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Prenatal and early-life exposures may contribute to lifelong hypertension risk. We examined the relationships between an individual’s birth weight or preterm birth status with their 1) risk for hypertension and 2) related quantitative blood pressure measures [mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and 30-second pulse] among post-menopausal women from the Women’s Health Initiative observational cohort. At study entry, birth weight and preterm birth status were self-reported by category (<6 lbs., 6–7 lbs. 15 oz., 8–9 lbs. 15 oz., or ≥10 lbs.; ≥4 weeks premature or full term). Prevalent and incident hypertension status were self-reported; baseline SBP, DBP, and 30-second pulse were measured by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to estimate associations between birth weight and preterm birth and blood pressure outcomes. After adjustments, participants born weighing <6 lbs. had a higher mean SBP and were at increased risk for prevalent and incident hypertension compared to participants born at a normal birth weight (6–7 lbs. 15 oz.). Women born weighing ≥10 lbs. had a lower mean SBP and were at lower risk for prevalent and incident hypertension when compared to participants born at a normal birth weight. Compared to participants born full term, those born preterm were at increased risk for prevalent and incident hypertension; however, this relationship was weaker when stratifying by birth weight. Long-term follow-up or targeted counseling may be required for individuals born prematurely or at lower birth weights to prevent hypertension and associated cardiovascular outcomes.
Pulse pressure (PP) calculated as systolic minus diastolic blood pressure is a surrogate measure of arterial stiffness that may affect executive function; however, this relationship could be moderated by age and genetic risk for Alzheimer’s disease (AD). We therefore examined relationships among PP, age, AD risk (i.e., APOE genotype) and executive function measured by the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults.
Methods:
PP was determined in 216 older adults without dementia (mean age: 77.5 ± 7.9 years, education: 16.8 ± 2.4 years, 55% women, 34.8% APOE ϵ4+) who were tested with the NIHTB-CB as part of the Advancing Reliable Measurement of Alzheimer’s Disease and Cognitive Aging (ARMADA) study.
Results:
Multiple linear regression revealed PP × Age × APOE genotype interaction effects for List Sorting Working Memory (β = 0.04; p = .007) and Picture Sequence Memory (β = 0.04; p = .006); higher PP was associated with worse scores in younger APOE ϵ4+ older adults (same pattern for fluid and total cognition composite scores). Higher PP was associated with lower Picture Vocabulary scores in ApoE ϵ4+ (PP X APOE interaction: β = −0.19; p = .022). Higher PP was associated with lower Flanker Inhibitory Control scores (β = −0.13; p = .005) across all participants.
Conclusions:
Arterial stiffness measured by PP in older adults is associated with worse performance on NIHTB-CB tests of executive function, working memory, and episodic sequence memory, particularly in younger APOE ϵ4 carriers. Arterial stiffness and AD risk may work synergistically in an age dependent manner to adversely affect cognition.
Smoking has been confirmed to induce systemic inflammation and oxidative stress (OS) and is associated with higher odds of chronic obstructive pulmonary disease (COPD). Dietary antioxidants can reduce inflammation and OS. This study seeks to score the dietary antioxidant intake and then assess its impact on the association between smoking and COPD in adults. The data extracted from the 2007–2012 National Health and Nutrition Examination Survey database were used. The Dietary Antioxidant Quality Score (DAQS) was evaluated by the total intake of vitamins A, C and E, Se, Zn and Mg in the daily diet. Smoking was used as the exposure variable and COPD as the outcome variable. Weighted multivariable logistic regression was conducted to evaluate the associations of DAQS with smoking and COPD, as well as their joint effects on the odds of COPD. The relationships between dietary antioxidant quality score, smoking status and COPD were subsequently assessed. Subgroup analyses were performed to explore associations between relevant covariates and smoking and COPD across DAQS strata. Current smoking was found to be linked to COPD (OR = 4·06, 95 % CI = 3·14, 5·27) in comparison to never smoking. Among smokers, significant associations were observed in both the medium-quality DAQS group (OR = 3·48, 95 % CI: 2·34, 5·17) and the low-quality DAQS group (OR = 5·60, 95 % CI: 3·58, 8·76). In conclusion, high DAQS levels are inversely related to the odds of COPD in adult smokers. Our findings provide valuable insights for management strategies for COPD.
