尼莫地平治疗高血压性脑出血疗效观察

目的:尼莫地平治疗高血压性脑出血的临床疗效。方法:90例高血压脑出血患者随机分为实验组(45例)和对照组(45例),对照组仅采用常规治疗,实验组在常规治疗的基础上采用尼莫地平进行治疗,比较两组临床疗效、治疗前后的临床神经功能缺损评分、临床残疾评分以及血肿和水肿带体积改变。结果:实验组和对照组的治疗有效率为73.33%和42.22%,差异具有统计学意义(P<0.05)。实验组和对照组治疗前、后临床神经功能缺损评分分别为(18.58±3.06)、(12.31±2.74)和(18.28±2.97)、(15.22±2.72),实验组和对照组治疗前、后临床残疾评分分别为(38.93±3.37)、(61.57±3.03)和(37.51±4.962)和(43.48±7.19),实验组和对照组治疗前、后的血肿体积分别为(17.23±5.48)cm3、(7.93±3.33)cm3和(17.60±5.46)cm3、(10.97±4.25)cm3,实验组和对照组治疗前、后的水肿带体积分别为(7.73±3.20)cm3、(4.21±1.60)cm3和(7.83±3.19)cm3和(5.67±1.82)cm3,所有患者治疗后各指标均优于治疗前,治疗后两组组间比较均有有显著性(P<0.01)。结论:尼莫地平能够明显的减少血肿体积和水肿带的体积,提高治疗的效果,减少脑出血患者发生神经功能缺损和残疾的可能。     

Blood pressure and hypertension in an American colony (Puerto Rico) and on the USA mainland compared, 1886–1930

We compare blood pressure and hypertension between adult men on the USA mainland and in Puerto Rico born during 1886-1930 to test hypotheses about the link between cardiovascular health and large socioeconomic and political changes in society: (a) 8853 men surveyed in Puerto Rico in 1965 and (b) 1449 non-Hispanic White men surveyed on the mainland during 1971-1975. Systolic and diastolic blood pressure and hypertension were regressed separately on demographic and socioeconomic variables and cardiovascular risk factors. Mainland men not taking anti-hypertensive medication showed statistically significant improvements in systolic blood pressure and hypertension at the beginning of the century and men in Puerto Rico showed improvements in diastolic blood pressure but only during the last two quinquenniums. An average man born on the mainland during the last birth quinquennium (1926-1930) had 7.4-8.7 mmHg lower systolic blood pressure and was 61% less likely to have systolic hypertension than one born before 1901. On average Puerto Rican men born during 1921-1925 had approximately 1.7 mmHg lower diastolic blood pressure than men born before 1901. Analyses of secular trends in cardiovascular health complements analyses of secular trends in anthropometric indicators and together provide a fuller view of the changing health status of a population.     

Antihypertensive effect of spent brewer yeast peptide

Numerous studies have investigated dietary approaches to prevent chronic lifestyle-related diseases, including hypertension. Spent brewer’s yeast is the second largest byproduct originated by the brewing industry and it deserves considerable attention because of its high nutritional value, ca. 40% of its dry mass is rich in protein which can be hydrolyzed into biologically active peptides. To upgrade this byproduct, the aim of this study was initially in vitro assessment of biological properties, e.g. ACE inhibition and antioxidant activity, and then, the in vivo effect in short-term oral antihypertensive effect of hydrolyzed yeast fractions on a well characterized model to study hypertension - Spontaneously Hypertensive Rats (SHR). Here, it was demonstrated that the fraction with molecular weight below 3 kDa containing tri and tetra- peptides with hydrophobic amino acid residues – SPQW, PWW and RYW, causes the most noticeable decrease in systolic, diastolic and mean blood pressure of SHR and shows highest antioxidant effect. These properties highlight the potential use of yeast extract as nutraceutical or functional food ingredient for the management and treatment of hypertension with antioxidant effect.     

