± 1.1/1.7 ± 1.5 mmHg; mean blood pressure (MBP), 1.3 ± 0.8/1.3 ± 0.8 mmHg; pulse pressure (PP), 3.0 ± 2.3/3.2 ± 2.6 mmHg; the root mean square error (RMSE) of the waveforms, 2.5 ± 1.0/2.6 ± 1.1 mmHg. Therefore, the proposed method can provide a non-invasive CABP estimation during routine cardiac US examination.
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Affiliation(s)
- Shuran Zhou
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Yang Yao
- School of Information Science and Technology, Shanghai Tech University, Shanghai, 201210, China
| | - Wenyan Liu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Jun Yang
- The First Hospital of China Medical University, Shenyang, 110122, China
| | - Junli Wang
- The First Hospital of China Medical University, Shenyang, 110122, China
| | - Liling Hao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China
| | - Lu Wang
- School of Computer Science and Engineering, Northeastern University, Shenyang, 110169, China
| | - Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, China; Engineering Research Center of Medical Imaging and Intelligent Analysis, Ministry of Education, Shenyang, 110169, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang, 110169, China.
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, 2109, New South Wales, Australia
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Associations of maternal gestational hypertension with high blood pressure and overweight/obesity in their adolescent offspring: a retrospective cohort study. Sci Rep 2022; 12:3800. [PMID: 35260718 PMCID: PMC8904808 DOI: 10.1038/s41598-022-07903-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/25/2022] [Indexed: 12/19/2022] Open
Abstract
Maternal hypertensive disorders during pregnancy may have an impact on fetal development and the health of the offspring in later life. The aim of the study was to evaluate the associations of maternal gestational hypertension (GH) with high blood pressure (HBP) (prehypertension/hypertension) and overweight/obesity in their adolescent offspring at the age of 12 to 15 years. We analyzed data of 4819 participants born in Kaunas city during 1995-1998 who were included in the study "Prevalence and Risk Factors of HBP in 12-15-Year-Old Lithuanian Children and Adolescents". The diagnosis of maternal gestational hypertension was obtained from medical records. Associations of maternal GH with their offspring's HBP and overweight/obesity in adolescence were assessed by multivariate logistic regression analysis. Among 4819 adolescents of 12-15 years of age, 25.7% had HBP, 12% had overweight, and 2.5% had obesity. Of 4819 mothers, 92.3% were normotensive during pregnancy, and 7.7% had GH. In the multivariate analysis after adjustment for age, sex, birth weight, adolescent BMI, and maternal pre/early pregnancy BMI, adolescent offspring born to mothers with GH had higher odds of prehypertension, hypertension, and prehypertension/hypertension (aOR 1.58; 95% CI 1.13-2.22; aOR 1.87; 95% CI 1.41-2.47; and aOR 1.76, 95% CI 1.39-2.24; respectively), compared to the offspring of normotensive mothers. After adjustment for age, sex, birth weight, and maternal pre/early pregnancy BMI, a significant association was found between maternal GH and the offspring's overweight/obesity in adolescence (aOR 1.41; 95% CI 1.04-1.91). The findings of this study suggest that maternal GH is associated with an increased odds of HBP (prehypertension and hypertension, both separately and combined) and overweight/obesity in their offspring during adolescence.
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Nogawa K, Watanabe Y, Sakuma S, Sakurai M, Nishijo M, Ishizaki M, Morikawa Y, Kido T, Nakagawa H, Suwazono Y. Renal tubular dysfunction and cancer mortality in the Japanese general population living in cadmium non-contaminated areas. J Appl Toxicol 2022; 42:1458-1466. [PMID: 35181909 DOI: 10.1002/jat.4304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/01/2022] [Accepted: 02/12/2022] [Indexed: 11/08/2022]
Abstract
The relationship between cadmium exposure, exposure-related renal tubular dysfunction, and mortality have been reported, mainly in the residents of Cd contaminated areas in Japan. The aim of this study was to establish the cause-effect relationship between renal tubular dysfunction and cancer mortality in the general population in non-contaminated areas. A 19-year cohort study was conducted in 1110 men and 1703 women in 1993 or 1994, who lived in three cadmium non-contaminated areas. Mortality risk ratios of urinary β2-microglobulin (β2MG) and N-acetyl-β-glucosaminidase (NAG) for all malignant neoplasms and specific cancers were estimated using the Fine and Gray competing risks regression model. Significant HRs for liver and pancreas cancer were observed for NAG (liver: HR corresponding to an increase of 1IU/g cr, 1.10, 95%CI, 1.02-1.19, pancreas: HR, 1.10, 95%CI, 1.02-1.19) in men. In women, a negative HR was observed for NAG (lung cancer: HR 0.80, 95% CI, 0.67-0.96) and for β2MG (all malignant neoplasms: HR, 0.97, 95% CI, 0.93-1.00). The present study indicated that renal tubular dysfunction was significantly related to mortality in the general population of cadmium non-contaminated areas in Japan.