Utilisation of nicardipine in the neonatal and infant period has been historically avoided due to a concern for a more calcium-sensitive myocardium. The aim of this study was to characterise the association between nicardipine and systolic blood pressure in neonates and infants after cardiac surgery.
Methods:
In this single-centre, retrospective study, patients under 12 months of age who underwent cardiac surgery and received nicardipine for at least one hour were included (September 2022 to January 2024). Patients were monitored with Etiometry. Variables of interest included haemodynamic parameters, ionised calcium, serum lactate, vasoactive infusion score, and nicardipine dose. A time series regression was conducted with each patient having 5 distinct time points.
Results:
One hundred and eighty-five time points were collected across 37 patients with a mean age of 3 months. Of these patients, 22% were neonates and 32% were functionally univentricular. With nicardipine utilisation, a decrease in systolic blood pressure of 14 mmHg after an 8-hour time period was noted (p = 0.017). Heart rate, diastolic blood pressure, cerebral and renal oxygen extraction, ionised calcium, serum lactate, and vasoactive inotrope score did not significantly change over the study period.
Conclusion:
Nicardipine utilisation in neonates and infants after cardiac surgery was associated with decreased systolic blood pressure. Indirect markers demonstrate no change in cardiac function. Additional studies are needed to better elucidate nicardipine’s role in this patient population.
White potatoes are a major contributor to energy and nutrient intake in the USA, which supports investigating their relationship with cardiometabolic health. This cross-sectional analysis assessed relationships of total white potato intake and dietary patterns containing white potatoes prepared by various methods with markers of cardiometabolic health in adults categorised by diabetes status. The dietary intake assessment component of the National Health and Nutrition Examination Survey (2001–2018), What We Eat in America (WWEIA), was linked with the Food and Nutrient Database for Dietary Studies and Food Patterns Equivalents Database to rank the consumption of white potato-containing foods. Dietary patterns were determined by percent calories from white potatoes and main food groups in WWEIA using cluster analysis. Regression analysis assessed trends in individuals with (n 5467) and without (n 38 159) diagnosed diabetes. P < 0·01 was significant. The most consumed white potato-containing foods were French fries, potato chips and home fries. In adults without diagnosed diabetes, total white potato intake was positively associated with glucose, insulin, Homeostatic Model Assessment for Insulin Resistance and waist circumference. Glycated Hb was lower in those who primarily consumed dietary patterns with baked/boiled potatoes, and waist circumference was higher in those who primarily consumed dietary patterns with chips, fried potatoes or mashed potatoes compared with adults with no white potato intake. In adults without diagnosed diabetes, total white potato intake was associated with greater cardiometabolic risk, which may be due, in part, to frying as the predominate preparation method of white potatoes in the USA.
This study is the first study in Middle Eastern population that aimed to investigate the association between global diet quality score (GDQS) and risk of hypertension (HTN) in Iranian adults.
Design:
This population-based cohort study was conducted on 5718 individuals aged ≥ 18 years from the third and fourth Tehran Lipid and Glucose Study surveys, who were followed until the sixth survey (mean follow-up: 7·8 years). Dietary data were collected using a validated FFQ to calculate GDQS as a novel food-based metric designed to assess diet quality across diverse populations. It evaluates the adequacy of healthy food groups (e.g. fruits, vegetables and whole grains) while monitoring the moderation of unhealthy or excessive intake (e.g. refined grains, processed meats and sugary foods).
Setting:
Tehran Lipid and Glucose Study.
Participants:
Iranian men and women.
