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Influence of testosterone on mean arterial pressure: A physiological study in male and female normotensive WKY and hypertensive SHR rats

Loh SY, Salleh N

Physiol Int, 2017 Mar 01;104(1):25-34.
PMID: 28361574 DOI: 10.1556/2060.104.2017.1.3

Introduction Testosterone plays an important role in the blood pressure regulation. However, information with regard to the effect of this hormone on blood pressure in normotensive and hypertensive conditions is limited. Therefore, in this study, the relationship between plasma testosterone level and mean arterial pressure (MAP) was investigated under these conditions. Methods Normotensive Wistar-Kyoto (WKY) and hypertensive Spontaneous Hypertensive (SHR) male and female rats were gonadectomized with female rats treated with testosterone. Estrous cycle stages of intact female rats of both strains were identified by vaginal smear. Pressure in the carotid artery of anesthetized rats was measured via direct cannulation technique. The blood was withdrawn for plasma testosterone level measurement by enzyme-linked immunosorbent assay. Results Treatment of ovariectomized female WKY and SHR rats with testosterone for 6-week duration has resulted in MAP to increase (P

Matched MeSH terms: Hypertension/blood; Hypertension/chemically induced*; Hypertension/diagnosis; Hypertension/physiopathology
Fulltext Concordance of recommendations across clinical practice guidelines for the management of hypertension in Southeast Asia with internationally reputable sources

Kow CS, Hasan SS, Wong PS, Verma RK

BMC Cardiovasc Disord, 2021 07 28;21(1):354.
PMID: 34320925 DOI: 10.1186/s12872-021-02054-x

OBJECTIVES: This study aimed to assess the rate of concordance, and to investigate sources of non-concordance of recommendations in the management of hypertension across CPGs in Southeast Asia, with internationally reputable clinical practice guidelines (CPGs).
METHODS: CPGs for the management of hypertension in Southeast Asia were retrieved from the websites of the Ministry of Health or cardiovascular specialty societies of the individual countries of Southeast Asia during November to December 2020. The recommendations for the management of hypertension specified in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline and the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guideline were selected to be the reference standards; the recommendations concerning the management of hypertension in the included CPGs in Southeast Asia were assessed if they were concordant with the reference recommendations generated from both the 2017 ACC/AHA guideline and the 2018 ESC/ESH guideline, using the population (P)-intervention (I)-comparison (C) combinations approach.
RESULTS: A total of 59 reference recommendations with unique and unambiguous P-I-C specifications was generated from the 2017 ACC/AHA guideline. In addition, a total of 51 reference recommendations with unique and unambiguous P-I-C specifications was generated from the 2018 ESC/ESH guideline. Considering the six included CPGs from Southeast Asia, concordance was observed for 30 reference recommendations (50.8%) out of 59 reference recommendations generated from the 2017 ACC/AHA guideline and for 31 reference recommendations (69.8%) out of 51 reference recommendations derived from the 2018 ESC/ESH guideline.
CONCLUSIONS: Hypertension represents a significant issue that places health and economic strains in Southeast Asia and demands guideline-based care, yet CPGs in Southeast Asia have a high rate of non-concordance with internationally reputable CPGs. Concordant recommendations could perhaps be considered a standard of care for hypertension management in the Southeast Asia region.

Matched MeSH terms: Hypertension/diagnosis; Hypertension/epidemiology; Hypertension/physiopathology; Hypertension/therapy*
Fulltext Association between the C34T polymorphism of the AMPD1 gene and essential hypertension in Malaysian patients

Nemati R, Lu J, Ramachandran V, Etemad A, Heidari M, Yahya MJ, et al.

