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
Objective: There are numerous studies suggesting that genetic polymor-phisms of inflammation factors Toll-like receptors 2 and 4 (TLR2, TLR4) might play a role in the pathophysiological process of hypertension. In thi...Objective: There are numerous studies suggesting that genetic polymor-phisms of inflammation factors Toll-like receptors 2 and 4 (TLR2, TLR4) might play a role in the pathophysiological process of hypertension. In this study, we evaluated the association in a sample of members of the Chinese Han population. Method: We selected four single nucleotide polymor-phisms (SNP) of TLR2 (rs3804099, rs3804100, rs7656411) and TLR4 (rs1927906) genes, and measured the distributions of genotypic and allelic frequencies in 1063 participants, including 391 essential hypertension pa-tients and 672 controls. Result: No significant differences in the genotypic and allelic frequencies of the four SNPs were detected between cases and controls. However, three haplotypes, CCG, TTG and TTT of TLR2, were significantly associated with a decrease in the risk of essential hyperten-sion (OR: 0.512, 95% CI: 0.397 - 0.660, P P = 0.0038;OR: 0.797, 95% CI: 0.667 - 0.952, P = 0.0122, respectively). Inversely, the risk of essential hypertension increased sig-nificantly in patients with the CTG, TCG or TCT haplotypes (OR: 2.924, 95% CI: 2.157 - 3.963, P P P Conclusion: Our study suggested that haplotypes (CCG, TTG, TTT, CTG, TCG and TCT) of TLR2 might have profound effects on the development of essential hypertension in the Chinese Han population.展开更多
Background:Essential hypertension affects over a billion people worldwide.Despite the absence of a definitive cure,current treatments primarily aim to manage blood pressure levels.There is a compelling need for antihy...Background:Essential hypertension affects over a billion people worldwide.Despite the absence of a definitive cure,current treatments primarily aim to manage blood pressure levels.There is a compelling need for antihypertensive medications that offer high effectiveness,low toxicity,and minimal side effects.Objective:This study seeks to investigate the antihypertensive properties of Cortex Lycii by employing network pharmacology and validating the findings through molecular docking.Methods:We utilized various platforms and databases related to traditional Chinese medicine to identify the active compounds within Cortex Lycii.Targets associated with hypertension were gathered from well-established disease-related resources.Shared targets were delineated using the EVenn.Subsequently,we conducted GO and KEGG analyses through the DAVID platform and visualized the resultant network with Cytoscape.Molecular docking was carried out using Autodock Vina and PyMOL.Results:Our investigation revealed ten active compounds in Cortex Lycii that demonstrated correlation with 82 essential hypertension-associated targets.These shared targets were categorized into four distinct clusters,each with unique functions.Fourteen hub targets were singled out based on predefined selection criteria.GO analysis unveiled the participation of shared targets in various biological processes linked to hypertension.KEGG analysis identified ten significant signaling pathways associated with hypertension development.Molecular docking analysis provided confirmation of the interaction between the selected hub targets and the active compounds.Conclusion:Cortex Lycii,a traditional Chinese herb with a long history of use,exerts its antihypertensive effects through a combination of active compounds,involvement of multiple targets,regulation of various biological processes,and modulation of key signaling pathways.展开更多
BACKGROUND: The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is hel...BACKGROUND: The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful to develop researches on the genetics of various diseases including hypertension in Mongolian population. OBJECTIVE: To analyze the association between the polymorphism of beta1 adrenergic receptor (β1-AR) gene G1165C (Arg389Gly), an important candidate gene for various diseases of cardiovascular system, and essential hypertension in Mongolian population. DESIGN: A cross-sectional study. SETTINGS: Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College; Wulate Houqi Red Cross Society. PARTICIPANTS: The survey was carried out from February 2003 to March 2005. Totally 239 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia, and they were all informed with the survey and detected items. Based on the diagnostic standard of hypertension set by WHO in 1999, the subjects were divided into two groups according to the level blood pressure: ① Normal blood pressure group (n=117): systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg =0.133 kPa), diastolic blood pressure (DBP) < 90 mm Hg, and those having histories of cerebrovascular disease, heart disease, diseases of liver, kidney and tiroides, and diabetes mellitus were excluded. ② Essential hypertension group (n=122): including 51 patients with simple high SBP. All the enrolled subjects had no blood relationship with each other, and had no history of miscegenation. METHODS: The body height, body mass, waist circumference and blood lipids were measured routinely, and their habits of smoking and drinking were also investigated. Peripheral venous blood (5 mL) was drawn, the genome DNA was extracted, and the polymorphisms of the β1-AR G1165C (Gly389Arg) genotype were detected with the Sequenom system. Polymerase chain reaction (PCR) experiment and SNP detection were performed in Huada Gene Laboratory of Bejing, then the univariate analysis of variance was applied in the sample comparison among groups, and the chi-square test was used to compare the genotypes and allele frequencies. The odd ratio (OR) and 95% confidence interval (CI) were calculated. MAIN OUTCOME MEASURES: The distributions of β1-AR G1165C (Gly389Arg) genotypes and alleles were observed. RESULTS: All the 239 subjects were involved in the analysis of results, and no one missed. ①Comparison of β1-AR G1165C (Gly389Arg) genotypes and allele distributions: In Mongolian population, the frequencies of CC and GG+GC genotypes at β1-AR G1165C (Gly389Arg) site in the essential hypertension group (72%, 28%) were not significantly different from those in the normal blood pressure group (67%, 33%) (χ2=0.841, P=0.359; OR: 0.773, 95%CI: 0.445-1.342); The frequencies of C and G alleles also had no significant differences between the essential hypertension group (85%, 15%) and the normal blood pressure group (82%, 18%) (χ2=1.136, P=0.287; OR: 0.769, 95%CI: 0.747-1.248). ②The frequencies of CC and GG+GC genotypes at β1-AR G1165C (Gly389Arg) site had no significant differences between the patients with simple high SBP (71%, 29%) and the normal blood pressure group (χ2=0.250, P=0.617; OR: 0.833, 95%CI: 0.408-1.703); The frequencies of C and G alleles were not significantly different between the patients with simple high SBP (86%, 14%) and the normal blood pressure group (χ2=0.670, P=0.413; OR: 0.766, 95%CI: 0.404-1.453). CONCLUSION: In Mongolian population, the distributions of the genotypes and alleles of β1-AR G1165C (Gly389Arg) have no obvious differences between the subjects with normal blood pressure and the patients with essential hypertension (including simple SBP increase), which suggests that G1165C (Glu389Asp) site of β1-AR gene may be not a genetic mark of essential hypertension and simple high SBP in Mongolian population.展开更多
Objective The aim is to ascertain whether phenylalanine (Phe) can inverse the left heart"remodeling" in patients with essential hypertension. Methods The changes of echocardiographic variables werecompared a...Objective The aim is to ascertain whether phenylalanine (Phe) can inverse the left heart"remodeling" in patients with essential hypertension. Methods The changes of echocardiographic variables werecompared aler 3,6 and 9 months of observation between the Phe intervention group (Phe 1g/d+amiloride complex1 tablet/d, 20 cases) and control group (placebo 1g/d+amiloride complex 1 tablet/d, 20 cases) with eitherinterventricular septum and (or) post- wall thickness≥12mm, and were carried on further to compare incross- over trial. Results (1) Phe improved elfectively the left heart and systolic dyslunction; while theimprovement, also shown in control group due to the concurrent use of diuretic antihypertensive drug-amiloridecomplex, was much less evident than that in Phe group. (2) The disturbed left heart structure and systolic functionwere improved prominently while placebo was crossed over to Phe, and the improvement decreased afer Phe wascrrossed over to placebo. (3) The changes almost attained to its peak level after 6 months and not improved furtherat 9 months. (4) The differences seen between above 2 groops could not be eoplained by their diverse drops of bloodpressure. Conclusion Phe does exert an indopendent inverse effect on cardiac "remodeling", which mightimplicate an important clinical oplication upon the prevention and control of essential hypertension and itscomplications.展开更多