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Affiliation(s)
- Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sayaka Sakuma
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masaru Sakurai
- Department of Hygiene, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Masao Ishizaki
- Department of Hygiene, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Yuko Morikawa
- Department of Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Teruhiko Kido
- Department of Community Health Nursing, Kanazawa University School of Health Sciences, Kanazawa, Ishikawa, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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Kotidis C, Wertheim D, Weindling M, Rabe H, Turner MA. Assessing patent ductus arteriosus in preterm infants from standard neonatal intensive care monitoring. Eur J Pediatr 2022; 181:1117-1124. [PMID: 34748081 PMCID: PMC8897357 DOI: 10.1007/s00431-021-04311-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/19/2021] [Accepted: 10/28/2021] [Indexed: 11/28/2022]
Abstract
Monitoring patent ductus arteriosus (PDA) in premature infants is currently performed intermittently using echocardiography which requires considerable expertise. The aim of this pilot study was to investigate whether PDA status could be assessed from standard neonatal intensive care monitoring. Electrocardiography (ECG) and blood pressure (BP) waveforms were acquired from extremely preterm infants using standard neonatal monitors. We developed software using MATLAB to analyse ECG and BP waveforms and their interrelationships in terms of pulse transit time (PTT) and pulse wave velocity (PWV). The times from peak systolic BP to diastolic trough (BPFt) and from the diastolic trough to peak systolic BP (BPRt) were also calculated. PTT, BPFt and BPRt were normalised for heart rate (HR) termed NPTT, NBPFt and NBPRt, respectively. ECG, invasive aortic BP monitoring and echocardiography were performed in 14 preterm infants < 29 weeks' gestation in the first 3 days after birth. The median (range) birth weight of the infants was 0.90 (0.48-1.31) kg, gestation 26.6 (24.0-28.7) weeks, PDA diameter 1.6 (0.8-3.6) mm and mean BP 32 (16-40) mmHg. We found a significant positive correlation between PDA diameter and NPTT (r = 0.69, P = 0.007) as well as NBPFt (r = 0.65, P = 0.012) and NBPRt (r = 0.71, P = 0.005). No relationship was found between PDA diameter and pulse pressure.Conclusions: Interrelationships between ECG and BP traces as well as BP waveform time analysis are straightforward to measure and associated with PDA diameter. The results of this pilot study suggest that this approach may help provide biomarkers for continuous monitoring PDA diameter and function. What is Known: • Patent ductus arteriosus (PDA) in premature infants is associated with increased risk of developing chronic lung disease, necrotising enterocolitis and cerebral injury. • Currently PDA is assessed intermittently using echocardiography which requires considerable expertise and sometimes is not well tolerated by critically ill preterm infants. What is New: • Blood pressure (BP) and ECG waveform interrelation and BP trace time analysis, taking account of heart rate, relate to PDA diameter. • ECG and BP waveform phase difference as well as BP waveform time analysis may be useful in the continuous assessment of PDA function.
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Affiliation(s)
- Charalampos Kotidis
- Department of Women's and Children's Health, University of Liverpool, Liverpool Health Partners, Liverpool, UK. .,University of Liverpool, Liverpool Womens Hospital, Crown Street, L8 7SS, Liverpool, UK.
| | - David Wertheim
- grid.15538.3a0000 0001 0536 3773Faculty of Science, Engineering and Computing, Kingston University, Surrey, UK
| | - Michael Weindling
- grid.10025.360000 0004 1936 8470Department of Women’s and Children’s Health, University of Liverpool, Liverpool Health Partners, Liverpool, UK
| | - Heike Rabe
- grid.12082.390000 0004 1936 7590Academic Department of Paediatrics, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Mark A. Turner
- grid.10025.360000 0004 1936 8470Department of Women’s and Children’s Health, University of Liverpool, Liverpool Health Partners, Liverpool, UK
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Chemla D, Millasseau S, Hamzaoui O, Teboul JL, Monnet X, Michard F, Jozwiak M. New Method to Estimate Central Systolic Blood Pressure From Peripheral Pressure: A Proof of Concept and Validation Study. Front Cardiovasc Med 2021; 8:772613. [PMID: 34977186 PMCID: PMC8714848 DOI: 10.3389/fcvm.2021.772613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The non-invasive estimation of central systolic blood pressure (cSBP) is increasingly performed using new devices based on various pulse acquisition techniques and mathematical analyses. These devices are most often calibrated assuming that mean (MBP) and diastolic (DBP) BP are essentially unchanged when pressure wave travels from aorta to peripheral artery, an assumption which is evidence-based. We tested a new empirical formula for the direct central blood pressure estimation of cSBP using MBP and DBP only (DCBP = MBP2/DBP). Methods and Results: First, we performed a post-hoc analysis of our prospective invasive high-fidelity aortic pressure database (n = 139, age 49 ± 12 years, 78% men). The cSBP was 146.0 ± 31.1 mmHg. The error between aortic DCBP and cSBP was −0.9 ± 7.4 mmHg, and there was no bias across the cSBP range (82.5–204.0 mmHg). Second, we analyzed 64 patients from two studies of the literature in whom invasive high-fidelity pressures were simultaneously obtained in the aorta and brachial artery. The weighed mean error between brachial DCBP and cSBP was 1.1 mmHg. Finally, 30 intensive care unit patients equipped with fluid-filled catheter in the radial artery were prospectively studied. The cSBP (115.7 ± 18.2 mmHg) was estimated by carotid tonometry. The error between radial DCBP and cSBP was −0.4 ± 5.8 mmHg, and there was no bias across the range. Conclusion: Our study shows that cSBP could be reliably estimated from MBP and DBP only, provided BP measurement errors are minimized. DCBP may have implications for assessing cardiovascular risk associated with cSBP on large BP databases, a point that deserves further studies.