Essential hypertension in patients exposed to high-arsenic exposed areas in western China: Genetic susceptibility and urinary arsenic metabolism characteristics

ObjectiveTo clarify the urinary arsenic metabolism characteristics in individuals with essential hypertension and to analyze the relationship between lipid metabolism gene polymorphisms and susceptibility to essential hypertension in individuals in high-arsenic areas in western China.MethodsA case-control study was conducted and involved individuals exposed to high arsenic levels (in this study, the arsenic content in the pressurized well water was 0–510.2 μg/L, and that in the mechanical well water was 167 μg/L) in two adjacent high-arsenic areas in Shanxi Province and the Inner Mongolia Autonomous Region, China. A total of 699 samples were collected, including 192 case samples (patients with hypertension) and 507 control samples (no hypertension). Blood pressure measurement data obtained from an epidemiological survey were used to determine whether the subjects had hypertension, and a logistic regression model was used to analyze the association between lipid metabolism gene polymorphisms and hypertension susceptibility. Blood and urine samples were collected based on epidemiological methods, single nucleotide polymorphisms (SNPs) were genotyped using a SNPscan™ multiple SNP typing kit, and urinary arsenic concentrations were determined using the hydride generation atomic fluorescence method (HG-AFS).ResultsADIPOQ/rs266729 was the dominant genetic model [(GC + GG) vs CC = 0.686:1, 95 % CI = 0.478−0.983], and FABP2/rs1799883 was the recessive genetic model [TT vs (CC + TC) = 1.690:1, 95 % CI = 1.014–2.816]. The distribution of the urinary arsenic secondary methylation ratio (SMR) [dimethylated arsenic (DMA)/monomethylated arsenic (MMA)] was different between hypertensive patients and controls.ConclusionADIPOQ/rs266729 and FABP2/rs1799883 polymorphisms affect susceptibility to essential hypertension in individuals exposed to high levels of arsenic; there was a clear difference in the urinary arsenic metabolism pattern between hypertensive patients and controls.     

Nebivolol And Quinapril Reduce P-Wave Duration And Dispersion In Hypertensive Patients

We aimed to investigate the effects of nebivolol and quinapril treatments on P-wave duration and dispersion in hypertensive patients. Hypertensive patients who were in sinus rhythm were assigned to the two treatment groups and received either 20 mg quinapril/day or 5 mg nebivolol/day. P-Wave dispersion (PWD) was measured at baseline and after four weeks of treatment and defined as the difference between the maximum (Pmax) and the minimum (Pmin) P-wave duration. The study group consisted of 54 patients (Mean age: 53 ± 9 years, 46% women) with 27 patients in each group. At 4-week follow up both treatment groups showed a significant reduction (p< 0.001) in systolic (SBP) and diastolic blood pressure (DBP). Heart rate (HR) reduction was significant in patients receiving nebivolol (P=0.001). Both groups showed a similar (P=0.413 for PWD, p=0.651 for Pmax) but significant reduction in PWD (nebivolol: -16± 14, P< 0.0001 and quinapril: -13± 11, P< 0.0001) and Pmax (nebivolol: -10± 11, P=0.001 and quinapril: -9± 11, P=0.001). A 2 (Time) x 2 (Group) mixed-model repeated-measures analysis of variance revealed that the main effect of Time was significant for Pmax (P=0.002) and PWD (P=0.008) after controlling for changes in SBP, DBP and HR. However, the main effect of Group and Time x Group interaction was not significant for both variables (All p values > 0.05). In conclusion, short-term treatment with nebivolol and quinapril produces a similar but significant reduction in Pmax and PWD in hypertensive patients. This effect is independent of blood pressure and heart rate changes.     

高血压患者动态血压与左心房增大多因素回归分析

目的:高血压病是心脏科常见疾病,本文观察动态血压(ambulatory blood pressure monitoring, ABPM)不同夜间血压类型患者左心房大小并分析左心房增大的独立危险因素。方法:收集86例高血压病患者,所有患者行24小时动态血压及超声心动图检查。根据动态血压中夜间血压下降幅度分为杓形高血压组(夜间血压下降率≥10%, 41例)和非杓形高血压组(夜间血压下降率10%,45例)。根据心脏超声左心室长轴切面左心房前后径分两组:左心房增大组(前后径≥3.85 cm,45例),左心房正常组(前后径3.85 cm,41例),采用Logistic多因素回归分析左心房增大的危险因素。结果:(1)非杓形高血压组较杓形高血压组夜间平均收缩压(125.6±15.0 mm Hg VS 107.7±14.9 mm Hg P0.05)及平均舒张压(70.3±9.0 mm Hg VS 60.3±12.2 mm Hg P0.05)明显增高,左心房内径明显增大(4.0±0.48 cm VS 3.74±0.35 cm P=0.005)。(2)左心房内径增大组夜间收缩压下降率(6.4±8.1 mm Hg VS10.3±6.7 mm Hg P=0.01)及舒张压下降率(10.1±9.0 mm Hg VS 14.3±7.9 mm Hg P=0.02)较左心房内径正常组明显降低。(3)Logistic多因素回归分析示左心室质量、总胆固醇是左心房增大的独立危险因素。结论:夜间血压升高更容易导致左心房内径增大。左心室质量增加、胆固醇增高与左心房内径增大有密切关系。     