Background: Blood pressure variability (BPV) in hypertensive patients is implicated as a remarkable feature leading to additional cardiovascular complications. The aim of the study was to identify the determinants inf...Background: Blood pressure variability (BPV) in hypertensive patients is implicated as a remarkable feature leading to additional cardiovascular complications. The aim of the study was to identify the determinants influencing BPV among patients with essential hypertension seen at the Cardiology department of the faculty of medicine, University of Alexandria, Egypt. Methods: This was a descriptive cross-sectional hospital-based study conducted from August 2019 to November 2019. All the eligible patients were made to fill out a standard questionnaire to obtain family and personal clinical history and undergo routine physical examination, laboratory tests and 24-hour ambulatory blood pressure monitoring. BPV was summarized as the standard deviation (SD) of all-day systolic and diastolic BP in both normal patients (with SD 11) and abnormal patients (with SD ≥ 11). Results: Out of a total of 114 patients, 18 (15.8%) non-hypertensive patients were included in the control group and the remaining 96 (84.3%) were classified based on the degree of hypertension. BPV in all these patients was found to be significantly related to the male gender, a mild or moderate degree of hypertension, high prevalence of non-dipping, diabetes, use of beta-blockers as antihypertensive medication, heart rate variability, BMI, and increased day-time variability. Conclusion: Variability in blood pressure influenced by different intrinsic and extrinsic factors plays an important role in the management of hypertension. In order to reduce the burden of disease and for a better quality of life for hypertensive patients, it is important that physicians start considering lowering BPV in addition to reducing physiological BP levels.展开更多
The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording,...The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording, ambulatory blood pressure monitoring, echocardiography examination, etc. According to the examinations, left ventricular geometric patterns and arrhythmias were identified. The comparison of morbidity of arrhythmias between the left ventricular remodeling group and the normal geometric pattern group was performed. The multiple stepwise regression analysis was carried out to identify the independent determinants of arrhythmias. After these predictors were controlled or adjusted, the severity of arrhythmias among different left ventricular geometric patterns was compared. It was found that the morbidity of atrial arrhythmia, ventricular arrhythmia and complex ventricular arrhythmias in the left ventricular remodeling group was significantly higher than in the normal geometric pattern group respectively. There were many independent factors influencing on arrhythmias in essential hypertension. Of all these factors, some indices of left ventricular anatomic structure, grade of hypertension, left atrial inner dimension, E/A, diastolic blood pressure load value at night and day average heart rate and so on were very important. After the above mentioned factors were adjusted, the differences of the orders of arrhythmias between partial geometric patterns were reserved, which resulted from the differences of the geometric patterns. Many factors contributed to arrhythmias of essential hypertension, such as grade of hypertension, LVMI, LA, PWT and so on. The severity of arrhythmias was different in different left ventricular geometric patterns.展开更多
Objective:Banxia Baizhu Tianma Decoction(半夏白术天麻汤,BBTD)combined with Xuefu Zhuyu Decoction(血府逐瘀汤,XFZYD)is widely used to treat essential hypertension in China,but its efficacy remains largely unexplored.We ...Objective:Banxia Baizhu Tianma Decoction(半夏白术天麻汤,BBTD)combined with Xuefu Zhuyu Decoction(血府逐瘀汤,XFZYD)is widely used to treat essential hypertension in China,but its efficacy remains largely unexplored.We systemically summarized relevant evidence from randomized controlled trials(RCTs)to assess the therapeutic efficacy of BBTD+XFZYD.Methods:This review retrieved 6 databases like Pubmed,Cochrane Library,Embase,CNKI,et al.RCTs of BBTD+XFZYD plus conventional Western drugs(experimental group)and conventional Western drugs alone(control group)for hypertension was collected from the database establishment to August 5,2020.And the outcomes included clinical total effective rate,systolic blood pressure(SBP),diastolic blood pressure(DBP),nitric oxide(NO)and endothelin-1(ET-1).All studies’risk of bias were assessed by the Cochrane Collaboration tool 5.1.0.The data was statistically analyzed by RevMan5.3 Software.Results:Six studies with 608 participants were identified.About duration of treatment,4 studies were 1 month,2 studies were 2 months.The quality presented a high risk of bias.The experimental group showed that clinical total effective rate of the 1-month and 2-month was higher(P<0.00001),the systolic pressure was significantly lower(P<0.05),the NO increased(P<0.00001),and the ET-1 decreased(P<0.00001)compared with the conventional Western drugs used alone.However,DBP was significantly lower(P<0.05)at 2 months of treatment.Conclusion:BBTD+XFZYD plus conventional Western drugs might reduce blood pressure,improve clinical efficacy,repair endothelial function,but still need high-quality RCTs to better assess the outcomes.展开更多
Introduction: Subclinical brain damage in essential hypertension is more prevalent than cardiovascular or renal impairment;nevertheless, screening for nervous system involvement is difficult due to the low accessibili...Introduction: Subclinical brain damage in essential hypertension is more prevalent than cardiovascular or renal impairment;nevertheless, screening for nervous system involvement is difficult due to the low accessibility and high costs of these techniques. Objective: To assess the frequency of silent target organ damage in a cohort of asymptomatic hypertensive patients and to evaluate the potential usefulness of carotid ultrasonographic (US) variables as predictors of subclinical brain damage. Patients and Methods: Thirty four neurologically asymptomatic subjects (mean age 59 years) with essential hypertension were included. Target organ damage was evaluated: degree of hypertensive retinopathy, heart, kidney and brain. Structural and hemodynamical carotid Doppler US parameters were also investigated. Results: The brain was the most frequently affected target organ (70.6%), followed by the heart (67.9%) and kidney (58.6%). Carotid US parameters showed no association of intima media thickness with brain MRI results;nevertheless, decreased diastolic flow velocity and increased resistive index pointed to a resistive carotid flow pattern in patients with classical brain MRI lesions and predicted subclinical lesions with a sensitivity of 70% and 74% and a specificity of 72% and 80% respectively. Conclusions: This study supports previous findings that place the brain as the most frequently affected target organ in essential hypertensive patients and sheds more light on the potential usefulness of carotid structure and hemodynamics as imaging biomarkers of subclinical brain lesions.展开更多
Background:This study aimed to clarify the effects of a Graded Brisk Walking Test(GBWT)program on blood pressure(BP)control in elderly patients with essential hypertension and to determine its appropriate degree of in...Background:This study aimed to clarify the effects of a Graded Brisk Walking Test(GBWT)program on blood pressure(BP)control in elderly patients with essential hypertension and to determine its appropriate degree of intensity for elderly people.Methods:In total,421 out of 620 participants were randomly sampled from a community health center in Shanghai,China.Among them,200 and 221 patients were assigned to the intervened and control groups,respectively.They were all treated with the GBWT program for 8 weeks,16 weeks,and 24 weeks.Results:Based on ANOVA,there was no significant time main effect,condition main effect,or time by condition interaction both in heart rate and body mass index indicators(P>0.05).There were significant condition main effects,time by condition interaction,or time main effects in blood pressure(F=21.875,33.457,65.342,respectively;All P<0.05).After the intervention,significant differences in systolic blood pressure(SBP)and diastolic blood pressure(DBP)values were also observed in the two groups(P<0.05);the average values of the baseline and second phases of the intervention group were significantly lower than those of the control group(P<0.05).Significant differences in blood pressure values after the first two phases were also observed when compared with those before the intervention.Similarly,a significant difference in the first phase and second phase was also found between the BP group and intervention group.However,after the third phase(24 weeks,high-intensity exercise),no significant differences existed both in SBP and DBP groups compared with those before the intervention(P=0.07).Conclusion:GBWT is an effective exercise prescription to mitigate the essential hypertension in elderly Chinese patients,and the intensity,walking distance,and target number of steps can be adjusted according to the age of the patients.展开更多