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Affiliation(s)
- Denis Chemla
- Service d'explorations fonctionnelles multidisciplinaires bi-site Antoine Béclère - Kremlin Bicêtre, GHU Paris Sud, AP-HP, Le Kremlin-Bicêtre, France
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
- *Correspondence: Denis Chemla
| | | | - Olfa Hamzaoui
- Service de Réanimation Polyvalente, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Jean-Louis Teboul
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Service de Médecine Intensive-Réanimation, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Xavier Monnet
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
- Service de Médecine Intensive-Réanimation, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Mathieu Jozwiak
- Equipe 2 CARRES, UR2CA - Unité de Recherche Clinique Côte d'Azur, Université Côte d'Azur UCA, Nice and Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire l'Archet, Nice, France
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Tzelefa V, Tsirimiagkou C, Argyris A, Moschonis G, Perogiannakis G, Yannakoulia M, Sfikakis P, Protogerou AD, Karatzi K. Associations of dietary patterns with blood pressure and markers of subclinical arterial damage in adults with risk factors for CVD. Public Health Nutr 2021; 24:6075-6084. [PMID: 34392855 PMCID: PMC11148598 DOI: 10.1017/s1368980021003499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Unhealthy diet is a modifiable risk factor leading to subclinical arterial damage (SAD), high BP and CVD. It was aimed to investigate the possible associations of dietary patterns (DPs) with SAD in adults having multiple CVD risk factors. DESIGN Dietary intake was evaluated through two 24-h dietary recalls and principal component analysis was used to identify DPs. Oscillometry, applanation tonometry with pulse wave analysis and carotid ultrasound were used to assess peripheral and aortic BP, arterial stiffness and pressure wave reflections. SETTING Laiko University Hospital, Athens, Greece. PARTICIPANTS A total of 470 individuals (53·1 ± 14·2 years) with CVD risk factors were enrolled. RESULTS A pattern characterised by increased consumption of whole-grain cereals, white meat and reduced consumption of sugar was positively associated with common carotid compliance (β = 0·01, 95 % CI 0·00, 0·01), whereas a pattern high in refined cereals, red and processed meat was positively associated with brachial but not aortic systolic pressure (β = 1·76, 95 % CI 0·11, 3·42) and mean arterial pressure (MAP) (β = 1·18, 95 % CI 0·02, -2·38). Low consumption of low-fat dairy products, high consumption of full-fat cheese and butter was positively associated with MAP (β = 0·97, 95 % CI 0·01, 1·95). Increased consumption of vegetables, fruits, fresh juices, fish and seafood was inversely associated with augmentation index (AIx) (β = -1·01, 95 % CI -1·93, -0·09). CONCLUSION Consumption of whole grains, white meat, fruits/vegetables, fish/seafood and avoidance of sugar was associated with improved SAD. Preference in refined grains, red/processed meat, high-fat cheese/butter and low intake of low-fat dairy products were associated with BP elevation. Future studies are needed to confirm the present findings.
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Affiliation(s)
- Vicky Tzelefa
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
| | - Christiana Tsirimiagkou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece
| | - Antonios Argyris
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
| | - George Perogiannakis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
| | - Maria Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Greece
| | - Petros Sfikakis
- Cardiovascular Research Laboratory, 1st Department of Propaedeutic and Internal Medicine, Athens University Medical School, Laiko Hospital, Athens, Greece
| | - Athanase D Protogerou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Greece
- Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece
| | - Kalliopi Karatzi
- Hellenic Foundation for Cardiovascular Health and Nutrition, Athens, Greece
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece Iera Odos 75, 118 55Athens, Greece
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Kaypakli O, Özgeyik M. The effect of heart rate and pulse pressure on mean arterial pressure: the combined formula for calculation of mean arterial pressure. Blood Press Monit 2021; 26:373-379. [PMID: 34054029 DOI: 10.1097/mbp.0000000000000548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We demonstrate a new formula to predict mean arterial pressure (MAP) using corrections of the key factors associated with the inaccuracy of the standard formula: heart rate (HR) and pulse pressure (PP). METHODS A total of 99 patients (50 men, 49 women; mean age 52.5 ± 10.3 years), who underwent elective coronary angiography, were enrolled in our study. The arterial pressure was measured in the aortic root. MAP was measured digitally by the area-under-the-pressure-time curve method. We evaluated the accuracy of four different formulas: the standard formula, the formula of Razminia et al., the formula of Meaney et al. and the combined formula. RESULTS PP coefficient deviation of the standard formula was negatively correlated with PP (R = -0,561, P < 0.001), and positively correlated with HR (R = 0,298, P = 0.003). Both R and R2 values of the combined formula were higher than previous formulas. Accuracy parameters of the combined formula [root mean square error (RMSE): 1.801 mmHg, mean square residuals (MSR): 3.244 mmHg2, Akaike information criterion (AIC): 401.4] were superior to the standard formula (RMSE: 1.902 mmHg, MSR: 3.620 mmHg2, AIC: 412.3), the formula of Razminia et al. (RMSE: 2.022 mmHg, MSR: 4.089 mmHg2, AIC: 424.3) and the formula of Meaney et al. (RMSE: 2.137 mmHg, MSR: 4.568 mmHg2, AIC: 435.3). In the multivariate linear regression analysis, the combined formula was the only method that independently predicts the measured MAP (beta = 0,990, P < 0.001). CONCLUSION The combined formula is superior to previous formulas for accurately predicting MAP.
