BACKGROUND The evidence from observational studies has been inconclusive on the causal relationship between cheese intake and gestational hypertension or diabetes.AIM To determine whether cheese consumption was causal...BACKGROUND The evidence from observational studies has been inconclusive on the causal relationship between cheese intake and gestational hypertension or diabetes.AIM To determine whether cheese consumption was causally related to hypertension and diabetes during pregnancy.METHODS This was a two-sample Mendelian randomized(MR)study.Summary-level genetic data for cheese intake was exposure and corresponding outcome data for gestational hypertension and gestational diabetes were extracted from the IEU OpenGWAS database.MR analysis was conducted using inverse variance weighting.For sensitivity analyses,MR-Egger regression,weighted median,weighted mode,and leave-one-out methods were conducted.A fixed-effect model was used to meta-analyze two sample MR estimates.The traits of gestational hypertension were pregnancy hypertension(123579 individuals)and oedema,proteinuria and hypertensive disorders in pregnancy,childbirth and the puerperium(123579 individuals),and traits of gestational diabetes were gestational diabetes(123579 individuals)and diabetes mellitus in pregnancy(116363 individuals),respectively.RESULTS Cheese intake per standard deviation increase has causally reduced the risks of gestational hypertension[odds ratio(OR)=0.60,95%confidence interval(CI):0.47-0.76,P<0.001]and gestational diabetes(OR=0.41,95%CI:0.30-0.55,P<0.001)in inverse variance weighted analysis.Sensitivity analysis showed no heterogeneity(all P>0.05)nor horizontal pleiotropy(all P>0.05)in the relationship between cheese intake and gestational hypertension,but heterogeneity presented(all P<0.05)in relation to gestational diabetes in the two-sample MR analysis.CONCLUSION Cheese intake was inversely associated with gestational hypertension and gestational diabetes in MR analysis,suggesting that cheese consumption may be beneficial in preventing hypertension and diabetes during pregnancy.展开更多
Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast mi...Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast microvilli (stbm) and l-arginine nitrosyl methyl ester were screened out via caudal vein injection. Twenty gestational hypertension-preeclampsia model SD (Sprague Dawley) rats successfully induced by L-NAME (L-arginine Nitrosyl methyl ester) were randomly divided into 2 groups (model group and Danshen injection group, n = 10). Then another 10 normal pregnant SD rats without model were selected as blank control group. The Salvia miltiorrhiza injection group was given Salvia miltiorrhiza injection (0.5 g?kg?1?d?1) through tail vein, and the control group and model group were given equal volume of normal saline through tail vein injection. All three groups were treated by tail vein injection once a day (d) for 7 days. After treatment, heart rate (HR), Systolic pressure (SP), diastolic pressure (DP) and mean arterial pressure (MAP) were measured by tail artery. Left ventricular end-diastolic diameter (LVDd) and Left ventricular end systolic diameter (LVDs) were recorded by echocardiography. Left ventricular end diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (left ventricular ejection) fraction, LVEF) and the maximum rate of increase/decrease of left ventricular pressure during isovolemic systole (+dp/dtmax/?dp/dtmax);Endothelin-1 (ET-1) levels in rat tail vein blood were detected by ELISA. Results: SP, DP, MP, HR, LVSP, LVDs and ?dp/dtmaxx were all decreased, plasma ET-1 expression was low, and LVDd, LVEDP, LVEF, and +dp/dtmax were all increased in the Salvia miltiorroot injection group, with statistical significance compared to the model group (p Conclusion: Salvia miltiorrhiza injection can improve the cardiac function and reduce blood pressure in rats with pregnancy-induced hypertension and preeclampsia, and the mechanism may be related to alleviating systemic arteriolar spasm by regulating ET-1 level.展开更多
Gestational hypertension(GH)is a common complication during pregnancy.GH is regarded as a potential public health challenge for pregnant women and infants.Limited evidence has linked ambient air pollution to an increa...Gestational hypertension(GH)is a common complication during pregnancy.GH is regarded as a potential public health challenge for pregnant women and infants.Limited evidence has linked ambient air pollution to an increased GH risk.However,most of the studies were conducted in developed countries,with inconsistent results obtained.The present study was performed to explore whether exposure to particulate matters with an aerodynamic diameter≤2.5(PM2.5)and ozone(O3)was related to elevated odds of GH in a Chinese population.This population-based cohort study involved 38115 pregnant women in Wuhan,China.All information was collected from the Wuhan Maternal and Child Health Management Information System,using standardized quality control.The daily air pollutant data for PM2.5 and O3 were obtained from the 20 monitoring stations of the Wuhan Environmental Monitoring Center during 2014.The nearest monitor approach was applied to individual exposure assessment of PM2.5 and O3 for each participant.After adjusting for major confounders and other air pollutants,a 10μg/m^3 increase in PM25 and O3 concentrations was found to correlate to a 1.14-fold[95%confidence interval(95%CI):1.09,1.20]and a 1.05-fold(95%CI:1.02,1.07)increase in GH risk,respectively.Additionally,stronger relationships between GH risk and PM25 and O3 exposure were observed in women who conceived in winter and summer,respectively.These findings suggest that air pollutants may contribute to the development of GH.展开更多
To clarify the role of TAFI in hypertensive disorders in pregnancy,22 subjects,including 10 with pre-eclampsia(PE) and 12 with gestational hypertension were examined for the levels of TAFI and thrombin-antithrombin(TA...To clarify the role of TAFI in hypertensive disorders in pregnancy,22 subjects,including 10 with pre-eclampsia(PE) and 12 with gestational hypertension were examined for the levels of TAFI and thrombin-antithrombin(TAT) complex.Thirty normal pregnant women served as controls.ELISA was employed for the detection.The results showed that the TAFI antigen levels in normal pregnancy group,gestational hypertension group and PE group were(85.35±24.69)%,(99.65±18.27)%,(110.12±23.36)%;(97.06±21.40)%,(114.08±27.76)%,(125.49±24.70)%;(106.6±19.21)%,(129.2±25.07)%,(139.1±30.12)%,in the 1st,2nd and 3rd trimester respectively.No significant differences were found between the normal pregnancy group and gestational hypertension group but significant difference existed between normal pregnancy group and PE group in each tri-mester(P<0.05).TAT complexes were significantly higher in patients with PE than that in controls(P<0.05),but no correlation was found between TAT and TAFI.It is concluded that TAFI may con-tributed to the impairment of fibrinolysis in the patients with PE and may serves as a sensitive indi-cator for PE,but it may not help in the diagnosis of the gestational hypertension.展开更多