Background Scraping therapy is widely used in treating stage I and II essential hypertension in China.However,there has been no systematic evaluation of the efficacy of scraping therapy on blood pressure and sleep qua...Background Scraping therapy is widely used in treating stage I and II essential hypertension in China.However,there has been no systematic evaluation of the efficacy of scraping therapy on blood pressure and sleep quality in stage I and II essential hypertension.Search strategy Seven electronic databases(PubMed,Scopus,Cochrane Library,Web of Science,EBSCO,China National Knowledge Infrastructure and Wanfang Data electronic databases)were searched from inception to December 2022.Based on the principle of combining subject words with text words,the search strategy was constructed around search terms for“scraping therapy,”“scraping,”“Guasha,”“Gua sha,”“hypertension,”and“high blood pressure”during the database searches.Inclusion criteria Randomized controlled trials(RCTs)were included if they recruited patients with stage I and II essential hypertension and included a scraping therapy intervention.The intervention group received antihypertensive drugs and scraping therapy,while the control group only took antihypertensive drugs.Data extraction and analysis Review Manager 5.4.0 and STATA 15.1 were used to enter all the relevant outcome variables to conduct the meta-analysis.The quality of the selected RCTs was assessed using the PEDro scale.The sensitivity analysis was carried out by iteratively excluding individual studies and repeating the analysis to determine the stability of the findings and identify any studies with greater influence on the outcome.Subgroup analysis was performed to find the source of heterogeneity.Funnel plots were used to evaluate the publication bias of included studies.Results Nine RCTs including 765 participants were selected.Meta-analysis showed that scraping therapy combined with medication had an advantage over the use of medication alone in lowering systolic blood pressure(mean difference[MD]=?5.09,95%confidence interval[CI]=?6.50 to?3.67,P<0.001)and diastolic blood pressure(MD=?2.66,95%CI=?3.17 to?2.14,P<0.001).Subgroup analysis showed that scraping therapy improved sleep quality in middle-aged patients with hypertension,but the efficacy was better in elderly patients(MD=?7.91,95%CI=?8.65 to?7.16,P<0.001)than in middle-aged patients(MD=?2.67,95%CI=?4.12 to?1.21,P=0.0003).Conclusion The available evidence indicates that scraping therapy has significant effects on patients with stage I and II hypertension,and it improves sleep quality for elderly patients with hypertension better than for middle-aged ones.Scraping therapy can be an adjunctive treatment for stage I and II essential hypertension.However,further high-quality studies are needed to verify its effectiveness and the best therapeutic strategies.展开更多
Objective:To explore the role of NLRP3/Caspase-1-mediated pyroptosis on peripheral blood monocytes in patients with essential hypertension(EH),and its regulation by pannexin-1(Panx-1)hemi-channels.Methods:The peripher...Objective:To explore the role of NLRP3/Caspase-1-mediated pyroptosis on peripheral blood monocytes in patients with essential hypertension(EH),and its regulation by pannexin-1(Panx-1)hemi-channels.Methods:The peripheral blood of EH patients and healthy subjects was collected,peripheral plasma of the two groups was subsequently separated,and IL-1βcontent in peripheral plasma was further measured by ELISA.In the meantime,the monocytes from peripheral blood were sorted by immunomagnetic beads,and mRNA and protein expression of Panx-1,NLRP3 inflammasome related molecules(NLRP3,ASC,Caspase-1),downstream effector IL-1β,and pyroptosis-related protein GSDMD,were analyzed by RT-qPCR and Western blot,respectively.Subsequently,human primary monocytes in two group were cultured in vitro.Immunofluorescence assay was performed to detect the expression and location of Panx-1 on monocytes.Finally,the cultured monocytes from EH patients were exposed to NLRP3 inflammasome activator lipopolysaccharide(LPS),and also to LPS pretreated with Panx-1 hemi-channel inhibitor probenecid or specific Panx-1 siRNA,followed by collection of the cell culture supernatant and monocytes.The cell viability of each group was detected by CCK-8 assay,IL-1βcontent in the culture supernatant was analyzed by ELISA,and the expression of target proteins on monocytes was determined by Western blot assay.Results:Compared with healthy subjects,EH patients showed higher IL-1βcontent in peripheral plasma,and increased expression in both mRNA and protein levels for Panx-1,NLRP3 inflammasome related molecules,IL-1βand GSDMD on peripheral monocytes.Furthermore,Panx-1 protein in EH patients was significantly higher than that in healthy subjects and localized on monocyte membrane as evidenced by immunofluorescence assay.In the cultured human primary monocytes from EH patients,the cell viability in each group showed no significant difference.LPS stimulation can induce NLRP3-dependent pyroptosis,by showing an increase in IL-1βcontent in cell culture supernatant and protein expressions of NLRP3 inflammasome related molecules and GSDMD on monocytes,by LPS exposure.However,the above stimulating effect of LPS could be counteracted by pretreatment with probenecid or Panx-1 siRNA.Conclusion:The NLRP3/Caspase-1-mediated pyroptosis is activated on peripheral blood monocytes in patients with EH,and this activation could be regulated by Panx-1 hemi-channels.展开更多
Objectives:To investigate the effect on essential hypertension of the topical application of TAT-Cu,Zn-superoxide dismutase(TAT-SOD)at left acupoint Zusanli(ST 36),and to observe whether the change of electrical poten...Objectives:To investigate the effect on essential hypertension of the topical application of TAT-Cu,Zn-superoxide dismutase(TAT-SOD)at left acupoint Zusanli(ST 36),and to observe whether the change of electrical potential difference(EPD)can be related to the change of blood pressure.Methods:Sixteen patients with essential hypertension and 16 healthy subjects were included in the study.EPD between the left acupoints of Yanglingquan(GB 34)and Qiuxu(GB 40)was firstly screened out for the EPD detection.An intracellular superoxide quenching enzyme,TAT-SOD,was topically applied to the acupoint ST 36 within an area of 1 cm^2 once a day,and the influence on EPD was investigated.The dosage applied to TAT-SOD group(n=8)was 0.2 mL of 3000 U/mL TAT-SOD cream prepared by adding purified TAT-SOD to a vehicle cream,while placebo group(n=8)used the vehicle cream instead.The left acupoints of Yanglingquan(GB 34)and Qiuxu(GB 40)were selected for EPD measurement after comparing EPD readings between 5 acupoints on each of all 12 meridians.Results:EPDs between the left acupoints of GB 34 and GB 40 for 16 patients of essential hypertension and 16 healthy subjects were 44.9±6.4 and 5.6±0.9 mV,respectively.Daily application of TAT-SOD for 15 days at ST 36 of essential hypertension patients significantly decreased systolic blood pressure(SBP)and diastolic blood pressure(DBP)of 179.6 and 81.5 mm Hg to 153.1 and 74.1 mm Hg,respectively.Responding to the change in blood pressure,EPD between the left acupoints of GB 34 and GB 40 also declined from 44.4 to 22.8 mV with the same trend.No change was observed with SBP,DBP and EPD between the left acupoints of GB 34 and GB 40 with the daily application of the placebo cream.Conclusion:Enzymatic scavenging of the intracellular superoxide at ST 36 proved to be effective in decreasing SBP and DBP.The results reconfirm the involvement of superoxide anions and its transportation along the meridians,and demonstrate that EPD between acupoints may be an indicator to reflect its functioning status.Moreover,prellmlnary results suggest a close correlatlon between EPD and blood pressure readings,implying a possibility of using EPD as a sensitive parameter for blood pressure and to monitor the effect of antihypertensive treatment.展开更多
OBJECTIVE:To evaluate the effect of songlingxuemaikang(松龄血脉康,SLXMK)on mild essential hypertension in patients in terms of endothelial function.METHODS:We enrolled 90 patients with mild essential hypertension in X...OBJECTIVE:To evaluate the effect of songlingxuemaikang(松龄血脉康,SLXMK)on mild essential hypertension in patients in terms of endothelial function.METHODS:We enrolled 90 patients with mild essential hypertension in Xuanwu Hospital from January 2016 to December 2016.To evaluate the effects of SLXMK,the 90 patients were randomly assigned at a 2∶1 ratio into 2 groups:the SLXMK group(500 mg per capsule,4500 mg/d,n=60)and the losartan potassium group(50 mg per table,50 mg/d,n=30).The total study period was 12 weeks,and the changes of blood pressure,laboratory test and endothelium function were compared between two groups.RESULTS:After 12 weeks of treatment with SLXMK,blood pressure(BP)and plasma lipid levels significantly improved(P<0.05).Meanwhile,the reactive hyperemia index(RHI)increased in the SLXMK group(P<0.05).The results of multivariate logisticregression analyses examining the association of selected variables with showed that high level of oxidized low density lipoprotein(ox-LDL)was positively associated with endothelial dysfunction.CONCLUSION:SLXMK not only effectively decreased BP and plasma lipid levels,but also reduced ox-LDL and RHI in patients with mild essential hypertension.And SLXMK might improve endothelial function through decreasing the circulating ox-LDL.展开更多