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Affiliation(s)
- Onur Kaypakli
- Department of Cardiology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay
| | - Mehmet Özgeyik
- Department of Cardiology, Eskisehir City Hospital, Eskisehir, Turkey
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Morotti A, Busto G, Bernardoni A, Marini S, Casetta I, Fainardi E. Association Between Perihematomal Perfusion and Intracerebral Hemorrhage Outcome. Neurocrit Care 2021; 33:525-532. [PMID: 32043266 DOI: 10.1007/s12028-020-00929-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The prognostic impact of perihematomal hypoperfusion in patients with acute intracerebral hemorrhage (ICH) remains unclear. We tested the hypothesis that perihematomal hypoperfusion predicts poor ICH outcome and explored whether hematoma growth (HG) is the pathophysiological mechanism behind this association. METHODS A prospectively collected single-center cohort of consecutive ICH patients undergoing computed tomography perfusion on admission was analyzed. Cerebral blood flow (pCBF) was measured in the manually outlined perihematomal low-density area. pCBF was categorized into normal (40-55 mL/100 g/min), low (< 40 mL/100 g/min), and high (> 55 mL/100 g/min). HG was calculated as total volume increase from baseline to follow-up CT. A modified Rankin scale > 2 at three months was the outcome of interest. The association between cerebral perfusion and outcome was investigated with logistic regression, and potential mediators of this relationship were explored with mediation analysis. RESULTS A total of 155 subjects were included, of whom 55 (35.5%) had poor outcome. The rates of normal pCBF, low pCBF, and high pCBF were 17.4%, 68.4%, and 14.2%, respectively. After adjustment for confounders and keeping subjects with normal pCBF as reference, the risk of poor outcome was increased in patients with pCBF < 40 mL/100 g/min (odds ratio 6.11, 95% confidence interval 1.09-34.35, p = 0.040). HG was inversely correlated with pCBF (R = -0.292, p < 0.001) and mediated part of the association between pCBF and outcome (proportion mediated: 82%, p = 0.014). CONCLUSION Reduced pCBF is associated with poor ICH outcome in patients with mild-moderate severity. HG appears a plausible biological mediator but does not fully account for this association, and other mechanisms might be involved.
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Affiliation(s)
- Andrea Morotti
- Department of Neurology and Neurorehabilitation, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy.
| | - Giorgio Busto
- Diagnostic Imaging Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Andrea Bernardoni
- Neuroradiology Unit, Department of Radiology, Arcispedale S. Anna, Ferrara, Italy
| | - Sandro Marini
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, USA
| | - Ilaria Casetta
- Section of Neurology, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Enrico Fainardi
- Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Brachial mean arterial pressure: extremely high accuracy, good precision and pressure dependence of currently used formulas. J Hypertens 2021; 39:196. [PMID: 33273365 DOI: 10.1097/hjh.0000000000002680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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De Clerck EEB, Schouten JSAG, Berendschot TTJM, Goezinne F, Liesenborghs I, Dagnelie PC, Schaper NC, Kroon AA, Henry RMA, Reesink KD, Schram MT, Stehouwer CDA, Webers CAB. Vascular risk factors for optical coherence tomography-detected macular cysts: The Maastricht Study. Acta Ophthalmol 2021; 99:e860-e868. [PMID: 33258290 DOI: 10.1111/aos.14677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether higher blood pressure and greater arterial stiffness are associated with the presence of macular cysts and whether this association is already present in the absence of micro-aneurysms in individuals with and without type 2 diabetes. METHODS Using spectral domain optical coherence tomography (OCT), we performed a macular volume scan in 2647 individuals (mean age 60 ± 8 years, 50% men, 27% type 2 diabetes). The association between macular cysts and 24-hour systolic and diastolic blood pressure, pulse pressure, mean arterial blood pressure, carotid-femoral pulse wave velocity and carotid distensibility was assessed by use of logistic regression. RESULTS Twenty-four hours systolic blood pressure was associated with the presence of macular cysts [OR = 1.03 (95% CI 1.00-1.05) per 1 mmHg, p = 0.03]. 24 hr pulse pressure [OR = 1.61 (95% CI 1.11-2.34) per 10 mmHg, p = 0.01] and carotid-femoral pulse wave velocity [OR = 1.16 (95% CI 1.02-1.32) per 1 m/s, p = 0.02] were associated with macular cysts, while carotid distensibility was not [OR = 1.03 (95% CI 0.96-1.11) per 1.0*10-3 /kPa, p = 0.45]. Associations were similar in individuals with and without type 2 diabetes and were already present in the absence of micro-aneurysms. CONCLUSION Twenty-four hours systolic blood pressure, 24 hr pulse pressure and carotid-femoral pulse wave velocity are associated with the presence of OCT-detected macular cysts in individuals with and without type 2 diabetes, even in the absence of micro-aneurysms. Therefore, blood pressure and aortic stiffness are potential factors contributing to macular cysts.