Objective:To explore the effect of nifedipine in combined with magnesium sulfate on the hemorheology and coagulation indicators in patients with gestational hypertension.Methods:A total of 90 patients with gestational...Objective:To explore the effect of nifedipine in combined with magnesium sulfate on the hemorheology and coagulation indicators in patients with gestational hypertension.Methods:A total of 90 patients with gestational hypertension were included in the study and randomized into the observation group and the control group with 45 cases in each group. The patients in the observation group were given magnesium sulfate in combined with nifedipine, while the patients in the control group were only given magnesium sulfate. The patients in the two groups were continuously treated for 2 weeks. The blood pressure, hemorheology indicators, and coagulation indicators before and after treatment in the two groups were detected and compared.Results: SBP, DBP, whole blood high, moderate, and low shear viscosity, plasma viscosity, and HCT after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05). The levels of the above indicators after treatment in the observation group were significantly lower than those in the control group (P<0.05). PT, APTT, and TT after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05), while Fib was significantly reduced (P<0.05). PT, APTT, and TT after treatment in the observation group were significantly higher than those in the control group (P<0.05), while Fib was significantly lower than that in the control group (P<0.05). Conclusions:Nifedipine in combined with magnesium sulfate can significantly stabilize the blood pressure level in patients with gestational hypertension, and improve the hemodynamic and coagulation indicators, with a significant efficacy.展开更多
Objective: To discuss the effect of medical nutrition combined with exercise intervention on the placental ischemic hypoxic injury and serum angiogenesis factors in patients with gestational hypertension. Methods: A t...Objective: To discuss the effect of medical nutrition combined with exercise intervention on the placental ischemic hypoxic injury and serum angiogenesis factors in patients with gestational hypertension. Methods: A total of 90 patients with gestational hypertension who received antenatal care and gave birth in our hospital between July 2014 and July 2016 were collected and divided into control group and observation group according to random number table, 45 cases in each group. Control group of patients received routine therapy, observation group of patients received routine therapy + nutrition combined with exercise intervention, and the ischemic hypoxic injury index expression in placenta tissue and serum angiogenesis factor levels before delivery were compared between two groups of patients. Results: After intervention, ischemic hypoxic injury index NO level in placental grinding fluid of observation group was higher than that of control group while ET-1, HIF-1α, Bax, Caspase-3 and MDA levels were lower than those of control group;serum angiogenesis factors TGFβ1, HGF, bFGF, VEGF and Ang-2 levels were significantly higher than those of control group while sFlt-1 level was lower than that of control group. Conclusion: The combination of medical nutrition and exercise can effectively reduce the placental ischemic hypoxic injury and reduce the angiogenesis in patients with gestational hypertension.展开更多
Introduction: The purpose of this study was to examine the clinical usefulness of postoperative epidural analgesia in patients possessing severe gestational hypertension after Cesarean delivery. Methods: We reviewed t...Introduction: The purpose of this study was to examine the clinical usefulness of postoperative epidural analgesia in patients possessing severe gestational hypertension after Cesarean delivery. Methods: We reviewed the obstetric records of 99 patients possessing severe gestational hypertension undergoing singleton Cesarean delivery at ≥ 22 weeks’ gestation. Thirty patients were received continuous epidural analgesia with 0.2% ropivacaine for pain relief after Cesarean delivery with spinal anesthesia, 69 patients were not received epidural analgesia after Cesarean delivery with spinal anesthesia. Results: During the preoperative period, there were no measurable differences in the diastolic blood pressure between the 2 groups (108 vs± 7 vs. 106 mmHg ± 10 mmHg, p = 0.29). The diastolic blood pressure at 2 and 4 hours after Cesarean section in the epidural analgesia group were significantly lower than those in the non-epidural group (2 hours after Cesarean section: 88 vs ± 13 vs. 95 mmHg ± 8 mmHg, p < 0.01;4 hours after Cesarean section: 92 vs ± 15 vs. 102 mmHg ± 9 mmHg, p < 0.01). Conclusions: The current results indicated that the postoperative epidural analgesia can inhibit the rise in diastolic blood pressure in patients possessing severe gestational hypertension after Cesarean delivery. This electronic document is a “live” template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.展开更多
The objective of this study was to evaluate the association between HIV infection and hypertensive disorders of pregnancy, comparing the rates of preeclampsia and gestational hypertension in a HIV-infected pregnant gr...The objective of this study was to evaluate the association between HIV infection and hypertensive disorders of pregnancy, comparing the rates of preeclampsia and gestational hypertension in a HIV-infected pregnant group and in a HIV-negative control pregnant group matched for age and parity. Furthermore, we aimed to compare the rates of hypertensive disorders in a subgroup of HIV-positive and HIV-negative African-American Black women. Patients and Methods: This was a prospective observational cohort study conducted at two University Departments of Obstetrics and Gynecology, Salesi Hospital, Ancona, and Sant’Orsola Hospital, Bologna. The HIV-infected patients’ group consisted of 126 pregnant women;140 HIV-negative pregnant women matched for age and parity served as controls. Gestational hypertension and preeclampsia were diagnosed according to NHBPEP-ISSHP criteria. Categorical data were analyzed using the Fisher exact test. Statistical significance was set at a p value < 0.05. Results: Gestational hypertension and preeclampsia were diagnosed in 3 of 126 HIV-positive patients (2.38%) and in 14 of 140 HIV-negative patients (10%), with a relative risk of 0.24 (p = 0.0112). In the subgroup of African-American Black women, gestational hypertension and preeclampsia were diagnosed in 2 out of 43 HIV-positive (4.7%) and in 3 out of 18 HIV-negative patients (16.7%) with a relative risk of 0.28, not statistically significant (p = 0.1887). Conclusion: Pregnant women with HIV infection seem to be protected against gestational hypertension and preeclampsia and this protective effect remains also in a high risk population, such as African-American Black ethnic group. The effect is present independently from treatment received and virus copies. The lack of immune response present since the conception period should account for unopposed trophoblast invasion resulting in a better placentation.展开更多
