297 research outputs found

    Orthostatic Hypotension and Intensive Blood Pressure Treatment: No Need to Worry?

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    Modelling spatial patterns in host-associated microbial communities

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    Microbial communities exhibit spatial structure at different scales, due to constant interactions with their environment and dispersal limitation. While this spatial structure is often considered in studies focusing on free-living environmental communities, it has received less attention in the context of host-associated microbial communities or microbiota. The wider adoption of methods accounting for spatial variation in these communities will help to address open questions in basic microbial ecology as well as realize the full potential of microbiome-aided medicine. Here, we first overview known factors affecting the composition of microbiota across diverse host types and at different scales, with a focus on the human gut as one of the most actively studied microbiota. We outline a number of topical open questions in the field related to spatial variation and patterns. We then review the existing methodology for the spatial modelling of microbiota. We suggest that methodology from related fields, such as systems biology and macro-organismal ecology, could be adapted to obtain more accurate models of spatial structure. We further posit that methodological developments in the spatial modelling and analysis of microbiota could in turn broadly benefit theoretical and applied ecology and contribute to the development of novel industrial and clinical applications.Peer reviewe

    Anticoagulation Therapy After Biologic Aortic Valve Replacement

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    Objectives: Thromboembolism prophylaxis after biologic aortic valve replacement (BAVR) is recommended for 3 months postoperatively. We examined the continuation of oral anticoagulation (OAC) treatment and its effect on the long-term prognosis after BAVR.Methods: We used nation-wide register data from 4,079 individuals who underwent BAVR. We examined the association between warfarin and the non-vitamin K antagonist oral anticoagulant use with death, stroke and major bleeding in 2010 – 2016.Results: The risk of stroke was higher (HR 2.39, 95% CI 1.62 – 3.53, p < 0.001) and the risk of death was lower (HR 0.79, 95% CI 0.65 – 0.96, p = 0.016) in OAC-users compared to individuals without OAC. We observed no significant associations between OAC use and bleeding risk.Conclusion: OAC use after BAVR was associated with increased risk of stroke and decreased risk of death. These observational findings warrant validation in randomized controlled trials before any clinical conclusions can be drawn

    Age of Hypertension Onset: Overview of Research and How to Apply in Practice

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    Purpose of review: To review the current evidence on research related to age of hypertension onset-its definition, correlates, heritability, and association with adverse outcomes. We also propose a framework for implementing assessment of hypertension onset age into clinical practice.Recent findings: Prior studies have used both objective measurements and self-report to determine age of hypertension onset or early-onset hypertension. Yet, no criterion for standard definition currently exists for either. Data from epidemiological and clinical studies demonstrate that early-onset hypertension is a highly heritable trait that confers an increased risk for cardiovascular death and end-organ damage compared with late-onset hypertension. Literature to date suggests that (parental) age of hypertension onset can be feasibly assessed for estimating (1) risk of future hypertension in non-hypertensive persons; and (2) the propensity for cardiovascular disease in individuals with established hypertension.Keywords: Age of hypertension onset; Blood pressure; Clinical implications; Hypertension; Hypertension and cardiovascular disease; Hypertension heritability.</p

    Clinical Correlates of Early-Onset Hypertension

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    BACKGROUNDEarly-onset hypertension has been established as a heritable trait and a risk factor for cardiovascular disease outcomes. However, the clinical correlates of early-onset hypertension remain unidentified.METHODSIn this study, we assessed the demographic characteristics and lifestyle factors related to hypertension onset age in a sample of 3,286 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (mean baseline age 25 4 years, 57% women). We examined the association between the participants' baseline characteristics and age of hypertension onset subgroups (= 45 years) using a multinomial logistic regression model with those who did not develop hypertension as the reference group. Hypertension onset was defined as blood pressure >= 140/90 mm Hg or antihypertensive medication use on 2 consecutively attended follow-up visits.RESULTSIn the multinomial logistic regression model, individuals who were black (odds ratio [OR], 5.08; 95% confidence interval [CI], 3.17-8.14), were more obese (OR, 1.57; 95% CI, 1.32-1.88), or had higher total cholesterol (OR, 1.34; 95% CI, 1.13-1.60 per SD) had increased odds of early-onset hypertension (onset at CONCLUSIONSOur findings suggest that individuals who are black, obese, have higher total cholesterol, or have lower HDL-cholesterol level, are potentially at an increased risk of having early-onset hypertension.</p

    Haptoglobin Hp1 Variant Does Not Associate with Small Vessel Disease

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    Haptoglobin (Hp) is a plasma protein that binds free hemoglobin and protects tissues from oxidative damage. An Hp2 allele has been associated with an increased risk of cardiovascular complications. On the other hand, recent studies have suggested that Hp1 allele increases risk to develop severe cerebral small vessel disease. We aimed to replicate this finding in a first-ever stroke patient cohort. Hp was genotyped by PCR and gel electrophoresis in the Helsinki Stroke Aging Memory Study in patients with DNA and magnetic resonance imaging (MRI) available (SAM; n = 316). Lacunar infarcts and white matter lesions (WML) classified by Fazekas grading from brain MRI were associated with Hp genotypes. As population controls, we used participants of Cardiovascular diseases—a sub study of Health 2000 Survey (n = 1417). In the SAM cohort, 63.0% of Hp1-1 carriers (n = 46), 52.5% of Hp1-2 carriers (n = 141) and 51.2% of Hp2-2 carriers (n = 129) had severe WML (p = 0.372). There was no difference in severe WMLs between Hp1-1 vs. Hp1-2 and Hp2-2 carriers (p = 0.201). In addition, 68.9% of Hp1-1 carriers (n = 45), 58.5% of Hp1-2 carriers (n = 135), and 61.8% of Hp2-2 carriers (n = 126) had one or more lacunar lesions (p = 0.472). There was no difference in the number of patients with at least one lacunar infarct between Hp1-1 vs. Hp1-2 and Hp2-2 groups (p = 0.322). Neither was there any difference when diabetic patients (type I and II) were examined separately. Hp1 allele is not associated with an increased risk for cerebral small vessel disease in a well-characterized Finnish stroke patient cohort

