Renal artery sympathetic denervation:observations from the UK experience

Background: Renal denervation (RDN) may lower blood pressure (BP); however, it is unclear whether medication changes may be confounding results. Furthermore, limited data exist on pattern of ambulatory blood pressure (ABP) response—particularly in those prescribed aldosterone antagonists at the time of RDN. Methods: We examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres. Results: Results from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p < 0.001 for trend). Use of aldosterone antagonist did not predict response (p < 0.2). Conclusion: In 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response

May measurement month 2018: an analysis of blood pressure screening results from Malaysia.

Hypertension continues to be the top global killer, contributing to over 10 million deaths annually. As prevalence and unawareness of hypertension remain high in Malaysia, this study was aimed to screen more individuals to identify those with undiagnosed hypertension. Respondents aged ≥18 years were recruited through opportunistic sampling at various screening sites including health clinics, hospitals, student health centres, universities, community halls, shopping malls, as well as through other health screening campaigns. Each respondent completed a questionnaire on socio-demographic, environmental, and lifestyle data. Anthropometric measurements as well as three blood pressure (BP) measurements were obtained from all participants. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medication. The total number of participants was 4866. The mean age of the participants was 39.8 (17.6) years with 61.1% female participants. Of the 4866 participants, 1405 (28.9%) had hypertension. The proportion of those aware of their hypertension status was 76.3% (1073/1405). The proportion of those with hypertension on medication was 71% (998/1405). Of those receiving antihypertensive treatment, 62.4% (623/998) had controlled BP. The proportion of hypertension in this study was 28.9%. The awareness rate of 76.3% compares favourably to a previously reported national level of 43.2%. Hence, BP screening programmes may be effective at increasing awareness and should be conducted annually

Fatty Acid Profile, Cholesterol and Oxidative Status in Broiler Chicken Breast Muscle Fed Different Dietary Oil Sources and Calcium Levels

The aim of the present study was to evaluate the effects of three feeds containing 6% oils: palm oil (PO), soybean oil (SO) and linseed oil (LO); and three calcium levels (NRC recommendation, 1.25% and 1.50%) on the fatty acid profile, lipid oxidation and cholesterol concentrations of broiler breast meat in a 3 × 3 factorial experiment. A total of 378 one-day-old chicks were randomly assigned to the diets and fed for six weeks. Birds fed diet supplemented with LO, SO and PO had higher proportions of α-linolenic, linoleic and oleic acids, respectively. The LO diet increased the total n-3 fatty acids and decreased the n-6 : n-3 compared with the PO and SO diets. Birds fed the PO diet had higher oxidative stability and cholesterol compared with those fed the SO and LO diets. However, the level of cholesterol in all treatments was within the normal range. The level of calcium and interaction between source of oil and calcium level did not influence lipid oxidation, fatty acid profile and cholesterol level of broiler breast muscle. It can be concluded that dietary LO and SO enhanced n-3 and n-6 polyunsaturated fatty acids, respectively, while dietary PO enhanced the oleic acid and oxidative stability of broiler breast muscle. Thus, this study showed that PO can be used as an alternative oil source in broiler diets with a positive effect on the oxidative stability of chicken meat refrigerated at seven days when compared with vegetable oils that are rich in linoleic and α-linolenic acid.Keywords: Chicken Meat Quality, Dietary Calcium Levels, Linseed Oil, Palm Oil, Soybean Oi