Objective:To explore the effects of Xintongding and labellol on hemorheology, oxidative stress and inflammatory endothelial factor in patients with gestational hypertension.Methods:104 patients with gestational hypert...Objective:To explore the effects of Xintongding and labellol on hemorheology, oxidative stress and inflammatory endothelial factor in patients with gestational hypertension.Methods:104 patients with gestational hypertension admitted to our hospital from March 2016 to January 2018 were selected as the research object. 52 patients in the control group and 52 patients in the observation group were randomly divided into two groups. The control group was treated with Xintongding, while the observation group was treated with Labellol on the basis of the control group. The changes of blood pressure, hemorheology, oxidative stress index and inflammatory endothelial factors were compared and analyzed between the two groups.Results:Before treatment, there were no significant differences in the levels of SBP, DBP, LBV, HBV, PV, FIB, LPO, MDA, SOD, TNF-α, CRP, VEGF and PLGF. After treatment, the levels of SBP, DBP, LBV, HBV, PV, FIB, LPO, MDA, TNF-α and CRP were significantly decreased, while the levels of SOD, VEGF and PLGF were significantly higher than before treatment, and the levels of SBP, DBP, LBV, HBV, PV, FIB, LPO, MDA, TNF-α and CRP in the observation group were significantly lower than those in the control group, and the levels of SOD, VEGF and PLGF were significantly higher than the control group. Conclusions: Xintongding combined with labetalol in the treatment of hypertensive disorder in pregnancy can effectively improve blood pressure, blood rheology and oxidative stress, reduce inflammation and promote angiogenesis, and has clinical significance.展开更多
Objective: To investigate the ultrasound assessment of left cardiac function in patients with gestational hypertension and its correlation with serum cytokine contents. Methods: A total of 76 patients with gestational...Objective: To investigate the ultrasound assessment of left cardiac function in patients with gestational hypertension and its correlation with serum cytokine contents. Methods: A total of 76 patients with gestational hypertension who were treated in Guangyuan Central Hospital between August 2015 and February 2017 were selected as gestational hypertension group, and 50 healthy pregnant women who received regular prenatal examination in Guangyuan Central Hospital during the same period were selected as normal control group. The differences in the ultrasonic left cardiac function parameter levels as well as serum contents of endothelial injury indexes and inflammatory factors were compared between the two groups of pregnant women. Pearson test was used to assess the correlation of ultrasonic left cardiac function parameter levels of gestational hypertension with serum endothelial injury index and inflammatory factor contents. Results: LAVmax, LVESV and LVEDV levels in gestational hypertension group were significantly higher than those in normal control group;serum endothelial injury indexes NO and PGE2 contents were lower than those of normal control group whereas ET-1 content was higher than that of normal control group;serum inflammatory factors IL-2, IFN-γ, IL-10, IL-13, IL-17 and IL-23 contents were significantly higher than those of normal control group. Correlation analysis showed that the ultrasonic left cardiac function parameter levels in patients with gestational hypertension were directly correlated with serum content of endothelial injury indexes and inflammatory factors. Conclusion: Ultrasonic left cardiac function parameter levels significantly change in patients with gestational hypertension, and the specific levels are directly correlated with the degree of endothelial injury and inflammatory response in the pregnant women.展开更多
Objective:To determine the fetal left ventricular Tei index level in gestational hypertension, and evaluate its correlation with the degree of placental hypoxia.Methods: A total of 98 pregnant women with gestational h...Objective:To determine the fetal left ventricular Tei index level in gestational hypertension, and evaluate its correlation with the degree of placental hypoxia.Methods: A total of 98 pregnant women with gestational hypertension who gave birth in our hospital between May 2013 and May 2016 were selected as the gestational hypertension group and 50 normal pregnant women were selected as the normal pregnancy group. Before delivery, the color Doppler diasonograph was used to detect fetal left ventricular Tei index and umbilical blood flow parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of hypoxia-related indexes and nerve injury indexes in umbilical venous blood after delivery of baby, and Pearson test was used to further evaluate the internal relations between fetal left ventricular Tei index and placental hypoxia degree.Results: Fetal left ventricular Tei index level of gestational hypertension group was higher than that of normal pregnancy group. Fetal ultrasonic umbilical blood flow parameters RI, PI and S/D levels of gestational hypertension group were higher than those of normal pregnancy group, ischemia hypoxia indexes HIF-1α and HSP70 contents in umbilical venous blood were higher than those of normal pregnancy group while NO content was lower than that of normal pregnancy group, and nerve injury indexes NSE, S100B and MBP contents in umbilical venous blood were higher than those of normal pregnancy group. After Pearson test, fetal left ventricular Tei index in gestational hypertension was directly correlated with umbilical blood flow parameter levels as well as ischemia hypoxia index and nerve injury index contents in umbilical venous blood. Conclusion:Fetal left ventricular Tei index level in gestational hypertension is higher than that in normal fetus, and Tei index level is directly correlated with placental ischemia hypoxia degree.展开更多