Genet. Mol. Res., 2016 Jun 20;15(2).
PMID: 27323204 DOI: 10.4238/gmr.15026241

The aim of this study was to determine whether C34T, a common polymorphism of the adenosine monophosphate deaminase 1 gene (AMPD1), is associated with essential hypertension (EH). We hypothesize that C34T is associated with the development of EH. A case-control design was used for this study. The DNA was extracted using a commercial kit from the whole blood of 200 patients with hypertension and 200 subjects without hypertension from selected Malaysian ethnicities (Malays, Chinese, and Indians). Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) and agarose gel electrophoresis were used for genotyping. The C34T gene polymorphism of AMPD1 was significantly associated with EH in the Malaysian subjects (P < 0.0001). The genotype frequencies of CC, CT, and TT were 6%, 79%, and 15%, respectively, among hypertensive subjects, while no TT genotypes were observed in the normotensive subjects. Further, the frequency of hypertension was higher among T allele carriers than C carriers (OD = 9.94; 95%CI = 6.851-14.434). There were significant differences in the systolic blood pressure, diastolic blood pressure, and pulse pressure (P ˂ 0.05) between the normotensive and hypertensive Malaysian subjects; we believe those difference were caused by the C34T polymorphism. For the first time in Malaysia, the current study provides evidence that a common polymorphism of the AMPD1 gene (C34T) is strongly associated with EH.

Matched MeSH terms: Hypertension/genetics*
Fulltext Unusual mediastinal lymph node uptake and peritoneopleural fistula demonstrated on Technetium-99m macro-aggregated human serum albumin (Tc-99m MAA) peritoneal scintigraphy in a patient with portal hypertension

Tan CJ, Thang SP, Lam WW

Med J Malaysia, 2016 04;71(2):69-71.
PMID: 27326945

Peritoneal radionuclide scan is an established imaging modality for evaluating peritoneopleural communications. In this case report, unusual mediastinal lymph node radiotracer uptake is seen in a patient with portal hypertension on peritoneal scintigraphy. This was suspected to be due to marked lymphatic enlargement from longstanding portal hypertension since childhood, permitting passage of the large Tc-99m MAA particle. The nodes were morphologically benign on CT. Mediastinal lymph node uptake on peritoneal scintigraphy is rare but should not raise undue clinical concern, particularly in a patient with chronic portal hypertension. Anatomic correlation with SPECT-CT can provide reassurance.

Matched MeSH terms: Hypertension, Portal/complications*
Potential effect of herbs on diabetic hypertension: alternative medicine treatment modalities

Zar CT, Das S

Clin Ter, 2013;164(6):529-35.
PMID: 24424219 DOI: 10.7417/CT.2013.1633

BACKGROUND AND OBJECTIVE: Diabetes mellitus is commonly known to lead to life threatening complications. Among them, hypertension is one complication which may be highlighted. In modern medical society, several drugs and treatment regimen have developed to treat diabetes mellitus. Although they obtain positive impacts, yet there are certain limitations encountered in the management of the disease due to their adverse effects and non-compliance by the patients. Herbs have been valued as a supplement in treating chronic oxidative stress disorder like diabetes mellitus. In the present review, some of the herbs which possess both anti-hyperglycemic and anti-hypertensive properties are being highlighted. Potential herbs which include Andrographis Paniculata, Ammi Visnaga, Allium sativum, Phyllanthus amarus, Ginkgo biloba, Solanum tuberosum, Tuberosum L. Piper sarmentosum and Lamiaceae family are known to possess antihypertensive properties. Various researches have been conducted on these herbs and positive results have been obtained. Based on these results, the present review article discusses the alternative management of diabetic hypertension with the herbal medicine. In conclusion, the present review article stresses on the need to ensure global awareness about the traditional medicines while treating diabetic hypertension.

Matched MeSH terms: Hypertension/drug therapy*
Fulltext eComment. Paradigm shift in surgery for massive pulmonary embolism: if not now then when?

Sachithanandan A

Interact Cardiovasc Thorac Surg, 2013 Aug;17(2):246.
PMID: 23868961 DOI: 10.1093/icvts/ivt274
Matched MeSH terms: Hypertension, Pulmonary/surgery*
Fulltext Physician adherence to hypertension treatment guidelines and drug acquisition costs of antihypertensive drugs at the cardiac clinic: a pilot study