Results:
Participants had a mean (sd) age of 37·7 (sd 12·8) years, BMI of 26·6 (sd 4·7) kg/m2 and GDQS of 25·3 (sd 4·4). During the 7·8-year follow-up, 1302 (18 %) new cases of HTN were identified. Higher GDQS and its healthy components were associated with reduced HTN risk (hazard ratio (HR): 0·83; 95 % CI: 0·70, 0·98; Ptrend = 0·034 and HR: 0·78; 95 % CI: 0·65, 0·92; Ptrend = 0·005, respectively), while unhealthy components of GDQS showed no association with HTN risk (HR: 1·14; 95 % CI: 0·98, 1·33; Ptrend = 0·059). These protective associations were observed across all weight categories and both genders, with stronger effects among obese individuals (for GDQS: HR: 0·75; 95 % CI: 0·58, 0·98; P = 0·041; for healthy components: HR: 0·75; 95 % CI: 0·57, 0·99; P = 0·044) and females (for GDQS: HR: 0·77; 95 % CI: 0·62, 0·97; P = 0·028; for healthy components: HR: 0·76; 95 % CI: 0·60, 0·96; P = 0·023).
Conclusions:
A higher GDQS was associated with a reduced risk of incident HTN among Iranian adults. Adherence to a high-quality diet, particularly focusing on the healthy dietary components of GDQS, may serve as an effective strategy for preventing HTN, especially among obese individuals and women.
Progression towards elevated blood pressure (BP) may begin as early as adolescence. In low- and middle-income countries (LMICs), consumption of ultra-processed foods (UPFs), which are linked to poor cardiometabolic health, is often highest in adolescence. We examined sex- and age-specific associations of systolic and diastolic BP (SBP and DBP) with concurrent and lagged UPF intake from age 15 to 25 in a Filipino cohort. We used data from the 1998–2009 waves of the Cebu Longitudinal Health and Nutrition Survey (n 2124, 52 % male); participants were 15, 18, 21 and 25 years old. UPFs (% daily kilocalories) were classified using NOVA. Linear mixed-effects models estimated differences in SBP and DBP associated with a 5-percentage point difference in concurrent and lagged UPF intake (3–4 years earlier). Mean UPF intake was 10–11 % of total energy intake among males and 14–17 % among females over the study period. At age 21, intake of ultra-processed meats and fish was positively associated with DBP (β = 0·48 (95 % CI: 0·02, 0·94)) among males and intake of ultra-processed sugary beverages was positively associated with SBP (0·80 (0·13, 1·48)) and DBP (0·93 (0·34, 1·51)) among females. Among females only, SBP at age 18 was positively associated with total UPF intake at age 15 (0·25 (0·00, 0·50)). In this cohort, there were modest, positive associations between BP and UPF intake, which varied by sex and age. UPF intake during the transition to adulthood may be linked to higher BP, supporting efforts to limit adolescents’ intake in LMICs.
To examine the association between snack characteristics (snack frequency, snack energy density and snack nutritional quality) with diet quality and cardiometabolic risks among US adolescents from the 2009–2016 National Health and Nutrition Examination Survey. Cross-sectional dietary data collected using a 24-h dietary recall from the 2011–2016 National Health and Nutrition Examination Survey (1999 boys and 1897 girls aged 12–19 years) were analysed. Associations between snack characteristics with diet quality, fasting blood glucose, TAG, total cholesterol, HDL, LDL, blood pressure, waist circumference and metabolic syndrome risk score using multiple linear regression were analysed stratified by sex. Higher snack nutritional quality (β (95 % CI): boys 0·31 (0·09, 0·52); girls 0·44 (0·30, 0·57)) was linked to better overall diet quality, whereas snack energy density excluding beverages (β (95 % CI): boys –1·82 (–2·52, –1·12); girls –1·75 (–2·69, –0·82)) was linked to poorer overall diet quality. Among girls, higher snack frequency was associated with lower waist circumference and lower fasting blood glucose (–0·67 (–1·28, −0·05)). Additionally, higher snack energy density and nutritional quality were associated with lower waist circumference and TAG, respectively. No associations between snack characteristics and cardiometabolic indicators or metabolic syndrome risk score were observed for boys. Findings suggest that strategies to improve adolescent snack nutritional quality and energy density may enhance overall diet quality. However, limited associations were observed between snack characteristics and cardiometabolic risk indicators among girls only. Prospective studies are needed to further investigate the relationship between snack characteristics and adolescent health outcomes.