Essential hypertension (EH) is thought to result from theinteraction of environmental and genetic factors. The molecular genetics of EH has witnessed considerable progress during the past few years. However, the numbe...Essential hypertension (EH) is thought to result from theinteraction of environmental and genetic factors. The molecular genetics of EH has witnessed considerable progress during the past few years. However, the number of genes involved, their chromosomal location and the magnitude of their effect on EH susceptibility are unknown. We conducted the present study to screen susceptibility genes to essential hypertension using a genome-wide scanning method in a group of Han people from Fangshan district located in the southwest of Beijing. A case-control study and affected sibpair were performed. Genotyping was carried out using a fluorescence-based semiautomated technique on automated DNA sequencer (ABI 377, PE). The basis for the genome-screen was the ABI prism linkage mapping sets of 400 microsatellite markers (version 2, PE, Co.). PCR for amplification of markers was carried out as multiplex reactions with Ampli Taq gold (PE, Co.) following protocols developed in our laboratory. Data were exported as a text file from genotyper for subsequent two-point affected sibpair linkage analysis. The data from case-control association study showed a linkage disequilibrium between EH and marker D1S249 locus (X2 = 14.6, P = 0.002). There are 12 alleles in the D1S249 locus. The frequency of A9 allele in hypertension was higher than in normotensives, (13.6% v.s. 2.7%, X2 = 6.30, p = 0.01, OR = 4.57, 95%CI = 1.24-25.4). The data from two-point affected sibpair linkage analysis demonstrated a linkage between EH and A9 allele, P＜0.05. It suggested that microsatellite marker D1S249 locus might be associated with the genetic susceptibility to essential hypertension in Han Chinese.展开更多
Genetic,environmental and demographic factors contribute to the development of essential hypertension.Genetic polymorphism of Rennin-angiotensin-aldosterone system(RAAS)has been extensively studied to determine the ge...Genetic,environmental and demographic factors contribute to the development of essential hypertension.Genetic polymorphism of Rennin-angiotensin-aldosterone system(RAAS)has been extensively studied to determine the genetic susceptibility to hypertension.The insertion/deletion(I/D)angiotensin converting enzyme(ACE)polymorphism has been established as a cardiovascular risk factor in some population,but its association with essential hypertension is controversial.This study sought to determine the association of I/D polymorphism of the ACE gene in south Indian essential hypertensive subjects.A total of 208 clinically diagnosed essential hypertensive patients without any associated diseases and 220 healthy control subjects were included in this study.Distribution and allelic frequency of Insertion(I)and Deletion(D)polymorphism at the 287 base pair Alu repeat sequence in the intron 16 of ACE gene were analyzed.The distribution of II,ID,DD genotypes of ACE gene was 28.3%,32.6%and 38.9%respectively in essential hypertensive patients and to 53.6%,26.3%and 20%in controls.The allele frequency for D allele is 0.58 in essential hypertension as compared to 0.34 of control subjects.The genotype and allele frequency of ACE gene polymorphism is significantly differed in patients when compared to controls.In conclusion,the I/D polymorphism of ACE gene is associated with Indian essential hypertension.展开更多
Objective To observe the clinical effects of acupuncture method of'Huoxue Sanfeng,Shugan Jianpi'(activating blood and eliminating wind,soothing liver and strengthening spleen)on morning blood pressure in patie...Objective To observe the clinical effects of acupuncture method of'Huoxue Sanfeng,Shugan Jianpi'(activating blood and eliminating wind,soothing liver and strengthening spleen)on morning blood pressure in patients with cerebral infarction combined with essential hypertension.Methods Sixty-eight patients were randomly divided into an observation group and a control group,34 cases in each one.The patients in the展开更多
Objective:To detect the levels of interleukin-33(IL-33)and soluble ST2(sST2)in peripheral blood of patients with essential hypertensive left ventricular hypertrophy,and to discusstheir correlation with patients with e...Objective:To detect the levels of interleukin-33(IL-33)and soluble ST2(sST2)in peripheral blood of patients with essential hypertensive left ventricular hypertrophy,and to discusstheir correlation with patients with essential hypertensive left ventricular hypertrophy was further discussed.Methods:A total of 220 patients with essential hypertension treated in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Bengbu Medical College were enrolled as the experimental group.According to left ventricular mass index(LVMI),patients with essential hypertension were divided into the non-left ventricular hypertrophy group(NLVH,n=108 cases)and the left ventricular hypertrophy group(LVH,n=112 cases).We used ELISA to detect the serum levels of IL-33 and sST2,the expression levels of IL-33 in peripheral blood lymphocytes of the NLVH group and the LVH group(60 cases each)were detected by Western blot,and the relationship between IL-33 and LVMI,a marker of left ventricular hypertrophic condition,was analyzed by Pearson.The relationship between IL-33,sST2 and left ventricular hypertrophy in essential hypertension was studied.Results:Compared with the NLVH group,the expression levels of IL-33 and sST2 in the LVH group were significantly increased.The results of Western blot showed that the expression level of IL-33 in the LVH group(1.07±0.08)was higher than that in the NLVH group(0.63±0.05)(P<0.05).Pearson correlation analysis showed that IL-33 was positively correlated with LVMI,sST2 was positively correlated with LVMI.Conclusion:The levels of IL-33 and sST2 in serum and the expression levels of IL-33 protein in peripheral blood lymphocytes are significantly increased in patients with hypertensive left ventricular hypertrophy,and the occurrence and development of essential hypertensive left ventricular hypertrophy may be related to IL-33 and sST2.展开更多
Objective To study the pattern of circadian blood pressure changes in patients with se-condary hypertension. Methods The 24h ambulatory blood pressure monitoring was performed in 80 patients with secondary hypertensio...Objective To study the pattern of circadian blood pressure changes in patients with se-condary hypertension. Methods The 24h ambulatory blood pressure monitoring was performed in 80 patients with secondary hypertension (SH) including primary aldosteronism in 44, pheochromocytoma in 11, renovas-cular hypertension in 10, renoparenchymal hypertension in 15 and compared with 80 patients with essential hy-pertension (EH) matched by age and sex. Results The diurnal rhythm in patients with SH was different from that of patients with EU. The diurnal curves in SU and EU was overlapped in daytime and separated from each other at nighttime. The nocturnal blood pressure fall was less and average blood pressure at nighttime was higher in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure loading and non-dipper phenomenon were much more frequently seen in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure/daytime blood pressure ratio was significantly higher in patients with SH than that in patients with Eli (P <0. 01). Conclusion The non-invasive 24h ambulatory blood pressure monitoring may be a useful method in screening for展开更多
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Objective: There are numerous studies suggesting that genetic polymor-phisms of inflammation factors Toll-like receptors 2 and 4 (TLR2, TLR4) might play a role in the pathophysiological process of hypertension. In this study, we evaluated the association in a sample of members of the Chinese Han population. Method: We selected four single nucleotide polymor-phisms (SNP) of TLR2 (rs3804099, rs3804100, rs7656411) and TLR4 (rs1927906) genes, and measured the distributions of genotypic and allelic frequencies in 1063 participants, including 391 essential hypertension pa-tients and 672 controls. Result: No significant differences in the genotypic and allelic frequencies of the four SNPs were detected between cases and controls. However, three haplotypes, CCG, TTG and TTT of TLR2, were significantly associated with a decrease in the risk of essential hyperten-sion (OR: 0.512, 95% CI: 0.397 - 0.660, P P = 0.0038;OR: 0.797, 95% CI: 0.667 - 0.952, P = 0.0122, respectively). Inversely, the risk of essential hypertension increased sig-nificantly in patients with the CTG, TCG or TCT haplotypes (OR: 2.924, 95% CI: 2.157 - 3.963, P P P Conclusion: Our study suggested that haplotypes (CCG, TTG, TTT, CTG, TCG and TCT) of TLR2 might have profound effects on the development of essential hypertension in the Chinese Han population.