Abdulameer SA, Sahib MN, Aziz NA, Hassan Y, Alrazzaq HA, Ismail O

Patient Prefer Adherence, 2012;6:101-8.
PMID: 22346346 DOI: 10.2147/PPA.S27223

Prescribing pattern surveys are one of the pharmacoepidemiological techniques that provide an unbiased picture of prescribing habits. Prescription surveys permit the identification of suboptimal prescribing patterns for further evaluation. The aims of this study were to determine the prescribing trend, adherence of the prescribers to the guideline, and the impact of drug expenditure on drug utilization at the cardiac clinic of Penang Hospital, Malaysia. This was a cross-sectional study. Demographic data of the patients, diagnoses and the drugs prescribed were recorded. The average drug acquisition costs (ADAC) were calculated for each antihypertensive drug class on a daily and annual basis. Adherence to the guideline was calculated as a percentage of the total number of patients. A total of 313 individuals fulfilled the inclusion criteria. The average age of the study population was 59.30 ± 10.35 years. The mean number of drugs per prescription in the study was 2.09 ± 0.78. There were no significant differences in the demographic data. Antihypertensive drugs were used in monotherapy and polytherapy in 20.8% and 79.2% of the patients, respectively. Adherence to the guideline regarding prescription occurred in 85.30% of the patients. The lowest priced drug class was diuretics and the highest was angiotensin-receptor blockers. In conclusion, the total adherence to the guideline was good; the adherence percentage only slightly decreased with a co-existing comorbidity (such as diabetes mellitus). The use of thiazide diuretics was encouraged because they are well tolerated and inexpensive, and perindopril was still prescribed for diabetic patients since it is relatively cheap (generic drug) and its daily dosage is beneficial.

Study site: cardiac clinic of Penang Hospital, Malaysia

Matched MeSH terms: Hypertension*
Elevated neutrophil respiratory burst activity in essential hypertensive patients

Ramasamy R, Maqbool M, Mohamed AL, Noah RM

Cell Immunol, 2010;263(2):230-4.
PMID: 20471005 DOI: 10.1016/j.cellimm.2010.04.004

Neutrophils play a significant role in maintaining the integrity of innate immunity via their potent respiratory burst activity. However, the uncontrolled activation of respiratory burst in neutrophils also attributes to chronic diseases such as primary hypertension and atherosclerosis. In our study, we have investigated the activation of respiratory burst function of neutrophils harvested from essential hypertensive patients. In the presence of stimuli PMA and opsonized zymosan (OZ), hypertensive patients' neutrophils secrete significantly higher amount of superoxide anions compared to normotensive control. Although the magnitude of activation varies between both groups, yet the kinetics of activation is similar. When normotensive control's neutrophils were pre-treated with hypertensive serum, the cells failed to migrate toward fMLP which indicates the impairment of the migration property. In conclusion, the respiratory burst activity of neutrophils is affected by hypertension and their elevated superoxide anions production could be an aggravating factor in hypertension-related complication.

Matched MeSH terms: Hypertension*
Fulltext Images in clinical medicine. Retinal detachment in malignant hypertension

Tajunisah I, Patel DK

N Engl J Med, 2009 Aug 27;361(9):899.
PMID: 19710488 DOI: 10.1056/NEJMicm0802683
Matched MeSH terms: Hypertension, Malignant/complications*
Fulltext The association of shift work and hypertension among male factory workers in Kota Bharu, Kelantan, Malaysia

Nazri SM, Tengku MA, Winn T

Southeast Asian J. Trop. Med. Public Health, 2008 Jan;39(1):176-83.
PMID: 18567459

Shift work associated with various health problems and there is concern that shift workers are at higher risk to develop hypertension. A cross-sectional study was conducted from December 2003 to May 2004 to compare the prevalence of hypertension and to examine the relationship between shift work and hypertension among 148 randomly selected male workers from one of the factories in Kota Bharu, Kelantan. Information on psychosocial and life-style factors, anthropometric and blood pressure measurements, and fasting blood sugar and lipid profiles analyses were obtained. The prevalence of hypertension was significantly higher among shift workers (22.4%) compared to day workers (4.2%), with p-value of 0.001. Shift work was significantly associated with hypertension (adjusted odds ratio 9.1; 95% CI 1.4-56.7).

Matched MeSH terms: Hypertension/epidemiology*
Fulltext Conditional multiple logistic regression can confirm the relationship between hypertension and income groups in a matched case-control study

Norsa'adah B, Naing L

Med J Malaysia, 2006 Aug;61(3):383-5.
PMID: 17240599
Matched MeSH terms: Hypertension/epidemiology*
Fulltext What influences patients' acceptance of a blood pressure telemonitoring service in primary care? A qualitative study

Abdullah A, Liew SM, Hanafi NS, Ng CJ, Lai PS, Chia YC, et al.

