Left Ventricular Hypertrophy is a predictor of cardiovascular events in elderly hypertensives: hypertension in the the very elderly trial (HYVET)

Objective: We assessed the prognostic value of electrocardiographic left ventricular hypertrophy (LVH) using Sokolow-Lyon (SL-LVH), Cornell Voltage (CV-LVH) or Cornell Product (CP-LVH) Criteria in 3043 hypertensive people aged 80 years and over enrolled in the Hypertension in the Very Elderly Trial. Methods: Multivariate Cox proportional hazard models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for all-cause mortality, cardiovascular diseases, stroke and heart failure in participants with and without LVH at baseline. The mean follow-up was 2.1 years. Results: LVH identified by CV- or CP-LVH Criteria was associated with a 1.6 to 1.9-fold risk of cardiovascular disease and stroke. The presence of CP-LVH was associated with an increased risk of heart failure (HR 2.38, 95% CL 1.16-4.86). In gender specific analyses, CV-LVH (HR 1.94, 95%Cl 1.06-3.55) and CP-LVH (HR 2.36, 95% CI 1.25-4.45) were associated with an increased risk of stroke in women and of heart failure in men, CV-LVH (HR 6.47, 95 % Cl 1.41-29.79) and CP-LVH (10.63, 95Cl % 3.58-31.57), respectively. There was no significant increase in the risk of any outcomes associated with SL LVH. LVH identified by these three methods was not a significant predictor of all-cause mortality. Conclusions: Use of Cornell Voltage and Cornell Product criteria for LVH predicted the risk of cardiovascular disease and stroke. Only Cornell Product was associated with an increased the risk of heart failure. This was particularly the case in men. The identification of electrocardiographic LVH proved to be important in very elderly hypertensive people

On the utilization of modified red mud in dimethyl disulfide and methyl mercaptan emission abatement

In this paper, a novel application of industrial waste, namely red mud (RM), in the abatement of two malodorous and harmful sulfur compounds, dimethyl disulfide (DMDS) and methyl mercaptan (MM), is presented. The effects of calcination and activations with hydrochloric acid or a mixture of hydrochloric and orthophosphoric acid on the properties and performance of RM are compared using laboratory-scale experiments. The RM-based materials were characterized by XRF, XRD, FE-SEM, N2 -physisorption, TGA/DTA, and FTIR analyses. RM exhibits very promising catalytic properties in the abatement of both DMDS and MM. The hydrochloric acid-activated RM was the most active in both cases, which was explained by its rather high specific surface area (144 m2 g −1 ), higher contents of Fe2O3 and TiO2, as well as lower content of phosphorus. For both DMDS and MM, the main oxidation products were sulfur dioxide, carbon monoxide, and carbon dioxide. DMDS was observed as a reaction intermediate in MM oxidation. While the final conversions of DMDS and MM were high, the oxidation was not complete, indicated by the formation of carbon monoxide. Nevertheless, the modified RM appears as a very interesting alternative to the existing DMDS and MM abatement catalysts.Web of Science121art. no.

Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension

The association between raised blood pressure and increased risk of subsequent cognitive decline is well known. Left ventricular hypertrophy (LVH), as a marker of hypertensive target organ damage, may help identify those at risk of cognitive decline. We assessed whether LVH was associated with subsequent cognitive decline or dementia in hypertensive participants aged ≥80 years in the randomized, placebo-controlled Hypertension in the Very Elderly Trial. LVH was assessed using 12-lead electrocardiography (ECG) based on the Cornell Product (CP-LVH), Sokolow-Lyon (SL-LVH), and Cornell Voltage (CV-LVH) criteria. The Mini-Mental State Examination (MMSE) was used to assess cognitive function at baseline and annually. A fall in MMSE to 3 points were defined as cognitive decline and triggered dementia screening (Diagnostic Statistical Manual IV). Death was defined as a competing event. Fine-Gray regression models were used to examine the relationship between baseline LVH and cognitive outcomes. There were 2645 in the analytical sample, including 201 (7.6%) with CP-LVH, 225 (8.5%) SL-LVH and 251 (9.5%) CV-LVH. CP-LVH was associated with increased risk of cognitive decline, subdistribution hazard ratio (sHR)1.3 (95% confidence interval (CI) 1.01-1.67) in multivariate analyses. SL-LVH and CV-LVH were not associated with cognitive decline (sHR1.06 (95% CI 0.82-1.37) and sHR1.13 (95% CI 0.89-1.43), respectively). LVH was not associated with dementia. LVH may be related to subsequent cognitive decline, but evidence was inconsistent depending on ECG criterion and there were no associations with incident dementia. Additional work is needed to understand the relationships between blood pressure, LVH assessment and cognition. [Abstract copyright: © 2022. The Author(s).