基金supported by Local special projects in major health of Hubei Provincial Science and Technology Department(2022BCE054)Key scientific research projects of Hubei polytechnic University(23xjz08A).
文摘Background:Essential hypertension affects over a billion people worldwide.Despite the absence of a definitive cure,current treatments primarily aim to manage blood pressure levels.There is a compelling need for antihypertensive medications that offer high effectiveness,low toxicity,and minimal side effects.Objective:This study seeks to investigate the antihypertensive properties of Cortex Lycii by employing network pharmacology and validating the findings through molecular docking.Methods:We utilized various platforms and databases related to traditional Chinese medicine to identify the active compounds within Cortex Lycii.Targets associated with hypertension were gathered from well-established disease-related resources.Shared targets were delineated using the EVenn.Subsequently,we conducted GO and KEGG analyses through the DAVID platform and visualized the resultant network with Cytoscape.Molecular docking was carried out using Autodock Vina and PyMOL.Results:Our investigation revealed ten active compounds in Cortex Lycii that demonstrated correlation with 82 essential hypertension-associated targets.These shared targets were categorized into four distinct clusters,each with unique functions.Fourteen hub targets were singled out based on predefined selection criteria.GO analysis unveiled the participation of shared targets in various biological processes linked to hypertension.KEGG analysis identified ten significant signaling pathways associated with hypertension development.Molecular docking analysis provided confirmation of the interaction between the selected hub targets and the active compounds.Conclusion:Cortex Lycii,a traditional Chinese herb with a long history of use,exerts its antihypertensive effects through a combination of active compounds,involvement of multiple targets,regulation of various biological processes,and modulation of key signaling pathways.
基金a grant from theGreat Program of Inner Mongo-lia Medical College, No.NY2004ZD006
文摘BACKGROUND: The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful to develop researches on the genetics of various diseases including hypertension in Mongolian population. OBJECTIVE: To analyze the association between the polymorphism of beta1 adrenergic receptor (β1-AR) gene G1165C (Arg389Gly), an important candidate gene for various diseases of cardiovascular system, and essential hypertension in Mongolian population. DESIGN: A cross-sectional study. SETTINGS: Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College; Wulate Houqi Red Cross Society. PARTICIPANTS: The survey was carried out from February 2003 to March 2005. Totally 239 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia, and they were all informed with the survey and detected items. Based on the diagnostic standard of hypertension set by WHO in 1999, the subjects were divided into two groups according to the level blood pressure: ① Normal blood pressure group (n=117): systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg =0.133 kPa), diastolic blood pressure (DBP) < 90 mm Hg, and those having histories of cerebrovascular disease, heart disease, diseases of liver, kidney and tiroides, and diabetes mellitus were excluded. ② Essential hypertension group (n=122): including 51 patients with simple high SBP. All the enrolled subjects had no blood relationship with each other, and had no history of miscegenation. METHODS: The body height, body mass, waist circumference and blood lipids were measured routinely, and their habits of smoking and drinking were also investigated. Peripheral venous blood (5 mL) was drawn, the genome DNA was extracted, and the polymorphisms of the β1-AR G1165C (Gly389Arg) genotype were detected with the Sequenom system. Polymerase chain reaction (PCR) experiment and SNP detection were performed in Huada Gene Laboratory of Bejing, then the univariate analysis of variance was applied in the sample comparison among groups, and the chi-square test was used to compare the genotypes and allele frequencies. The odd ratio (OR) and 95% confidence interval (CI) were calculated. MAIN OUTCOME MEASURES: The distributions of β1-AR G1165C (Gly389Arg) genotypes and alleles were observed. RESULTS: All the 239 subjects were involved in the analysis of results, and no one missed. ①Comparison of β1-AR G1165C (Gly389Arg) genotypes and allele distributions: In Mongolian population, the frequencies of CC and GG+GC genotypes at β1-AR G1165C (Gly389Arg) site in the essential hypertension group (72%, 28%) were not significantly different from those in the normal blood pressure group (67%, 33%) (χ2=0.841, P=0.359; OR: 0.773, 95%CI: 0.445-1.342); The frequencies of C and G alleles also had no significant differences between the essential hypertension group (85%, 15%) and the normal blood pressure group (82%, 18%) (χ2=1.136, P=0.287; OR: 0.769, 95%CI: 0.747-1.248). ②The frequencies of CC and GG+GC genotypes at β1-AR G1165C (Gly389Arg) site had no significant differences between the patients with simple high SBP (71%, 29%) and the normal blood pressure group (χ2=0.250, P=0.617; OR: 0.833, 95%CI: 0.408-1.703); The frequencies of C and G alleles were not significantly different between the patients with simple high SBP (86%, 14%) and the normal blood pressure group (χ2=0.670, P=0.413; OR: 0.766, 95%CI: 0.404-1.453). CONCLUSION: In Mongolian population, the distributions of the genotypes and alleles of β1-AR G1165C (Gly389Arg) have no obvious differences between the subjects with normal blood pressure and the patients with essential hypertension (including simple SBP increase), which suggests that G1165C (Glu389Asp) site of β1-AR gene may be not a genetic mark of essential hypertension and simple high SBP in Mongolian population.