    Association between Life Stressors and Arterial Stiffness: The Finnish Retirement and Aging Study

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    Objective: Besides traditional risk factors, other factors such as life stressors are linked with incident cardiovascular disease. However, the underlying mechanisms for this association remain mostly unknown. We studied the relation of life stressors (job strain, sleep loss due to worry, illness or death in family, financial difficulties and caregiving) and their accumulation with arterial stiffness, an independent predictor of cardiovascular disease.Methods: 258 participants (mean age 62.4 years, 82% women) from the Finnish Retirement and Aging Study underwent measurements for carotid-femoral Pulse Wave Velocity (PWV), a standard criterion for assessing arterial stiffness and responded to a survey inquiring life stressors. Using analysis of covariance, we estimated group means adjusted for age, gender, occupation, lifestyle factors and hypertension.Results: Participants with recent illness or death in family (8.04 m/s; 95% CI, 7.40-8.73 vs. 7.52 m/s; 95% CI, 7.03-8.05) and financial difficulties (8.65 m/s; 95% CI, 7.62-9.81 vs. 7.71 m/s; 95% CI, 7.21-8.24) had increased PWV compared to those who did not have exposed to these stressors independent of lifestyle factors, diabetes and systolic blood pressure. In addition, increasing number of life stressors demonstrated an association towards increased PWV (>= 2 stressors: 8.04 m/s; 95% CI, 7.42-8.72 vs. 0 stressors 7.74 m/s; 95% CI, 7.23-8.28; p for trend 0.27) but the association attenuated after adjusting for lifestyle factors, diabetes and systolic blood pressure.Conclusion: Life stress was found to associate with higher arterial stiffness. Increased arterial stiffness could explain some of the increased cardiovascular disease risk related to life stressors.HIGHLIGHTS -Arterial stiffness was assesed as carotid-femoral pulse wave velocity.center dot -Illness or death in the family were associated with an increased arterial stiffness.-Financial difficulties were associated with an increased arterial stiffness.-A trend toward increasing number of stressors and higher arterial stiffness exists. (C) 2021 The Authors. Publishing services by Atlantis Press International B.V.</p

    Haptoglobin Hp1 Variant Does Not Associate with Small Vessel Disease

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    Haptoglobin (Hp) is a plasma protein that binds free hemoglobin and protects tissues from oxidative damage. An Hp2 allele has been associated with an increased risk of cardiovascular complications. On the other hand, recent studies have suggested that Hp1 allele increases risk to develop severe cerebral small vessel disease. We aimed to replicate this finding in a first-ever stroke patient cohort. Hp was genotyped by PCR and gel electrophoresis in the Helsinki Stroke Aging Memory Study in patients with DNA and magnetic resonance imaging (MRI) available (SAM; n = 316). Lacunar infarcts and white matter lesions (WML) classified by Fazekas grading from brain MRI were associated with Hp genotypes. As population controls, we used participants of Cardiovascular diseases—a sub study of Health 2000 Survey (n = 1417). In the SAM cohort, 63.0% of Hp1-1 carriers (n = 46), 52.5% of Hp1-2 carriers (n = 141) and 51.2% of Hp2-2 carriers (n = 129) had severe WML (p = 0.372). There was no difference in severe WMLs between Hp1-1 vs. Hp1-2 and Hp2-2 carriers (p = 0.201). In addition, 68.9% of Hp1-1 carriers (n = 45), 58.5% of Hp1-2 carriers (n = 135), and 61.8% of Hp2-2 carriers (n = 126) had one or more lacunar lesions (p = 0.472). There was no difference in the number of patients with at least one lacunar infarct between Hp1-1 vs. Hp1-2 and Hp2-2 groups (p = 0.322). Neither was there any difference when diabetic patients (type I and II) were examined separately. Hp1 allele is not associated with an increased risk for cerebral small vessel disease in a well-characterized Finnish stroke patient cohort

    24-h urinary sodium excretion and the risk of adverse outcomes

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    Aims: The objective was to evaluate whether sodium intake, assessed with the gold standard 24-h urinary collections, was related to long-term incidence of death, cardiovascular disease (CVD) and diabetes mellitus (DM). Methods:A cohort of 4630 individuals aged 25-64 years collected 24-h urine samples in 1979-2002 and were followed up to 14 years for the incidence of any CVD, coronary heart disease (CHD), stroke, heart failure (HF) and DM event, and death. Cox proportional hazards models were used to estimate the association between the baseline salt intake and incident events and adjusted for baseline age, body mass index, serum cholesterol, prevalent DM, and stratified by sex and cohort baseline year. Results: During the follow-up, we observed 423 deaths, 424 CVD events (288 CHD events, 142 strokes, 139 HF events) and 161 DM events. Compared with the highest quartile of salt intake, persons in the lowest quartile had a lower incidence of CVD (hazard ratio [HR] 0.70; 95% confidence interval [CI], 0.51-0.95,p = .02), CHD (HR 0.63 [95% CI 0.42-0.94],p = .02) and DM (HR 0.52 [95% CI 0.31-0.87],p = .01). The results were non-significant for mortality, HF, and stroke. Conclusion: High sodium intake is associated with an increased incidence of CVD and DM.Peer reviewe
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