Objective: To investigate the ultrasonic evaluation of uterine spiral artery characteristics in patients with gestational hypertension and their correlation with the placental hypoxia injury. Methods: A total of 128 p...Objective: To investigate the ultrasonic evaluation of uterine spiral artery characteristics in patients with gestational hypertension and their correlation with the placental hypoxia injury. Methods: A total of 128 puerperae with gestational hypertension who gave birth in this hospital between December 2014 and February 2017 were collected as gestational hypertension group, and 100 healthy puerperae who gave birth in this hospital during the same period were collected as normal control group. The differences in uterine spiral artery parameter levels as well as the contents of angiogenesis indexes, oxidative stress indexes and inflammatory mediators in the placental grinding fluid were compared between the two groups 1 week before delivery. Pearson test was used to evaluate the correlation between uterine spiral artery characteristics and placental hypoxia injury in patients with gestational hypertension. Results: Uterine spiral artery RI, PI and S/D levels in gestational hypertension group were higher than those in normal control group;angiogenesis indexes HIF-1α, VEGF and sFlt-1 contents in placental grinding fluid of gestational hypertension group were higher than those of normal control group;anti-oxidation indexes CTA and SOD contents were lower than those of control group whereas LHP content was higher than that of normal control group;inflammatory mediators IL-6, TNF-α, NF-κB and HSP70 contents were higher than those of normal control group. Pearson test showed that the uterine spiral artery RI, PI and S/D levels in puerperae with gestational hypertension were positively correlated with the degree of angiogenesis, oxidative stress and inflammatory response in the placenta. Conclusion: There are abnormal changes of uterine spiral artery flow parameters in puerperae with gestational hypertension, and the abnormality can objectively reflect the degree of placental hypoxia injury.展开更多
Objective:To study the fetal middle cerebral artery blood flow characteristics of gestational hypertension combined with fetal distress in uterus as well as their correlation with hypoxia. Methods: Puerperae with hype...Objective:To study the fetal middle cerebral artery blood flow characteristics of gestational hypertension combined with fetal distress in uterus as well as their correlation with hypoxia. Methods: Puerperae with hypertensive disorders in pregnancy and fetal distress in uterus, puerperae with hypertensive disorders in pregnancy alone and healthy puerperae who gave birth in our hospital between January 2013 and January 2016 were included in group A, group B and group C of the study respectively. At 34-36 weeks of pregnancy, color Doppler ultrasonography was conducted to determine fetal middle cerebral artery blood flow parameters;after childbirth, umbilical arterial blood was collected to determine blood gas analysis parameters, and the placenta tissue was collected to determine oxidative stress and mitochondria damage indexes.Results:Fetal middle cerebral artery S/D, PI and RI of group A were significantly higher than those of group B and group C while umbilical artery pH value and PaO2 as well as HCO3- and BE content were significantly lower than those of group B and group C;fetal middle cerebral artery S/D, PI and RI as well as umbilical artery pH value, PaO2, HCO3- and BE content of group B were not significantly different from those of group C;Nrf2, ARE, NQO1, VitC, SVCT1, SVCT2, ATP, PGC-1α, PGC-1β, NRF1 and NRF2 content in placenta tissue of group A were significantly lower than those of group B and group C while ROS content was significantly higher than those of group B and group C;Nrf2, ARE, NQO1, VitC, SVCT1, SVCT2, ATP, PGC-1α, PGC-1β, NRF1 and NRF2 content in placenta tissue of group B were significantly lower than those of group C while ROS content was significantly higher than that of group C. Fetal middle cerebral artery S/D, PI and RI were negatively correlated with umbilical artery pH value, PaO2, HCO3- and BE content as well as Nrf2, ARE, NQO1, VitC, SVCT1, SVCT2, ATP, PGC-1α, PGC-1β, NRF1 and NRF2 content, and were positively correlated with ROS content.Conclusions:Gestational hypertension combined with fetal distress in uterus can lead to increased fetal middle cerebral artery blood flow resistance and decreased blood perfusion, and the changes of middle cerebral artery blood flow characteristics can assess the degree of hypoxia and oxidative stress damage.展开更多
Objective:Preeclampsia(PE)is a common complication during pregnancy.miR-100a is expressed in the placenta and regulates the survival and development of placental cells.Insulin growth factor-2(IGF-2)may serve as its do...Objective:Preeclampsia(PE)is a common complication during pregnancy.miR-100a is expressed in the placenta and regulates the survival and development of placental cells.Insulin growth factor-2(IGF-2)may serve as its downstream target.This study investigated the protective mechanisms of ginsenoside Rg3 against PE in rat model.Materials and Methods:LPS-induced rat PE models were suitable for intravenous administration of the highly expressed miR-100a ginsenoside Rg3 lentiviral vector.Human trophoblasts were cultured in vitro for JEG-3,and PE cell models were constructed.In vivo effects on tumor growth and apoptosis were observed.Ginsenoside Rg3 was treated with different concentrations of shRNA,miR-100a analogs,inhibitors,or IGF-2.Autophagy and the expression of autophagy-related proteins were examined.Trophoblast activity and migration were determined using Cell Counting Kit-8 and Transwell assays.Both drugs strongly inhibited trophoblasts under normal conditions with some synergy between them.Double-luciferase return assay confirmed the binding affinity of miR-100a for IGF-2.Results:In response to Rg3,autophagy and the expression of autophagy-related proteins LC3-I/II,Beclin1,and SQSTM1 were reduced in PE rat placental trophoblasts.Rg3 inhibited autophagy in JEG-3 cells and promoted JEG-3 survival and migration in a concentration-dependent manner.miR-100a upregulated PE expression.These results suggested that autophagy was a vital signaling system.Rg3 intervention inhibited miR-100a expression and miR-100a downregulated IGF-2 expression in placental tissues and promoted autophagy,thereby inhibiting JEG-3cell survival and migration.In rats,Rg3 inhibited PE development by regulating the activity of the miR-100a-IGF-2 signaling axis.Conclusion:Ginsenoside Rg3 positively regulates the miR-100a-IGF-2 axis and protects PE rats by inhibiting trophoblastic autophagy and promoting trophoblastic cell survival and migration.展开更多
Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of...Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.展开更多
