Research - Blood Pressure / Blood Diseases
Effectiveness of Acupressure on the Taichong Acupoint in Lowering Blood Pressure in Patients with Hypertension: A Randomized Clinical Trial
Gan-Hon Lin,1 Wei-Chun Chang,2 Kuan-Ju Chen,2 Chen-Chen Tsai,3,4 Sung-Yuan Hu,5,6 and Li-Li Chen7,8
Objectives. To evaluate the effectiveness of acupressure on the Taichong acupoint in lowering systolic and diastolic blood pressure (BP) in hypertensive patients.
Methods. Eighty patients with hypertension attending a cardiology outpatient department in central Taiwan were included in this randomized clinical trial. Acupressure was applied to the Taichong acupoint in the experimental group (n=40) and to the first metatarsal (sham acupoint) in the control group (n=40). Blood pressure was measured by electronic monitoring before and immediately 15 min and 30 min after acupressure.
Results. The average age of the experimental and control participants was 59.3 ± 9.2 years and 62.7 ± 8.4 years, respectively. The two groups were similar for demographics and antihypertensive drug use. Mean systolic and diastolic BP in the experimental group decreased at 0, 15, and 30 min after acupressure (165.0/96.3, 150.4/92.7, 145.7/90.8, and 142.9/88.6 mmHg); no significant changes occurred in the control group. There was a significant difference in systolic and diastolic BP between the experimental and control groups immediately and 15 and 30 min after acupressure (p<0.05).
Conclusion. Acupressure on the Taichong acupoint can lower BP in hypertensive patients and may be included in the nursing care plan for hypertension. However, additional studies are needed to determine the optimal dosage, frequency, and long-term effects of this therapy.
Source : Evidence Based Complementary and Alternative Medicine
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Acute Effects of T’ai Chi Chuan Exercise on Blood Pressure and Heart Rate in Peripheral Artery Disease Patients
Filipe Fernandes Oliveira Dantas, PhD,1 Fa´ bio da Silva Santana, BS,2 Thiago Souza Rosas da Silva, BS,2 Gabriel Grizzo Cucato, PhD,3 Breno Quintella Farah, MS,4,5 and Raphael Mendes Ritti-Dias, PhD3
Objective: To investigate the acute effect of a t’ai chi chuan session on blood pressure and heart rate in patients with peripheral artery disease (PAD). Design: Randomized crossover intervention study.
Setting: Outpatient therapy center. Participants: Seven patients with PAD, aged 50–79 years, not using b-blockers, calcium-channel blockers, or nondihidropiridinic vasodilators. Intervention: T’ai chi chuan and control session (both sessions lasted 40 minutes).
Outcome measures: Systolic and diastolic blood pressure and heart rate, which were evaluated before and after the intervention (10, 30, and 50 minutes).
Results: T’ai chi chuan exercise acutely decreased systolic blood pressure at 30 minutes after exercise ( p = 0.042) and increased diastolic blood pressure at 50 minutes after exercise ( p = 0.041). Heart rate did not change after t’ai chi chuan exercise.
Conclusion: T’ai chi chuan acutely decreases systolic blood pressure in patients with PAD.
Source : The Journal Alternative and Complementary Medicine
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Essential Oil Inhalation on Blood Pressure and Salivary Cortisol Levels in Prehypertensive and Hypertensive Subjects
In-Hee Kim,1 Chan Kim,2 Kayeon Seong,1 Myung-Haeng Hur,1 Heon Man Lim,3 and Myeong Soo Lee4
The purpose of this study was to identify the effects of essential oil inhalation on the 24-hour ambulatory blood pressure (BP) and salivary cortisol level in 83 prehypertensive and hypertensive subjects. The experimental group (n=28) was asked to inhale an essential oil blended with lavender, ylang-ylang, marjoram, and neroli (20 : 15 : 10 : 2), whereas the placebo group (n=27) was asked to inhale an artificial fragrance for 24 hours and the control group received no treatment (n=28). The SBP (P<.001) and DBP (P=.009) measured at home in the experimental group were significantly decreased compared with the placebo group and the control group after treatment. The daytime SBP during the 24-hour ambulatory BP measurement of the experimental group presented with significant decreases in comparison with the measurements of the placebo group and the control group (P<.001). There was no statistically significant difference in the nighttime SBPs. The daytime DBPs during the 24-hour ambulatory BP measurements of the experimental group presented with significant decreases in comparison with the measurements of the placebo group and the control group (P=.002). There was no significant difference in the night time DBPs. The experimental group showed significant decreases in the concentration of salivary cortisol in comparison with the concentrations of the placebo group and the control group (P=.012). In conclusion, the inhalation of an essential oil had immediate and continuous effects on the home SBP, daytime BP, and the stress reduction. Essential oils may have relaxation effects for controlling hypertension.
Source : Evidence Based Complementary and Alternative Medicine
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Hibiscus Extract Decreases Blood Pressure to a Greater Extent than Hydrochlorothiazide in Nigerian Patients with Mild to Moderate Hypertension
Nwachukwu DC, Aneke E, Nwachukwu NZ, Obika L, Nwagha UI, Eze AA. Effect of Hibiscus sabdariffa on blood pressure and electrolyte profile of mild to moderate hypertensive Nigerians: a comparative study with hydrochlorothiazide. Niger J Clin Pract. November-December 2015;18(6):762-770.
Hypertension is one of the risk factors of cardiovascular disease and the main risk factor for stroke. It affects approximately 20% of the world's population with more severe sequelae among individuals of African descent. Hypertension is likely the result of many physiologic changes which include changes in electrolyte concentrations in the blood. Blood concentrations of sodium and chloride ions are higher and potassium ions are lower in patients with hypertension than in individuals with normal blood pressure. One common method of treating hypertension involves the reduction of blood electrolytes with prescription medications, such as hydrochlorothiazide (HCTZ). Studies in animal models and in humans provide evidence that hibiscus (Hibiscus sabdariffa, Malvaceae) extracts can help lower blood pressure. The goal of this randomized, controlled study was to compare the effects of a hibiscus extract and HCTZ on blood pressure and electrolyte balance in Nigerian patients with mild to moderate hypertension.
Patients were recruited from the Medical Outpatient Clinic of the Enugu State University Teaching Hospital in Enugu, Nigeria. Patients were included if they had newly diagnosed mild to moderate hypertension. Patients were excluded if they were taking prescription medications for hypertension; had diabetes, nephropathy, hepatic disease, cardiopathy, or cancer; were pregnant; smoked; or were alcoholics. Patients were randomly assigned to 1 of 3 groups, which included a placebo group, a group that drank hibiscus tea, and a group that took HCTZ. Each treatment was administered once per day before breakfast for 4 weeks. The placebo contained an extract of black currant (Ribes nigrum, Grossulariaceae) (GlaxoSmithKline®; London, UK) that was diluted until the solution matched the color of the hibiscus extract. A preliminary study found that the black currant dose had no effect on blood pressure. For each day's supply of hibiscus extract, 20 g of dried calyces, obtained from the Ogbete Main Market in Enugu, were ground into a powder and then infused with 1 L of boiling water for 30 minutes. The extract was filtered and stored in the refrigerator. The extract was standardized to a total anthocyanin concentration of 10.04 mg from 20 g of calyces in 1 L. The HCTZ group took 25 mg of HCTZ (Esidrex®; Novartis Pharmaceuticals; Basel, Switzerland). Blood pressure, serum electrolytes, and urine electrolytes were measured at baseline; at 1, 2, 3, and 4 weeks during the study; and 1 week after the study ended. Data were analyzed with one-way analysis of variance and Bonferroni tests.
Eighty patients were recruited for the study, of which 75 completed the study. Both hibiscus and HCTZ decreased systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) compared to placebo. HCTZ significantly reduced SBP by 12.9 ± 4.31 mmHg and DBP by 9.50 ± 2.06 mmHg (P < 0.05 and P < 0.001, respectively). There was an even greater reduction in SBP (17.08 ± 5.12 mmHg) and DBP (11.12 ± 3.12 mmHg) with the hibiscus treatment than with HCTZ, and these measures also were significantly lower than the placebo (P < 0.001 for both). MAP also was significantly lower in the hibiscus and HCTZ groups than in the placebo group at the end of the study (P < 0.001 and P < 0.01, respectively). Serum sodium and potassium were significantly lower at the end of the study in both treatment groups when compared to placebo (P < 0.001). In addition, serum sodium was still significantly lower in the hibiscus group than in the placebo group 1 week after the end of the dosing (P < 0.001), though in the HCTZ group it returned to baseline levels. It should be noted that serum potassium was significantly lower in the hibiscus group than in the placebo group at baseline (P < 0.001). Serum chloride increased significantly with hibiscus treatment and decreased significantly with HCTZ treatment (P < 0.001 for both). HCTZ resulted in a significant increase in urine sodium, potassium, and chloride concentrations after 4 weeks (P < 0.001, P < 0.001, and P < 0.01, respectively). The hibiscus treatment resulted in a decrease in the urine concentration of potassium ions in weeks 2-5 (P < 0.001 for all). Again, it should be noted that urine concentrations of sodium, potassium, and chloride ions were lower in the hibiscus group than in the placebo group at baseline (P < 0.01, P < 0.01, and P < 0.001, respectively).
Hibiscus extract decreased SBP, DBP, and MAP to a greater extent than HCTZ in Nigerian patients with mild to moderate hypertension. HCTZ decreased serum concentrations of sodium, potassium, and chloride ions and increased urine concentrations of these ions. HCTZ is a diuretic, and these results are in keeping with the function of HCTZ. The patients in the hibiscus group had significantly lower baseline concentrations of serum potassium ions and urine sodium, potassium, and chloride ions than did patients in the placebo group. Because of this bias at baseline, it is difficult to draw conclusions about the effect of hibiscus on these electrolytes. Despite these discrepancies, the hibiscus treatment did reduce the serum concentration of sodium ions and the urinary concentration of potassium ions (a potassium-sparing effect), even a week after dosing stopped. Hibiscus does not affect serum and urine concentrations of dissolved ions in the same way as HCTZ. Evidence has shown that hibiscus may operate via many mechanisms and not only as a diuretic. Previous studies have shown that hibiscus appears to act as a vasodilator and diuretic, suppresses uptake of calcium ions, and inhibits angiotensin-converting enzyme. The study was limited by the small sample size, lack of description of blinding of the placebo and hibiscus groups, and the inability to blind the HCTZ group. The authors also recommend quantifying the types and concentrations of anthocyanins in the hibiscus extract.