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Affiliation(s)
- Eline E. B. De Clerck
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Jan S. A. G. Schouten
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Tos T. J. M. Berendschot
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Fleur Goezinne
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Ilona Liesenborghs
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Epidemiology Maastricht University Maastricht The Netherlands
- School for Public Health and Primary Care (CAPHRI) Maastricht University Maastricht The Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Epidemiology Maastricht University Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Abraham A. Kroon
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering Maastricht University Medical Center+ Maastricht The Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
- Heart and Vascular Center Maastricht University Medical Center+ Maastricht The Netherlands
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center+ Maastricht The Netherlands
- Department of Internal Medicine Maastricht University Medical Center+ Maastricht The Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht Maastricht University Medical Center+ Maastricht The Netherlands
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Li K, Haynie DL, Gao X, Lipsky LM, Nansel T, Iannotti RJ, Vaca FE, Simons-Morton BG. Validation of a continuous measure of cardiometabolic risk among adolescents. J Pediatr Endocrinol Metab 2021; 34:763-770. [PMID: 33823099 PMCID: PMC11349060 DOI: 10.1515/jpem-2020-0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES We validated a continuous cardiometabolic risk (CMR) measure among adolescents. METHODS Five metabolic syndrome (MetS) components including waist circumference, triglycerides, high-density lipoprotein cholesterol, fasting blood glucose, and mean arterial pressure were assessed in a national cohort of U.S. adolescents (n=560; 16.5 ± 0.5 y/o at baseline) in 10th grade (2010, Wave 1 (W1)), and follow-up assessments four (W4) and seven (W7) years later. Separately by wave, linear regressions were fitted to each MetS component controlling for age, sex, and race/ethnicity, and yielded standardized residuals (Z-scores). Wave-specific component Z-scores were summed to obtain composite CMR Z-scores. Four- and seven-year CMR change (CMR-diff W1-W4 and W1-W7). and average CMR risk (CMR-avg; (W1 + W4)/2 and (W1 + W7)/2) were calculated using the CMR Z-scores. W7 MetS was determined using adult criteria. Student's t-test and receiver operating characteristic (ROC) curve were conducted. RESULTS Participants meeting the adult criteria for MetS at W7 (74 of 416, 17.8%) had statistically significant (p<0.01) higher values for W1 CMR Z-scores (0.92 vs. -0.21), W4 CMR Z-scores (1.69 vs. -0.28), W7 CMR Z-scores (2.21 vs. -0.55), W1-W4 CMR-avg (1.53 vs. -0.27), W1-W7 CMR-diff (1.29 vs. -0.21), and W1-W7 CMR-avg (1.46 vs. -0.48) than those not meeting MetS criteria. Most results were similar for males and females in the sex-stratified analyses. The areas under the ROC curve were 0.61, 0.71, and 0.75 for W1, W4 and W7 Z-scores. CONCLUSIONS Findings support the validity of the continuous CMR Z-scores calculated using linear regression in evaluating and monitoring CMR profiles from adolescence to early adulthood.
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Affiliation(s)
- Kaigang Li
- Department of Health & Exercise Science, Colorado State University, 215E Moby B Complex, Fort Collins, CO 80523, USA; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; and Colorado School of Public Health, Fort Collins, CO, USA
| | - Denise L. Haynie
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, USA
| | - Xiang Gao
- Department of Health & Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Leah M. Lipsky
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, USA
| | - Tonja Nansel
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, USA
| | | | - Federico E. Vaca
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; and Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Bruce G. Simons-Morton
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, Bethesda, MD, USA
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Garcia-Rojas IJ, Omidakhsh N, Arah OA, Krause N. Blood Pressure Changes After a Health Promotion Program Among Mexican Workers. Front Public Health 2021; 9:683655. [PMID: 34249846 PMCID: PMC8261043 DOI: 10.3389/fpubh.2021.683655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determined. Methods: This non-randomized company-based trial evaluated 6- and 12-months effects of a WHP intervention on BP among 2,002 participating workers from seven Mexican companies. Intervention and control groups were assigned at the company level. The intervention included nutrition counseling, physical exercise, and stress management components. Mixed models assessed differences in BP change between intervention and control companies in intent-to-treat (ITT), per-protocol (PerP), and as-treated (AsTr) analyses, and also within-group changes stratified by company, intervention component, and baseline cardiovascular risk factor levels. All analyses were adjusted for potential confounders. We accounted for missing data and loss to follow-up using inverse probability of censoring weighting. Results: ITT analyses revealed mean BP change differences of -1.1 mmHg at 12 months (95% CI: -2.9; 0.6) in intervention companies relative to control companies. PerP and AsTr analyses confirmed this finding. Within-group analyses showed consistent BP reductions at both 6 and 12 months. Substantial differences in BP changes ranging from diastolic -6.1 mmHg, (95% CI: -11.2; -1.2) to systolic -13.0 mmHg (95% CI: -16.0; -10.1) were found among individuals with diabetes at baseline in intervention companies relative to control companies. Conclusion: After 1 year, WHP was associated with modest but uncertain BP reductions. Substantial reductions were mainly observed among diabetic workers.
