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The effect of vitamin D treatment on clinical and biochemical outcomes of primary aldosteronism

Ismail NA, Kamaruddin NA, Azhar Shah S, Sukor N

Clin Endocrinol (Oxf), 2020 06;92(6):509-517.
PMID: 32073675 DOI: 10.1111/cen.14177

INTRODUCTION: Primary aldosteronism (PA) contributed to the cardiovascular disease and metabolic alterations independent of the blood pressure level. Evidence exists that aldosterone excess also affects calcium and mineral homeostasis. PA subjects have been shown to have greater prevalence of vitamin D deficiency. However, the impact of vitamin D treatment in this population has never been assessed.
OBJECTIVE: This study aimed to evaluate the effect of vitamin D treatment on clinical and biochemical outcomes of PA patients.
METHODS: Two hundred forty hypertensive subjects were screened, 31 had positive ARR, and 17 patients with newly confirmed PA following positive confirmatory test that has not been subjected for definitive treatment were enrolled. Clinical parameter (blood pressure) and biochemical parameters (renal profile, plasma aldosterone concentration, plasma renin activity, serum calcium, vitamin D, intact parathyroid hormone, 24-hour urinary calcium) were measured at baseline and 3 months of treatment with Bio-D3 capsule. Primary outcomes were the changes in the blood pressure and biochemical parameters.
RESULTS: About 70% of our PA subjects have low vitamin D levels at baseline. Three months following treatment, there were significant: (a) improvement in 25(OH)D levels; (b) reduction in systolic blood pressure and plasma aldosterone concentration; and (c) improvement in the eGFR. The vitamin D deficient subgroup has the greatest magnitude of the systolic blood pressure reduction following treatment.
CONCLUSIONS: This study demonstrated significant proportion of PA patients has vitamin D insufficiency. Vitamin D treatment improves these interrelated parameters possibly suggesting interplay between vitamin D, aldosterone, renal function and the blood pressure.

Matched MeSH terms: Blood Pressure
Fulltext Grade IV hypertensive retinopathy as a rare first representation of hypertension: a case report

Tengku Kamalden, T.A., Choo, M.M., Fauzi, A.

JUMMEC, 2006;9(2):32-34.
MyJurnal

Malignant hypertension affects less than 1% of people with high blood pressure, and is a hypertensive emergency. It is rare for patients to present initially with this form of elevated blood pressure, which is almost always associated with acute target organ damage, which can manifest in many forms including ocular, neurological, cardiac and renal. This treatable condition is associated with a high rate of morbidity and mortality therefore, early detection and immediate management is of paramount importance.

Matched MeSH terms: Blood Pressure
A review of blood pressure profile and hypertension studies in Malaysia

Liew YM, Tan H, Khoo KL

Family Physician, 1994;6:36-45.

This paper reviews the literature on blood pressure profile and hypertension studies carried out in Peninsular Malaysia from 1952 to 1988. From these studies, the following key information is summarised: 1. Blood pressure profiles of Malaysians, irrespective of sex and the three major ethnic groups viz., Malay, Chinese and Indian followed a similar rising trend with age. 2. The mean systolic and diastolic pressures were 134 mmHg and 84 mmHg respectively across the major ethnic groups. 3. The prevalence of hypertension for Malaysians was 16.0%, 4.2% and 3.4% when 140/90 mmHg, 150/90 mmHg or a diastolic pressure of 100 mmHg or greater were taken as cut-off values respectively. Males generally showed a higher prevalence of hypertension than females. 4. Orang Asli living in the deep jungle had relatively low blood pressures (Mean: 109/70 mmHg) and their blood pressure did not rise with increasing age. 5. There was generally no difference in the prevalence of hypertension amongst the major ethnic groups. However, there was a tendency for the Malays to have a higher prevalence of hypertension than the Chinese or the Indians. 6. There was an increased prevalence of hypertension among subjects who smoked heavily or who did very little or no physical exercise. Differences in prevalence of hypertension among subjects living in changing environment and lifestyle, such as urban versus rural, alcohol versus non-alcohol consumers and low income versus moderate income groups were not evident in the studies reviewed. 7. Percent unawareness of hypertension in hypertension subjects was generally high i.e. 57 % - 69% except in one sample which recorded a moderately value (33%).