—Cheryl McCutchan, PhD
Source : American Botanical Council - HerbClip
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Therapeutic effect of forest bathing on human hypertension in the elderly
- Gen-Xiang Mao, MDa,
- Yong-Bao Cao, MBa, 1,
- Xiao-Guang Lan, BAb,
- Zhi-Hua He, BAb,
- Zhuo-Mei Chen,PhDc,
- Ya-Zhen Wang, MMa,
- Xi-Lian Hu, PhDa,
- Yuan-Dong Lv, MBa,
- Guo-Fu Wang, PhDa, , ,
- Jing Yan, MMa,
ObjectiveTo provide scientific evidence supporting the efficacy of forest bathing as a natural therapy for human hypertension.
Methods Twenty-four elderly patients with essential hypertension were randomly divided into two groups of 12. One group was sent to a broad-leaved evergreen forest to experience a 7-day/7-night trip, and the other was sent to a city area in Hangzhou for control. Blood pressure indicators, cardiovascular disease-related pathological factors including endothelin-1, homocysteine, renin, angiotensinogen, angiotensin II, angiotensin II type 1 receptor, angiotensin II type 2 receptor as well as inflammatory cytokines interleukin-6 and tumor necrosis factor α were detected. Meanwhile, profile of mood states (POMS) evaluation was used to assess the change of mood state of subjects. In addition, the air quality in the two experimental sites was monitored during the 7-day duration, simultaneously.
Results The baselines of the indicators of the subjects were not significantly different. Little alteration in the detected indicators in the city group was observed after the experiment. While subjects exposed to the forest environment showed a significant reduction in blood pressure in comparison to that of the city group. The values for the bio-indicators in subjects exposed to the forest environment were also lower than those in the urban control group and the baseline levels of themselves. POMS evaluation showed that the scores in the negative subscales were lowered after exposure to the forest environment. Besides, the air quality in the forest environment was much better than that of the urban area evidenced by the quantitative detection of negative ions and PM10 (particulate matter <10 μm in aerodynamic diameter).
Conclusion Our results provided direct evidence that forest bathing has therapeutic effects on human hypertension and induces inhibition of the renin–angiotensin system and inflammation, and thus inspiring its preventive efficacy against cardiovascular disorders.
Source : European Journal of Integrative Medicine
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Gastrodin Reduces Blood Pressure by Intervening with RAAS and PPARγ in SHRs
Wei Liu,1 Lingyan Wang,1 Jiahui Yu,1 Patrick Fordjour Asare,1 and Ying-Qiang Zhao2
1Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
2Department of Cardiology, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
Gastrodin is a bioactive compound extracted from traditional Chinese medicine, Gastrodia elata Bl. It has a definite effect on reducing blood pressure in hypertensive patients. However, the mechanisms of gastrodin in lowering blood pressure still remain unclear. In this study, 4 weeks of administration of gastrodin (100 mg/kg/d intraperitoneally injected) decreased the systolic blood pressure (SBP) in spontaneously hypertensive rats (SHRs) (190.2 + 89 versus 169.8 + 6.4, P<0.01). Among SHRs receiving gastrodin treatment, angiotensin II (Ang II) and aldosterone (ALD) in serum were significantly decreased (2022.1 + 53.0 versus 1528.7 + 93.9, 213.33 + 35.7 versus, 179.65 + 20.31 and P<0.01, P<0.05 , resp.) and dramatically downregulated expression of angiotensin type 1 receptor (AT1R) (4.9 + 0.9, versus 2.6 + 0.9 , P<0.05) in myocardium in both mRNA and protein levels compared with their corresponding groups without gastrodin treatment. Additionally, gastrodin increased the mRNA expression (0.18 + 0.07 versus 0.82 + 0.10, P<0.01) and protein synthesis (0.40 + 0.10 versus 0.34 + 0.10, P<0.01) of peroxisome proliferator-activated receptor γ (PPARγ) in myocardium tissues. Overall, our data demonstrated that gastrodin was able to decrease the SBP in SHR. Furthermore, this study showed that gastrodin intervened with the renin-angiotensin-aldosterone system (RAAS) and PPARγ effectively, which indicates its antihypertensive mechanism.
Source : Evidence Based Complementary and Alternative Medicine
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Effects of a quercetin-rich onion skin extract on 24 h ambulatory blood pressure and endothelial function in overweight-to-obese patients with (pre-)hypertension: a randomised double-blinded placebo-controlled cross-over trial
Verena Brülla1, Constanze Buraka1, Birgit Stoffel-Wagnera2, Siegfried Wolfframa3, Georg Nickeniga4, Cornelius Müllera4, Peter Langgutha5, Birgit Altehelda1, Rolf Fimmersa6, Stefanie Naafa7, Benno F. Zimmermanna7a8, Peter Stehlea1 and Sarah Egerta1 c1
a1 Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany
a2 Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
a3 Institute of Animal Nutrition and Physiology, Christian-Albrechts-University Kiel, 24118 Kiel, Germany
a4 Department of Cardiology, Angiology and Pneumology, University Hospital Bonn, 53127 Bonn, Germany
a5 Department of Biopharmaceutics and Pharmaceutical Technology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University Mainz, 55099 Mainz, Germany
a6 Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, 53127 Bonn, Germany
a7 Institut Prof. Dr. Georg Kurz GmbH, 50933 Köln, Germany
a8 Department of Nutrition and Food Sciences, Food Technology and Biotechnology, University of Bonn, 53117 Bonn, Germany
The polyphenol quercetin may prevent CVD due to its antihypertensive and vasorelaxant properties. We investigated the effects of quercetin after regular intake on blood pressure (BP) in overweight-to-obese patients with pre-hypertension and stage I hypertension. In addition, the potential mechanisms responsible for the hypothesised effect of quercetin on BP were explored. Subjects (n 70) were randomised to receive 162 mg/d quercetin from onion skin extract powder or placebo in a double-blinded, placebo-controlled cross-over trial with 6-week treatment periods separated by a 6-week washout period. Before and after the intervention, ambulatory blood pressure (ABP) and office BP were measured; urine and blood samples were collected; and endothelial function was measured by EndoPAT technology. In the total group, quercetin did not significantly affect 24 h ABP parameters and office BP. In the subgroup of hypertensives, quercetin decreased 24 h systolic BP by −3·6 mmHg (P=0·022) when compared with placebo (mean treatment difference, −3·9 mmHg; P=0·049). In addition, quercetin significantly decreased day-time and night-time systolic BP in hypertensives, but without a significant effect in inter-group comparison. In the total group and also in the subgroup of hypertensives, vasoactive biomarkers including endothelin-1, soluble endothelial-derived adhesion molecules, asymmetric dimethylarginine, angiotensin-converting enzyme activity, endothelial function, parameters of oxidation, inflammation, lipid and glucose metabolism were not affected by quercetin. In conclusion, supplementation with 162 mg/d quercetin from onion skin extract lowers ABP in patients with hypertension, suggesting a cardioprotective effect of quercetin. The mechanisms responsible for the BP-lowering effect remain unclear.
Source : British Journal of Nutrition
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Managing Hypertension by Polyphenols
Salvador Fernández-Arroyo1, Jordi Camps1, Javier A. Menendez2, Jorge Joven1
Some polyphenols, obtained from plants of broad use, induce a favorable endothelial response in hypertension and beneficial effects in the management of other metabolic cardiovascular risks. Previous studies in our laboratories using the calyces of Hibiscus sabdariffa as a source of polyphenols show that significant effects on hypertension are noticeable in humans only when provided in high amounts. Available data are suggestive in animal models and ex vivo experiments, but data in humans are difficult to acquire. Additionally, and despite the low bioavailability of polyphenols, intervention studies provide evidence for the protective effects of secondary plant metabolites. Assumptions on public health benefits are limited by the lack of scientific knowledge, robust data derived from large randomized clinical trials, and an accurate assessment of the bioactive components provided by common foodstuff. Because it is likely that clinical effects are the result of multiple interactions among different polyphenols rather than the isolated action of unique compounds, to provide polyphenol-rich botanical extracts as dietary supplements is a suggestive option. Unfortunately, the lack of patent perspectives for the pharmaceutical industries and the high cost of production and release for alimentary industries will hamper the performance of the necessary clinical trials. Here we briefly discuss whether and how such limitations may complicate the extensive use of plant-derived products in the management of hypertension and which steps are the necessary to deal with the predictable complexity in a possible clinical practice.
Source : Planta Medica
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Calcium intake and hypertension among obese adults in United States: associations and implications explored
Y Chen1, S Strasser2, Y Cao1, K-S Wang1 and S Zheng1
- 1Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
- 2Georgia State University, School of Public Health, Atlanta, GA, USA
The relationship between calcium intake and hypertension is receiving increased research attention. The prevalence of hypertension is high among the obese populations. Calcium is a mineral that influences blood pressure. The aim of the study was to examine the association between calcium intake and hypertension in a large nationally representative sample of obese American adults. A total of 14 408 obese adults aged 20 years or older were obtained from the 1999–2010 National Health and Nutrition Examination Survey. Analysis of variance and linear regression models were used to examine relationships between calcium intake and systolic blood pressure (SBP) as well as diastolic blood pressure (DBP). Multiple logistic regression models were used to examine the association between calcium intake and hypertension after adjusting for potential confounders and interactions, including: age, race, education level, alcohol use, smoking, diabetes status, sodium intake and potassium intake. Calcium intake was significantly lower for the hypertensive group compared with the normotensive group (P<0.0001), especially among those obese female young adults aged 20–44 years and among non-diabetic obese adults. Based on ordinary linear regression analysis, a significant inverse relationship was detected, SBP and DBP decreased if calcium intake increased (SBP: regression coefficient estimate=−0.015, P<0.0001; DBP: regression coefficient estimate=−0.028, P<0.0001). Multiple logistic regression showed that calcium intake was negatively associated with the probability of hypertension (odds ratio (OR)=0.81, 95% confidence interval (CI): 0.74–0.87, P<0.0001). In stratified analysis, calcium intake in youngest adults (age 20–44 years) had the lowest likelihood of hypertension (OR=0.77, 95% CI: 0.64–0.93, P<0.0001), the inverse relationship between calcium intake and probability of hypertension was stronger among females (OR: 0.68, 95% CI: 0.55–0.84, P<0.0001), when compared with the whole sample including all of 14 408 obese adults. The protective effect of calcium intake and hypertension was found significantly in obese non-diabetic adults (OR: OR=0.77, 95% CI: 0.67–0.89, P<0.0001) not in obese diabetic adults. SBP, DBP and calcium intake were log transformed for both ordinary linear regression analysis and logistic regression analysis. Our study findings underscore the need to explore the physiological mechanism between calcium intake and hypertension. In this study, increased calcium intake was associated with the lowest risk of hypertension. Future studies utilizing longitudinal research designs are needed to quantify therapeutic levels of calcium for control of hypertension among obese adults. Increasing calcium intake among American adults may offer promise as a cost-effective strategy to improve hypertension among obese adults; however, further scientific exploration is warranted.