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Affiliation(s)
- Isabel J. Garcia-Rojas
- Fielding School of Public Health, Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Negar Omidakhsh
- Fielding School of Public Health, Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Onyebuchi A. Arah
- Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Niklas Krause
- Fielding School of Public Health, Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, United States
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Mean arterial pressure estimated by brachial pulse wave analysis and comparison with currently used algorithms. J Hypertens 2021; 38:2161-2168. [PMID: 32694334 DOI: 10.1097/hjh.0000000000002564] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mean arterial pressure (MAP) is usually calculated by adding one-third of pulse pressure (PP) to DBP. This formula assumes that the average value of pulse waveform is constant in all individuals and coincides with 33.3% of PP amplitude (MAP = DBP + PP × 0.333). Other formulas were lately proposed to improve the MAP estimation, adding to DBP an established percentage of PP: MAP = DBP + PP × 0.40; MAP = DBP + PP × 0.412; MAP = DBP + PP × 0.333 + 5 mmHg. METHODS The current study evaluated the integral of brachial pulse waveform recorded by applanation tonometry in 1526 patients belonging to three distinct cohorts: normotensive or hypertensive elderly, hypertensive adults, and normotensive adults. RESULTS The percentage of PP to be added to DBP to obtain MAP was extremely variable among individuals, ranging from 23 to 58% (mean: 42.2 ± 5.5%), higher in women (42.9 ± 5.6%) than men (41.2 ± 5.1%, P < 0.001), lower in the elderly cohort (40.9 ± 5.3%) than in the general population cohort (42.8 ± 6.0%, P < 0.001) and in the hypertensive patients (42.4 ± 4.8%, P < 0.001). This percentage was significantly associated with DBP (β = 0.357, P < 0.001) and sex (β = 0.203, P < 0.001) and significantly increased after mental stress test in 19 healthy volunteers (from 39.9 ± 3.2 at baseline, to 43.0 ± 4.0, P < 0.0001). The average difference between MAP values estimated by formulas, compared with MAP assessed on the brachial tonometric curve, was (mean ± 1.96 × SD): -5.0 ± 6.7 mmHg when MAP = DBP + PP × 0333; -1.2 ± 6.1 mmHg when MAP = DBP + PP × 0.40; -0.6 ± 6.1 mmHg when MAP = DBP + PP × 0.412; -0.4 ± 6.7 mmHg when MAP = DBP + PP × 0.333 + 5. CONCLUSION Due to high interindividual and intraindividual variability of pulse waveform, the estimation of MAP based on fixed formulas derived from SBP and DBP is unreliable. Conversely, a more accurate estimation of MAP should be based on the pulse waveform analysis.
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Ajeigbe OF, Oboh G, Ademosun AO, Oyagbemi AA. Ficus asperifolia Miq
‐enriched biscuit diet protects against
L
‐NAME induced hyperlipidemia and hypertension in rats. FOOD FRONTIERS 2021. [DOI: 10.1002/fft2.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Olufunke Florence Ajeigbe
- Functional Foods and Nutraceutical Unit Department of Biochemistry Federal University of Technology Akure Ondo P.M.B 704, 340001 Nigeria
- Department of Physical and Chemical Sciences Elizade University Ilara‐Mokin Ondo State P.M.B, 002, 340271 Nigeria
| | - Ganiyu Oboh
- Functional Foods and Nutraceutical Unit Department of Biochemistry Federal University of Technology Akure Ondo P.M.B 704, 340001 Nigeria
| | - Ayokunle Olubode Ademosun
- Functional Foods and Nutraceutical Unit Department of Biochemistry Federal University of Technology Akure Ondo P.M.B 704, 340001 Nigeria
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Liu M, Chen X, Zhang S, Lin Y, Xiong Z, Zhong X, Guo Y, Sun X, Zhou H, Xu X, Wang L, Liao X, Zhuang X. Long-Term Visit-to-Visit Mean Arterial Pressure Variability and the Risk of Heart Failure and All-Cause Mortality. Front Cardiovasc Med 2021; 8:665117. [PMID: 34150867 PMCID: PMC8211989 DOI: 10.3389/fcvm.2021.665117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Systolic or diastolic blood pressure (BP) variability is associated with an increased risk of cardiovascular events. We assessed whether BP variability measured by mean arterial pressure (MAP) was associated with increased risk of heart failure (HF) and death in individuals with or without hypertension. Methods: We evaluated 9,305 Atherosclerosis Risk in Communities (ARIC) study participants with or without hypertension and calculated BP variability based on MAP values from visit 1 to 4 [expressed as standard deviation (SD), average real variability (ARV), coefficient of variation (CV), and variability independent of the mean (VIM)]. Multivariate-adjusted Cox regression model and restricted cubic spline curve were used to evaluate the associations of MAP variability with all-cause mortality and HF. Results: During a median follow-up of 16.8 years, 1,511 had an HF event and 2,903 died. Individuals in the highest quartile of VIM were both associated with a 21% higher risk of all-cause mortality [hazard ratio (HR), 1.21; 95% CI, 1.09-1.35] and HF (HR, 1.21; 95% CI, 1.04-1.39) compared with the lowest quartile of VIM. Cubic spline curves reveal that the risk of deaths and HF increased with MAP variability when it reached a higher level. Results were similar in individuals with normotension (all-cause mortality: HR, 1.30; 95% CI, 1.09-1.55; HF, HR, 1.49; 95% CI, 1.12-1.98). Conclusions: In individuals with or without hypertension, greater visit-to-visit MAP variability was associated with a higher risk of all-cause mortality and HF, indicating that the BP variability assessed by MAP might be a potential risk factor for HF and death.
