高龄老年高血压患者高尿酸血症相关因素分析

目的分析高龄老年高血压患者高尿酸血症相关因素,探讨老年高血压与高尿酸血症之间的相关性。方法选择2015年6~12月收治的高龄老年高血压患者50例为观察组,同期选择50例健康体检的老年志愿者为对照组,观察两组血尿酸水平并进行比较分析。结果观察组高龄老年高血压患者并发高尿酸血症27例,发生率54.00%;对照组未检出高尿酸血症。两组血尿酸水平比较,差异具有统计学意义(P0.05);而且观察组TC、TG、LDL-C、HDL-C各指标均明显高于对照组,差异具有统计学意义(P0.05)。结论高龄老年高血压病与高尿酸血症密切相关,高尿酸血症也是导致高龄老年人心血管疾病的危险因素之一,临床需引起重视。     

The mitochondrial calcium uniporter is involved in mitochondrial calcium cycle dysfunction: Underlying mechanism of hypertension associated with mitochondrial tRNAIle A4263G mutation

Recent studies have shown that the mitochondrial DNA mutations are involved in the pathogenesis of hypertension. Our previous study identified mitochondrial tRNA^Ile A4263G mutation in a large Chinese Han family with maternally-inherited hypertension. This mutation may contribute to mitochondrial Ca²⁺ cycling dysfuntion, but the mechanism is unclear. Lymphoblastoid cell lines were derived from hypertensive and normotensive individuals, either with or without tRNA^Ile A4263G mutation. The mitochondrial calcium ([Ca²⁺]_m) in cells from hypertensive subjects with the tRNA^Ile A4263G mutation, was lower than in cells from normotension or hypertension without mutation, or normotension with mutation (P < 0.05). Meanwhile, cytosolic calcium ([Ca²⁺]_c) in hypertensive with mutation cells was higher than another three groups. After exposure to caffeine, which could increase the [Ca²⁺]_c by activating ryanodine receptor on endoplasmic reticulum, [Ca²⁺]_c/[Ca²⁺]_m increased higher than in hypertensive with mutation cells from another three groups. Moreover, MCU expression was decreased in hypertensive with mutation cells compared with in another three groups (P < 0.05). [Ca²⁺]_c increased and [Ca²⁺]_m decreased after treatment with Ru360 (an inhibitor of MCU) or an siRNA against MCU. In this study we found decreased MCU expression in hypertensive with mutation cells contributed to dysregulated Ca²⁺ uptake into the mitochondria, and cytoplasmic Ca²⁺ overload. This abnormality might be involved in the underlying mechanisms of maternally inherited hypertension in subjects carrying the mitochondrial tRNA^Ile A4263G mutation.     

GST M1/T1 and MTHFR polymorphisms as risk factors for hypertension

The aim of this study is to investigate GSTM1, GSTT1 and MTHFR genetic polymorphisms and its relation with total plasma glutathione (tGSH) levels in hypertension. Genotype distributions of GSTM1 and GSTT1 deletion polymorphisms and C677T variant of MTHFR were examined in a sample of 94 hypertensive patients with congestive heart failure and 207 healthy unrelated Portuguese individuals using PCR techniques. Plasma GST activity was determined spectrophotometrically. The antioxidant status was evaluated by fluorometric assays of tGSH. Genotype distributions of GSTT1 (chi2 test; p < 0.01) and MTHFR (chi2 test; p < 0.01) differ significantly between control and hypertensive patients with a greater prevalence of "non-null GSTT1/M1" and CT (heterozygous) genotypes. Moreover, GST activity and tGSH were markedly decreased in hypertension but there is no correlation with the studied polymorphisms. GSH depletion confirmed the possible involvement of oxidative stress in this pathology. Deletion of GSTT1 gene might be considered as protective factor for hypertension.     

氨氯地平联合阿托伐他汀钙对高血压合并冠心病的疗效分析

目的:研究氨氯地平联合阿托伐他汀钙对高血压合并冠心病的临床疗效,对该方法的安全性和有效性进行评价。方法:选取80例高血压合并冠心病患者,随机分为两组,即对照组和观察组。对照组患者给予阿托伐他汀钙片,观察组患者给予氨氯地平阿托伐他汀钙片。观察并记录两组患者治疗前后的收缩压、舒张压水平,以及心绞痛发生情况,治疗前后检测患者体内TG、TC、LDL-C及HDL-C表达水平。结果:和对照组患者相比,观察组患者降压作用及心绞痛改善作用均显效率显著提高(P0.05);和治疗前相比,两组患者收缩压、舒张压,以及TG、TC、LDL-C表达水平均显著降低,HDL-C表达水平均显著升高(P0.05);和对照组患者相比,观察组患者治疗后收缩压、舒张压,以及TG、TC、LDL-C表达水平降低更显著,HDL-C表达水平升高更显著(P0.05)。结论:和单独应用阿托伐他汀钙相比,氨氯地平联合阿托伐他汀钙治疗高血压合并冠心病具有更好的的临床疗效,能有效的控制血压及血脂水平。     