Source : Journal of Human Hypertension
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Selenium status in UK pregnant women and its relationship with hypertensive conditions of pregnancy
Margaret P. Rayman, 1 ,* Sarah C. Bath, 1 Jacob Westaway, 2 Peter Williams, 3 Jinyuan Mao, 1 Jessica J. Vanderlelie, 2Anthony V. Perkins, 2 and Christopher W. G. Redman 4
Dietary intake/status of the trace mineral Se may affect the risk of developing hypertensive conditions of pregnancy, i.e. pre-eclampsia and pregnancy-induced hypertension (PE/PIH). In the present study, we evaluated Se status in UK pregnant women to establish whether pre-pregnant Se status or Se supplementation affected the risk of developing PE/PIH. The samples originated from the SPRINT (Selenium in PRegnancy INTervention) study that randomised 230 UK primiparous women to treatment with Se (60 μg/d) or placebo from 12 weeks of gestation. Whole-blood Se concentration was measured at 12 and 35 weeks, toenail Se concentration at 16 weeks, plasma selenoprotein P (SEPP1) concentration at 35 weeks and plasma glutathione peroxidase (GPx3) activity at 12, 20 and 35 weeks. Demographic data were collected at baseline. Participants completed a FFQ. UK pregnant women had whole-blood Se concentration lower than the mid-range of other populations, toenail Se concentration considerably lower than US women, GPx3 activity considerably lower than US and Australian pregnant women, and low baseline SEPP1 concentration (median 3·00, range 0·90–5·80 mg/l). Maternal age, education and social class were positively associated with Se status. After adjustment, whole-blood Se concentration was higher in women consuming Brazil nuts (P= 0·040) and in those consuming more than two seafood portions per week (P= 0·054). A stepwise logistic regression model revealed that among the Se-related risk factors, only toenail Se (OR 0·38, 95 % CI 0·17, 0·87, P= 0·021) significantly affected the OR for PE/PIH. On excluding non-compliers with Se treatment, Se supplementation also significantly reduced the OR for PE/PIH (OR 0·30, 95 % CI 0·09, 1·00, P= 0·049). In conclusion, UK women have low Se status that increases their risk of developing PE/PIH. Therefore, UK women of childbearing age need to improve their Se status.
Source : British Journal of Nutrition
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Dietary functional benefits of Bartlett and Starkrimson pears for potential management of hyperglycemia, hypertension and ulcer bacteria Helicobacter pylori while supporting beneficial probiotic bacterial response
Pear has potential for phenolic-linked management of type 2 diabetes associated hyperglycemia and hypertension.
Fermented pear juices also possess inhibitory activity of stomach ulcer relevant bacteriumHelicobacter pylori.
Pear cultivars have relevance to be included in dietary strategies for better management of early stage hyperglycemia.
This in vitro study provides conceptual foundation for animal and clinical studies involving pear to combat type 2 diabetes.
Phenolic-linked health benefits of Bartlett and Starkrimson pear cultivars were investigated for the potential relevance in managing type 2 diabetes and hypertension using in vitro enzyme models. Further effects of fermented (0, 24, 48, and 72-h with Lactobacillus helveticus) pear juice on inhibition of Helicobacter pyloriand proliferation of probiotic Bifidobacterium longum were also evaluated. High total phenolic content along with high 2,2 diphenyl-1-picrylhydrazyl-linked free radical scavenging antioxidant activities were observed in peel extracts of both cultivars. In vitro enzyme assays with peel and pulp extracts also indicated high inhibitory activity of α-glucosidase and α-amylase used as models for anti-hyperglycemia benefits. Only the aqueous pulp extract of Bartlett pear had angiotensin I-converting enzyme inhibitory activity used as model for anti-hypertension benefits. Fermented acidic pH samples of both cultivars showed H. pylori inhibition at 48 and 72 h, while fermented sample of Starkrimson even showed inhibition at 24 h. Both cultivar extracts did not inhibit growth of probiotic B. longum
Source : Food Research International
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The effect of back massage on blood pressure in the patients with primary hypertension in 2012-2013: a randomized clinical trial.
Mohebbi Z1, Moghadasi M1, Homayouni K2, Nikou MH3.
BACKGROUND:Tension and stress are among the factors that lead to hypertension. In most individuals, behavioral strategies, such as relaxation and massage, are effective in controlling the individuals' response to stress, thus reducing hypertension.
METHODS:This non-blind clinical trial was conducted on 90 patients with primary hypertension. The patients were randomly divided into a control and an intervention group. In both groups, blood pressure was measured and recorded twice a week before and after a 10-min Swedish back massage and rest for 6 weeks. The study data were collected using a questionnaire including demographic information, a check list of blood pressure record, and a fixed manometer.
RESULTS:In the intervention group, systolic and diastolic blood pressure decreased to 6.44 and 4.77 mmHg, respectively after back massage (P<0.001).
CONCLUSION:The obtained results were indicative of the effectiveness of back massage in reducing blood pressure in the study participants. Using stress control methods, such as massage, is a simple, acceptable, and teachable method for families to control blood pressure. After conducting more studies on this issue, back massage can be recommended as a non-pharmacological method to control blood pressure.
Source : Int J Community Based Nurs Midwifery.
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Antihypertensive Effect of Syzygium cumini in Spontaneously Hypertensive Rats
Rachel Melo Ribeiro,1 Vicente Férrer Pinheiro Neto,2 Kllysmann Santos Ribeiro,1 Denilson Amorim Vieira,1 Iracelle Carvalho Abreu,1 Selma do Nascimento Silva,1 Maria do Socorro de Sousa Cartágenes,1 Sônia Maria de Farias Freire,1 Antonio Carlos Romão Borges,1 and Marilene Oliveira da Rocha Borges1
1Laboratory of Pharmacology, Department of Physiological Science, Federal University of Maranhão (UFMA), Avenida dos Portugueses 1966, Bacanga, 65080-805 São Luís, MA, Brazil
2Department of Veterinary Medicine, State University of Maranhão (UEMA), 65055-970 São Luís, MA, Brazil
This study evaluated the in vivo potential antihypertensive effect of hydroalcoholic extract of Syzygium cuminileaves (HESC) in normotensive Wistar rats and in spontaneously hypertensive rats (SHR), as well as its in vitroeffect on the vascular reactivity of resistance arteries. The hypotensive effect caused by intravenous infusion of HESC (0.01–4.0 mg/kg) in anesthetized Wistar rats was dose-dependent and was partially inhibited by pretreatment with atropine sulfate. SHR received HESC (0.5 g/kg/day), orally, for 8 weeks and mean arterial pressure, heart rate, and vascular reactivity were evaluated. Daily oral administration of HESC resulted in a time-dependent blood pressure reduction in SHR, with a maximum reduction of 62%. In the endothelium-deprived superior mesenteric arteries rings the treatment with HESC reduced by 40% the maximum effect (Emax) of contraction induced by NE. The contractile response to calcium and NE of endothelium-deprived mesenteric rings isolated from untreated SHR was reduced in a concentration-dependent manner by HESC (0.1, 0.25, and 0.5 mg/mL). This study demonstrated that Syzygium cumini reduces the blood pressure and heart rate of SHR and that this antihypertensive effect is probably due to the inhibition of arterial tone and extracellular calcium influx.
Source : Journal Evidence Based Complementary and Alternative Medicine
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More than salt, sugars may contribute to high blood pressure
Cardiovascular disease is the number one cause of premature mortality in the developed world, and hypertension is its most important risk factor.
Hypertension was implicated as a primary or contributing factor in more than 348,000 deaths in the US in 2009, with costs to the nation in excess of $50 billion annually. Controlling hypertension is a major focus of public health initiatives, and dietary approaches to address hypertension have historically focused on sodium.
Nonetheless, the potential benefits of sodium reduction are debatable; studies have shown that the reduction in blood pressure achieved by restricting salt is slim.
Recent data encompassing over 100,000 patients indicates that sodium intake between 3-6 g/day is associated with a lower risk of death and cardiovascular events compared with either a higher or lower level of intake. "Thus, guidelines advising restriction of sodium intake below 3 g/day may cause harm," the authors write.
Processed foods happen to be major sources of not just sodium, but also of highly refined carbohydrates: that is, various sugars and the simple starches that give rise to them through digestion. The researchers comment:
"Compelling evidence from basic science, population studies, and clinical trials implicate sugars, and particularly the monosaccharide fructose, as playing a major role in the development of hypertension. Moreover, evidence suggests that sugars in general and fructose in particular may contribute to overall cardiovascular risk through a variety of mechanisms."
Sucrose, or table sugar, is a disaccharide composed of two monosaccharides: glucose and fructose. Sucrose is a common ingredient in industrially processed foods, but not as common as another sweetener: high-fructose corn syrup (HFCS). Whereas sucrose is equal parts fructose and glucose, HFCS has more fructose (usually 55%) than glucose (the remaining 45%) and is the most frequently used sweetener in processed foods - particularly in fruit drinks and sodas.
Ingesting one 24-ounce soft drink has been shown to cause an average maximum increase in blood pressure of 15/9 mm Hg and heart rate of 9 bpm.