Matched MeSH terms: Blood Pressure
Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function

Asmuje NF, Mat S, Goh CH, Myint PK, Tan MP

Am J Hypertens, 2022 Dec 08;35(12):998-1005.
PMID: 36153737 DOI: 10.1093/ajh/hpac107

BACKGROUND: Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function among community-dwellers aged 55 years and over.
METHODS: Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment.
RESULTS: Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62-3.24)] and [OR (95% CI) = 1.80 (1.32-2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03-1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18-0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34-0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34-0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57-1.17)], compared to normal aging with similar adjustments.
CONCLUSION: Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline.

Matched MeSH terms: Blood Pressure
Fulltext Improved Measurement of Blood Pressure by Extraction of Characteristic Features from the Cuff Oscillometric Waveform

Lim PK, Ng SC, Jassim WA, Redmond SJ, Zilany M, Avolio A, et al.

Sensors (Basel), 2015 Jun 16;15(6):14142-61.
PMID: 26087370 DOI: 10.3390/s150614142

We present a novel approach to improve the estimation of systolic (SBP) and diastolic blood pressure (DBP) from oscillometric waveform data using variable characteristic ratios between SBP and DBP with mean arterial pressure (MAP). This was verified in 25 healthy subjects, aged 28 ± 5 years. The multiple linear regression (MLR) and support vector regression (SVR) models were used to examine the relationship between the SBP and the DBP ratio with ten features extracted from the oscillometric waveform envelope (OWE). An automatic algorithm based on relative changes in the cuff pressure and neighbouring oscillometric pulses was proposed to remove outlier points caused by movement artifacts. Substantial reduction in the mean and standard deviation of the blood pressure estimation errors were obtained upon artifact removal. Using the sequential forward floating selection (SFFS) approach, we were able to achieve a significant reduction in the mean and standard deviation of differences between the estimated SBP values and the reference scoring (MLR: mean ± SD = -0.3 ± 5.8 mmHg; SVR and -0.6 ± 5.4 mmHg) with only two features, i.e., Ratio2 and Area3, as compared to the conventional maximum amplitude algorithm (MAA) method (mean ± SD = -1.6 ± 8.6 mmHg). Comparing the performance of both MLR and SVR models, our results showed that the MLR model was able to achieve comparable performance to that of the SVR model despite its simplicity.

Matched MeSH terms: Blood Pressure/physiology*; Blood Pressure Determination/methods*
Anti-hypertensive prescription practices in private hospitals in Malaysia: a prospective, non-interventional, observational study

Ng WK, Philip AZ, Lim TT, Wong M, Goh EL, Tengku Ismail TS, et al.

Med J Malaysia, 2023 May;78(3):350-356.
PMID: 37271845

INTRODUCTION: In managing hypertension, monotherapy and sometimes a combination of more than one agent are used to achieve blood pressure (BP) control. The objective of this prospective, observational, multi-centre study was to assess the level of BP control in patients receiving one or more anti-hypertensive drugs in private medical centres in Malaysia according to the treatment regimens (monotherapy, free drug combinations and single pill combinations).
MATERIALS AND METHODS: Data were collected through medical records and interview sessions with patients on current pharmacotherapy for hypertension management at baseline and 2-3 months later. Results are expressed as mean ± SD for continuous data and as frequencies and percentages for categorical data.
RESULTS: Among 182 recruited patients, 89 (49%) achieved BP control by the end of the study. Majority (62/89) patients were on single-pill (monotherapy or SPC) antihypertensives. Majority (63/89) required more than two antihypertensives to achieve BP control.
CONCLUSION: Both SPC and free drug combination antihypertensives reduced BPs, but physicians preferred SPC to improve BP control and increase treatment compliance.

Matched MeSH terms: Blood Pressure
Fulltext Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension

Schutte AE, Jafar TH, Poulter NR, Damasceno A, Khan NA, Nilsson PM, et al.

