Gut Microbiota, Blood Metabolites, and Left Ventricular Diastolic Dysfunction in Us Hispanics/Latinos

BACKGROUND: Left ventricular diastolic dysfunction (LVDD) is an important precursor of heart failure (HF), but little is known about its relationship with gut dysbiosis and microbial-related metabolites. By leveraging the multi-omics data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a study with population at high burden of LVDD, we aimed to characterize gut microbiota associated with LVDD and identify metabolite signatures of gut dysbiosis and incident LVDD. RESULTS: We included up to 1996 Hispanic/Latino adults (mean age: 59.4 years; 67.1% female) with comprehensive echocardiography assessments, gut microbiome, and blood metabolome data. LVDD was defined through a composite criterion involving tissue Doppler assessment and left atrial volume index measurements. Among 1996 participants, 916 (45.9%) had prevalent LVDD, and 212 out of 594 participants without LVDD at baseline developed incident LVDD over a median 4.3 years of follow-up. Using multivariable-adjusted analysis of compositions of microbiomes (ANCOM-II) method, we identified 7 out of 512 dominant gut bacterial species (prevalence \u3e 20%) associated with prevalent LVDD (FDR-q \u3c 0.1), with inverse associations being found for Intestinimonas_massiliensis, Clostridium_phoceensis, and Bacteroide_coprocola and positive associations for Gardnerella_vaginali, Acidaminococcus_fermentans, Pseudomonas_aeruginosa, and Necropsobacter_massiliensis. Using multivariable adjusted linear regression, 220 out of 669 circulating metabolites with detection rate \u3e 75% were associated with the identified LVDD-related bacterial species (FDR-q \u3c 0.1), with the majority being linked to Intestinimonas_massiliensis, Clostridium_phoceensis, and Acidaminococcus_fermentans. Furthermore, 46 of these bacteria-associated metabolites, mostly glycerophospholipids, secondary bile acids, and amino acids, were associated with prevalent LVDD (FDR-q \u3c 0.1), 21 of which were associated with incident LVDD (relative risk ranging from 0.81 [p = 0.001, for guanidinoacetate] to 1.25 [p = 9 × 10 CONCLUSION: In this study of US Hispanics/Latinos, we identified multiple gut bacteria and related metabolites linked to LVDD, suggesting their potential roles in this preclinical HF entity. Video Abstract

The First Amendment in a Time That Tries Men’s Souls

Government requests to suspend civil liberties are always rationalized by crisis. In the aftermath of the terrorist attacks of Sep 11, 2001, not only legal scholars but all Americans wondered what the civil liberties fallout would be. A particular area of concern was, and still is, the First Amendment protections, especially of speech and press

Race and blood pressure status influences cardiovascular responses to challenge

The influence of race and blood pressure status on cardiovascular responses to three challenges (interview, video game and cold pressor) was investigated in 50 healthy normotensive and 30 unmedicated mild-to-moderate hypertensive black and white men, aged 25-44 years old. Group differences were obtained for two tasks. The interview evoked race and blood pressure status differenceshigher heart rate responses were elicited from normotensives compared with hypertensives and larger diastolic blood pressure (DBP) responses were elicited from whites compared with blacks. For the video game, black hypertensives displayed larger DBP responses than white hypertensives and greater systolic blood pressure and DBP responses than black normotensives. The video game heart rate response of white normotensives exceeded that of black normotensives and white hypertensives. These findings suggest that cardiovascular responses to challenge are affected by race and blood pressure status. The blood pressure hyperresponsiveness of black hypertensives compared with black normotensives to a psychological challenge (video game) provides generality to previous research conducted only on whites

Blood Pressure Stability of Normotensives and Mild Hypertensives in Different Settings

Generalizability theory was used to examine the stability of blood pressure (BP) measurement in normotensives and mild hypertensives. Three to six readings at home or at work provided adequate reliability for the same day in each setting. Under structured laboratory conditions, two to three BP measures taken on each of 2 to 3 days for systolic and diastolic BP provided conservative estimates that were generalizable across days. Finally, generalizations across settings called for five or more measurements taken in at least two settings. Key words: generalizability theory, blood pressure measurements, mild hypertension, normotension, measurement reliabilit

Posture, Place, and Mood Effects on Ambulatory Blood Pressure

ABSTRACT Ambulatory blood pressure was studied as a function of posture, place, and mood in 131 subjects classified according to race, gender, and hypertensive status. The effect of posture was significant and explained a substantial proportion of within‐subject variability. After controlling for posture, significant place and mood effects were observed when subjects were sitting but not when they were standing. Home vs. work differences in both systolic and diastolic blood pressure were significantly greater in Whites than in Blacks. Similar differences in systolic blood pressure were greater in mild hypertensive than in normotensive subjects. The results of this study underscore the need to control for effects of posture when interpreting ambulatory blood pressure readings

Predicting Home and Work Blood Pressure Measurements from Resting Baselines and Laboratory Reactivity in Black and White Americans

ABSTRACT The relationship between blood pressure in the laboratory (both at rest and in response to laboratory tasks) and ambulatory blood pressure at home and at work was evaluated. One hundred nineteen normotensive and unmedicated mild‐moderate hypertensive black and white females and males participated in laboratory blood pressure monitoring at rest and during four challenging tasks (structured interview, video game, bicycle exercise, and cold pressor test) as well as ambulatory blood pressure monitoring while at home and at work. Baseline blood pressure taken while subjects were at rest was the strongest predictor of ambulatory systolic blood pressure (r=.64) and diastolic blood pressure (r=.77) at work. Among reactivity tasks the strongest predictors of ambulatory blood pressure in the total population were the structured interview and the video game (both psychological tasks) followed by the cold pressor test. Racial comparisons, however, determined that the cold pressor test predicted diastolic blood pressure significantly better for blacks (r=.73) than for whites (r=.40), suggesting a possible difference in blood pressure regulation

Differential patterns of dynamic cardiovascular regulation as a function of task

In cardiovascular reactivity studies, interpretations of the processes supporting the blood pressure response may become problematic when systolic blood pressure, diastolic blood pressure, and heart rate all increase in response to a behavioral challenge. Therefore, in addition to evaluating these cardiovascular responses, this study examined cardiac output, total peripheral resistance and systolic time intervals derived from impedance cardiogram, electrocardiogram and phonocardiogram recordings during a speech Stressor, a mirror tracing task, and a foot cold pressor test. All of the behavioral Stressors elicited increases in blood pressure and heart rate, with the largest changes occurring during the overt speech. Based on the examination of the response patterns of the underlying hemodynamic variables it would appear that, in both men and women, the blood pressure increase during the speech preparation period was supported by increased cardiac output; the speech itself resulted in a mixed pattern of increased cardiac output and total peripheral resistance; whereas, the mirror tracing and cold pressor tasks produced increased total peripheral resistance. Although men and women produced similar response patterns to the behavioral challenges, sex differences in the estimates of myocardial contractility were observed during rest. These results provide evidence that different behavioral stressors can produce a distinct yet integrated pattern of responses, whose differences may be revealed, when impedance cardiography is used, to derive sufficient response measures for assessing dynamic cardiovascular processes