The researchers indicate "sugar may be much more meaningfully related to blood pressure than sodium, as suggested by a greater magnitude of effect with dietary manipulation."
Higher sugar intake significantly increases systolic (6.9 mm Hg) and diastolic blood pressure (5.6 mm Hg) in trials of 8 weeks or more in duration. This effect is increased to 7.6/6.1 mm Hg, when studies that received funding from the sugar industry are excluded.
Those who consume 25% or more calories from added sugar have an almost threefold increased risk of death due to cardiovascular disease, according to the research.
Even moderate doses of added sugar for short durations may cause harmCurrent US per capita intake of added sugars is approximately two to eight times higher than current recommendations by the American Heart Association (AHA) and the World Health Organization (WHO). Considering adolescents specifically, current consumption might be as much as six to 16 times higher.
An increase in sympathetic tone from the overconsumption of fructose is one likely mechanism for the sugar's ability to increase heart rate, cardiac output, renal sodium retention and vascular resistance, all of which may interact to elevate blood pressure and increase myocardial oxygen demand.
However, ingestion of sugars - including fructose - in their naturally occurring biological contexts (i.e. as whole fruits) is not harmful and is likely beneficial.
Just as most dietary sodium does not come from the salt shaker, most dietary sugar does not come from the sugar bowl. Dr James DiNicolantonio, from the Department of Preventive Cardiology at Saint Luke's Mid America Heart Institute on Kansas City, MO, concludes:
"Reducing consumption of added sugars by limiting processed foods containing them, made by corporations would be a good place to start."
The evidence shows that even moderate doses of added sugar for short durations may cause substantial harm.
Source : Medical News Today
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Higher urinary heavy metal, phthalate and arsenic concentrations accounted for 3–19% of the population attributable risk for high blood pressure: US NHANES, 2009–2012
Ivy Shiue1,2,3 and Krasimira Hristova4
- 1School of the Built Environment, Heriot-Watt University, Edinburgh, Scotland, UK
- 2Owens Institute for Behavioral Research, University of Georgia, Athens, GA, USA
- 3Alzheimer’s Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, Scotland, UK
- 4Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria
The link between environmental chemicals and human health has emerged, but has not been completely examined in terms of its risk factors. Therefore, we aimed to study the relationships of different sets of urinary environmental chemical concentrations and high blood pressure (BP) in a national, population-based study. Data were retrieved from the United States National Health and Nutrition Examination Surveys, 2009–2012, including demographics, BP readings and urinary environmental chemical concentrations. Analyses included χ2-test, t-test, survey-weighted logistic regression models and population attributable risk estimation. Urinary cesium (odds ratio (OR) 1.52, 95% confidence interval (CI) 1.06–2.18,P=0.026), molybdenum (OR 1.45, 95% CI 1.04–2.02, P=0.029), lead (OR 1.49, 95% CI 1.12–1.98, P=0.009), platinum (OR 1.66, 95% CI 1.14–2.21,P=0.002), antimony (OR 1.44, 95% CI 1.12–1.86, P=0.008) and tungsten (OR 1.48, 95% CI 1.22–1.79, P<0.001) concentrations were observed to be associated with high BP. Similar results were observed for mono-2-ethyl-5-carboxypentyl (OR 1.29, 95% CI 1.04–1.59, P=0.024), mono-n-butyl (OR 1.36, 95% CI 1.11–1.67, P=0.005), mono-2-ethyl-5-hydroxyhexyl (OR 1.21, 95% CI 1.01–1.46, P=0.041), mono-n-methyl (OR 1.24, 95% CI 1.01–1.46,P=0.014), mono-2-ethyl-5-oxohexyl (OR 1.21, 95% CI 1.01–1.45, P=0.036), mono-benzyl (OR 1.41, 95% CI 1.15–1.74, P=0.002), dimethylarsonic acid (OR 1.38, 95% CI 1.08–1.76, P=0.012) and trimethylarsine oxide (OR 2.56, 95% CI 1.29–5.07, P=0.010) concentrations. Each chemical could account for 3–19% of the population attributable risk for high BP. A small sex difference was found. However, there are no associations between environmental parabens and pesticides and high BP. Urinary heavy metal, phthalate and arsenic concentrations were associated with high BP, although a causal effect cannot be established. Elimination of environmental chemical exposure in humans still needs to be pursued.
Source : Hypertension Research
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Impact of Beverage Content on Health and the Kidneys
Johnson, Richard J. MD; Thomas, Jeffrey MD; Lanaspa, Miguel A. PhD
The last 50 years have witnessed an epidemic rise in obesity, diabetes, high blood pressure, and chronic kidney disease. Some animal research suggests the epidemic may in part be triggered by sugar. Sugar contains glucose and fructose, and studies suggest it is the fructose component that may have a role in chronic disease development. Animal studies indicate that fructose is distinct from other sugars by its ability to cause transient adenosine triphosphate (ATP) depletion in the cell with uric acid generation. The administration of fructose, or the raising of uric acid, can induce kidney disease and accelerate established kidney disease in animals. Therefore, we believe that the greatest risk from sugar is when it is given as a soft drink, as the rapidity of ingestion relates directly to the concentration of fructose that the cells are exposed to and hence govern the degree of ATP depletion and uric acid generation. Restricting sugar-sweetened beverages may be one strategy to combat obesity, diabetes, high blood pressure, and kidney disease, but human intervention studies are needed to support the theory.
Source : Journal Nutrition Today
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Effect of garlic on blood pressure: A systematic review and meta-analysis
Karin Ried1*, Oliver R Frank1, Nigel P Stocks1, Peter Fakler1 and Thomas Sullivan2
1 Discipline of General Practice, The University of Adelaide, Adelaide, South Australia
2 Discipline of Public Health, The University of Adelaide, Adelaide, South Australia
Background Non-pharmacological treatment options for hypertension have the potential to reduce the risk of cardiovascular disease at a population level. Animal studies have suggested that garlic reduces blood pressure, but primary studies in humans and non-systematic reviews have reported mixed results. With interest in complementary medicine for hypertension increasing, it is timely to update a systematic review and meta-analysis from 1994 of studies investigating the effect of garlic preparations on blood pressure.
Methods We searched the Medline and Embase databases for studies published between 1955 and October 2007. Randomised controlled trials with true placebo groups, using garlic-only preparations, and reporting mean systolic and/or diastolic blood pressure (SBP/DBP) and standard deviations were included in the meta-analysis. We also conducted subgroup meta-analysis by baseline blood pressure (hypertensive/normotensive), for the first time. Meta-regression analysis was performed to test the associations between blood pressure outcomes and duration of treatment, dosage, and blood pressure at start of treatment.
Results Eleven of 25 studies included in the systematic review were suitable for meta-analysis. Meta-analysis of all studies showed a mean decrease of 4.6 ± 2.8 mm Hg for SBP in the garlic group compared to placebo (n = 10; p = 0.001), while the mean decrease in the hypertensive subgroup was 8.4 ± 2.8 mm Hg for SBP (n = 4; p < 0.001), and 7.3 ± 1.5 mm Hg for DBP (n = 3; p < 0.001). Regression analysis revealed a significant association between blood pressure at the start of the intervention and the level of blood pressure reduction (SBP: R = 0.057; p = 0.03; DBP: R = -0.315; p = 0.02).
Conclusion Our meta-analysis suggests that garlic preparations are superior to placebo in reducing blood pressure in individuals with hypertension.
Source BMC Cardiovascular Disorders
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Association of Alcohol Consumption With Incident Hypertension Among Middle-Aged and Older Japanese Population The Ibarakai Prefectural Health Study (IPHS)
Yoshiro Okubo,Toshimi Sairenchi,Fujiko Irie, Kazumasa Yamagishi,Hiroyasu Iso, Hiroshi Watanabe,Takashi Muto, Kiyoji Tanaka, Hitoshi Ota
From the Doctor’s Program in Health and Sport Sciences, Graduate School of Comprehensive Human Sciences (Y.O.), Department of Public Health Medicine, Faculty of Medicine (K.Y.), and Faculty of Health and Sport Sciences (K.T.), University of Tsukuba, Tsukuba, Japan; Ibaraki Health Plaza (Y.O., T.S., H.O., H.W.), Ibaraki Health Service Association, Mito, Japan; Department of Public Health, Dokkyo Medical University School of Medicine, Shimotugagun-Mibu, Japan (T.S., T.M.); Department of Health and Welfare, Ibaraki Prefectural Office, Mito, Japan (F.I.); and Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan (H.I.).
The objective of this study was to examine the effect of age on the relationship between alcohol consumption and incident hypertension in a general Japanese population. A cohort of Japanese men (n=37 310) and women (n=78 426) aged 40 to 79 years who underwent community-based health checkups from 1993 to 2004 and were free of hypertension were followed up with annual examinations, including the measurement of blood pressure, until the end of 2010. Incident hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or the initiation of treatment for hypertension. Hazard ratios for incident hypertension according to alcohol consumption were estimated using a Cox proportional hazards model adjusted for possible confounding variables. A total of 45 428 participants (39.3%) developed hypertension (16 155 men and 29 273 women) for a mean follow-up time of 3.9 (1–18) years. Significant associations between alcohol consumption and incident hypertension were found in both sexes and age groups (P for trend was <0.001 for men aged 40–59 years and aged 60–79 years; 0.004 for women aged 40–59 years and 0.026 for women aged 60–79 years). No significant interaction with age on the association of alcohol consumption with incident hypertension was found in either sex (P for interaction, >0.05). Our results suggest that alcohol consumption is a similar risk factor for incident hypertension in both the middle-aged and the older populations.
Source : Journal Hypertension
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Potent Antihypertensive Action of Dietary Flaxseed in Hypertensive Patients
Delfin Rodriguez-Leyva, Wendy Weighell, Andrea L. Edel, Renee LaVallee, Elena Dibrov, Reinhold Pinneker, Thane G. Maddaford, Bram Ramjiawan, Michel Aliani, Randolph Guzman, Grant N. Pierce
- From the Cardiovascular Research Division, V.I. Lenin Universitary Hospital, Holguin, Cuba (D.R.-L.); and Department of Surgery, St Boniface Hospital and the Asper Clinical Research Institute (W.W., R.G.), Canadian Centre for Agri-food Research in Health and Medicine, St Boniface Hospital Research Centre, Department of Physiology, Faculties of Medicine and Pharmacy (A.L.E., R.L., E.D., R.P., T.G.M., B.R., G.N.P.), and Department of Human Nutritional Sciences, Faculty of Human Ecology (M.A.), University of Manitoba, Winnipeg, Manitoba, Canada.