Patient Prefer Adherence, 2016;10:99-106.
PMID: 26869773 DOI: 10.2147/PPA.S94687

BACKGROUND: Telemonitoring of home blood pressure (BP) is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients' acceptance of such service in routine clinical care.
OBJECTIVE: This study aimed to explore patients' acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM).
METHODS: A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis.
RESULTS: Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and suggested improvement to the BP telemonitoring functionalities to improve interactions. Patients cited being involved in research as the main reason for their intention to use the service. They felt that patients with limited experience with the internet and information technology, who worked out of town, or who had an outdoor hobby would not be able to benefit from such a service.
CONCLUSION: Patients found BP telemonitoring service in primary care easy to use but needed help to interpret the meanings of monitored BP readings. Implementations of BP telemonitoring service must tackle these issues to maximize the patients' acceptance of a BP telemonitoring service.

Matched MeSH terms: Hypertension*
Fulltext Massive pericardial effusion in primary hypothyroidism

Hanip MR, Ong SB, Tan TT, Khalid BA

Med J Malaysia, 1989 Dec;44(4):341-3.
PMID: 2520045

A 44 year old lady with primary hypothyroidism presented with massive pericardial effusion without cardiac tamponade. Pericardial tap was done twice and the effusion resolved as the hypothyroid state improved. She remained hypertensive despite the euthyroid state. She was discharged well with L-thyroxine and anti-hypertensive therapy.

Matched MeSH terms: Hypertension/etiology
Fulltext Prazosin and priapism

Segasothy M

Med J Malaysia, 1982 Dec;37(4):384.
PMID: 7167095
Matched MeSH terms: Hypertension/drug therapy
Negative Coombs tests in Chinese on methyldopa

Burns-Cox CJ

Lancet, 1970 Sep 26;2(7674):673-4.
PMID: 4195819
Matched MeSH terms: Hypertension/drug therapy
Treatment of hypertension with acebutolol

Fah NT

Med J Malaysia, 1977 Dec;32(2):127-32.
PMID: 614478
Matched MeSH terms: Hypertension/drug therapy*
Fulltext Elevated blood pressure and its predictors among secondary school students in Sarawak: a cross-sectional study

Grace Kho WF, Cheah WL, Hazmi H

Cent. Eur. J. Public Health, 2018 Mar;26(1):16-21.
PMID: 29684292 DOI: 10.21101/cejph.a5186

OBJECTIVES: Hypertension is a health issue affecting adolescents. Accumulating evidence affirms that elevated blood pressure begins in childhood and tracks into adulthood. This cross-sectional study was conducted to determine the prevalence of elevated blood pressure and its predictors among secondary school students in Sarawak, Malaysia.
METHODS: A total of 2,461 secondary school students aged 12-17 years from 19 schools in Sarawak participated in the study. Questionnaire was used to obtain socio-demographic data, parental history of hypertension, and self-reported physical activity. Anthropometric and blood pressure measurements were taken. Data was entered and analysed using SPSS version 23.0.
RESULTS: The prevalence of adolescents with elevated blood pressure, overweight, central obesity, and overfat were 30.1%, 24.3%, 13.5%, and 6.7%, respectively. Multivariate logistic regression demonstrated the predictors significantly associated with elevated blood pressure among respondents: overweight (adjusted odds ratio=3.144), being male (adjusted odds ratio=3.073), being Chinese (adjusted odds ratio=2.321) or Iban (adjusted odds ratio=1.578), central obesity (adjusted odds ratio=2.145), being overfat (adjusted odds ratio=1.885), and being an older adolescent (adjusted odds ratio=1.109). Parental history of hypertension, locality, and physical activity showed no significant associations.
CONCLUSION: The obesity epidemic must be tackled at community and school levels by health education and regulation of school canteen foods.

Matched MeSH terms: Hypertension/epidemiology*
Transient blindness in pregnancy induced hypertension

Nalliah S, Thavarashah AS

Int J Gynaecol Obstet, 1989 Jul;29(3):249-51.
PMID: 2569423

Transient blindness associated with pregnancy induced hypertension without neurological symptoms is a rare phenomenon. The blindness in these cases is postulated to be of "cortical blindness". Two such cases occurring immediately after childbirth are presented. The ophthalmic manifestations of this complication of pregnancy induced hypertension and the importance of an urgent evaluation are discussed.