AIM:To determine the dry eye(DE)rate and its relationship with disease stage in patients with primary hypertension.METHODS:A cross-sectional study included 432 patients with primary hypertension(with an equal number o...AIM:To determine the dry eye(DE)rate and its relationship with disease stage in patients with primary hypertension.METHODS:A cross-sectional study included 432 patients with primary hypertension(with an equal number of patients in each group:144 in stage Ⅰ,Ⅱ,and Ⅲ hypertension)and 144 healthy subjects as a control group.The Ocular Surface Disease Index(OSDI)and Schirmer Ⅰ test without anesthetics were conducted on all 576 subjects.Subjects with OSDI scores<13 and Schirmer Ⅰ values equal to or under 10 mm were diagnosed with DE.RESULTS:The ratio of DE in hypertension patients was higher than in the control group(41.7%versus 18.8%;P<0.001).The proportion of patients with DE increased gradually according to the hypertension stage:27.1% in stage Ⅰ,40.3% in stage Ⅱ,and 57.6% in stage Ⅲ,P<0.001.Age,duration of hypertension,plasma urea,creatinine,and high-sensitivity C-reactive protein(CRP-hs)levels in hypertension patients with DE were higher than those without DE,P<0.001.Advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma creatinine,and CRP-hs levels were independent factors associated with DE in primary hypertension patients,P<0.001.CONCLUSION:DE is a common disorder associated with advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma CRP-hs,and creatinine levels in patients with primary hypertension.展开更多
In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combi...In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.展开更多
Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve damage.Thiamine deficiency is easily mis...Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve damage.Thiamine deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 levels.Since clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.展开更多
BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to invest...BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension.展开更多
Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several...Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.展开更多
文摘BACKGROUND The evidence from observational studies has been inconclusive on the causal relationship between cheese intake and gestational hypertension or diabetes.AIM To determine whether cheese consumption was causally related to hypertension and diabetes during pregnancy.METHODS This was a two-sample Mendelian randomized(MR)study.Summary-level genetic data for cheese intake was exposure and corresponding outcome data for gestational hypertension and gestational diabetes were extracted from the IEU OpenGWAS database.MR analysis was conducted using inverse variance weighting.For sensitivity analyses,MR-Egger regression,weighted median,weighted mode,and leave-one-out methods were conducted.A fixed-effect model was used to meta-analyze two sample MR estimates.The traits of gestational hypertension were pregnancy hypertension(123579 individuals)and oedema,proteinuria and hypertensive disorders in pregnancy,childbirth and the puerperium(123579 individuals),and traits of gestational diabetes were gestational diabetes(123579 individuals)and diabetes mellitus in pregnancy(116363 individuals),respectively.RESULTS Cheese intake per standard deviation increase has causally reduced the risks of gestational hypertension[odds ratio(OR)=0.60,95%confidence interval(CI):0.47-0.76,P<0.001]and gestational diabetes(OR=0.41,95%CI:0.30-0.55,P<0.001)in inverse variance weighted analysis.Sensitivity analysis showed no heterogeneity(all P>0.05)nor horizontal pleiotropy(all P>0.05)in the relationship between cheese intake and gestational hypertension,but heterogeneity presented(all P<0.05)in relation to gestational diabetes in the two-sample MR analysis.CONCLUSION Cheese intake was inversely associated with gestational hypertension and gestational diabetes in MR analysis,suggesting that cheese consumption may be beneficial in preventing hypertension and diabetes during pregnancy.
文摘Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast microvilli (stbm) and l-arginine nitrosyl methyl ester were screened out via caudal vein injection. Twenty gestational hypertension-preeclampsia model SD (Sprague Dawley) rats successfully induced by L-NAME (L-arginine Nitrosyl methyl ester) were randomly divided into 2 groups (model group and Danshen injection group, n = 10). Then another 10 normal pregnant SD rats without model were selected as blank control group. The Salvia miltiorrhiza injection group was given Salvia miltiorrhiza injection (0.5 g?kg?1?d?1) through tail vein, and the control group and model group were given equal volume of normal saline through tail vein injection. All three groups were treated by tail vein injection once a day (d) for 7 days. After treatment, heart rate (HR), Systolic pressure (SP), diastolic pressure (DP) and mean arterial pressure (MAP) were measured by tail artery. Left ventricular end-diastolic diameter (LVDd) and Left ventricular end systolic diameter (LVDs) were recorded by echocardiography. Left ventricular end diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (left ventricular ejection) fraction, LVEF) and the maximum rate of increase/decrease of left ventricular pressure during isovolemic systole (+dp/dtmax/?dp/dtmax);Endothelin-1 (ET-1) levels in rat tail vein blood were detected by ELISA. Results: SP, DP, MP, HR, LVSP, LVDs and ?dp/dtmaxx were all decreased, plasma ET-1 expression was low, and LVDd, LVEDP, LVEF, and +dp/dtmax were all increased in the Salvia miltiorroot injection group, with statistical significance compared to the model group (p Conclusion: Salvia miltiorrhiza injection can improve the cardiac function and reduce blood pressure in rats with pregnancy-induced hypertension and preeclampsia, and the mechanism may be related to alleviating systemic arteriolar spasm by regulating ET-1 level.
基金the National Key Research&Development Program of China(No.2017YFC0212003)the National Natural Science Foundation of China(No.21577043)the Natural Science Foundation of Hubei Province(No.2010CDB08803).
文摘Gestational hypertension(GH)is a common complication during pregnancy.GH is regarded as a potential public health challenge for pregnant women and infants.Limited evidence has linked ambient air pollution to an increased GH risk.However,most of the studies were conducted in developed countries,with inconsistent results obtained.The present study was performed to explore whether exposure to particulate matters with an aerodynamic diameter≤2.5(PM2.5)and ozone(O3)was related to elevated odds of GH in a Chinese population.This population-based cohort study involved 38115 pregnant women in Wuhan,China.All information was collected from the Wuhan Maternal and Child Health Management Information System,using standardized quality control.The daily air pollutant data for PM2.5 and O3 were obtained from the 20 monitoring stations of the Wuhan Environmental Monitoring Center during 2014.The nearest monitor approach was applied to individual exposure assessment of PM2.5 and O3 for each participant.After adjusting for major confounders and other air pollutants,a 10μg/m^3 increase in PM25 and O3 concentrations was found to correlate to a 1.14-fold[95%confidence interval(95%CI):1.09,1.20]and a 1.05-fold(95%CI:1.02,1.07)increase in GH risk,respectively.Additionally,stronger relationships between GH risk and PM25 and O3 exposure were observed in women who conceived in winter and summer,respectively.These findings suggest that air pollutants may contribute to the development of GH.
