Blood pressure targets in the elderly

No abstract available

Sex differences in hypertension and other cardiovascular diseases

No abstract available

Genomics and precision medicine for clinicians and scientists in hypertension

No abstract available

DIETARY ANTIOXIDANT SUPPLEMENTATION (ECONOMASE–BIOPLEX) TO ALLEVIATE ADVERSE IMPACTS OF OXIDIZED OIL ON BROILER MEAT QUALITY: A CHEMICAL, TEXTURAL, ENZYMATIC, AND PROTEOMIC STUDY

This study investigated the influence of dietary antioxidants and quality of oil on the oxidative and enzymatic properties of chicken broiler meat stored in an oxygen-enriched package (HiOx: 80% O2/20% CO2) in comparison with air-permeable polyvinylchloride (PVC) or skin (SK) packaging systems during retail display 2–4 °C for up to 14, 7, and 21 d, respectively. Broilers were fed a diet either with a low-oxidized oil (peroxide vale POV 23 meq O2/kg) or with a high-oxidized oil (POV 121 meq O2/kg), supplemented with an antioxidant pack (200 ppm EconomasE and organic minerals Se, Zn, Cu, Mn, and Fe as in Bioplex) in substitution for vitamin E and inorganic minerals for 42 d. In all packaging systems, lipid oxidation and protein oxidation were inhibited by up to 65% with an antioxidant-supplemented diet when compared to diets without antioxidant supplements. Antioxidant enzyme activities were significantly higher (P \u3c 0.05) in the antioxidant-supplemented diets compared with control diets, regardless of oil quality. Meat samples from the antioxidant-supplemented group, irrespective of oil quality, has less purge and cooking loss compared to control diets. In all packaging systems, meat shear force was higher (P \u3c 0.05) for broilers fed high-oxidized diets than the low-oxidized groups. Comparison between muscle types (breast as white vs. thigh as red) showed a similar trend in muscle susceptibility to oxidized oil in the diet but greater protection of antioxidant supplements for thigh meat in both physiochemical and textural properties. Dietary regimen influenced protein expression in broiler breast meat. Three protein spots from 2-dimensional gel electrophoresis, identified by mass spectrometry as glyceraldehyde 3-phosphate dehydrogenase, creatine kinase, and heat shock protein beta-1 were over-abundant in muscle from low-oxidized diets. The differential proteomes that suggested down regulation of the genes encoding antioxidative proteins upon feeding oxidized oil may be implicated in the broiler meat quality deterioration during storage. In summary, feeding diets with poor oil quality increased the vulnerability of lipids and proteins to oxidation in broiler breast and thigh meat during refrigerated and / or frozen storage in various packaging conditions, yet these effects were alleviated upon dietary supplementation with antioxidants

Thyroid stimulating hormone (TSH) ≥2.5mU/l in early pregnancy: prevalence and subsequent outcomes

Objective: There remains controversy over how women with abnormal thyroid function tests in pregnancy should be classified. In this study we assessed the proportion of women with thyroid stimulating hormone (TSH) ≥ 2.5 mU/l in a large obstetric cohort, and examined how many have gone on to develop thyroid disease in the years since their pregnancy. Study design: 4643 women were recruited and samples taken in early pregnancy between 2007 and 2010. Thyroid function tests were analysed in 2014; in women with raised TSH computerised health records and prescription databases were used to identify thyroid disease detected since pregnancy. Results: 58 women (1.5%) had a TSH over 5 mU/l and 396 women (10.3%) had TSH between 2.5 and 5 mU/l. Women with TSH > 5mU/l delivered infants of lower birthweight than those with TSH < 2.5 mU/l; there were no other differences in obstetric outcomes between the groups. Of those who have had thyroid tests since their pregnancy, 78% of those with TSH > 5 mU/l and 19% of those with TSH between 2.5 and 5 mU/l have gone on to be diagnosed with thyroid disease. Conclusions: Using a TSH cut-off of 2.5 mU/l in keeping with European and US guidelines means that over 12% of women in this cohort would be classified as having subclinical hypothyroidism. Treatment and monitoring of these women would have major implications for planning of obstetric services

Natural killer cells in placentation and cancer: Implications for hypertension during pregnancy