Flaxseed contains ω-3 fatty acids, lignans, and fiber that together may provide benefits to patients with cardiovascular disease. Animal work identified that patients with peripheral artery disease may particularly benefit from dietary supplementation with flaxseed. Hypertension is commonly associated with peripheral artery disease. The purpose of the study was to examine the effects of daily ingestion of flaxseed on systolic (SBP) and diastolic blood pressure (DBP) in peripheral artery disease patients. In this prospective, double-blinded, placebo-controlled, randomized trial, patients (110 in total) ingested a variety of foods that contained 30 g of milled flaxseed or placebo each day over 6 months. Plasma levels of the ω-3 fatty acid α-linolenic acid and enterolignans increased 2- to 50-fold in the flaxseed-fed group but did not increase significantly in the placebo group. Patient body weights were not significantly different between the 2 groups at any time. SBP was ≈10 mm Hg lower, and DBP was ≈7 mm Hg lower in the flaxseed group compared with placebo after 6 months. Patients who entered the trial with a SBP ≥140 mm Hg at baseline obtained a significant reduction of 15 mm Hg in SBP and 7 mm Hg in DBP from flaxseed ingestion. The antihypertensive effect was achieved selectively in hypertensive patients. Circulating α-linolenic acid levels correlated with SBP and DBP, and lignan levels correlated with changes in DBP. In summary, flaxseed induced one of the most potent antihypertensive effects achieved by a dietary intervention.
Source : Journal Hypertension
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Acute effects of violent video-game playing on blood pressure and appetite perception in normal-weight young men: a randomized controlled trial
M Siervo1, S Sabatini2, M S Fewtrell2 and J C K Wells2
- 1Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Newcastle on Tyne, UK
- 2Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
Watching television and playing video game being seated represent sedentary behaviours and increase the risk of weight gain and hypertension. We investigated the acute effects of violent and non-violent video-game playing on blood pressure (BP), appetite perception and food preferences. Forty-eight young, normal-weight men (age: 23.1±1.9 years; body mass index: 22.5±1.9 kg/m2) participated in a three-arm, randomized trial. Subjects played a violent video game, a competitive, non-violent video game or watched TV for 1 h. Measurements of BP, stress and appetite perception were recorded before a standardized meal (~300 kcal) and then repeated every 15 min throughout the intervention. Violent video-game playing was associated with a significant increase in diastolic BP (Δ±s.d.=+7.5±5.8 mm Hg; P=0.04) compared with the other two groups. Subjects playing violent video games felt less full (P=0.02) and reported a tendency towards sweet food consumption. Video games involving violence appear to be associated with significant effects on BP and appetite perceptions compared with non-violent gaming or watching TV.
Source : EU Journal of Clinical Nutrition
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Melatonin May Help Sleep Problems in People With High Blood Pressure Who Take Beta-Blockers
Melatonin supplements may help improve sleep in people with high blood pressure (hypertension) who take beta-blockers, according to a recent randomized controlled study. Beta-blockers are prescribed to treat a number of health problems and are the most commonly prescribed class of drugs for hypertension. However, frequent side effects of these drugs are difficulty sleeping and daytime fatigue, which may result from their suppression of melatonin, a hormone that promotes sleep. The intent of this study was to determine whether melatonin supplements for 3 weeks would improve sleep in hypertensive patients who were chronically treated with beta-blockers. Findings from this clinical trial, co-funded by NCCAM, were published in the journal Sleep.
The 16 participants enrolled in the study were adults (45 to 64 years of age) who had been diagnosed with uncomplicated essential hypertension, but were otherwise healthy. They had taken beta-blockers for at least 6 months, and some also took other antihypertensive drugs. Participants were not required to have sleep problems. Researchers randomly assigned participants to take either a 2.5 mg capsule of melatonin or a matching placebo by mouth 1 hour before bedtime, for approximately 3 weeks (20 to 28 days, depending upon laboratory and scheduling factors). An inpatient laboratory stay of 4 days in a private suite occurred at the beginning and at the end of this period, where patients were monitored for changes in sleep and daytime activities. The laboratory schedule consisted of 16 hours of scheduled wakefulness per day and 8 hours of scheduled bed rest per night at the same times as patients had maintained during the out-patient portions in the week prior to both admissions. Outside the lab, sleep and activity patterns were measured through several means, including a sensor worn on the wrist.
The researchers found that, compared with placebo, taking melatonin supplements significantly increased the participants’ total sleep time by 36 minutes; increased sleep efficiency by almost 8 percent; decreased sleep onset latency (by 14 minutes) to stage 2 sleep; and increased the length of sleep by 41 minutes in stage 2 (though not in other stages). In addition, a number of negative effects that can occur with chronic use of prescription sleep aids did not occur with melatonin. Patients did not experience tolerance (lowering of effectiveness following chronic use) or rebound sleep disturbance (sleep problems that develop after stopping a sleep aid), nor did the researchers find a decrease in slow-wave and/or REM sleep. Since beta-blockers must typically be taken for life, these benefits would be significant advantages.
The researchers acknowledged limitations in the study, particularly the small size and the unavailability of pre-study measurements (prior to beta-blocker therapy). However, investigators suggested that melatonin may have profound potential benefits in improving sleep, not only for the more than 20 million people taking beta-blockers, but also for patients with other health conditions and risks associated with sleep disturbances.
Scheer FA, Morris CJ, Garcia JI, et al. Repeated melatonin supplementation improves sleep in hypertensive patients treated with beta-blockers: a randomized controlled trial. Sleep. 2012;35(10):1395-1402.
Source : NNCAM
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Mindfulness-Based Stress Reduction Helps Lower Blood Pressure, Study Finds
Blood pressure is effectively lowered by mindfulness-based stress reduction (MBSR) for patients with borderline high blood pressure or "prehypertension," according to new research.
The finding is reported in the October issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
"Our results provide evidence that MBSR, when added to lifestyle modification advice, may be an appropriate complementary treatment for BP in the prehypertensive range," writes Joel W. Hughes, PhD, of Kent State (Ohio) University and colleagues.
Mindfulness Practice Leads to Drop in Blood Pressure
The study included 56 women and men diagnosed with prehypertension -- blood pressure that was higher than desirable, but not yet so high that antihypertensive drugs would be prescribed. Prehypertension receives increasing attention from doctors because it is associated with a wide range of heart disease and other cardiovascular problems. About 30% of Americans have prehypertension and may be prescribed medications for this condition.
One group of patients was assigned to a program of MBSR: eight group sessions of 2½ hours per week. Led by an experienced instructor, the sessions included three main types of mindfulness skills: body scan exercises, sitting meditation, and yoga exercises. Patients were also encouraged to perform mindfulness exercises at home.
The other "comparison" group received lifestyle advice plus a muscle-relaxation activity. This "active control" treatment group was not expected to have lasting effects on blood pressure. Blood pressure measurements were compared between groups to determine whether the mindfulness-based intervention reduced blood pressure in this group of people at risk of cardiovascular problems.
Patients in the mindfulness-based intervention group had significant reductions in clinic-based blood pressure measurements. Systolic blood pressure (the first, higher number) decreased by an average of nearly 5 millimeters of mercury (mm Hg), compared to less than 1 mm Hg with in the control group who did not receive the mindfulness intervention.
Diastolic blood pressure (the second, lower number) was also lower in the mindfulness-based intervention group: a reduction of nearly 2 mm Hg, compared to an increase of 1 mm Hg in the control group.
Mindfulness-based interventions Could 'Prevent or Delay' Need for Antihypertensive Drugs Ambulatory monitoring is an increasingly used alternative to clinic-based blood pressure measurements. However, 24-hour ambulatory blood pressure monitoring showed no significant difference in blood pressure with the mindfulness-based intervention.
"Mindfulness-based stress reduction is an increasingly popular practice that has been purported to alleviate stress, treat depression and anxiety, and treat certain health conditions," according to Dr Hughes and coauthors. It has been suggested that MBSR and other types of meditation may be useful in lowering blood pressure. Previous studies have reported small but significant reductions in blood pressure with Transcendental Meditation; the new study is the first to specifically evaluate the blood pressure effects of mindfulness-based intervention in patients with prehypertension.
Although the blood pressure reductions associated with mindfulness-based interventions are modest, they are similar to many drug interventions and potentially large enough to lead to reductions in the risk of heart attack or stroke. Further studies are needed to see if the blood pressure-lowering effects are sustained over time.
The researchers argue that mindfulness-based interventions may provide a useful alternative to help "prevent or delay" the need for antihypertensive medications in patients with borderline high blood pressure.
Source : Newswise
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Cardiovascular Protective Effects of Adjunctive Alternative Medicine (Salvia miltiorrhiza and Pueraria lobata )in High-Risk Hypertension
K. S. Woo,1,2,3Thomas W. C. Yip,4Ping Chook,1,2S. K. Kwong,5C. C. Szeto,2June K. Y. Li,4Alex W. Y. Yu,5William K. F. Cheng,1Thomas Y. K. Chan,2K. P. Fung,1,6andP.C.Leung1
1Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong
2Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
3Room 186, Science Centre South Block, School of Life Sciences, Biochemistry Programme,The Chinese University of Hong Kong, Hong Kong
4Department of Medicine, Yan Chai Hospital, Hong Kong
5Department of Medicine, Alice Ho Miu Ling Nethersole Hopsital, Hong Kong
6School of Medical Sciences, The Chinese University of Hong Kong, Hong Kong
Introduction. Hypertension in association with diabetes (DM), renal impairment (RI), and left ventricular hypertrophy (LVH)increases the risk of future cardiovascular events. We hypothesize, traditional herbal medicines Danshen and Gegen (D&G) have beneficial effects on atherogenesis in these high-risk hypertensive subjects.