基金a grant from the Key Program of Clinical Sciences of Ministry of Health of China (No. WGCF468)
文摘To clarify the role of TAFI in hypertensive disorders in pregnancy,22 subjects,including 10 with pre-eclampsia(PE) and 12 with gestational hypertension were examined for the levels of TAFI and thrombin-antithrombin(TAT) complex.Thirty normal pregnant women served as controls.ELISA was employed for the detection.The results showed that the TAFI antigen levels in normal pregnancy group,gestational hypertension group and PE group were(85.35±24.69)%,(99.65±18.27)%,(110.12±23.36)%;(97.06±21.40)%,(114.08±27.76)%,(125.49±24.70)%;(106.6±19.21)%,(129.2±25.07)%,(139.1±30.12)%,in the 1st,2nd and 3rd trimester respectively.No significant differences were found between the normal pregnancy group and gestational hypertension group but significant difference existed between normal pregnancy group and PE group in each tri-mester(P<0.05).TAT complexes were significantly higher in patients with PE than that in controls(P<0.05),but no correlation was found between TAT and TAFI.It is concluded that TAFI may con-tributed to the impairment of fibrinolysis in the patients with PE and may serves as a sensitive indi-cator for PE,but it may not help in the diagnosis of the gestational hypertension.
文摘Objective:To explore the effect of nifedipine in combined with magnesium sulfate on the hemorheology and coagulation indicators in patients with gestational hypertension.Methods:A total of 90 patients with gestational hypertension were included in the study and randomized into the observation group and the control group with 45 cases in each group. The patients in the observation group were given magnesium sulfate in combined with nifedipine, while the patients in the control group were only given magnesium sulfate. The patients in the two groups were continuously treated for 2 weeks. The blood pressure, hemorheology indicators, and coagulation indicators before and after treatment in the two groups were detected and compared.Results: SBP, DBP, whole blood high, moderate, and low shear viscosity, plasma viscosity, and HCT after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05). The levels of the above indicators after treatment in the observation group were significantly lower than those in the control group (P<0.05). PT, APTT, and TT after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05), while Fib was significantly reduced (P<0.05). PT, APTT, and TT after treatment in the observation group were significantly higher than those in the control group (P<0.05), while Fib was significantly lower than that in the control group (P<0.05). Conclusions:Nifedipine in combined with magnesium sulfate can significantly stabilize the blood pressure level in patients with gestational hypertension, and improve the hemodynamic and coagulation indicators, with a significant efficacy.
文摘Objective: To discuss the effect of medical nutrition combined with exercise intervention on the placental ischemic hypoxic injury and serum angiogenesis factors in patients with gestational hypertension. Methods: A total of 90 patients with gestational hypertension who received antenatal care and gave birth in our hospital between July 2014 and July 2016 were collected and divided into control group and observation group according to random number table, 45 cases in each group. Control group of patients received routine therapy, observation group of patients received routine therapy + nutrition combined with exercise intervention, and the ischemic hypoxic injury index expression in placenta tissue and serum angiogenesis factor levels before delivery were compared between two groups of patients. Results: After intervention, ischemic hypoxic injury index NO level in placental grinding fluid of observation group was higher than that of control group while ET-1, HIF-1α, Bax, Caspase-3 and MDA levels were lower than those of control group;serum angiogenesis factors TGFβ1, HGF, bFGF, VEGF and Ang-2 levels were significantly higher than those of control group while sFlt-1 level was lower than that of control group. Conclusion: The combination of medical nutrition and exercise can effectively reduce the placental ischemic hypoxic injury and reduce the angiogenesis in patients with gestational hypertension.
文摘Introduction: The purpose of this study was to examine the clinical usefulness of postoperative epidural analgesia in patients possessing severe gestational hypertension after Cesarean delivery. Methods: We reviewed the obstetric records of 99 patients possessing severe gestational hypertension undergoing singleton Cesarean delivery at ≥ 22 weeks’ gestation. Thirty patients were received continuous epidural analgesia with 0.2% ropivacaine for pain relief after Cesarean delivery with spinal anesthesia, 69 patients were not received epidural analgesia after Cesarean delivery with spinal anesthesia. Results: During the preoperative period, there were no measurable differences in the diastolic blood pressure between the 2 groups (108 vs± 7 vs. 106 mmHg ± 10 mmHg, p = 0.29). The diastolic blood pressure at 2 and 4 hours after Cesarean section in the epidural analgesia group were significantly lower than those in the non-epidural group (2 hours after Cesarean section: 88 vs ± 13 vs. 95 mmHg ± 8 mmHg, p < 0.01;4 hours after Cesarean section: 92 vs ± 15 vs. 102 mmHg ± 9 mmHg, p < 0.01). Conclusions: The current results indicated that the postoperative epidural analgesia can inhibit the rise in diastolic blood pressure in patients possessing severe gestational hypertension after Cesarean delivery. This electronic document is a “live” template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.
文摘The objective of this study was to evaluate the association between HIV infection and hypertensive disorders of pregnancy, comparing the rates of preeclampsia and gestational hypertension in a HIV-infected pregnant group and in a HIV-negative control pregnant group matched for age and parity. Furthermore, we aimed to compare the rates of hypertensive disorders in a subgroup of HIV-positive and HIV-negative African-American Black women. Patients and Methods: This was a prospective observational cohort study conducted at two University Departments of Obstetrics and Gynecology, Salesi Hospital, Ancona, and Sant’Orsola Hospital, Bologna. The HIV-infected patients’ group consisted of 126 pregnant women;140 HIV-negative pregnant women matched for age and parity served as controls. Gestational hypertension and preeclampsia were diagnosed according to NHBPEP-ISSHP criteria. Categorical data were analyzed using the Fisher exact test. Statistical significance was set at a p value < 0.05. Results: Gestational hypertension and preeclampsia were diagnosed in 3 of 126 HIV-positive patients (2.38%) and in 14 of 140 HIV-negative patients (10%), with a relative risk of 0.24 (p = 0.0112). In the subgroup of African-American Black women, gestational hypertension and preeclampsia were diagnosed in 2 out of 43 HIV-positive (4.7%) and in 3 out of 18 HIV-negative patients (16.7%) with a relative risk of 0.28, not statistically significant (p = 0.1887). Conclusion: Pregnant women with HIV infection seem to be protected against gestational hypertension and preeclampsia and this protective effect remains also in a high risk population, such as African-American Black ethnic group. The effect is present independently from treatment received and virus copies. The lack of immune response present since the conception period should account for unopposed trophoblast invasion resulting in a better placentation.