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Affiliation(s)
- Menghui Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Xiaohong Chen
- Department of Otorhinolaryngology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Shaozhao Zhang
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Yifen Lin
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Zhenyu Xiong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Xiangbin Zhong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Yue Guo
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Xiuting Sun
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Huimin Zhou
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Xingfeng Xu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Lichun Wang
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Xinxue Liao
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Xiaodong Zhuang
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
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A comparison between body mass index and waist circumference for identifying continuous metabolic syndrome risk score components in Iranian school-aged children using a structural equation modeling approach: the CASPIAN-V study. Eat Weight Disord 2021; 26:1609-1616. [PMID: 32772336 DOI: 10.1007/s40519-020-00971-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the association of anthropometric indices with continuous metabolic syndrome (cMetS) risk score components in a large population-based sample of children and adolescents. METHODS This multi-centric study was performed on 3843 students aged 7-18 years who were selected by multistage, stratified cluster sampling method from 30 provinces of Iran. Demographic, anthropometric and biochemical factors were obtained and standardized residuals (z-scores) were calculated for MetS components. A structural equation modeling approach was applied to evaluate the relationships among the study variables and to implement the subsequent structural modeling. RESULTS The mean age of the participants (52.3% boys) was 12.4 ± 3.05 years. Standardized scores of body mass index (ZBMI) and waist circumference (ZWC) had a direct effect on standardized scores of mean arterial pressure (ZMAP) (0.23 and 0.24 in boys and 0.22 and 0.23 in girls, respectively) and triglyceride (ZTG) (0.07 and 0.04 in boys and 0.02 and 0.06 in girls, respectively), but the effect of ZWC was stronger than ZBMI on these variables. Age, socioeconomic status and sedentary behaviors showed a positive direct effect on ZWC (0.01, 0.05 and 0.07 in boys and 0.05, 0.08 and 0.002 in girls, respectively). These variables induced indirect effects on cMets risk score components through ZWC. CONCLUSION The magnitude of association between WC and continuous metabolic syndrome risk score components was higher compared to BMI in school-aged children, emphasizing on paying more attention to central obesity in childhood. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Kakimoto Y, Matsushima Y, Tsuboi A, Seto Y, Osawa M. Nonocclusive mesenteric ischemia secondary to spinal cord injury: an autopsy case. Spinal Cord Ser Cases 2021; 7:37. [PMID: 33986243 DOI: 10.1038/s41394-021-00402-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/17/2021] [Accepted: 04/20/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Spinal cord injury (SCI) is a major direct cause of accidental death. Cervical SCI can lead to death in a short time period by neurogenic shock. Prompt vasopressor administration is recommended for patients with SCI accompanied by hypotension (systolic blood pressure < 90 mmHg). We herein present the first fatal case of nonocclusive mesenteric ischemia (NOMI) secondary to cervical SCI in a patient who suddenly died 1 week after an accidental fall. CASE PRESENTATION A 72-year-old man without medical history of cardiovascular disease suffered tetraplegia with a neurological level at C4 after a fall accident. He was fully conscious with stable respiratory ability, and the systolic blood pressure was maintained at >90 mmHg without vasopressor agents. High fever occurred 7 days after the accident and he died in the next morning. Autopsy revealed segmental intestinal necrosis from the ileum to the ascending colon, without mesenteric embolism, or severe arteriosclerosis. DISCUSSION This case implies that maintenance of >90-mmHg systolic blood pressure can insufficiently keep the blood flow to prevent NOMI, and the mean arterial blood pressure of >85 mmHg can be more plausible as suggested in the guideline. Monitoring the mean arterial blood pressure in acute SCI is useful not only for neurological recovery but also for the maintenance of vital intestinal perfusion.