文摘Objective The aim is to ascertain whether phenylalanine (Phe) can inverse the left heart"remodeling" in patients with essential hypertension. Methods The changes of echocardiographic variables werecompared aler 3,6 and 9 months of observation between the Phe intervention group (Phe 1g/d+amiloride complex1 tablet/d, 20 cases) and control group (placebo 1g/d+amiloride complex 1 tablet/d, 20 cases) with eitherinterventricular septum and (or) post- wall thickness≥12mm, and were carried on further to compare incross- over trial. Results (1) Phe improved elfectively the left heart and systolic dyslunction; while theimprovement, also shown in control group due to the concurrent use of diuretic antihypertensive drug-amiloridecomplex, was much less evident than that in Phe group. (2) The disturbed left heart structure and systolic functionwere improved prominently while placebo was crossed over to Phe, and the improvement decreased afer Phe wascrrossed over to placebo. (3) The changes almost attained to its peak level after 6 months and not improved furtherat 9 months. (4) The differences seen between above 2 groops could not be eoplained by their diverse drops of bloodpressure. Conclusion Phe does exert an indopendent inverse effect on cardiac "remodeling", which mightimplicate an important clinical oplication upon the prevention and control of essential hypertension and itscomplications.
文摘Background: Blood pressure variability (BPV) in hypertensive patients is implicated as a remarkable feature leading to additional cardiovascular complications. The aim of the study was to identify the determinants influencing BPV among patients with essential hypertension seen at the Cardiology department of the faculty of medicine, University of Alexandria, Egypt. Methods: This was a descriptive cross-sectional hospital-based study conducted from August 2019 to November 2019. All the eligible patients were made to fill out a standard questionnaire to obtain family and personal clinical history and undergo routine physical examination, laboratory tests and 24-hour ambulatory blood pressure monitoring. BPV was summarized as the standard deviation (SD) of all-day systolic and diastolic BP in both normal patients (with SD 11) and abnormal patients (with SD ≥ 11). Results: Out of a total of 114 patients, 18 (15.8%) non-hypertensive patients were included in the control group and the remaining 96 (84.3%) were classified based on the degree of hypertension. BPV in all these patients was found to be significantly related to the male gender, a mild or moderate degree of hypertension, high prevalence of non-dipping, diabetes, use of beta-blockers as antihypertensive medication, heart rate variability, BMI, and increased day-time variability. Conclusion: Variability in blood pressure influenced by different intrinsic and extrinsic factors plays an important role in the management of hypertension. In order to reduce the burden of disease and for a better quality of life for hypertensive patients, it is important that physicians start considering lowering BPV in addition to reducing physiological BP levels.
文摘The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording, ambulatory blood pressure monitoring, echocardiography examination, etc. According to the examinations, left ventricular geometric patterns and arrhythmias were identified. The comparison of morbidity of arrhythmias between the left ventricular remodeling group and the normal geometric pattern group was performed. The multiple stepwise regression analysis was carried out to identify the independent determinants of arrhythmias. After these predictors were controlled or adjusted, the severity of arrhythmias among different left ventricular geometric patterns was compared. It was found that the morbidity of atrial arrhythmia, ventricular arrhythmia and complex ventricular arrhythmias in the left ventricular remodeling group was significantly higher than in the normal geometric pattern group respectively. There were many independent factors influencing on arrhythmias in essential hypertension. Of all these factors, some indices of left ventricular anatomic structure, grade of hypertension, left atrial inner dimension, E/A, diastolic blood pressure load value at night and day average heart rate and so on were very important. After the above mentioned factors were adjusted, the differences of the orders of arrhythmias between partial geometric patterns were reserved, which resulted from the differences of the geometric patterns. Many factors contributed to arrhythmias of essential hypertension, such as grade of hypertension, LVMI, LA, PWT and so on. The severity of arrhythmias was different in different left ventricular geometric patterns.
文摘Objective:Banxia Baizhu Tianma Decoction(半夏白术天麻汤,BBTD)combined with Xuefu Zhuyu Decoction(血府逐瘀汤,XFZYD)is widely used to treat essential hypertension in China,but its efficacy remains largely unexplored.We systemically summarized relevant evidence from randomized controlled trials(RCTs)to assess the therapeutic efficacy of BBTD+XFZYD.Methods:This review retrieved 6 databases like Pubmed,Cochrane Library,Embase,CNKI,et al.RCTs of BBTD+XFZYD plus conventional Western drugs(experimental group)and conventional Western drugs alone(control group)for hypertension was collected from the database establishment to August 5,2020.And the outcomes included clinical total effective rate,systolic blood pressure(SBP),diastolic blood pressure(DBP),nitric oxide(NO)and endothelin-1(ET-1).All studies’risk of bias were assessed by the Cochrane Collaboration tool 5.1.0.The data was statistically analyzed by RevMan5.3 Software.Results:Six studies with 608 participants were identified.About duration of treatment,4 studies were 1 month,2 studies were 2 months.The quality presented a high risk of bias.The experimental group showed that clinical total effective rate of the 1-month and 2-month was higher(P<0.00001),the systolic pressure was significantly lower(P<0.05),the NO increased(P<0.00001),and the ET-1 decreased(P<0.00001)compared with the conventional Western drugs used alone.However,DBP was significantly lower(P<0.05)at 2 months of treatment.Conclusion:BBTD+XFZYD plus conventional Western drugs might reduce blood pressure,improve clinical efficacy,repair endothelial function,but still need high-quality RCTs to better assess the outcomes.
文摘Introduction: Subclinical brain damage in essential hypertension is more prevalent than cardiovascular or renal impairment;nevertheless, screening for nervous system involvement is difficult due to the low accessibility and high costs of these techniques. Objective: To assess the frequency of silent target organ damage in a cohort of asymptomatic hypertensive patients and to evaluate the potential usefulness of carotid ultrasonographic (US) variables as predictors of subclinical brain damage. Patients and Methods: Thirty four neurologically asymptomatic subjects (mean age 59 years) with essential hypertension were included. Target organ damage was evaluated: degree of hypertensive retinopathy, heart, kidney and brain. Structural and hemodynamical carotid Doppler US parameters were also investigated. Results: The brain was the most frequently affected target organ (70.6%), followed by the heart (67.9%) and kidney (58.6%). Carotid US parameters showed no association of intima media thickness with brain MRI results;nevertheless, decreased diastolic flow velocity and increased resistive index pointed to a resistive carotid flow pattern in patients with classical brain MRI lesions and predicted subclinical lesions with a sensitivity of 70% and 74% and a specificity of 72% and 80% respectively. Conclusions: This study supports previous findings that place the brain as the most frequently affected target organ in essential hypertensive patients and sheds more light on the potential usefulness of carotid structure and hemodynamics as imaging biomarkers of subclinical brain lesions.
基金the Shanghai University of Medicine&Health Sciences’Institutional Review Board for the Protection of Human Subjects(No.2018-pdwjw-01-372424198012222511).
文摘Background:This study aimed to clarify the effects of a Graded Brisk Walking Test(GBWT)program on blood pressure(BP)control in elderly patients with essential hypertension and to determine its appropriate degree of intensity for elderly people.Methods:In total,421 out of 620 participants were randomly sampled from a community health center in Shanghai,China.Among them,200 and 221 patients were assigned to the intervened and control groups,respectively.They were all treated with the GBWT program for 8 weeks,16 weeks,and 24 weeks.Results:Based on ANOVA,there was no significant time main effect,condition main effect,or time by condition interaction both in heart rate and body mass index indicators(P>0.05).There were significant condition main effects,time by condition interaction,or time main effects in blood pressure(F=21.875,33.457,65.342,respectively;All P<0.05).After the intervention,significant differences in systolic blood pressure(SBP)and diastolic blood pressure(DBP)values were also observed in the two groups(P<0.05);the average values of the baseline and second phases of the intervention group were significantly lower than those of the control group(P<0.05).Significant differences in blood pressure values after the first two phases were also observed when compared with those before the intervention.Similarly,a significant difference in the first phase and second phase was also found between the BP group and intervention group.However,after the third phase(24 weeks,high-intensity exercise),no significant differences existed both in SBP and DBP groups compared with those before the intervention(P=0.07).Conclusion:GBWT is an effective exercise prescription to mitigate the essential hypertension in elderly Chinese patients,and the intensity,walking distance,and target number of steps can be adjusted according to the age of the patients.