Subjects and Methods. 90 asymptomatic hypertensive subjects associated with LVH (63.3%), DM (62.2%), or RI (30%) were randomized to receive D&G herbal capsules 1gm/day,2gm/day, or identical placebo capsules in double-blind and parallel fashion for 12 months. Brachial flow-mediated dilation(endothelium-dependent dilation, FMD) and carotid intima-media thickness (IMT) were measured by ultrasound. All data were analyzed using the Statistical Package for Social Sciences in Windows 16.0.Results.Theirmeanagewas55±8years, and 74.4% were male. After 12 months of adjunctive therapies and compared with baseline, there were no significant changes in blood pressure,heart rate, hematological, glucose, and creatinine profiles in both placebo and D&G groups. FMD improved significantly during D&G (𝑃=0.0001) and less so after placebo treatment (𝑃=0.001). There was a mild but significant decrease in carotid IMT afterD&G (𝑃<0.001) but no significant changes after placebo. A trend of better improvement in FMD after higher versus lower D&G dosages was seen. D&G were well tolerated, with no significant adverse events or blood biochemistry changes.Conclusion.D&G adjunctive treatment was well tolerated and significantly improved atherogenesis in high-risk hypertensive patients, with potential in primary atherosclerosis prevention
Source : Evidence Based Complementary and Alternative Medicine
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Effects of Chinese herbal medicine Yiqi Huaju Formula on hypertensive patients with metabolic syndrome: a randomized, placebo-controlled trial
1. Yi Chen (Institute of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China )
2. De-yu Fu (Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China )
3. Yu Chen (Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China )
4. Yan-ming He (Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China )
5. Xiao-dong Fu (Institute of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China )
6. Yan-qiu Xu (Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China )
7. Yi Liu (Institute of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China )
8. Xiao-tao Feng (Institute of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China )
9. Teng Zhang (Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China )
10. Wen-jian Wang (Institute of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China )
BACKGROUND: Patients with hypertension coupled with metabolic syndrome (MetS) are among the high risk population in cardiovascular and cerebrovascular diseases. To reduce the prevalence of cardiovascular and cerebrovascular diseases, it is essential to appropriately control blood pressure together with other cardiovascular risk factors.
OBJECTIVE: The current study was designed to investigate the therapeutic effects on blood pressure, blood pressure variability and other cardiovascular risk factors by giving Yiqi Huaju Formula, a compound traditional Chinese herbal medicine, in addition to routine treatment to hypertensive patients coupled with MetS.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A total of 43 patients with hypertension coupled with MetS were recruited into this study. The enrolled patients were randomly divided into the Chinese herbal formula group (anti-hypertensive drugs plus Yiqi Huaju Formula, CHF) and the control group (anti-hypertensive drugs plus placebo). The CHF group enrolled 22 patients while the control group received 21 cases. Treatments were given for 12 weeks in both groups.
MAIN OUTCOME MEASURES: Parameters examined include 24-hour ambulatory blood pressure monitoring, body mass index, waist circumference, waist-to-hip ratio, homeostatic model assessment for insulin resistance (HOMA-IR), fasting glycosylated hemoglobin (HbA1c), fasting plasma glucose, 2-hour postprandial plasma glucose (PPG), fasting plasma insulin, serum lipid, etc. RESULTS: Compared with the control group, the CHF group had significant improvement (P<0.01) in anthropometric parameters, FPG, HOMA-IR, blood pressure amplitude, blood pressure variability and blood pressure load.
CONCLUSION: This study showed that integrated traditional Chinese and Western medicine treatment can achieve better results in controlling blood pressure as well as other cardiovascular risk factors. The mechanism of controlling of blood pressure may be associated with the improvement of insulin sensitivity due to the Yiqi Huaju intervention
Source : Journal of Chinese Integrative Medicine
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Study Links Chemicals Widely Found in Plastics and Processed Food to Elevated Blood Pressure in Children and Teens
Plastic additives known as phthalates (pronounced THAL-ates) are odorless, colorless and just about everywhere: They turn up in flooring, plastic cups, beach balls, plastic wrap, intravenous tubing and—according to the Centers for Disease Control and Prevention—the bodies of most Americans. Once perceived as harmless, phthalates have come under increasing scrutiny. A growing collection of evidence suggests dietary exposure to phthalates (which can leech from packaging and mix with food) may cause significant metabolic and hormonal abnormalities, especially during early development. Now, new research published this Wednesday in The Journal of Pediatrics suggests that certain types of phthalates could pose another risk to children: compromised heart health. Drawing on data from a nationally representative survey of nearly 3,000 children and teens, researchers at NYU Langone Medical Center, in collaboration with researchers at the University of Washington and Penn State University School of Medicine, have documented for the first time a connection between dietary exposure to DEHP (di-2-ethyhexylphthalate), a common class of phthalate widely used in industrial food production, and elevated systolic blood pressure, a measure of pressure in the arteries when the heart contracts.
“Phthalates can inhibit the function of cardiac cells and cause oxidative stress that compromises the health of arteries. But no one has explored the relationship between phthalate exposure and heart health in children” says lead author Leonardo Trasande, MD, MPP, associate professor of pediatrics, environmental medicine and population health at NYU Langone Medical Center. “We wanted to examine the link between phthalates and childhood blood pressure in particular given the increase in elevated blood pressure in children and the increasing evidence implicating exposure to environmental exposures in early development of disease.”
Hypertension is clinically defined as a systolic blood-pressure reading above 140 mm Hg. It’s most common in people over 50 years old, although the condition is becoming increasingly prevalent among children owing to the global obesity epidemic. Recent national surveys indicate that 14 percent of American adolescents now have pre-hypertension or hypertension. “Obesity is driving the trend but our findings suggest that environmental factors may also be a part of the problem,” says Dr. Trasande. “This is important because phthalate exposure can be controlled through regulatory and behavioral interventions.”
Researchers from NYU School of Medicine, the University of Washington and Penn State University School of Medicine examined six years of data from a nationally representative survey of the U.S. population administered by the National Centers for Health Statistics of the Centers for Disease Control and Prevention. Phthalates were measured in urine samples using standard analysis techniques. Controlling for a number of potential confounders, including race, socioeconomic status, body mass index, caloric intake and activity levels, the researchers found that every three-fold increase in the level of breakdown products of DEHP in urine correlated with a roughly one-millimeter mercury increase in a child’s blood pressure. “That increment may seem very modest at an individual level, but on a population level such shifts in blood pressure can increase the number of children with elevated blood pressure substantially,” says Dr. Trasande. “Our study underscores the need for policy initiatives that limit exposure to disruptive environmental chemicals, in combination with dietary and behavioral interventions geared toward protecting cardiovascular health.”
Source : Newswise
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BP Control May Help Slow Alzheimer's
Genetics and high blood pressure appear to interact to increase deposits in the brain of a protein involved in the pathology of Alzheimer's disease, researchers reported.
In a cross-sectional study of cognitively normal older adults, brain levels of beta-amyloid were highest in volunteers with both hypertension and the ε4 variant of the apolipoprotein E gene, according to Karen Rodrigue, PhD, of the University of Texas at Dallas, and colleagues.
But people with just one of those factors were not significantly different in terms of beta-amyloid deposition in the brain from volunteers with neither, Rodrigue and colleagues reported online in JAMA Neurology.
And within the group with the genetic risk factor, unmedicated hypertension was associated with the greatest risk for accumulating beta-amyloid, while participants with controlled hypertension had significantly less amyloid burden than the unmedicated group and just slightly more than those without hypertension.
Since hypertension is highly responsive to treatment, the researchers argued, medication or lifestyle modifications "may be able to prevent, or at least slow, pathological aging."
Current theories suggest that deposition of beta-amyloid in the brain is one of the earliest signs of Alzheimer's, Rodrigue and colleagues noted, and determining what factors affect that process might help with early detection and treatment.
The E4 allele of the apolipoprotein E (ApoE) gene is associated with increased risk for Alzheimer's – up to 12-fold higher for people with two copies of the variant, compared with those with two copies of the E3 allele, Rodrigue and colleagues noted.
As well, epidemiological studies have linked vascular disease with an increased risk for Alzheimer's, so the researchers hypothesized that hypertension and the ApoE4 allele might have a synergistic effect on beta-amyloid deposition.
To find out, they studied 147 cognitively normal adults – ages 30 to 89 -- who had cognitive testing, magnetic resonance imaging, and fluorine 18–labeled florbetapir positron emission tomography imaging (to determine beta-amyloid levels in the brain) as part of the Dallas Lifespan Brain study.
The participants also had blood drawn to determine their ApoE genotype and had seven blood pressure measurements during study visits.
All told, 75 volunteers had normal blood pressure, but the normotensive and hypertensive groups were significantly different in age, so Rodrigue and colleagues excluded normotensive volunteers younger than 47 – the youngest age in the hypertensive group.
In the reduced cohort of 118 people, 69 had high blood pressure, including 54 who were medicated for the condition. If they carried at least one E4 allele, participants were classified as having genetic risk; 18.6% had one allele and 4.2% had two.
Analysis showed that hypertension and genetic risk had a significant interaction at P<0.05, the researchers reported.
Among those with normal blood pressure, the presence of the E4 allele made no difference in uptake of beta-amyloid, they found, but in the participants with high blood pressure, having the E4 allele meant a significant increase in beta-amyloid deposition (P=0.05).
When participants were stratified by genetic risk, there was no significant difference in amyloid burden by blood pressure among those without the E4 allele.
On the other hand, among those with the allele, normal blood pressure was associated with amyloid burden similar to the non-E4 group. Those with high blood pressure controlled by medication had a higher burden, but not significantly so.
But participants with unmedicated hypertension and the E4 allele had significantly higher levels of amyloid burden than all other groups (P=0.02), Rodrigue and colleagues reported.
Although more study is needed, "these initial findings suggest that individuals with an ApoE4 allele may be able to attenuate their likelihood for amyloid accumulation through proper control of blood pressure," the researchers argued.
Rodrigue and colleagues cautioned that the study was snapshot and can't say anything about cause and effect. As well, the study population is highly screened for a study of healthy aging, so the results may not apply more widely.
Source: MedPage Today via JAMA Neurology reference: Rodrigue KM, et al "Risk factors for β-amyloid deposition in healthy aging: Vascular and genetic effects" JAMA Neurol 2013; DOI: 10.1001/jamaneurol.2013.1342.