The contribution of urbanization to non-communicable diseases: Evidence from 173 countries from 1980 to 2008

It is widely believed that the expanding burden of non-communicable diseases (NCDs) is in no small part the result of major macro-level determinants. We use a large amount of new data, to explore in particular the role played by urbanization – the process of the population shifting from rural to urban areas within countries – in affecting four important drivers of NCDs world-wide: diabetes prevalence, as well as average body mass index (BMI), total cholesterol level and systolic blood pressure. Urbanization is seen by many as a double-edged sword: while its beneficial economic effects are widely acknowledged, it is commonly alleged to produce adverse side effects for NCD-related health outcomes. In this paper we submit this hypothesis to extensive empirical scrutiny, covering a global set of countries from 1980–2008, and applying a range of estimation procedures. Our results indicate that urbanization appears to have contributed to an increase in average BMI and cholesterol levels: the implied difference in average total cholesterol between the most and the least urbanized countries is 0.40 mmol/L, while people living in the least urbanized countries are also expected to have an up to 2.3 kg/m² lower BMI than in the most urbanized ones. Moreover, the least urbanized countries are expected to have an up to 3.2 p.p. lower prevalence of diabetes among women. This association is also much stronger in the low and middle-income countries, and is likely to be mediated by energy intake-related variables, such as calorie and fat supply per capita.     

原发性高血压相关基因DNA甲基化的研究进展

高血压是常见的慢性疾病,也是心脑血管病最主要的风险因素。原发性高血压是由多基因和环境因素共同作用引起的复杂疾病,但具体的发病机制仍不清楚。随着研究的深入,DNA甲基化等表观遗传学因素在原发性高血压病理过程中起到的作用逐渐受到重视。本文总结了部分原发性高血压关联基因中DNA甲基化在其患病中的研究进展,阐述可受环境因素影响的DNA甲基标记与原发性高血压的关系,进一步了解高血压的发病机制。     

Recent advances in selective alpha1-adrenoreceptor antagonists as antihypertensive agents

Hypertension is one of the most serious health problems of the modern world with a continuous rise in the number of patients. Selective α₁-adrenoreceptor antagonists though have many advantages and uses in the management of arterial hypertension, their lack of specificity at the level of α₁-adr subtypes leads to multiple side effects. Existence of multiple α₁-adr subtypes holds great promise for the discovery and development of more specific and selective drug molecules, targeting only one α₁-adr subtype at a time and thus relative freedom from side effects. Herein, the research done on the discovery and evaluation of a variety of chemically diverse structures as selective antagonists of α₁-adr and α₁-adr subtypes in recent years has been reviewed.     

Free fatty acid profiles in preeclampsia

Preeclampsia has many characteristics similar to the metabolic syndrome. One of these is aberrant lipid metabolism. We studied free fatty acid (FFA) profiles at baseline and after oral glucose load in 21 preeclamptic and 11 normotensive pregnant women. Insulin sensitivity was measured by intravenous glucose tolerance test.We found that serum total FFA concentrations at baseline were 67% higher in preeclamptic than in normotensive pregnancies (P=0.0002). The difference between the two groups was largest in the concentrations of oleic (75%), linoleic (129%) and arachidonic (315%) acids. Oral intake of glucose suppressed total FFA in preeclamptic women by 40% (95% CI 32.1–46.1%, P<0.0001) but only 24% in control women (95% CI 0.01–42.0%, P=0.045). Insulin sensitivity, which in preeclamptic women was 37% lower (P=0.009), was unrelated to total or any individual FFA concentration.We concluded that preeclamptic women have higher circulating FFA concentrations, which despite insulin resistance are suppressed by oral glucose loading.     

An allometric analysis of the giraffe cardiovascular system

There has been co-evolution of a long neck and high blood pressure in giraffes. How the cardiovascular system (CVS) has adapted to produce a high blood pressure, and how it compares with other similar sized mammals largely is unknown. We have measured body mass and heart structure in 56 giraffes of both genders ranging in body mass from 18 kg to 1500 kg, and developed allometric equations that relate changes in heart dimensions to growth and to cardiovascular function. Predictions made from these equations match measurements made in giraffes. We have found that heart mass increases as body mass increases but it has a relative mass of 0.51 ± 0.7% of body mass which is the same as that in other mammals. The left ventricular and interventricular walls are hypertrophied and their thicknesses are linearly related to neck length. Systemic blood pressure increases as body mass and neck length increase and is twice that of mammals of the same body mass. Cardiac output is the same as, but peripheral resistance double that predicted for similar sized mammals. We have concluded that increasing hydrostatic pressure of the column of blood during neck elongation results in cardiac hypertrophy and concurrent hypertrophy of arteriole walls raising peripheral resistance, with an increase in blood pressure following.