文摘Objective:To explore the effects of Xintongding and labellol on hemorheology, oxidative stress and inflammatory endothelial factor in patients with gestational hypertension.Methods:104 patients with gestational hypertension admitted to our hospital from March 2016 to January 2018 were selected as the research object. 52 patients in the control group and 52 patients in the observation group were randomly divided into two groups. The control group was treated with Xintongding, while the observation group was treated with Labellol on the basis of the control group. The changes of blood pressure, hemorheology, oxidative stress index and inflammatory endothelial factors were compared and analyzed between the two groups.Results:Before treatment, there were no significant differences in the levels of SBP, DBP, LBV, HBV, PV, FIB, LPO, MDA, SOD, TNF-α, CRP, VEGF and PLGF. After treatment, the levels of SBP, DBP, LBV, HBV, PV, FIB, LPO, MDA, TNF-α and CRP were significantly decreased, while the levels of SOD, VEGF and PLGF were significantly higher than before treatment, and the levels of SBP, DBP, LBV, HBV, PV, FIB, LPO, MDA, TNF-α and CRP in the observation group were significantly lower than those in the control group, and the levels of SOD, VEGF and PLGF were significantly higher than the control group. Conclusions: Xintongding combined with labetalol in the treatment of hypertensive disorder in pregnancy can effectively improve blood pressure, blood rheology and oxidative stress, reduce inflammation and promote angiogenesis, and has clinical significance.
文摘Objective: To investigate the ultrasound assessment of left cardiac function in patients with gestational hypertension and its correlation with serum cytokine contents. Methods: A total of 76 patients with gestational hypertension who were treated in Guangyuan Central Hospital between August 2015 and February 2017 were selected as gestational hypertension group, and 50 healthy pregnant women who received regular prenatal examination in Guangyuan Central Hospital during the same period were selected as normal control group. The differences in the ultrasonic left cardiac function parameter levels as well as serum contents of endothelial injury indexes and inflammatory factors were compared between the two groups of pregnant women. Pearson test was used to assess the correlation of ultrasonic left cardiac function parameter levels of gestational hypertension with serum endothelial injury index and inflammatory factor contents. Results: LAVmax, LVESV and LVEDV levels in gestational hypertension group were significantly higher than those in normal control group;serum endothelial injury indexes NO and PGE2 contents were lower than those of normal control group whereas ET-1 content was higher than that of normal control group;serum inflammatory factors IL-2, IFN-γ, IL-10, IL-13, IL-17 and IL-23 contents were significantly higher than those of normal control group. Correlation analysis showed that the ultrasonic left cardiac function parameter levels in patients with gestational hypertension were directly correlated with serum content of endothelial injury indexes and inflammatory factors. Conclusion: Ultrasonic left cardiac function parameter levels significantly change in patients with gestational hypertension, and the specific levels are directly correlated with the degree of endothelial injury and inflammatory response in the pregnant women.
文摘Objective:To determine the fetal left ventricular Tei index level in gestational hypertension, and evaluate its correlation with the degree of placental hypoxia.Methods: A total of 98 pregnant women with gestational hypertension who gave birth in our hospital between May 2013 and May 2016 were selected as the gestational hypertension group and 50 normal pregnant women were selected as the normal pregnancy group. Before delivery, the color Doppler diasonograph was used to detect fetal left ventricular Tei index and umbilical blood flow parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of hypoxia-related indexes and nerve injury indexes in umbilical venous blood after delivery of baby, and Pearson test was used to further evaluate the internal relations between fetal left ventricular Tei index and placental hypoxia degree.Results: Fetal left ventricular Tei index level of gestational hypertension group was higher than that of normal pregnancy group. Fetal ultrasonic umbilical blood flow parameters RI, PI and S/D levels of gestational hypertension group were higher than those of normal pregnancy group, ischemia hypoxia indexes HIF-1α and HSP70 contents in umbilical venous blood were higher than those of normal pregnancy group while NO content was lower than that of normal pregnancy group, and nerve injury indexes NSE, S100B and MBP contents in umbilical venous blood were higher than those of normal pregnancy group. After Pearson test, fetal left ventricular Tei index in gestational hypertension was directly correlated with umbilical blood flow parameter levels as well as ischemia hypoxia index and nerve injury index contents in umbilical venous blood. Conclusion:Fetal left ventricular Tei index level in gestational hypertension is higher than that in normal fetus, and Tei index level is directly correlated with placental ischemia hypoxia degree.
文摘Objective: To investigate the ultrasonic evaluation of uterine spiral artery characteristics in patients with gestational hypertension and their correlation with the placental hypoxia injury. Methods: A total of 128 puerperae with gestational hypertension who gave birth in this hospital between December 2014 and February 2017 were collected as gestational hypertension group, and 100 healthy puerperae who gave birth in this hospital during the same period were collected as normal control group. The differences in uterine spiral artery parameter levels as well as the contents of angiogenesis indexes, oxidative stress indexes and inflammatory mediators in the placental grinding fluid were compared between the two groups 1 week before delivery. Pearson test was used to evaluate the correlation between uterine spiral artery characteristics and placental hypoxia injury in patients with gestational hypertension. Results: Uterine spiral artery RI, PI and S/D levels in gestational hypertension group were higher than those in normal control group;angiogenesis indexes HIF-1α, VEGF and sFlt-1 contents in placental grinding fluid of gestational hypertension group were higher than those of normal control group;anti-oxidation indexes CTA and SOD contents were lower than those of control group whereas LHP content was higher than that of normal control group;inflammatory mediators IL-6, TNF-α, NF-κB and HSP70 contents were higher than those of normal control group. Pearson test showed that the uterine spiral artery RI, PI and S/D levels in puerperae with gestational hypertension were positively correlated with the degree of angiogenesis, oxidative stress and inflammatory response in the placenta. Conclusion: There are abnormal changes of uterine spiral artery flow parameters in puerperae with gestational hypertension, and the abnormality can objectively reflect the degree of placental hypoxia injury.