Cardiovasc Res, 2023 Mar 31;119(2):381-409.
PMID: 36219457 DOI: 10.1093/cvr/cvac130

Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.

Matched MeSH terms: Blood Pressure
Reduction of salt intake: time for more action

Jones ESW, Lee HY, Khan N, Charchar FJ, Williams B, Chia YC, et al.

J Hypertens, 2022 Nov 01;40(11):2130-2132.
PMID: 36205011 DOI: 10.1097/HJH.0000000000003262
Matched MeSH terms: Blood Pressure
Experimental feasibility study of estimation of the normalized central blood pressure waveform from radial photoplethysmogram

Zahedi E, Sohani V, Ali MA, Chellappan K, Beng GK

J Healthc Eng, 2015;6(1):121-44.
PMID: 25708380 DOI: 10.1260/2040-2295.6.1.121

The feasibility of a novel system to reliably estimate the normalized central blood pressure (CBPN) from the radial photoplethysmogram (PPG) is investigated. Right-wrist radial blood pressure and left-wrist PPG were simultaneously recorded in five different days. An industry-standard applanation tonometer was employed for recording radial blood pressure. The CBP waveform was amplitude-normalized to determine CBPN. A total of fifteen second-order autoregressive models with exogenous input were investigated using system identification techniques. Among these 15 models, the model producing the lowest coefficient of variation (CV) of the fitness during the five days was selected as the reference model. Results show that the proposed model is able to faithfully reproduce CBPN (mean fitness = 85.2% ± 2.5%) from the radial PPG for all 15 segments during the five recording days. The low CV value of 3.35% suggests a stable model valid for different recording days.

Matched MeSH terms: Blood Pressure/physiology; Blood Pressure Determination/methods*
Fulltext Protocol For Intervention Study In Reducing Elevated Blood Pressure Through Intermittent Fasting

Baharuddin D, Said MA, Majid HA

J Pak Med Assoc, 2023 Nov;73(11):2171-2176.
PMID: 38013523 DOI: 10.47391/JPMA.7748

OBJECTIVES: To chart out a protocol for conducting an intervention-based study to compare the efficacy of intermittent fasting intervention and usual diet in reducing elevated blood pressure among working adults.
METHODS: The quasi-experimental study with single-blinded parallel groups will comprise subjects from two civil departments. The intervention group will be required to conduct 2 days of fasting and 5 days of ad libitum diet in a week, while the control group will follow the usual healthy lifestyle. The largest sample size will be taken to achieve a power of 80% and an alpha value of 5%. Based on the 30% attrition rate, the total sample size needed in the study will be 140 participants, with 70 in each of the two arms. This study will use SPSS 24 for statistical analysis.
DISCUSSION: The study describes a unique protocol of intermittent fasting mimicking the Muslim Sunnah of fasting among people with elevated blood pressure. The findings will contribute to decrease blood pressure among those with elevated blood pressure. If proven to be effective, the intermittent fasting method would be useful for developing an effective programme to prevent elevated blood pressure among adults. The protocol will contribute to efforts to find whether or not intermittent fasting can improve elevated blood pressure as well as body weight, body mass index, waist circumference and nutrition status among adults.
CLINICAL TRIAL NUMBER: The study was registered with clinicaltrials.gov (NCT04953650).

Matched MeSH terms: Blood Pressure
Prevalence of true resistant hypertension in those referred for uncontrolled hypertension in Malaysia: A comparison using different definitions

Yeo JJP, Yeo LS, Tan SSN, Delailah DDRA, Lee SWH, Hu ATH, et al.

Hypertens Res, 2024 Feb;47(2):352-357.
PMID: 37673957 DOI: 10.1038/s41440-023-01418-4

Resistant hypertension is a well-recognised clinical challenge. However, the definition and epidemiology of true resistant hypertension (RH) are less understood, especially in Asia. This cross-sectional study examined the prevalence of RH referred from primary care clinics based on various guidelines. RH was defined as blood pressure (BP) being above the threshold using ambulatory blood pressure monitoring despite adequate lifestyle measures and optimal treatment with ≥3 medications at maximally tolerated doses. Between one in four (n = 94, 24.0% using Malaysian guidelines) and up to two-thirds (n = 249, 63.7% using 2018 American guidelines) of adults referred for uncontrolled hypertension met the criteria of true RH. Of those with RH, a further one-quarter (n = 26, 26.6%) were deemed to have refractory hypertension (elevated BP despite treatment with at least 5 antihypertensive medications). Adults with RH were generally younger, more likely to be male, had a higher BMI and were more likely to have gout, CKD, and angina compared to those with controlled hypertension. The prevalence of RH amongst Asian adults with poor hypertension control is high. A concerted effort is needed to reduce the high burden of RH, especially among this population.