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Haematological and Hepatotoxic Potential of Onion (Allium cepa) and Garlic (Allium sativum) Extracts in Rats
Enitan Seyi Samson1*, Ajeigbe Kazeem Olasunkanmi1, Josiah Sunday Joel2 and Ehiaghe Friday Alfred3
1Department of Physiology, School of Basic Medical Sciences, College of Health Sciences, Igbinedion University Okada, P.M.B. 0006, Edo state, Nigeria.
2Department of Biochemistry, School of Basic Medical Sciences, College of Health
Sciences, Igbinedion University Okada, P.M.B. 0006, Edo state, Nigeria.
3Department of Haematology, School of Clinical Medicine, College of Health Sciences, Igbinedion University Okada, P.M.B. 0006, Edo state, Nigeria.
Aims: To evaluate and compare the effects of single and combined oral administration of fresh aqueous onion (Allium cepa) and garlic (Allium sativum) extracts at different concentrations (200mg/kg/d, 400mg/kg/d and 600mg/kg/d) on some haematological and
hepatotoxicity indicator parameters in treated rats.
Study Design: Cross-sectional nonclinical study in animal model.
Place and Duration of Study: The study was carried out at the Department of Physiology, Department of Biochemistry and Department of Haematology, College of Health Sciences, Igbinedion University Okada, Edo state, Nigeria between the month of
July and August, 2011.
Methodology: Following 30 days post-oral administration of extracts in 36 treated male albino rats as well as 4 controls, haematological parameters were determined using the Sysmex® Automated Haematology Analyzer, while serum levels of liver enzymes were evaluated using the Reflotron® Plus Auto-Analyzer and liver weight was determined using electronic sensitive weighing balance.
Results: Red blood cell count (RBC), Packed cell volume (PCV), Haemoglobin concentration (HGB), Total White blood cell count (TWBC), Absolute Count of Neutrophil (NEUT#), Absolute Count of Lymphocyte (LYM#), Absolute Count of the summation of
Monocyte, Eosinophil and Basophil (MXD#) and Platelet count (PLT) were significantly increased (P<0.05) to varied extent, except Mean cell volume (MCV), Mean cell haemoglobin (MCH) and Mean cell haemoglobin concentration (MCHC) while Alanine
aminotransferase (ALAT) and Aspartate aminotransferase (ASAT) serum levels were significantly decreased (P<0.001) and liver weight (LW) was non-significantly (P>0.05) reduced in a dose-dependent manner when compared to the control. Synergistic effect
was not observed in the haematological parameters when the two extracts were combined.
Conclusion: The results of this study reveal the haematological potential of onion and garlic extracts with no potential risk of hepatotoxicity (at the concentrations tested) as earlier anticipated. It also further confirms the higher efficacy of garlic over
that of onion, but the molecular mechanism behind their combined effect would require further investigation.
Source European Journal of Medicinal Plants, 2(4): 290-307, 2012
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DDT linked to high blood pressure in women
Women exposed before birth to the banned pesticide DDT may have a greater risk of developing high blood pressure later in life, according to a study published today. The study of San Francisco Bay Area women is the first to link DDT exposure in the womb to hypertension, which raises the risk of stroke and heart disease.
A widely used insecticide, DDT was banned in the United States in 1972 because it was building up in the environment. It is still used in Africa to combat malaria-infected mosquitoes.
“Our findings suggest that DDT may be targeting the system in the body that keeps blood pressure under control,” said Michele La Merrill, a toxicologist at the University of California, Davis and lead author of the study published today in Environmental Health Perspectives.
In previous research, pesticide applicators with high blood pressure had higher DDT exposures than those with healthy blood pressure. Research also has suggested that DDT interferes with hormones, and it has been linked to decreased fertility, preterm delivery and diabetes.
In the new study, more than 500 women born between 1959 and 1967 participated. They were the daughters of more than 15,000 women from the Oakland area who were recruited by scientists to investigate how environmental exposures, even those that occur before birth, can affect health over a lifetime.
Because DDT can pass to the child through the placenta, the blood of the mothers, collected shortly before or after birth, served as a proxy for fetal exposure.
Several decades later, 111 of the daughters, 21 percent, reported having been diagnosed with hypertension.
Overall, the women in the highest two-thirds of prenatal DDT exposure were 2.5 to 3.6 times more likely to develop high blood pressure before age 50 than women in the lowest one-third of exposure. “We are now seeing the potential long-term health consequences of introducing chemicals whose safety we know very little about,” said Jonathan Chevrier, an environmental health scientist at the University of California, Berkeley, who did not participate in the new study.
Almost one-third of adult U.S. women have hypertension, according to the Centers for Disease Control and Prevention. Prevalence in postmenopausal women is much greater than in premenopausal women.
The researchers found that the association between DDT and high blood pressure held after accounting for some factors known to raise the risk of hypertension, including age, race, body mass and diabetes status.
However, it is unclear how factors they did not test, such as how much salt a person eats, may have affected the findings.
It also is impossible to know whether some women had undiagnosed high blood pressure or how blood pressure levels differed across exposure groups.
“The degree of hypertension matters in terms of clinical significance, so from a clinical perspective it’s hard to say anything about the relative importance of the findings,” said Dr. Ted Schettler, science director of the Science and Environmental Health Network, a non-profit organization.
However, he added, “anything that raises the blood pressure of an entire population, even a small amount, can have large public health consequences.”
DDT breaks down slowly, so most people alive today have traces in their bodies, and it remains in the environment and the food web.
“Each of us carries with us this history of past exposures,” said Barbara Cohn, director of the Oakland-based study group.
While the findings are thought-provoking, we have no control over our past exposures, said Dr. Keith Ferdinand, a cardiologist at Tulane University in New Orleans.
“We must continue to focus on risk factors that are modifiable, including obesity, sedentary lifestyle and socioeconomic stress,” he said.
Source : Environmental Health News
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Neuroendocrine Mechanisms of Acupuncture in the Treatment of Hypertension
Wei Zhou1 and John C. Longhurst2
1Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
2Department of Medicine, University of California Irvine, Irvine, CA 92697, USA
Hypertension affects approximately 1 billion individuals worldwide. Pharmacological therapy has not been perfected and often is associated with adverse side effects. Acupuncture is used as an adjunctive treatment for a number of cardiovascular diseases like hypertension. It has long been established that the two major contributors to systemic hypertension are the intrarenal renin-angiotensin system and chronic activation of the sympathetic nervous system. Recent evidence indicates that in some models of
cardiovascular disease, blockade of AT1 receptors in the rostral ventrolateral medulla (rVLM) reduces sympathetic nerve activity and blood pressure, suggesting that overactivity of the angiotensin system in this nucleus may play a role in the maintenance of hypertension. Our experimental studies have shown that electroacupuncture stimulation activates neurons in the arcuate nucleus,
ventrolateral gray, and nucleus raphe to inhibit the neural activity in the rVLM in a model of visceral reflex stimulation-induced hypertension. This paper will discuss current knowledge of the effects of acupuncture on central nervous system and how they contribute to regulation of acupuncture on the endocrine system to provide a perspective on the future of treatment of hypertension with this ancient technique.
Acupuncture has been shown to decrease BP in hypertensive patients and in animal models of hypertension. The mechanisms underlying the beneficial effects of acupuncture are associated with modulation of sympathetic outflow and possibly the endocrine system. Experimental studies have shown that EA inhibits the reflex-induced hypertension by modulating the activity of cardiovascular presympathetic neurons in the rVLM. Activation of neurons in the arcuate nucleus of the hypothalamus, vlPAG in the midbrain, and NRP in the medulla by EA can inhibit the activity of premotor sympathetic neurons in the rVLM. Glutamate, acetylcholine, opioids, GABA, nociceptin, serotonin, NO, and endocannabinoids in the brain all appear to participate in the EA antihypertensive response (Figure 2). The central action of EA may also affect the endocrine system and lead to a decrease in plasma renin, aldosterone, angiotensin II, norepinephrine, and serotonin. The neuroendocrine mechanisms of acupuncture in the treatment of hypertension are not yet fully understood, and thus are worthy of further investigation
Source : Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 878673
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Nonlinear Meta-analysis of Cocoa Effects on Blood Pressure Finds It Provides a Dose-dependent Benefit
Ellinger S, Reusch A, Stehle P, Helfrich HP.
Epicatechin ingested via cocoa products reduces blood pressure in humans: a nonlinear regression model with a Bayesian approach. Am J Clin Nutr. 2012;95(6):1365-1377.
Four separate meta-analyses have been performed on the effects of cocoa (Theobroma cacao) on blood pressure (BP), all showing that it provides a benefit. It is thought that these effects are due to the dose of epicatechin; if so, this may explain the differences in results in the studies used in the meta-analyses. This paper reports on the novel use of an alternate meta-analysis using a nonlinear regression model with a Bayesian approach and which includes a Markov chain Monte Carlo method that takes full account of the nonlinearity of the regression model. The authors hoped to thereby understand whether the dose of epicatechin is related to the magnitude of its BP-lowering effect and if this can explain between-study differences in effects.
Medline was searched until July 2011 for randomized, controlled trials (RCTs), which were included if they met the following criteria: (1) control substances were of low-flavanol composition; (2) BP was measured after an overnight fast; (3) mean or median systolic BP (SBP) or diastolic BP (DBP), standard deviations (SDs), standard error of the mean (SEM), 95% credible intervals (CIs), or P-values for changes were given; and (4) data on epicatechin intake were recorded.
Twenty-six RCTs were identified, of which 13 met the inclusion criteria. An additional study was obtained from an author; and 1 study had 3 arms, each of which was considered separately. This yielded a total of 16 studies for consideration (16 on SBP and 15 on DBP).
The regression curve showed that reductions in SBP and DBP were dependent on the dose of epicatechin. The estimated asymptotic value K of the treatment effect was -4.6 mmHg (95% CI: -5.4, -3.9 mmHg) for SBP and -2.1 mmHg (95% CI: -2.7, -1.6 mmHg) for DBP (Figure 3). The coefficient c reflecting the initial slope of the curve was -2.5 mmHg/mg for SBP (95% CI: -8.4, -0.6 mmHg/mg). For DBP, the mean value for c was -4.3 mmHg/mg (95% CI: -9.6, -0.2 mmHg/mg).