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Affiliation(s)
- Yu Kakimoto
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Yutaka Matsushima
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Akio Tsuboi
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshihisa Seto
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Motoki Osawa
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Correlation between Myocardial Function and Electric Current Pulsatility of the Sputnik Left Ventricular Assist Device: In-Vitro Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study assesses the electric current parameters and reports on the analysis of the associated degree of myocardial function during left ventricular assist device (LVAD) support. An assumption is made that there is a correlation between cardiac output and the pulsatility index of the pump electric current. The experimental study is carried out using the ViVitro Pulse Duplicator System with Sputnik LVAD connected. Cardiac output and cardiac power output are used as a measure of myocardial function. Different heart rates (59, 73, 86 bpm) and pump speeds (7600–8400 rpm in 200 rpm steps) are investigated. In our methodology, ventricular stroke volumes in the range of 30–80 mL for each heart rate at a certain pump speed were used to simulate different levels of contractility. The correlation of the two measures of myocardial function and proposed pulsatility index was confirmed using different correlation coefficients (values ≥ 0.91). Linear and quadratic models for cardiac output and cardiac power output versus pulsatility index were obtained using regression analysis of measured data. Coefficients of determination for CO and CPO models were in the ranges of 0.914–0.982 and 0.817–0.993, respectively. Study findings suggest that appropriate interpretation of parameters could potentially serve as a valuable clinical tool to assess myocardial therapy using LVAD infrastructure.
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Kuroda R, Nogawa K, Watanabe Y, Morimoto H, Sakata K, Suwazono Y. Association between High-Sensitive C-Reactive Protein and the Development of Liver Damage in Japanese Male Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062985. [PMID: 33799436 PMCID: PMC7998110 DOI: 10.3390/ijerph18062985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND The aim of this study was to determine whether a causative relationship exists between the development of liver damage and increased high-sensitivity C-reactive protein (HsCRP) levels by long-term follow-up in Japanese workers. METHODS The target participants comprised 7830 male workers in a Japanese steel company. The prospective cohort study was performed over a 6-year period, and annual health screening information was analyzed by pooled logistic regression. The endpoint, regarded as the development of liver damage, was defined as aspartate aminotransferase (AST) ≥ 40 IU/L. RESULTS A significant relationship between the development of liver damage and increased HsCRP levels was observed after adjusting for confounding factors such as various physiological and blood chemistry parameters and lifestyle factors. The odds ratio of a 1.5-fold increase in HsCRP was 1.07 (95% confidence interval: 1.03-1.10, p < 0.001). CONCLUSIONS The results suggested that an increase of HsCRP is associated with the development of liver damage.
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Affiliation(s)
- Reiko Kuroda
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (R.K.); (K.N.); (Y.W.); (H.M.); (K.S.)
- Division for Environment, Health and Safety, The University of Tokyo, Tokyo 113-8654, Japan
| | - Kazuhiro Nogawa
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (R.K.); (K.N.); (Y.W.); (H.M.); (K.S.)
| | - Yuuka Watanabe
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (R.K.); (K.N.); (Y.W.); (H.M.); (K.S.)
| | - Hideki Morimoto
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (R.K.); (K.N.); (Y.W.); (H.M.); (K.S.)
| | - Kouichi Sakata
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (R.K.); (K.N.); (Y.W.); (H.M.); (K.S.)
| | - Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan; (R.K.); (K.N.); (Y.W.); (H.M.); (K.S.)
- Correspondence: ; Tel.: +81-43-226-2065
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Predictive modeling of depression and anxiety using electronic health records and a novel machine learning approach with artificial intelligence. Sci Rep 2021; 11:1980. [PMID: 33479383 PMCID: PMC7820000 DOI: 10.1038/s41598-021-81368-4] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022] Open
Abstract
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are highly prevalent and impairing problems, but frequently go undetected, leading to substantial treatment delays. Electronic health records (EHRs) collect a great deal of biometric markers and patient characteristics that could foster the detection of GAD and MDD in primary care settings. We approached the problem of predicting MDD and GAD using a novel machine learning pipeline to re-analyze data from an observational study. The pipeline constitutes an ensemble of algorithmically distinct machine learning methods, including deep learning. A sample of 4,184 undergraduate students completed the study, undergoing a general health screening and completing a psychiatric assessment for MDD and GAD. After explicitly excluding all psychiatric information, 59 biomedical and demographic features from the general health survey in addition to a set of engineered features were used for model training. We assessed the model's performance on a held-out test set and found an AUC of 0.73 (sensitivity: 0.66, specificity: 0.7) and 0.67 (sensitivity: 0.55, specificity: 0.7) for GAD, and MDD, respectively. Additionally, we used advanced techniques (SHAP values) to illuminate which features had the greatest impact on prediction for each disease. The top predictive features for MDD were being satisfied with living conditions and having public health insurance. The top predictive features for GAD were vaccinations being up to date and marijuana use. Our results indicate moderate predictive performance for the application of machine learning methods in detection of GAD and MDD based on EHR data. By identifying important predictors of GAD and MDD, these results may be used in future research to aid in the early detection of MDD and GAD.
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Environmental cadmium exposure and noncancer mortality in a general Japanese population in cadmium nonpolluted regions. J Appl Toxicol 2020; 41:587-594. [DOI: 10.1002/jat.4067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 01/29/2023]
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