Matched MeSH terms: Hypertension/etiology*
PLASMA MICRORNA-133А LEVEL IN PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION

Koval S, Snihurska I, Yushko K, Lytvynova O, Berezin A

Georgian Med News, 2019 May.
PMID: 31322515

The aim of research was to investigate the plasma microRNA (miR-133а) level in patients with essential arterial hypertension (EAH). A total of 45 patients with EAH 2-3 degrees aged 52.14 ± 8.25 years and 21 healthy individuals (control group) with comparable age and sex distributions. The following frequency of risk factors was revealed among the examined patients: overweight (53%), dyslipidaemia (73%), pre-diabetes (13%), asymptomatic hyperuricemia (29%); hypertension-mediated organ damage: increased arterial stiffness (27%), left ventricular hypertrophy (55%), atherosclerotic plaque in the carotid artery (40%), microalbuminuria (15%), moderate stage of chronic kidney disease (22%) and cardiovascular diseases: stable ischemic heart disease (11%) and heart failure with preserved ejection fraction of NYHA functional class I (18%). The plasma miR-133a level was determined by polymerase chain reaction using "CFX96 Touch" detection system (BioRad) and "TaqMan microRNA Assay" and "TaqMan® Universal PCR Master Mix" reagents (Thermo Fisher Scientific, USA). It has been established that in patients with EAH the plasma level of miR-133a was significantly lower than in practically healthy individuals (0,182 [0,102; 0,301] ), vs (0,382 [0,198; 0,474]), p <0.05). It has also been revealed a significant decrease in the level of miR-133a in the blood plasma in patients with such organs damage as LVH (0,133 [0,099;0,184]) in comparison with patients without LVH (0,238 [0,155; 0,410]), p <0.05) and also significantly lower than in healthy subjects in the control group (0,382 [0,198; 0,474]), p<0.05). There were no statistically significant differences in the plasma levels of miR-133a in the group of patients with EAH, depending on the presence of risk factors, other organ damage and cardiovascular diseases. The findings suggest the significant role of reducing of plasma levels of miR-133a in the pathogenesis of hypertension itself and in pathological remodeling of the heart.

Matched MeSH terms: Hypertension/blood*
Uric acid, xanthine oxidase and other risk factors of hypertension in normotensive subjects

Newaz MA, Adeeb NN, Muslim N, Razak TA, Htut NN

Clin Exp Hypertens, 1996 Nov;18(8):1035-50.
PMID: 8922344

Uric acid produced by xanthine oxidase (also a source of superoxide radicals) has been known to increase in hypertensive patients. In this study we evaluated the possible involvement of uric acid and xanthine oxidase in the pathogenesis of hypertension by examining their association with mean arterial pressure (MAP) and factors related to blood pressure. These factors include age, quetelet index (weight/height2), cholesterol, creatinine, calcium (Ca), magnesium (Mg), sodium (Na), potassium (K) and urea. Fifty Two (male-19, female-33) normal healthy individuals were studied. Correlation studies of demographic variables showed that age was positively correlated with MAP [r = 0.309, p = 0.026] and cholesterol [r = 0.503, p = 0.000] while quetelet index was positively correlated with age [r = 422, p = 0.000] MAP [r = 0.331, p = 0.016] and xanthine oxidase [r = 0.331, p = 0.016]. MAP was positively correlated with uric acid [r = 0.511, p = 0.000], cholesterol [r = 0.492, p = 0.000] and xanthine oxidase enzyme activity [r = 0.388, p = 0.004] and negatively correlated with plasma calcium [r = 0.603, p = 0.000]. Correlation studies of measured parameters with uric acid and xanthine oxidase showed that uric acid was positively correlated with creatinine [r = 0.627, p = 0.000], plasma magnesium [r 0.442, p = 0.001] and negatively correlated with plasma calcium [r = 0.546, p = 0.000] while xanthine oxidase was negatively correlated with plasma calcium [r = -0.404, p = 0.003] and plasma sodium [r = -0.288, p = 0.038]. Stepwise multiple regression with MAP as dependent variable showed that 65% of total variability of blood pressure can be accounted for by plasma calcium, cholesterol, creatinine, plasma K, plasma Na, uric acid and xanthine oxidase in order of increasing R2 [xanthine oxidase: T-value = 3.26, R2 = 0.653]. It can be concluded that in normotensive subjects, uric acid and xanthine oxidase have significant association with blood pressure and thus are one of the many factors which are involved in the cause or effect of hypertension.

Matched MeSH terms: Hypertension/etiology*

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