Matched MeSH terms: Blood Pressure/physiology; Blood Pressure Monitoring, Ambulatory*
Fulltext Peer-led lifestyle interventions for the primary prevention of cardiovascular disease in community: a systematic review of randomised controlled trials

Lim GP, Appalasamy JR, Ahmad B, Quek KF, Ramadas A

BMC Public Health, 2024 Mar 14;24(1):812.
PMID: 38486215 DOI: 10.1186/s12889-024-18328-w

BACKGROUND: Peer-led lifestyle interventions have gained recognition as effective approaches for managing and preventing chronic diseases. However, there remains a critical knowledge gap regarding the impact and effectiveness of peer-led interventions specifically in the primary prevention of cardiovascular disease (CVD). Our systematic review aims to synthesise the available evidence and evaluate the impact of peer-led lifestyle interventions, providing invaluable insights that can guide the development of peer-led strategies for preventing CVD.
METHODS: Systematic database searches were conducted on Ovid Medline, Embase, Cochrane Centre for Controlled Trials, PubMed and Scopus to source peer-reviewed articles published between 2013 and 2023. Reference lists of the included publications were also manually searched.
RESULTS: Fourteen unique randomised controlled trials were identified, of which three were pilot studies. Most of the interventions were conducted among individuals at moderate to high risk of CVD and lasted for a year. There is a variety of components in intervention delivery, including group discussions and individual counselling. Peer leader training mostly covered intervention delivery, communication, and research-specific skills. Systolic blood pressure showed the most promising CVD-related improvement, while mixed results were found for several other dietary and lifestyle behavioural outcomes.
CONCLUSION: Peer-led lifestyle interventions have shown varying effectiveness in cardiovascular health outcomes. The competencies and roles of peer leaders were identified to guide future intervention development with a more comprehensive approach to the primary prevention of CVD.

Matched MeSH terms: Blood Pressure
Fulltext Hypertension and stroke in Asia: A comprehensive review from HOPE Asia

Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang JG, Sukonthasarn A, et al.

J Clin Hypertens (Greenwich), 2021 Mar;23(3):513-521.
PMID: 33190399 DOI: 10.1111/jch.14099

Stroke is the primary cause of disability and vascular death worldwide, including Asia. Asian characteristics that differ from the West lead to higher stroke incidence. Stroke epidemiology studies in Asia have shown varying levels of mortality, incidence, prevalence, and burden of disease. Hypertension is the most prevalent risk factor found in Asia. Besides ethnicity that is associated with stroke incidence, both systolic blood pressure, diastolic blood pressure, and blood pressure variability are positively correlated with stroke incidence. Post-stroke cognitive impairment is one of the sequelae that affect one-third of stroke survivors and has become a significant public health concern that is often neglected despite its increasing prevalence. Therefore, it is very important to prevent recurrence by treating stroke optimally and effectively. Increasing awareness and treatment adherence to hypertension, the leading risk factor for stroke, became the main goal in several countries in Asia.

Matched MeSH terms: Blood Pressure
Fulltext Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network

Sogunuru GP, Kario K, Shin J, Chen CH, Buranakitjaroen P, Chia YC, et al.

J Clin Hypertens (Greenwich), 2019 02;21(2):324-334.
PMID: 30525279 DOI: 10.1111/jch.13451

Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.

Matched MeSH terms: Blood Pressure; Blood Pressure Determination/methods*; Blood Pressure Monitoring, Ambulatory
Fulltext Home blood pressure control status in 2017-2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study

Kario K, Tomitani N, Buranakitjaroen P, Chia YC, Park S, Chen CH, et al.