广东丰顺地区老年高血压患者的危险因素及合并症的特征

目的:分析广东省丰顺地区老年高血压患者的临床特点,为临床治疗该地区老年高血压病提供参考。方法:选取广东省丰顺县人民医院等共3所医院2015年1月至2016年1月收治的老年高血压患者827例,并对所收集的临床资料进行整理,回顾性分析该地区老年人高血压病心脑血管危险因素的分布特征以及其合并症的发生情况。结果:本次纳入研究的827例老年高血压患者中,男性409人,占49.5%,女性418人,占50.5%,平均年龄(75.32±8.74)岁。其中,34.23%存在血脂异常,15.60%有吸烟史,4.47%有高血压家族史,肥胖占2.06%,23.10%合并糖尿病,29.02%合并冠心病,5.20%合并心力衰竭,28.78%合并脑血管疾病,25.83%合并肾功能不全。不同高血压级别合并脑血管病、冠心病、心力衰竭、肾功能不全的发生率存在显著差异(P=0.047,P0.001,P=0.026,P=0.041),而吸烟、血脂异常、肥胖、糖尿病的占比差异无统计学意义(P0.05)。结论:广东省丰顺地区老年高血压患者在心脑血管病危险因素中所占比重最大的是血脂异常,合并冠心病及脑血管疾病比例最大,这可能与血脂异常有着密切的关系。     

Potent ACE inhibitors from 5-hydroxy indanone derivatives

A novel triazole derivatives(±)-2-(hydroxymethyl)-7,8-dihydro-1H-indeno[5,4-b]furan-6(2H)-one (12a–j) were designed and synthesized by the reaction between racemic azide and terminal acetylenes under click chemistry reaction conditions followed by biological evaluation as angiotensin converting enzyme (ACE) inhibitors. β-Amino alcohol derivatives of 1-indanone (15a–l) were synthesized from 5-hydroxy indanone, it was reacted with epichlorohydrin and followed by oxirane ring opening with various piperazine derivatives. Among the newly synthesized compounds 12b (IC₅₀: 1.388024 µM), 12g (IC₅₀: 1.220696 µM), 12j (IC₅₀: 1.312428 µM) and 15k (IC₅₀: 1.349671 µM) and 15l (IC₅₀: 1.330764 µM) emerged as most active non-carboxylic acid ACE inhibitors with minimal toxicity comparable to clinical drug Lisinopril.     

Involvement of mitochondrial fission in calcium sensing receptor-mediated vascular smooth muscle cells proliferation during hypertension

Hyperproliferation of vascular smooth muscle cells (VSMC) is a major risk factor for cardiovascular diseases. Proper mitochondrial fission and fusion is involved with VSMC function. However, the role and mechanism of mitochondrial morphological changes in VSMC proliferation are not well understood. Here, we found that calcium sensing receptor (CaSR) was increased in the aortas from spontaneous hypertensive rats (SHRs) compared with age-matched Wistar Kyoto (WKY) rats. There was also an increase in mitochondrial fission and VSMC proliferation, which was attenuated by Calhex231. In primary rat VMSC, angiotensin II (Ang II) stimulation induced cytosolic [Ca²⁺]_i increase, mitochondrial shortening and proliferation, all of which could be attenuated by pretreatment with mitochondrial division inhibitor-1 (Mdivi-1) and Calhex231. Our data indicate that CaSR-mediated mitochondrial fission could be a therapeutic target for hyperproliferative disorders.     

Biological activities of (−)-epicatechin and (−)-epicatechin-containing foods: Focus on cardiovascular and neuropsychological health

Recent studies have suggested that certain (?)-epicatechin-containing foods have a blood pressure-lowering capacity. The mechanisms underlying (?)-epicatechin action may help prevent oxidative damage and endothelial dysfunction, which have both been associated with hypertension and certain brain disorders. Moreover, (?)-epicatechin has been shown to modify metabolic profile, blood's rheological properties, and to cross the blood-brain barrier. Thus, (?)-epicatechin causes multiple actions that may provide unique synergy beneficial for cardiovascular and neuropsychological health. This review summarises the current knowledge on the biological actions of (?)-epicatechin, related to cardiovascular and brain functions, which may play a remarkable role in human health and longevity.