Association between dietary salt intake and reservation of renal function in patients with mild hypertension

BACKGROUND: It is now hypothesized whether restricted salt intake can be a potential precursor to renal dysfunction in mild hypertension state. We aimed to study the association between salt intake and renal function in patients with mild hypertension. METHODS: One hundred consecutive hypertensive Iranian patients (with systolic blood pressure 140-160 mmHg and/or diastolic 90-100 mmHg) who were referred to the hypertension research center, Isfahan, Iran, between 2011 and 2014 for screening of hypertension were assessed. Renal function was assessed by measuring serum creatinine (Cr) and creatinine clearance (CrCl). Daily salt intake was assessed on the basis of 24 h urinary sodium excretion. RESULTS: There was no association between the amounts of sodium intake and serum Cr concentration (r = 0.138, P = 0.174), however, an association was revealed between sodium intake and value of CrCl (r = 0.303, P = 0.003). Multivariable linear regression model showed that sodium intake could effectively predict renal function assessed by CrCl (Beta = 0.070, P = 0.016). CONCLUSION: There is an association between sodium intake and reservation of renal function in mild hypertension state and thus by restriction of dietary salt intake, reserving renal function, and preventing appearance and progression of renal insufficiency in higher degrees of hypertension can be facilitated

The protective effects of ginger on the development of coronary atherosclerosis: An experimental animal study

The use of ginger extracts has been recently suggested to be effective for prevention of establishing and development of coronary atherosclerosis due to its antioxidant and anti-inflammatory components. In the present study, the effect of standardized ginger extract on the development of experimentally induced atherosclerosis in animal models was investigated. The study protocol was consist of three groups of male rabbits (n = 5 each group) that were randomly divided to three groups to fed a common stock diet (containing bran and fresh vegetables) plus high cholesterol pack, or stock diet plus ginger (0.1 g/kg body weight/day) (group II) together with cholesterol, or only stock diet as the atheroma control for 75 days. Atheroma was graded macroscopically by mean graticule count percent. The degree of experimental cholesterol atherosclerosis was graded on an arbitrary scale of 0 to 4, and serum level of total cholesterol was also measured. The atherosclerotic lesion area was macroscopically smaller in rabbits that consumed ginger in comparison with the lesion area in those animals no received ginger extract (43.26 ± 8.7 mm2 versus 82.3 ± 7.9 mm2, p<0.001). Microscopically, the mean grading in coronary artery of rabbits received high cholesterol diet without ginger was 3.1±0.56, while in the group received high cholesterol diet plus ginger was 1.6±0.85 with a significant difference. Regarding effects of ginger on total cholesterol level and considering nonsignificant cholesterol level at baseline, the level of cholesterol after 75 days reached 66.72±0.12 mg/dL in the control group, 776±40.55 mg/dL in group fed high cholesterol without ginger, and 446±23.97 mg/dL in the group fed ginger with a significant level in high cholesterol plus ginger group than in high cholesterol alone group (p<0.001). Ginger can effectively protect the development of atherosclerosis manifested by lowering serum cholesterol level, as well as reducing infarct size and grade

Anti-hyperelipidemic effects of sumac (Rhus coriaria L.): Can sumac strengthen anti-hyperlipidemic effect of statins?

People believe that sumac is used as reducing fat. In the present study, the hypolipidemic effect of sumac fruits was compared with lovastatin in patients suffered hypercholesterolemia. In a randomized double-blinded-controlled trial, 172 patients diagnosed as hypercholesterolemia (high LDL level) and indicated for lipid-lowering schedules were randomly allocated to receive lovastatin (20 mg/day) or a combination of lovastatin (20 mg/day) and sumac (1 gram equivalent to a teaspoon/day, soluble in water). Immediately before initial assessment and also after a 3- month period of drugs prescription, the level of serum lipid profile was measured in both intervention groups by enzymatic assay and serum LDL level was determined using the Friedewald's equation. At baseline, the mean level of LDL was 149.26±22.36 mg/dL in the group received combination therapy, and 146.25±19.89 mg/dL in the group received lovastatin alone with no significant different (p=0.352). However, following administration of the two treatment schedules, the level of LDL was significantly more reduced in combination treatment group compared with another group that the serum level of LDL after 3-month study period was 105.75±21.21 mg/dL in combination therapy group and 117.04±15.78 mg/dL in single therapy group (p≤0.001). The positive response rate in the two groups was 93.0% and 75.6%, respectively (p=0.002). Using Multivariable logistic regression model, the use of sumac combined with statin led to higher response rate indicated by lowering serum LDL level (p=0.019). Sumac has a potential role in lowering LDL level especially when combined with anti-hyperlipidemic drugs as statins

Nothing new under the sun, or the moon, or both

PC and CR were supported by the PRIN grant 2010RP5RNM_001 from the Italian Ministry of University./nLB was supported by MINECO grant PSI2012-31961

Pre-hypertension, pre-diabetes or both: which is best at predicting cardiovascular events in the long term?