J Clin Hypertens (Greenwich), 2018 12;20(12):1686-1695.
PMID: 30444315 DOI: 10.1111/jch.13415

A self-measured home blood pressure (BP)-guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well-controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white-coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.

Matched MeSH terms: Blood Pressure/drug effects; Blood Pressure/physiology; Blood Pressure Determination/instrumentation; Blood Pressure Determination/methods*; Blood Pressure Monitoring, Ambulatory/instrumentation; Blood Pressure Monitoring, Ambulatory/methods*
Fulltext Impact of community pharmacy-based educational intervention on patients with hypertension in Western Nepal

Sharma S, Kc B, Alrasheedy AA, Kaundinnyayana A, Khanal A

Australas Med J, 2014;7(7):304-13.
PMID: 25157270 DOI: 10.4066/AMJ.2014.2133

BACKGROUND: There is a paucity of data regarding the feasibility and impact of community pharmacy-based educational interventions on the management of chronic diseases in developing countries.
AIMS: The aim of this study was to establish the feasibility, and to investigate the impact, of community pharmacy-based educational intervention on knowledge, practice, and disease management of patients with hypertension in Western Nepal.
METHOD: A single-cohort pre-/post-intervention study was conducted from August 2012 to April 2013. The participants included in the study were patients diagnosed with hypertension attending a pharmacist-led hypertension clinic. The educational intervention was conducted by pharmacists, was individualised, and consisted of three counselling sessions over a period of six months. The patients' knowledge of hypertension, their practice of lifestyle modification and non-pharmacological approaches concerning hypertension management, and blood pressure were assessed at baseline and again after nine months by using a pre-validated questionnaire.
RESULTS: Fifty patients met the inclusion criteria and were enrolled in the study. The median (IQR) knowledge score changed from 6 (4) to 13 (0) after the intervention (p<0.01) with the median (IQR) practice score changing from 7 (4) to 16 (2) (p<0.01). The mean (SD) systolic BP changed from 150.1 (7.8) to 137.7 (9.9) (p<0.01) and the mean (SD) diastolic BP from 104 (9.5) to 94.5 (7.8) after the intervention (p< 0.01).
CONCLUSION: A simple, educational intervention by community pharmacists had improved patients' disease knowledge, practice, and management of their hypertension. Evidence suggests Nepalese community pharmacists need could play an important role in the management of chronic diseases like hypertension through simple interventions such as providing educational support for patients.

Matched MeSH terms: Blood Pressure; Blood Pressure Determination
Fulltext Involvement of inflammation and adverse vascular remodelling in the blood pressure raising effect of repeatedly heated palm oil in rats

Ng CY, Kamisah Y, Faizah O, Jubri Z, Qodriyah HM, Jaarin K

Int J Vasc Med, 2012;2012:404025.
PMID: 22778962 DOI: 10.1155/2012/404025

Oil thermoxidation during deep frying generates harmful oxidative free radicals that induce inflammation and increase the risk of hypertension. This study aimed to investigate the effect of repeatedly heated palm oil on blood pressure, aortic morphometry, and vascular cell adhesion molecule-1 (VCAM-1) expression in rats. Male Sprague-Dawley rats were divided into five groups: control, fresh palm oil (FPO), one-time-heated palm oil (1HPO), five-time-heated palm oil (5HPO), or ten-time-heated palm oil (10HPO). Feeding duration was six months. Blood pressure was measured at baseline and monthly using tail-cuff method. After six months, the rats were sacrificed and the aortic arches were dissected for morphometric and immunohistochemical analyses. FPO group showed significantly lower blood pressure than all other groups. Blood pressure was increased significantly in 5HPO and 10HPO groups. The aortae of 5HPO and 10HPO groups showed significantly increased thickness and area of intima-media, circumferential wall tension, and VCAM-1 than other groups. Elastic lamellae were disorganised and fragmented in 5HPO- and 10HPO-treated rats. VCAM-1 expression showed a significant positive correlation with blood pressure. In conclusion, prolonged consumption of repeatedly heated palm oil causes blood pressure elevation, adverse remodelling, and increased VCAM-1, which suggests a possible involvement of inflammation.