基金supported by the Aid Program for Science and Technology Innovative Research Team in Higher Educational Institutions of Hunan Province and Funding for University Reform,Development in Hunan Province in 2023(Grant number:202331)Funding for Discipline Building at Hunan University of Chinese Medicine.
文摘Background Scraping therapy is widely used in treating stage I and II essential hypertension in China.However,there has been no systematic evaluation of the efficacy of scraping therapy on blood pressure and sleep quality in stage I and II essential hypertension.Search strategy Seven electronic databases(PubMed,Scopus,Cochrane Library,Web of Science,EBSCO,China National Knowledge Infrastructure and Wanfang Data electronic databases)were searched from inception to December 2022.Based on the principle of combining subject words with text words,the search strategy was constructed around search terms for“scraping therapy,”“scraping,”“Guasha,”“Gua sha,”“hypertension,”and“high blood pressure”during the database searches.Inclusion criteria Randomized controlled trials(RCTs)were included if they recruited patients with stage I and II essential hypertension and included a scraping therapy intervention.The intervention group received antihypertensive drugs and scraping therapy,while the control group only took antihypertensive drugs.Data extraction and analysis Review Manager 5.4.0 and STATA 15.1 were used to enter all the relevant outcome variables to conduct the meta-analysis.The quality of the selected RCTs was assessed using the PEDro scale.The sensitivity analysis was carried out by iteratively excluding individual studies and repeating the analysis to determine the stability of the findings and identify any studies with greater influence on the outcome.Subgroup analysis was performed to find the source of heterogeneity.Funnel plots were used to evaluate the publication bias of included studies.Results Nine RCTs including 765 participants were selected.Meta-analysis showed that scraping therapy combined with medication had an advantage over the use of medication alone in lowering systolic blood pressure(mean difference[MD]=?5.09,95%confidence interval[CI]=?6.50 to?3.67,P<0.001)and diastolic blood pressure(MD=?2.66,95%CI=?3.17 to?2.14,P<0.001).Subgroup analysis showed that scraping therapy improved sleep quality in middle-aged patients with hypertension,but the efficacy was better in elderly patients(MD=?7.91,95%CI=?8.65 to?7.16,P<0.001)than in middle-aged patients(MD=?2.67,95%CI=?4.12 to?1.21,P=0.0003).Conclusion The available evidence indicates that scraping therapy has significant effects on patients with stage I and II hypertension,and it improves sleep quality for elderly patients with hypertension better than for middle-aged ones.Scraping therapy can be an adjunctive treatment for stage I and II essential hypertension.However,further high-quality studies are needed to verify its effectiveness and the best therapeutic strategies.
基金National Natural Science Foundation of China(No.81970313)Natural Science Foundation of Anhui Province(No.2008085MH238)+1 种基金512 Talent Cultivation Plan of Bengbu Medical College(No.by51201321)Key Program of Natural Science Foundation of Bengbu Medical College(No.2020byzd109)。
文摘Objective:To explore the role of NLRP3/Caspase-1-mediated pyroptosis on peripheral blood monocytes in patients with essential hypertension(EH),and its regulation by pannexin-1(Panx-1)hemi-channels.Methods:The peripheral blood of EH patients and healthy subjects was collected,peripheral plasma of the two groups was subsequently separated,and IL-1βcontent in peripheral plasma was further measured by ELISA.In the meantime,the monocytes from peripheral blood were sorted by immunomagnetic beads,and mRNA and protein expression of Panx-1,NLRP3 inflammasome related molecules(NLRP3,ASC,Caspase-1),downstream effector IL-1β,and pyroptosis-related protein GSDMD,were analyzed by RT-qPCR and Western blot,respectively.Subsequently,human primary monocytes in two group were cultured in vitro.Immunofluorescence assay was performed to detect the expression and location of Panx-1 on monocytes.Finally,the cultured monocytes from EH patients were exposed to NLRP3 inflammasome activator lipopolysaccharide(LPS),and also to LPS pretreated with Panx-1 hemi-channel inhibitor probenecid or specific Panx-1 siRNA,followed by collection of the cell culture supernatant and monocytes.The cell viability of each group was detected by CCK-8 assay,IL-1βcontent in the culture supernatant was analyzed by ELISA,and the expression of target proteins on monocytes was determined by Western blot assay.Results:Compared with healthy subjects,EH patients showed higher IL-1βcontent in peripheral plasma,and increased expression in both mRNA and protein levels for Panx-1,NLRP3 inflammasome related molecules,IL-1βand GSDMD on peripheral monocytes.Furthermore,Panx-1 protein in EH patients was significantly higher than that in healthy subjects and localized on monocyte membrane as evidenced by immunofluorescence assay.In the cultured human primary monocytes from EH patients,the cell viability in each group showed no significant difference.LPS stimulation can induce NLRP3-dependent pyroptosis,by showing an increase in IL-1βcontent in cell culture supernatant and protein expressions of NLRP3 inflammasome related molecules and GSDMD on monocytes,by LPS exposure.However,the above stimulating effect of LPS could be counteracted by pretreatment with probenecid or Panx-1 siRNA.Conclusion:The NLRP3/Caspase-1-mediated pyroptosis is activated on peripheral blood monocytes in patients with EH,and this activation could be regulated by Panx-1 hemi-channels.
基金National Key R&D Program of China(No.2016YFD0400202)National Natural Science Foundation of China(No.31500685,30973720)+1 种基金Zhejiang Provincial Natural Science Foundation of China(No.LY16C050002)Start-Up Fund of Research in Quanzhou Normal University(No.G16062)。
文摘Objectives:To investigate the effect on essential hypertension of the topical application of TAT-Cu,Zn-superoxide dismutase(TAT-SOD)at left acupoint Zusanli(ST 36),and to observe whether the change of electrical potential difference(EPD)can be related to the change of blood pressure.Methods:Sixteen patients with essential hypertension and 16 healthy subjects were included in the study.EPD between the left acupoints of Yanglingquan(GB 34)and Qiuxu(GB 40)was firstly screened out for the EPD detection.An intracellular superoxide quenching enzyme,TAT-SOD,was topically applied to the acupoint ST 36 within an area of 1 cm^2 once a day,and the influence on EPD was investigated.The dosage applied to TAT-SOD group(n=8)was 0.2 mL of 3000 U/mL TAT-SOD cream prepared by adding purified TAT-SOD to a vehicle cream,while placebo group(n=8)used the vehicle cream instead.The left acupoints of Yanglingquan(GB 34)and Qiuxu(GB 40)were selected for EPD measurement after comparing EPD readings between 5 acupoints on each of all 12 meridians.Results:EPDs between the left acupoints of GB 34 and GB 40 for 16 patients of essential hypertension and 16 healthy subjects were 44.9±6.4 and 5.6±0.9 mV,respectively.Daily application of TAT-SOD for 15 days at ST 36 of essential hypertension patients significantly decreased systolic blood pressure(SBP)and diastolic blood pressure(DBP)of 179.6 and 81.5 mm Hg to 153.1 and 74.1 mm Hg,respectively.Responding to the change in blood pressure,EPD between the left acupoints of GB 34 and GB 40 also declined from 44.4 to 22.8 mV with the same trend.No change was observed with SBP,DBP and EPD between the left acupoints of GB 34 and GB 40 with the daily application of the placebo cream.Conclusion:Enzymatic scavenging of the intracellular superoxide at ST 36 proved to be effective in decreasing SBP and DBP.The results reconfirm the involvement of superoxide anions and its transportation along the meridians,and demonstrate that EPD between acupoints may be an indicator to reflect its functioning status.Moreover,prellmlnary results suggest a close correlatlon between EPD and blood pressure readings,implying a possibility of using EPD as a sensitive parameter for blood pressure and to monitor the effect of antihypertensive treatment.