文摘Objective:To study the fetal middle cerebral artery blood flow characteristics of gestational hypertension combined with fetal distress in uterus as well as their correlation with hypoxia. Methods: Puerperae with hypertensive disorders in pregnancy and fetal distress in uterus, puerperae with hypertensive disorders in pregnancy alone and healthy puerperae who gave birth in our hospital between January 2013 and January 2016 were included in group A, group B and group C of the study respectively. At 34-36 weeks of pregnancy, color Doppler ultrasonography was conducted to determine fetal middle cerebral artery blood flow parameters;after childbirth, umbilical arterial blood was collected to determine blood gas analysis parameters, and the placenta tissue was collected to determine oxidative stress and mitochondria damage indexes.Results:Fetal middle cerebral artery S/D, PI and RI of group A were significantly higher than those of group B and group C while umbilical artery pH value and PaO2 as well as HCO3- and BE content were significantly lower than those of group B and group C;fetal middle cerebral artery S/D, PI and RI as well as umbilical artery pH value, PaO2, HCO3- and BE content of group B were not significantly different from those of group C;Nrf2, ARE, NQO1, VitC, SVCT1, SVCT2, ATP, PGC-1α, PGC-1β, NRF1 and NRF2 content in placenta tissue of group A were significantly lower than those of group B and group C while ROS content was significantly higher than those of group B and group C;Nrf2, ARE, NQO1, VitC, SVCT1, SVCT2, ATP, PGC-1α, PGC-1β, NRF1 and NRF2 content in placenta tissue of group B were significantly lower than those of group C while ROS content was significantly higher than that of group C. Fetal middle cerebral artery S/D, PI and RI were negatively correlated with umbilical artery pH value, PaO2, HCO3- and BE content as well as Nrf2, ARE, NQO1, VitC, SVCT1, SVCT2, ATP, PGC-1α, PGC-1β, NRF1 and NRF2 content, and were positively correlated with ROS content.Conclusions:Gestational hypertension combined with fetal distress in uterus can lead to increased fetal middle cerebral artery blood flow resistance and decreased blood perfusion, and the changes of middle cerebral artery blood flow characteristics can assess the degree of hypoxia and oxidative stress damage.
文摘Objective:Preeclampsia(PE)is a common complication during pregnancy.miR-100a is expressed in the placenta and regulates the survival and development of placental cells.Insulin growth factor-2(IGF-2)may serve as its downstream target.This study investigated the protective mechanisms of ginsenoside Rg3 against PE in rat model.Materials and Methods:LPS-induced rat PE models were suitable for intravenous administration of the highly expressed miR-100a ginsenoside Rg3 lentiviral vector.Human trophoblasts were cultured in vitro for JEG-3,and PE cell models were constructed.In vivo effects on tumor growth and apoptosis were observed.Ginsenoside Rg3 was treated with different concentrations of shRNA,miR-100a analogs,inhibitors,or IGF-2.Autophagy and the expression of autophagy-related proteins were examined.Trophoblast activity and migration were determined using Cell Counting Kit-8 and Transwell assays.Both drugs strongly inhibited trophoblasts under normal conditions with some synergy between them.Double-luciferase return assay confirmed the binding affinity of miR-100a for IGF-2.Results:In response to Rg3,autophagy and the expression of autophagy-related proteins LC3-I/II,Beclin1,and SQSTM1 were reduced in PE rat placental trophoblasts.Rg3 inhibited autophagy in JEG-3 cells and promoted JEG-3 survival and migration in a concentration-dependent manner.miR-100a upregulated PE expression.These results suggested that autophagy was a vital signaling system.Rg3 intervention inhibited miR-100a expression and miR-100a downregulated IGF-2 expression in placental tissues and promoted autophagy,thereby inhibiting JEG-3cell survival and migration.In rats,Rg3 inhibited PE development by regulating the activity of the miR-100a-IGF-2 signaling axis.Conclusion:Ginsenoside Rg3 positively regulates the miR-100a-IGF-2 axis and protects PE rats by inhibiting trophoblastic autophagy and promoting trophoblastic cell survival and migration.
文摘Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.
文摘AIM:To determine the dry eye(DE)rate and its relationship with disease stage in patients with primary hypertension.METHODS:A cross-sectional study included 432 patients with primary hypertension(with an equal number of patients in each group:144 in stage Ⅰ,Ⅱ,and Ⅲ hypertension)and 144 healthy subjects as a control group.The Ocular Surface Disease Index(OSDI)and Schirmer Ⅰ test without anesthetics were conducted on all 576 subjects.Subjects with OSDI scores<13 and Schirmer Ⅰ values equal to or under 10 mm were diagnosed with DE.RESULTS:The ratio of DE in hypertension patients was higher than in the control group(41.7%versus 18.8%;P<0.001).The proportion of patients with DE increased gradually according to the hypertension stage:27.1% in stage Ⅰ,40.3% in stage Ⅱ,and 57.6% in stage Ⅲ,P<0.001.Age,duration of hypertension,plasma urea,creatinine,and high-sensitivity C-reactive protein(CRP-hs)levels in hypertension patients with DE were higher than those without DE,P<0.001.Advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma creatinine,and CRP-hs levels were independent factors associated with DE in primary hypertension patients,P<0.001.CONCLUSION:DE is a common disorder associated with advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma CRP-hs,and creatinine levels in patients with primary hypertension.
文摘In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.
基金General Research Project of Education Bureau of Zhejiang Province(Y202353789)。
文摘Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve damage.Thiamine deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 levels.Since clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.
基金Supported by National Natural Science Foundation of China(General Program),No.82070631.
文摘BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension.
文摘Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.