The present study aimed to assess the value of pre-diabetes and pre-hypertension in predicting cardiovascular events. A population-based, cross-sectional survey was conducted, representing a large sample of the general Iranian population aged 35 years and older from the Isfahan Province and determined using a random, multistage cluster-sampling 10-year cohort. The five end points considered as study outcome were unstable angina (UA), acute occurrence of myocardial infarction (MI), sudden cardiac death (SCD), brain stroke and cardiovascular disease (CVD). Of the 6323 subjects scheduled for assessment of diabetes state 617 were diabetics and 712 were pre-diabetic. In addition, of these subjects, 1754 had hypertension and 2500 had pre-hypertension. Analysing only pre-hypertension, pre-diabetes and its combination and adjusted for gender and age variables, pre-hypertension and pre-diabetes status together, could only effectively predict occurrence of MI (hazard ratio (HR) = 3.21, 95% confidence interval (CI): 1.06–9.76, P = 0.04). In the same COX regression models, pre-hypertension status could predict UA and CVD occurrence (HR = 2.94, 95% CI: 1.68–5.14, Po0.001 and HR = 1.74, 95% CI: 1.23–2.47, P = 0.002, respectively). However, pre-diabetes status could not predict any of these events after adjustment for gender and age. Our data provide valuable evidence of the triggering role of pre-hypertension and pre-diabetes together, on appearance and progression of MI even in healthy individuals and the significant predicting value of pre-hypertension on the occurrence of UA and CVD. In this regard, the value of pre-hypertension and prediabetes together, and the pre-hypertension state alone, are clearly superior to pre-diabetes state alone in predicting cardiovascular event

Sex based levels of C-reactive protein and white blood cell count in subjects with metabolic syndrome: Isfahan Healthy Heart Program

Background: C-reactive protein (CRP) and white blood cell (WBC) are proinflammatory markers. They are major pathophysiological for the development of metabolic syndrome (MetS). This study aimed to address the independent associations between MetS and WBC counts and serum CRP levels and evaluation of their magnitude in relation to the MetS, based on the sex in the Iranian adults. Materials and Methods: In this cross-sectional study, subjects who met the MetS criteria, based on the Adult Treatment Panel III were selected from the Isfahan Healthy Heart Program database. A questionnaire containing the demographic data, weight, height, waist, and hip circumference of the respondents was completed for each person. Blood pressure was measured and the anthropometric measurements were done, and fasting blood samples were taken for 2 h postload plasma glucose (2 hpp). Serum total, high-density lipoprotein (HDL), and low-density lipoprotein] levels of cholesterol, triglyceride, and CRP as well as WBC counts were determined. The univariate analyses were carried out to assess the relation between the CRP levels, WBC counts with the MetS in both sexes the. Results: In men with the abdominal obesity, the higher levels of WBC count, high serum triglyceride and blood glucose levels, a low serum HDL level, and raised systolic and diastolic blood pressure were observed. However, the higher serum CRP levels were only observed in those with the low serum HDL-cholesterol levels. The mean values of the WBC counts were statistically different between the men with and without MetS, but the mean values of the CRP levels were similar between the two groups. In women, the mean values of WBC count and CRP levels were statistically different in the subjects with and without a MetS components (except for the low serum HDL levels and high diastolic blood pressure for the WBC measures and abdominal obesity for the CRP measures) and for those with and without MetS. The age and smoking adjusted changes in the CRP levels and WBC counts correlated with the number of Mets components in the women. Conclusion: The findings of this study suggest substantial implications for the prevention and management of the MetS and atherosclerotic diseases, as these involve the suppression of inflammatory conditions rather than the incitement of anti-inflammatory conditions

Cheese consumption in relation to cardiovascular risk factors among Iranian adults- IHHP Study

BACKGROUND/OBJECTIVE: It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. SUBJECTS/METHODS: Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. RESULTS: Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. CONCLUSION: This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms

Evaluating factors associated with uncontrolled hypertension: Isfahan cohort study, Iran

BACKGROUND: Hypertension (HTN) considers as one of the most common risk factors, which potentially raises the risk of cardiovascular disease. Regarding high prevalence of HTN among Iranian population this study designed to examine a range of socio-demographic and clinical variables to determine the association with failure to achieve blood pressure control in a cohort of hypertensive subjects. METHODS: This retrospective cohort study is a part of Isfahan cohort study which carried out on adults aged 35 years old or more. Subjects with confirmed HTN entered in this sub-study. For all subjects questionnaire included socio-demographic characteristics, clinical data and lifestyle behavior completed by trained nurses. Uncontrolled HTN was defined as systolic and diastolic blood pressure more than 140/90 in the presence or absent of pharmacological treatment. RESULTS: The prevalence of uncontrolled men was significantly higher than controlled in both 2001 and 2007 (P < 0.001). A significant association was found between sex and control of blood pressure: compared with women, being men [odds ratio (OR) = 2.31; 95 % confidence interval (CI) = 1.64-3.24] was significantly associated with uncontrolled HTN in 2001 and (OR = 2.38; 95% CI = 1.78-3.18). Among lifestyle behaviors, tendency for more consumption of salty foods increased the risk of uncontrolled HTN in 2001 by 1.73 times [OR = 1.73, 95% CI = 1.20-2.50, (P = 0.003)]. Patients who were naive to mono-therapy without considering the type of antihypertensive drug were found to be associated with uncontrolled blood pressure (OR = 0.14; 95 % CI =0.1-0.2). CONCLUSION: Uncontrolled HTN was sex, marital status, diabetes, tendency to salty foods and medication adherence. Assessment of them presence of these risk factors is warranted to recommend an aggressive HTN management with the goal of reducing excessive risk of cardiovascular events caused by uncontrolled HTN