Matched MeSH terms: Blood Pressure; Blood Pressure Determination
Fulltext Prehypertension: What is the current status?

Chia YC

Malays Fam Physician, 2008;3(2):72-6.
PMID: 25606120 MyJurnal

Cardiovascular disease (CVD) risk is a continuum across blood pressure. The term prehypertension was introduced because it is now recognized that blood pressure readings between what is deemed optimal and hypertension is associated with increased CVD risk. The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/ obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives. A recent study has shown a reduction in the development of hypertension from prehypertension with the use of an angiotensin receptor blocker. Unfortunately to date, the impact of treatment of prehypertension on CVD outcome is still unknown except in those with high CVD risk like diabetes or established CVD. However this does not mean nothing can be done for those with prehypertension. The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Until more evidence about other modalities of treatment become available this is a sensible and cost-effective way to manage prehypertension.

Matched MeSH terms: Blood Pressure; Blood Pressure Determination
Fulltext Impact of a Workplace Health Promotion Program on Employees' Blood Pressure in a Public University

Eng JY, Moy FM, Bulgiba A

PLoS One, 2016;11(2):e0148307.
PMID: 26840508 DOI: 10.1371/journal.pone.0148307

INTRODUCTION: Workplace health promotion is important in the prevention of non-communicable diseases among employees. Previous workplace health programs have shown benefits such as lowered disease prevalence, reduced medical costs and improved productivity. This study aims to evaluate the impact of a 6-year workplace health promotion program on employees' blood pressure in a public university.
METHODS: In this prospective cohort study, we included 1,365 employees enrolled in the university's workplace health promotion program, a program conducted since 2008 and using data from the 2008-2013 follow-up period. Participants were permanent employees aged 35 years and above, with at least one follow up measurements and no change in antihypertensive medication during the study period. Baseline socio-demographic information was collected using a questionnaire while anthropometry measurements and resting blood pressure were collected during annual health screening. Changes in blood pressure over time were analyzed using a linear mixed model.
RESULTS: The systolic blood pressure in the hypertension subgroup decreased 2.36 mmHg per year (p<0.0001). There was also significant improvement in systolic blood pressure among the participants who were at risk of hypertension (-0.75 mmHg, p<0.001). The diastolic blood pressure among the hypertensive and at risk subgroups improved 1.76 mmHg/year (p<0.001) and 0.56 mmHg/year (p<0.001), respectively. However, there was no change in both systolic and diastolic blood pressure among participants in the healthy subgroup over the 6-year period.
CONCLUSION: This study shows that continuing participation in workplace health promotion program has the potential to improve blood pressure levels among employees.

Matched MeSH terms: Blood Pressure*
Fulltext The relationship between telomere length and beekeeping among Malaysians

Nasir NF, Kannan TP, Sulaiman SA, Shamsuddin S, Azlina A, Stangaciu S

Age (Dordr), 2015 Jun;37(3):9797.
PMID: 26028466 DOI: 10.1007/s11357-015-9797-6

The belief that beekeepers live longer than anyone else is present since ages. However, no research has been done to explore the longevity of life in beekeepers. Here, we investigated the telomere length in 30 male beekeepers and 30 male non-beekeepers and associated them with the longevity of life using Southern analysis of terminal restriction fragments (TRFs) generated by Hinf I/Rsa I digestion of human genomic DNA using TeloTAGGG Telomere Length Assay. Interestingly, we found that the telomere length of male beekeepers was significantly longer than those of male non-beekeepers with a p value of less than 0.05, suggesting that beekeepers may have longer life compared to non-beekeepers. We further found that the consumption of bee products for a long period and frequent consumption of bee products per day are associated with telomere length. An increase of year in consuming bee products is associated with a mean increase in telomere length of 0.258 kbp. In addition, an increase in frequency of eating bee products per day was also associated with a mean increase of 2.66 kbp in telomere length. These results suggested that bee products might play some roles in telomere length maintenance.

Matched MeSH terms: Blood Pressure/physiology

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