基金Correspondence to:HUA Qi,Department of Cardiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China.huaqi_5371@sina.com,Telephone:+86-13911469619。
文摘OBJECTIVE:To evaluate the effect of songlingxuemaikang(松龄血脉康,SLXMK)on mild essential hypertension in patients in terms of endothelial function.METHODS:We enrolled 90 patients with mild essential hypertension in Xuanwu Hospital from January 2016 to December 2016.To evaluate the effects of SLXMK,the 90 patients were randomly assigned at a 2∶1 ratio into 2 groups:the SLXMK group(500 mg per capsule,4500 mg/d,n=60)and the losartan potassium group(50 mg per table,50 mg/d,n=30).The total study period was 12 weeks,and the changes of blood pressure,laboratory test and endothelium function were compared between two groups.RESULTS:After 12 weeks of treatment with SLXMK,blood pressure(BP)and plasma lipid levels significantly improved(P<0.05).Meanwhile,the reactive hyperemia index(RHI)increased in the SLXMK group(P<0.05).The results of multivariate logisticregression analyses examining the association of selected variables with showed that high level of oxidized low density lipoprotein(ox-LDL)was positively associated with endothelial dysfunction.CONCLUSION:SLXMK not only effectively decreased BP and plasma lipid levels,but also reduced ox-LDL and RHI in patients with mild essential hypertension.And SLXMK might improve endothelial function through decreasing the circulating ox-LDL.
基金China Medical Board of New York, Inc. (96-657) and National Natural Science Foundation of China (Grant No. 39870687).
文摘Essential hypertension (EH) is thought to result from theinteraction of environmental and genetic factors. The molecular genetics of EH has witnessed considerable progress during the past few years. However, the number of genes involved, their chromosomal location and the magnitude of their effect on EH susceptibility are unknown. We conducted the present study to screen susceptibility genes to essential hypertension using a genome-wide scanning method in a group of Han people from Fangshan district located in the southwest of Beijing. A case-control study and affected sibpair were performed. Genotyping was carried out using a fluorescence-based semiautomated technique on automated DNA sequencer (ABI 377, PE). The basis for the genome-screen was the ABI prism linkage mapping sets of 400 microsatellite markers (version 2, PE, Co.). PCR for amplification of markers was carried out as multiplex reactions with Ampli Taq gold (PE, Co.) following protocols developed in our laboratory. Data were exported as a text file from genotyper for subsequent two-point affected sibpair linkage analysis. The data from case-control association study showed a linkage disequilibrium between EH and marker D1S249 locus (X2 = 14.6, P = 0.002). There are 12 alleles in the D1S249 locus. The frequency of A9 allele in hypertension was higher than in normotensives, (13.6% v.s. 2.7%, X2 = 6.30, p = 0.01, OR = 4.57, 95%CI = 1.24-25.4). The data from two-point affected sibpair linkage analysis demonstrated a linkage between EH and A9 allele, P＜0.05. It suggested that microsatellite marker D1S249 locus might be associated with the genetic susceptibility to essential hypertension in Han Chinese.
文摘Genetic,environmental and demographic factors contribute to the development of essential hypertension.Genetic polymorphism of Rennin-angiotensin-aldosterone system(RAAS)has been extensively studied to determine the genetic susceptibility to hypertension.The insertion/deletion(I/D)angiotensin converting enzyme(ACE)polymorphism has been established as a cardiovascular risk factor in some population,but its association with essential hypertension is controversial.This study sought to determine the association of I/D polymorphism of the ACE gene in south Indian essential hypertensive subjects.A total of 208 clinically diagnosed essential hypertensive patients without any associated diseases and 220 healthy control subjects were included in this study.Distribution and allelic frequency of Insertion(I)and Deletion(D)polymorphism at the 287 base pair Alu repeat sequence in the intron 16 of ACE gene were analyzed.The distribution of II,ID,DD genotypes of ACE gene was 28.3%,32.6%and 38.9%respectively in essential hypertensive patients and to 53.6%,26.3%and 20%in controls.The allele frequency for D allele is 0.58 in essential hypertension as compared to 0.34 of control subjects.The genotype and allele frequency of ACE gene polymorphism is significantly differed in patients when compared to controls.In conclusion,the I/D polymorphism of ACE gene is associated with Indian essential hypertension.
文摘Objective To observe the clinical effects of acupuncture method of'Huoxue Sanfeng,Shugan Jianpi'(activating blood and eliminating wind,soothing liver and strengthening spleen)on morning blood pressure in patients with cerebral infarction combined with essential hypertension.Methods Sixty-eight patients were randomly divided into an observation group and a control group,34 cases in each one.The patients in the
基金supported by the National Natural Science Foundation of China(No.81970313)Anhui Province Science and Technology Project(No.1804h08020246)。
文摘Objective:To detect the levels of interleukin-33(IL-33)and soluble ST2(sST2)in peripheral blood of patients with essential hypertensive left ventricular hypertrophy,and to discusstheir correlation with patients with essential hypertensive left ventricular hypertrophy was further discussed.Methods:A total of 220 patients with essential hypertension treated in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Bengbu Medical College were enrolled as the experimental group.According to left ventricular mass index(LVMI),patients with essential hypertension were divided into the non-left ventricular hypertrophy group(NLVH,n=108 cases)and the left ventricular hypertrophy group(LVH,n=112 cases).We used ELISA to detect the serum levels of IL-33 and sST2,the expression levels of IL-33 in peripheral blood lymphocytes of the NLVH group and the LVH group(60 cases each)were detected by Western blot,and the relationship between IL-33 and LVMI,a marker of left ventricular hypertrophic condition,was analyzed by Pearson.The relationship between IL-33,sST2 and left ventricular hypertrophy in essential hypertension was studied.Results:Compared with the NLVH group,the expression levels of IL-33 and sST2 in the LVH group were significantly increased.The results of Western blot showed that the expression level of IL-33 in the LVH group(1.07±0.08)was higher than that in the NLVH group(0.63±0.05)(P<0.05).Pearson correlation analysis showed that IL-33 was positively correlated with LVMI,sST2 was positively correlated with LVMI.Conclusion:The levels of IL-33 and sST2 in serum and the expression levels of IL-33 protein in peripheral blood lymphocytes are significantly increased in patients with hypertensive left ventricular hypertrophy,and the occurrence and development of essential hypertensive left ventricular hypertrophy may be related to IL-33 and sST2.
文摘Objective To study the pattern of circadian blood pressure changes in patients with se-condary hypertension. Methods The 24h ambulatory blood pressure monitoring was performed in 80 patients with secondary hypertension (SH) including primary aldosteronism in 44, pheochromocytoma in 11, renovas-cular hypertension in 10, renoparenchymal hypertension in 15 and compared with 80 patients with essential hy-pertension (EH) matched by age and sex. Results The diurnal rhythm in patients with SH was different from that of patients with EU. The diurnal curves in SU and EU was overlapped in daytime and separated from each other at nighttime. The nocturnal blood pressure fall was less and average blood pressure at nighttime was higher in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure loading and non-dipper phenomenon were much more frequently seen in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure/daytime blood pressure ratio was significantly higher in patients with SH than that in patients with Eli (P <0. 01). Conclusion The non-invasive 24h ambulatory blood pressure monitoring may be a useful method in screening for
