7 research outputs found
Ambulatory Blood Pressure Monitoring (ABPM) as the reference standard for diagnosis of hypertension and assessment of vascular risk in adults
Retinal microvascular damage and nocturnal hypertension: Therapeutic targets to bear in mind
Research of applications of technical carboxymethyl cellulose in Czech republic and Slovak republic
Katedra podnikové ekonomiky a managementuDokončená práce s úspěšnou obhajobo
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Serum Bicarbonate Concentrations and Kidney Disease Progression in Community-Living Elders: The Health, Aging, and Body Composition (Health ABC) Study
BackgroundIn populations with prevalent chronic kidney disease (CKD), lower serum bicarbonate levels are associated with more rapid CKD progression, but whether lower bicarbonate levels also are associated with risk of incident estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) and CKD progression among community-living persons with predominantly preserved kidney function is unknown.Study designLongitudinal observational cohort study.Setting & participantsWell-functioning community-living elders aged 70-79 years at inception.PredictorSerum bicarbonate level measured at the time of collection by arterialized venous blood sample using an arterial blood gas analyzer.OutcomesChange in eGFR over 7 years, and new eGFR < 60 mL/min/1.73 m(2) with a rate of loss of at least 1 mL/min/1.73 m(2) per year.MeasurementsLinear and logistic regressions were used to evaluate associations of baseline serum bicarbonate level with change in eGFR and incident eGFR < 60 mL/min/1.73 m(2).ResultsAt baseline, mean eGFR was 84 ± 16 (SD)mL/min/1.73 m(2), and serum bicarbonate level was 25.2 ± 1.9 mmol/L. Compared with participants with higher bicarbonate concentrations (23.0-28.0 mmol/L), those with bicarbonate concentrations < 23 mmol/L (n = 85 [8%]) lost eGFR0.55 (95% CI, 0.13-0.97) mL/min/1.73 m(2) per year faster in models adjusted for demographics, CKD risk factors, baseline eGFR, and urine albumin-creatinine ratio. Among the 989 (92%) participants with baseline eGFRs > 60 mL/min/1.73 m(2), 252 (25%) developed incident eGFRs < 60 mL/min/1.73 m(2) at follow-up. Adjusting for the same covariates, participants with bicarbonate concentrations < 23 mmol/L had nearly 2-fold greater odds of incident eGFRs < 60 mL/min/1.73 m(2) (OR, 1.72; 95% CI, 0.97-3.07) compared with those with higher bicarbonate concentrations.LimitationsOnly 2 measurements of kidney function separated by 7 years and loss to follow-up due to intervening mortality in this elderly population.ConclusionsLower serum bicarbonate concentrations are associated independently with decline in eGFR and incident eGFR < 60 mL/min/1.73 m(2) in community-living older persons. If confirmed, serum bicarbonate levels may give insight into kidney tubule health in persons with preserved eGFRs and suggest a possible new target for intervention to prevent CKD development
Prognostic Value of Masked Uncontrolled Hypertension Defined by Different Ambulatory Blood Pressure Criteria
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Alzheimer's polygenic risk scores are associated with cognitive phenotypes in Down syndrome
Funder: NeuroGenomics and Informatics CenterFunder: Washington University School of MedicineFunder: Chan Zuckerberg Initiative; doi: http://dx.doi.org/10.13039/100014989Funder: Washington UniversityFunder: National Institute on Aging; doi: http://dx.doi.org/10.13039/100000049Funder: German Center for Neurodegenerative Diseases; doi: http://dx.doi.org/10.13039/501100005224Funder: FLENIFunder: Japan Agency for Medical Research and Development; doi: http://dx.doi.org/10.13039/100009619Funder: KHIDI; doi: http://dx.doi.org/10.13039/501100003710Funder: National Institute of Biomedical Imaging and Bioengineering; doi: http://dx.doi.org/10.13039/100000070Funder: NICHD; doi: http://dx.doi.org/10.13039/100009633INTRODUCTION: This study aimed to investigate the influence of the overall Alzheimer's disease (AD) genetic architecture on Down syndrome (DS) status, cognitive measures, and cerebrospinal fluid (CSF) biomarkers. METHODS: AD polygenic risk scores (PRS) were tested for association with DS‐related traits. RESULTS: The AD risk PRS was associated with disease status in several cohorts of sporadic late‐ and early‐onset and familial late‐onset AD, but not in familial early‐onset AD or DS. On the other hand, lower DS Mental Status Examination memory scores were associated with higher PRS, independent of intellectual disability and APOE (PRS including APOE, PRS APOE , p = 2.84 × 10−4; PRS excluding APOE, PRS nonAPOE , p = 1.60 × 10−2). PRS APOE exhibited significant associations with Aβ42, tTau, pTau, and Aβ42/40 ratio in DS. DISCUSSION: These data indicate that the AD genetic architecture influences cognitive and CSF phenotypes in DS adults, supporting common pathways that influence memory decline in both traits. Highlights: Examination of the polygenic risk of AD in DS presented here is the first of its kind. AD PRS influences memory aspects in DS individuals, independently of APOE genotype. These results point to an overlap between the genes and pathways that leads to AD and those that influence dementia and memory decline in the DS population. APOE ε4 is linked to DS cognitive decline, expanding cognitive insights in adults
Circadian and cyclic environmental determinants of blood pressure patterning and implications for therapeutic interventions
Blood pressure (BP) exhibits significant 24 h variation; in most normotensive and uncomplicated hypertensive persons, BP declines during the first half of nighttime sleep by 10–20% from its daytime mean level, starts rising in the second half of sleep, further increases with commencement of diurnal activity, and peaks in the afternoon or early evening. Environmental 24 h cycles of temperature and noise; behavior-driven nyctohemeral patterning of food, liquid, and stimulant consumption, posture, mental and emotional stress, and physical activity; plus innate circadian rhythms in wake/sleep, autonomic nervous, hypothalamic-pituitary-adrenal, renal hemodynamic, opioid, renin-angiotensin-aldosterone, endothelial, and vasoactive peptide systems constitute the key determinants of the BP day/night variation. The current perspective is the environmental and behavioral cycles are far more influential than the innate circadian ones in determining the BP nyctohemeral profile. Yet, the facts that the: (i) BP 24h pattern of secondary hypertension, e.g., diabetes and other endocrine disorders, renal disease, heart failure, is different -- BP fails to decline as expected during nighttime sleep typically due to pathological alteration of autonomic nervous system and other influential circadian rhythms, and (ii) scheduling of conventional long-acting medications at bedtime, rather than in the morning, results in much better hypertension control and vascular risk reduction, presumably because highest drug concentration coincides closely with the peak of most key circadian determinants of the BP 24h profile, indicates the endogenous rhythmic influences are of much greater importance than previously appreciate