Acute effects of a daily dose of red wine may cause deterioration of visual function; however, there is limited information on healthy individuals. This study aims to investigate acute effects of daily red wine consumption on visual function and retinal microvasculature in healthy young adults through a randomised self-controlled design and to explore the molecular mechanisms using an animal model. In healthy young adults’ study, twenty-seven adults with follow-up at baseline, 0·5 h and 2 h after consuming 300 ml of either red wine or water underwent blood biochemistry, visual function, morphology and blood flow of retinal and choroidal vasculatures, and cerebral blood flow (CBF) evaluation. Acute red wine consumption caused abnormal changes in retinal function (multifocal visual electrophysiology) that preceded changes in vision. Macular vessel diameter index (VDI) increased significantly at 0·5 h but decreased significantly at 2 h, despite increased regional CBF following red wine consumption, which was consistent with increased choroidal thickness and decreased retinal thickness. Animal experiments conducted on Brown Norway rats demonstrated a significant decrease in retinal VDI and vessel area density (VAD) associated with increased reactive oxygen species production following red wine administration, as well as decreased endothelial nitric oxide synthase (eNOS) and increased endothelin-1 (ET-1) levels in the retina. Consequently, red wine consumption caused abnormal changes in retinal function and microvascular constriction in healthy young adults, and an animal model suggested that the underlying mechanism may involve the regulation of eNOS and ET-1 levels in the retina. These findings imply the potential detrimental effects of drinking habits on individuals with retinal ischaemic diseases.
While increasing seafood consumption may help address micronutrient deficiencies and metabolic disorders, evidence supporting this recommendation in the Indian context remains limited and inconclusive. Using the nationally representative cross-sectional 2019–2021 National Family Health Survey dataset, we investigated the association of fish consumption frequency with anaemia and metabolic disorders (overweight/obesity, hypertension and hyperglycaemia) among adult men (aged 15–54 years) and women (aged 15–49 years) in India. A control function (CF) method was employed to examine the association in individuals who consumed fish daily and those who reported consuming fish daily/weekly. The analysis was restricted to non-vegetarians (who reported ever consuming egg, fish or meat). Overall, 86·9 % of men and 74·7 % of women were non-vegetarians. CF analysis revealed that both daily and daily/weekly fish consumption were associated with a reduced risk of anaemia among both men and women. Daily fish consumers exhibited increased likelihood of overweight/obesity (men: β: 0·405, 95 % CI: 0·074, 0·735, P: 0·017; women: β: 0·248, 95 % CI 0·125, 0·370, P < 0·001). Conversely, daily/weekly fish intake was associated with a reduced risk of overweight/obesity in men (β: −0·041, 95 % CI: −0·069, −0·013; P: 0·004). Daily/weekly fish consumption was associated with a reduced risk of hypertension and increased odds of hyperglycaemia among men. Fish consumption demonstrated a potentially protective relationship against hypertension in women, regardless of how often they consumed fish, while also being associated with a higher prevalence of hyperglycaemia. Indian adults can improve their health by eating more fish, which can help fight anaemia and may also reduce overweight/obesity and high blood pressure.
The dietary inflammatory index (DII) has emerged as a promising tool associated with the development of cardiovascular risk factors. This systematic review and meta-analysis, developed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines (the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42022323267), aimed to synthesise observational studies that evaluated the association between the DII and indicators of body adiposity and blood pressure in children and adolescents. PubMed/MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Google Scholar were searched, without time and language restrictions. The methodological quality of the studies and the certainty of the evidence were assessed using the Newcastle–Ottawa scale and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. The meta-analysis revealed that a higher DII (pro-inflammatory diet) was significantly associated with increased odds of body adiposity, as indicated by body mass index (BMI) (odds ratio [OR] = 1·62; 95% confidence interval [CI] 1·38–1·86), waist circumference (OR = 1·45; 95% CI 1·10–1·81) and the waist-to-height ratio (OR = 1·76; 95% CI 1·38–2·14) in adolescents, compared with those with a lower DII (anti-inflammatory diet). In addition, for every unit increase in the DII, there was a small but significant rise in mean BMI (β = 0·06 kg/m2). The children’s dietary inflammatory index (CDII) showed no association with cardiometabolic risk factors. There were no consistent associations between the DII or CDII and blood pressure. In conclusion, while a pro-inflammatory diet (based on the DII) is linked to body adiposity, additional longitudinal studies are needed to explore these associations, particularly regarding the CDII and blood pressure.