Hypertension during pregnancy is the most common medical condition encountered during gestation. Despite this, knowledge of the mechanisms that underlie the disease and the development of new therapies are limited. Hypertension during pregnancy and some forms of cancer confer an increased risk to the development of cardiovascular disease later in life; one mechanism which may link these conditions is the involvement of natural killer (NK) cells. Whilst immunology and immunotherapy are well-developed areas in oncology; the complex mechanisms of the immune system in health and disease at the maternal-fetal interface are less well-defined. Natural killer (NK) cells have emerged as key immune cells involved in physiology and pathology of pregnancy. These small lymphocytes are present in the decidua (the uterine-specific uNK cells) and are distinct from peripheral NK cells. The uNK cell population plays a vital role in mediating trophoblast invasion and affecting decidual vascular remodelling whereas the role of the peripheral NK cell population during pregnancy is less well-defined. This review will give an overview of NK cell biology followed by a discussion of the current evidence for the role of uterine and peripheral NK cells at the maternal-fetal interface in health and disease. Furthermore, examples of NK cell research from cancer biology will be employed to inform future directions of research. By combining this knowledge from oncology where the field of immunotherapy has now matured into clinical trials; it is hopeful that new mechanisms can be elucidated to generate targets for similar therapeutic strategies for women with hypertensive pregnancies where interventions are needed

Impaired endothelial function of the retinal vasculature in hypertensive patients

<p><b>Background and Purpose:</b> Arterial hypertension constitutes a central factor in the pathogenesis of stroke. We examined endothelial function of the retinal vasculature as a model of the cerebral circulation.</p> <p><b>Methods:</b> Thirty-eight young subjects (19 hypertensive and 19 normotensive) were treated with the AT1-receptor blocker candesartan cilexetil and placebo, each over 7 days. Retinal capillary flow and blood flow velocity in the central retinal artery were assessed with scanning laser Doppler flowmetry and pulsed Doppler ultrasound, respectively. NG-monomethyl-L-arginine (L-NMMA) was infused to inhibit nitric oxide (NO) synthesis. Diffuse luminance flicker was applied to stimulate NO release.</p> <p><b>Results:</b> In normotensive subjects, L-NMMA decreased retinal capillary flow by 8.2%±13% (P<0.05) and flickering light increased mean blood flow velocity in the central retinal artery by 19%±29% (P<0.01). In contrast, no significant change to these provocative tests was seen in hypertensive subjects. Treatment with candesartan cilexetil restored a normal pattern of reactivity in retinal capillaries (L-NMMA: decrease in perfusion by 10%±17%, P<0.05) and the central retinal artery (flicker: increase in mean blood flow velocity by 42%±31%, P<0.001) in hypertensive patients.</p> <p><b>Conclusions:</b> Endothelial function of the retinal vasculature is impaired in early essential hypertension but can be improved by AT1-receptor blockade.</p&gt

Vascular biomedicine in an era of chronic disease and multimorbidity

It is increasingly common that patients present with more than one disease and that diseases are chronic in nature. Cardiovascular conditions such as hypertension, heart failure and stroke, renal diseases and cardiometabolic conditions such as diabetes are prime examples of chronic diseases which pose major challenges in contemporary healthcare provision. The complex features of multimorbidity call for precision medicine approaches that take comorbidity and chronicity into account. The research basis of chronic disease and multimorbidity, however, is currently in its infancy. This applies to all domains including basic, translational and clinical science. In this article we call for development of new models, smarter use of existing models and better characterisation of vascular and cardiovascular phenotypes in studies not directly related to cardiovascular diseases. This has the potential to further improve the quality of translational research, papers in journals such as Clinical Science and ultimately translate into better patient care

Use of biomarkers in the evaluation and treatment of hypertensive patients

The current definition of hypertension is based on blood pressure values, and blood pressure also drives treatment decisions, is the most important treatment monitoring tool and helps estimating risk of hypertension related organ damage. In an era of precision medicine additional biomarkers are needed in the diagnosis and management of patients with hypertension. In this review we outline the areas in which functional, imaging and circulating biomarkers could help in a more individualised definition of hypertension and associated risk. We will cover biomarkers for diagnosis; of pathophysiology and prediction of hypertension; response to treatment, organ damage; and to monitor treatment. A clear focus is on the vasculature, the heart and the kidneys, whereas we see a need to further develop biomarkers of cerebral function in order to diagnose cognition deficits and monitor changes in cognition in the future to support addressing the growing burden of hypertension associated vascular dementia