Response to HYVET ambulatory blood pressure substudy

status: publishe

Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline

Background: The association between health-related quality of life (HRQoL) and care costs in people at risk for cognitive decline is not well understood. Studying this association could reveal the potential benefits of increasing HRQoL and reducing care costs by improving cognition. Objective: In this exploratory data analysis we investigated the association between cognition, HRQoL utilities and costs in a well-functioning population at risk for cognitive decline. Methods: An exploratory data analysis was conducted using longitudinal 2-year data from the FINGER study (n= 1,120). A change score analysis was applied using HRQoL utilities and total medical care costs as outcome. HRQoL utilities were derived from the Short Form Health Survey-36 (SF-36). Total care costs comprised visits to a general practitioner, medical specialist, nurse, and days at hospital. Analyses were adjusted for activities of daily living (ADL) and depressive symptoms. Results: Although univariable analysis showed an association between cognition and HRQoL utilities, multivariable analysis showed no association between cognition, HRQoL utilities and total care costs. A one-unit increase in ADL limitations was associated with a -0.006 (p Conclusion: The level of cognition in people at-risk for cognitive decline does not seem to be associated with HRQoL utilities. Future research should examine the level at which cognitive decline starts to affect HRQoL and care costs. Ideally, this would be done by means of cross-validation in populations with various stages of cognitive functioning and decline.Peer reviewe

Investigation of antihypertensive class, dementia, and cognitive decline: A meta-analysis

Objective High blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data. Methods To identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration. Outcome measures were incident dementia or incident cognitive decline (classified using the reliable change index method). Data were separated into mid and late-life (>65 years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives. Meta-analysis was used to synthesize data. Results Over 50,000 participants from 27 studies were included. Among those aged >65 years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia. Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome. Limited data precluded meaningful analyses in those ≤65 years of age. Conclusion Our findings, drawn from the current evidence base, support clinical freedom in the selection of antihypertensive regimens to achieve blood pressure goals. Clinical trials registration The review was registered with the international prospective register of systematic reviews (PROSPERO), registration number CRD42016045454.The corresponding author is funded by the Australian National Health and Medical Research Council, National Institute for Dementia Research, and Dementia Centre for Research Collaboration (NHMRC NNIDR DCRC)

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

On the Utilization of Modified Red Mud in Dimethyl Disulfide and Methyl Mercaptan Emission Abatement

In this paper, a novel application of industrial waste, namely red mud (RM), in the abatement of two malodorous and harmful sulfur compounds, dimethyl disulfide (DMDS) and methyl mercaptan (MM), is presented. The effects of calcination and activations with hydrochloric acid or a mixture of hydrochloric and orthophosphoric acid on the properties and performance of RM are compared using laboratory-scale experiments. The RM-based materials were characterized by XRF, XRD, FE-SEM, N2-physisorption, TGA/DTA, and FTIR analyses. RM exhibits very promising catalytic properties in the abatement of both DMDS and MM. The hydrochloric acid-activated RM was the most active in both cases, which was explained by its rather high specific surface area (144 m2 g−1), higher contents of Fe2O3 and TiO2, as well as lower content of phosphorus. For both DMDS and MM, the main oxidation products were sulfur dioxide, carbon monoxide, and carbon dioxide. DMDS was observed as a reaction intermediate in MM oxidation. While the final conversions of DMDS and MM were high, the oxidation was not complete, indicated by the formation of carbon monoxide. Nevertheless, the modified RM appears as a very interesting alternative to the existing DMDS and MM abatement catalysts

Leaching of metals from red mud and toxicity in human cells in vitro

Toxicity of red mud, a waste from alumina production, was studied using human breast cancer MCF-7 cells. Culture medium was prepared by mixing water for 3 days with the red mud and removing solid particles afterwards (red mud water). Culture for 48 h of the cells in this medium in neutral pH decreased the cell viability, as analyzed by the MTT-test, and increased the formation of reactive oxygen species. Thus, neutralization does not eliminate the toxicity of red mud. In preliminary experiments, a combined effect of five metals (Cr, Li, V, Al, As) increased the formation of ROS (reactive oxygen species) statistically significantly. Each element separately did not have a similar effect. In environmental applications, red mud is likely to be used after activation. In this work, the red mud was activated using hydrochloric acid to study the physical and chemical properties before and after the treatment. Activation increased the specific surface area of red mud from 16 m2 g−1 to 148 m2 g−1, which is beneficial in many environmental applications such as in the adsorptive removal of pollutants. After activation, leaching of some elements from the red mud decreased (e.g. Al from 38.0 to 0.56 mg L−1, As from 21.0 to 2.1 μg L−1, V from 172.0 to 29.8 μg L−1) while some increased (e.g. Li from 0.04 to 2.81 mg L−1, Cr from 0.35 to 3.23 mg L−1).Web of Science332art. no. 13880