Amiodarone is a frequently used medication in paediatric patients to manage atrial and ventricular arrhythmias, but its acute haemodynamic effects, particularly in children, remain underexplored. This retrospective, single-centre study aimed to characterise the clinical impact of amiodarone intravenous infusions on heart rate, blood pressure, oxygen delivery, and transaminase levels within the first 48 hours of amiodarone initiation in paediatric cardiac ICU patients.
Methods:
Single-centre, retrospective study of patients receiving amiodarone infusions, with measurements taken at baseline and at various intervals up to 48 hours after initiation. The primary outcome was the effect on heart rate, while secondary outcomes included blood pressure, arterial saturation, near-infrared spectroscopy values, central venous pressure, and transaminase levels. Several types of analysis models were employed to assess the results.
Results:
Data were collected from 87 paediatric patients. No significant changes in liver enzymes, blood pressure, or renal oxygen extraction were observed. These findings provide novel insights into the acute haemodynamic effects of amiodarone infusions in paediatric patients, suggesting that while amiodarone significantly lowers heart rate, it does not substantially affect oxygen delivery or necessitate increased vasoactive support.
Conclusion:
Amiodarone infusions are associated with a significant decrease in heart rate without greatly impacting oxygen delivery or requiring increased vasoactive support. Heart rate decreases most until a cumulative dose of 30,000 mcg/kg, and heart rate decrease is most pronounced in those with ventricular tachycardia.
William Fawcett, Royal Surrey County Hospital, Guildford and University of Surrey,Olivia Dow, Guy's and St Thomas' NHS Foundation Trust, London,Judith Dinsmore, St George's Hospital, London
Monitoring is essential to safe anaesthesia and should be applied to any case wherever an anaesthetic is conducted. Safe monitoring of an anaesthetised patient includes the presence of a trained anaesthetist together with clinical and technical monitoring. Regular checking and maintenance of equipment should be undertaken. Safe monitoring aspects of the anaesthetic machine are emphasised in this chapter. Vital technical monitoring includes the use of electrocardiogram trace, pulse oximetry, respiratory rate, blood pressure and capnography. Depth of anaesthesia monitoring is discussed during the use of total intravenous anaesthesia (TIVA). Similarly, the use of neuromuscular monitoring is described as essential for patients who have received neuromuscular blocking drugs.
Specialised patient monitoring devices may be used in some cases, such as the use of invasive cardiac output monitoring, arterial or central venous pressures, neurological evoked potentials, or cerebral oximetry.
Hypertension disorders of pregnancy are a clinical spectrum that includes gestational hypertension, preeclampsia, and eclampsia. Hypertensive disorders are a common cause of significant maternal and fetal morbidity and mortality. Therefore, it is important for women’s health clinicians to be knowledgeable of the diagnostic criteria and management guidelines. A 25-year-old gravida 3 para 0 at 35 weeks’ gestation presents with a blood pressure of 165/95, proteinuria, and develops seizures. Based on her clinical presentation, physical examination, and laboratory findings, a diagnosis of eclampsia was made. The patient was promptly stabilized, treated with magnesium sulfate for seizure prophylaxis, received antihypertensive treatment, and delivered in a timely manner. The case highlights the recommended maternal evaluation, fetal surveillance, timing of delivery, and treatment for hypertension disorders of pregnancy.
Aortic coarctation can occur isolated or associated with ventricular septal defect. This study evaluated aortic stiffness in normotensive patients surgically treated for aortic coarctation and ventricular septal defect and in those who underwent simple aortic coarctation repair. Both groups were compared with healthy controls. Again, the two pathological groups were compared with each other regarding aortic stiffness and left ventricular diastolic function. A possible relationship between aortic stiffness and left ventricular diastolic function was investigated.
Methods:
Twenty-two isolated aortic coarctation patients and 17 aortic coarctation and ventricular septal defect patients were enrolled. Aortic root distensibility and aortic stiffness index were calculated from echocardiography and blood pressure. E wave to A wave (E/A) ratio was measured from mitral valve inflow profile.
Results:
Aortic root distensibility and aortic stiffness index in simple aortic coarctation vs healthy controls: both p < 0.0001. Aortic root distensibility and aortic stiffness index in aortic coarctation/ventricular septal defect vs healthy controls: both p < 0.0001. Aortic root distensibility and aortic stiffness index were similar in the two pathological groups (both p = ns). No statistically significant difference was detected in relation to left ventricular diastolic function (p = ns). No correlation was detected between aortic stiffness and diastolic function in simple aortic coarctation and aortic coarctation/ventricular septal defect groups (both p = ns).
Conclusions:
In both normotensive isolated aortic coarctation and aortic coarctation/ventricular septal defects subgroups, aortic stiffness is increased in a similar way in comparison with controls. Diastolic function was normal and similar in both groups. Aortic stiffness was not related to left ventricular diastolic function in this specific setting.
This study was designed to explore the mediating role of serum 25-hydroxyvitamin D (25(OH) D) in Triglyceride–glucose (TyG) index and hypertension (HTN). Study participants were selected from the 2001 to 2018 National Health and Nutrition Examination Survey. Firstly, we estimated the association between TyG index and serum 25(OH)D with HTN using a weighted multivariable logistic regression model and restricted cubic spline. Secondly, we used a generalised additive model to investigate the correlation between TyG index and serum 25(OH)D. Lastly, serum 25(OH)D was investigated as a mediator in the association between TyG index and HTN. There were 14 099 subjects in total. TyG index was positively and linearly associated with HTN risk, while serum 25(OH)D had a U-shaped relationship with the prevalence of HTN. When the serum 25(OH)D levels were lower than 57·464 mmol/l, the prevalence of HTN decreased with the increase of serum 25(OH)D levels. When serum 25(OH)D levels rise above 57·464 mmol/l, the risk of HTN increases rapidly. Based on the U-shaped curve, serum 25(OH)D concentrations were divided into two groups: < 57·464 and ≥57·464 mmol/l. According to the mediation analysis, when serum 25(OH)D levels reached < 57·464 mmol/l, the positive association between the TyG index and incident HTN was increased by 25(OH)D. When serum 25(OH)D levels reached ≥ 57·464 mmol/l, the negative association between the TyG index and incident HTN was increased by 25(OH)D. There was a mediation effect between the TyG index and HTN, which was mediated by 25(OH)D. Therefore, we found that the association between serum 25(OH)D levels and TyG index may influence the prevalence of HTN.
Wearable pressure sensors with high sensitivity, fast response time, and low detection limit have great potential for blood pressure monitoring and early diagnosis of hypertension. This article introduces a piezoresistive pressure sensor based on carbon nanotubes (CNTs), polyaniline (PAni), and fabric (CNT/PAni/fabric) for health monitoring applications. This sensor is made by using two layers of linen fabric coated with CNT and PAni. These layers are placed on a polyester fabric substrate. One of the coated layers has a mesh structure, which increases the sensitivity of the sensor and lowers its detection limit. The CNT/PAni/fabric sensor has a high sensitivity of 2.035 kPa−1 at pressures from 0 to 0.2 kPa, a response time of 290 ms, and a detection limit of 1.5 Pa. These features make it suitable for measuring blood pressure. The results obtained by measuring blood pressure using the pulse transit time method on four people, compared with the values obtained using the digital sphygmomanometer, show a discrepancy ranging between 0.019% and 1.62%. Also, the average error and standard deviation for the sensor measurement in systolic and diastolic pressures are 0.56 ± 0.33 and 0.57 ± 0.46, respectively, which shows that measurement with this sensor can be an alternative to existing devices.
Although research on the relationship between lean body mass and blood pressure (BP) has been inconsistent, most studies reported that measures of lean body mass are associated with a higher risk of hypertension. We explored relationships between body composition (fat and skeletal muscle mass) and BP in 1162 young adult African women. Dual-energy X-ray absorptiometry-derived measures of whole-body, central and arm fat mass were associated with higher systolic and diastolic BP, while leg fat percentage was associated with lower systolic and diastolic BP. However, only the associations with diastolic BP remained after adjusting for appendicular skeletal muscle mass (ASM). ASM was associated with higher systolic and diastolic BP, before and after adjusting for whole-body fat percentage and visceral adipose tissue. While there was no overlap in targeted proteomics of BP and body composition, REN was lower in the elevated BP than the normal BP group and was inversely associated with diastolic BP (false rate discovery adjusted P< 0·050). Several proteins were positively associated with both visceral adipose tissue and ASM (LEP, FABP4, IL6 and GGH) and negatively associated with both visceral adipose tissue and ASM (ACAN, CELA3A, PLA2G1B and NCAM1). NOTCH3, ART3, COL1A1, DKK3, ENG, NPTXR, AMY2B and CNTN1 were associated with lower visceral adipose tissue only, and IGFBP1 was associated with lower ASM only. While the associations between body fat and BP were not independent of skeletal muscle mass, the associations between muscle mass and BP were independent of overall and central adiposity in young adult African women. Future interventions targeting muscle mass should also monitor BP in this population.
Adherence to healthy diet principles and to cardiopreventive medication, both key behaviours in CVD prevention, is known to differ between women and men. Whether these adherence behaviours are differentially related among women and men has never been thoroughly assessed. The objective was to assess gender differences in the association between adherence to healthy diet principles and to cardiopreventive medication in adults free of CVD. This cross-sectional study included 268 women and 204 men from the CARTaGENE cohort (Québec, Canada) who were using antihypertensive and/or cholesterol-lowering medication. Adherence to healthy diet principles was assessed using the Alternate Healthy Eating Index (AHEI, %), calculated from a validated FFQ assessing diet in the 12-month preceding its completion. Medication adherence was assessed using the daily pharmacotherapy possession rate (DPPR, %), calculated from prescription claim data over the same 12-month period. In multivariable-adjusted analyses, an inverse association between AHEI and DPPR was observed among men (βAHEI for 10 % increment in DPPR = –0·65 %; 95 % CI −1·28 %, −0·03 %; P = 0·04), while it tended to be positive among women (β = 0·44 %; 95 % CI −0·11 %, 1·00 %; P = 0·12; Pgender×DPPR = 0·01). The negative association between AHEI and DPPR was stronger among men who never smoked or used cholesterol-lowering medication only. Among women, the positive association was stronger and statistically significant among those with obesity or using ≥ 3 medications simultaneously. Association between adherence to healthy diet principles and to cardiopreventive medication differs between women and men, with men potentially facing greater challenges in achieving optimal complementarity between these two behaviours.
This interventional single-centre prospective open-label study aims to evaluate the effects of a vegan diet, compared with a vegetarian and omnivorous diet, on metabolic parameters, insulin sensitivity, and liver and kidney steatosis in healthy adults. The study included fifty-three omnivorous participants aged 18–40 years, BMI 18–30 kg/m2, without any chronic disease, chronic medication use, active smoking or significant alcohol consumption. All participants were omnivorous at baseline and selected to continue an omnivorous diet or transition to a vegetarian or vegan diet, with follow-up over 6 months. Anthropometric measurements, biochemical parameters and liver and kidney steatosis were assessed at baseline and after six months using MRI-proton density fat fraction. Primary outcomes included changes in liver and kidney steatosis, while secondary outcomes were alterations in anthropometric and biochemical markers. Among fifty-three participants, eighteen followed an omnivorous diet, twenty-one adopted a vegetarian diet and fourteen transitioned to a vegan diet. Dietary interventions did not result in statistically significant changes in BMI, fat mass, fat percentage or muscle mass over 6 months. However, statistically significant improvements in systolic and diastolic blood pressure, favouring the vegan diet, were observed. We aimed to control for potentially confounding variables to ensure the reliability of these findings. We have demonstrated a better decline in steatosis at the lower kidney pole, the total hilus and the Liver 6 index in vegans. We demonstrated that a plant-based diet is associated with improvements in several metabolic parameters and may reduce liver and kidney steatosis.