From this curve, a mean reduction for a dose of 25 mg of epicatechin for SBP could be estimated to be -4.1 mmHg (95% CI: -4.6, -3.6 mmHg) and for DBP, a mean reduction of -2.0 mmHg (95% CI: -2.4, -1.5 mmHg) could be estimated.
Because the 95% CIs are narrower in the nonlinear regression model than in the regular meta-analyses, the authors conclude that the dose of epicatechin is responsible for the heterogeneity of the studies, and that their model estimates the treatment effects more precisely than the linear regression model. They argue that the likelihood of confounding effects was low and that the merging of data from both ambulatory and 24-hour BP readings should not affect the results since they are very similar in magnitude. Limitations include the inability to understand the effects of low doses of epicatechin (because of lack of data for such doses) and the fact that the data cannot be readily extrapolated to normotensive subjects, since only 25% of the studies examined that population.
The authors conclude that a dose of 25-30 g of high-flavanol cocoa should lower SBP by -4.1 mmHg and DBP by -2.0 mmHg. The cocoa should be consumed in a form that will not lead to unwanted weight gain.
--Risa Schulman, PhD
Source : American Botanical Council
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Effect of beetroot juice on lowering blood pressure in free-living, disease-free adults: a randomized, placebo-controlled trial
The consumption of beetroot juice on a low nitrate diet may lower blood pressure (BP) and therefore reduce the risk of cardiovascular events. However, it is unknown if its inclusion as part of a normal diet has a similar effect on BP. The aim of the study was to conduct a randomized controlled trial with free-living adults to investigate if consuming beetroot juice in addition to a normal diet produces a measureable reduction in BP.
Fifteen women and fifteen men participated in a double-blind, randomized, placebocontrolled, crossover study. Volunteers were randomized to receive 500 g of beetroot and apple juice (BJ) or a placebo juice (PL). Volunteers had BP measured at baseline and at least hourly for 24-h following juice consumption using an ambulatory blood pressure monitor (ABPM). Volunteers remained at the clinic for 1-h before resuming normal non-strenuous daily activities. The identical procedure was repeated 2-wk later with the drink (BJ or PL) not consumed on the first visit.
Overall, there was a trend (P=0.064) to lower systolic blood pressure (SBP) at 6-h after drinking BJ relative to PL. Analysis in men only (n=13) after adjustment for baseline differences demonstrated a significant (P<0.05) reduction in SBP of 4 – 5 mmHg at 6-h after drinking BJ.
Beetroot juice will lower BP in men when consumed as part of a normal diet in free-living healthy adults
Source Journal Nutrition
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Dark Chocolate Increases Nitric Oxide Levels and Decreases Blood Pressure in Prehypertensive Subjects
Sudarma V, Sukmaniah S, Siregar P. Effect of dark chocolate on nitric oxide serum levels and blood pressure in prehypertension subjects. Acta Med Indones. October 2011;43(4):224-228.
Prehypertension, a risk factor for coronary heart disease and stroke, is defined as a systolic blood pressure between 120 and 139 mm Hg or diastolic blood pressure between 80 and 89 mm Hg.1, 2 According to these authors from the University of Indonesia, the mean blood pressure in Indonesians aged 25 to 34 years is 124.7/79.9 mm Hg. Risk factors for hypertension are obesity, age, high intake of energy and sodium, a low level of physical activity, and alcohol intake. Vascular disorders in prehypertensive patients are influenced by, among other factors, a decrease in synthesis and bioavailability of nitric oxide (NO) leading to endothelial dysfunction.3 Flavanols reportedly can activate endothelial nitric oxide synthase, which increases synthesis and bioavailability of NO and in turn restores endothelial function. Dark chocolate (Theobroma cacao) is a major source of flavanols. These authors conducted a parallel, randomized clinical trial to investigate the effects of dark chocolate on NOx serum levels and blood pressure in individuals with prehypertension. NOx serum levels are the sum of nitrite and nitrate levels as the metabolite of NO. Investigators estimate NO production by measuring NOx levels.
Thirty-two male and female employees of a dental faculty and a private company were recruited and divided into 2 groups of 16 each. Exclusion criteria included those with a history of hypertension; smokers; those who consumed red wine or alcohol; pregnant or breast feeding women; menopausal women; those who used antihypertension drugs; and those who took vitamin C, vitamin E, or other antioxidant supplements. Data are reported on 30 of the subjects (14 in the treatment group and 16 in the control group). The treatment group received 30 grams of dark chocolate daily (containing 70% cocoa; no other data on the source given) and dietary counseling. Those in the placebo group received 25 grams of white chocolate daily (no data on the source given) and dietary counseling. The study lasted 15 days.
The subjects were aged 25 to 44 years, prehypertensive, and had a body mass index (BMI) of 18.5 to 24.9 kg/m2. The characteristics of the members of the 2 groups were similar, except that the treatment group was more physically active than the placebo group.
Food intake data were obtained to determine energy, sodium, and polyphenol intake. The subjects were asked to fast overnight for 10 to 12 hours before having blood samples drawn to measure NOx serum levels.
At baseline, on treatment day 8, and after treatment, blood pressure was measured for all subjects. Mean intakes of energy and sodium were not significantly different between the 2 groups. The polyphenol intake of the treatment group during weeks 1 and 2 were significantly higher than those of the placebo group. After 15 days, the NOx serum levels in the treatment group increased significantly compared to baseline (P=0.001), while the same levels in the placebo group decreased significantly compared to baseline (P=0.001). The intergroup difference was also significant (P<0.001), with the treatment group being 4-fold higher than the control after 15 days. After 15 days, the systolic blood pressure decreased by an average of 8 mm Hg compared to baseline (significant, but P value not fully reported). The difference in systolic blood pressure between the groups was significant (P=0.001), while the difference in diastolic blood pressure was not significant.
The authors report a strong negative correlation between the changes in NOx serum levels and the changes in systolic blood pressure, while there was a significantly moderate negative correlation for the changes in diastolic blood pressure. The authors cite a study4 confirming that increased NOx serum levels increase vasodilation, which in turn decreases blood pressure.
According to the authors, this study was limited by the difficulty in blinding between the dark and white chocolate, although they claim that it was minimized by placing the chocolates in boxes of the same shape and color.
The authors conclude that in prehypertensive subjects, the consumption of 30 grams of dark chocolate with 70% cocoa daily for 15 days increased NOx serum levels. Systolic blood pressure was significantly decreased in those who consumed the dark chocolate; however, the decrease in diastolic blood pressure was not significant. There were a number of limitations to the study, including insufficient blinding and use of a food database lacking in many of the locally eaten foods. The reporting in this paper was also of poor quality with errors in data interpretation, omissions of critical information about the study design, and misreporting of statistics. The authors mention the importance of flavanols, but yet no testing was done on the dark chocolate to evaluate the flavanol level. The use of a list of polyphenol content is not enough.
1Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. 2003;289(19):2560-2572.
2Lim S. Recent update in the management of hypertension. Acta Med Indones. 2007;39(4):186-191.
3Foëx P, Sear JW. Hypertension: pathophysiology and treatment. Continuing Education in Anaesthesia, Critical Care & Pain. 2004;4(3):71-75.
4Hall WL, Formanuik NL, Harnpanich D, et al. A meal enriched with soy isoflavones increases nitric oxide-mediated vasodilation in healthy postmenopausal women. J Nutr. 2008;138(7):1288-1292.
Source : American Botanical Council
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Beetroot Juice May Reduce Blood Pressure - Consuming beetroot juice may reduce blood pressure, according to a new study.
Beet is a flowering perennial plant that produces leaves and roots that are widely used as a food source in humans and animals. Beets are a source of vitamins A and C, iron, and other minerals, carotenoids and dietary fiber. Betalins are natural pigments (colors) in beets that account for the red color in beet stems and leaves. After eating beets, these pigments produce red or pink urine (called beeturia) in about 10-14 percent of people. The American Academy of Pediatrics recommends avoiding feeding beets and other high-nitrate foods to infants younger than three months of age to avoid the risk of nitrate poisoning.
Human studies have tested the effects of beet on blood sugar, cholesterol and blood pressure levels. However, results are mixed. Early evidence suggests that sugar beet fiber may modestly lower systolic blood pressure in patients with type 2 diabetes. Additional research is warranted.
In a new study, researchers conducted two separate studies to evaluate the effects of beetroot juice on blood pressure. People with normal blood pressure levels were randomly assigned to drink 0 grams, 100 grams, 250 grams or 500 grams of beetroot juice; or to eat a control bread product containing no beetroot juice, a bread product containing 100 grams of red beetroot juice or a bread product containing 100 grams white beetroot juice. Blood pressure was measured over 24 hours and nitrate levels in the urine were measured before treatment and again two hours, four hours and 24 hours after treatment.
The researchers found that consuming beetroot juice was significantly linked to reduced blood pressure over the 24-hour period. The authors noted that the reduction in blood pressure was almost dependent on the amount of beetroot juice consumed. Additionally, the researchers found that consuming both the red and white beetroot juice bread products were significantly linked to reduced blood pressure. With the exception of the white beetroot bread, all beetroot juice and bread products significantly increased nitrate levels in the urine after consumption.
The authors concluded that small amounts of beetroot juice may reduce blood pressure. Larger-scale, well-designed clinical trials are needed to further evaluate these findings.
In addition to beets, many other foods have been evaluated for their potential effects on blood pressure. Numerous human studies report that garlic may lower blood pressure, and some studies have suggested that chocolate may lower blood pressure. More research is needed.
For more information about integrative therapies for high blood pressure, please visit Natural Standard's Comparative Effectiveness Database.
For more information about beets, please visit Natural Standard's Foods, Herbs & Supplements Database.
To comment on this story, please visit Natural Standard's blog.
- Hobbs DA, Kaffa N, George TW, et al. Blood pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects. Br J Nutr. 2012 Mar 14:1-9. View Abstract
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Spice up the hypertension diet - curcumin and piperine prevent remodeling of aorta in experimental L-NAME induced hypertension
Livia Hlavačková1, Andrea Janegová1, Olga Uličná2, Pavol Janega3,1, Andrea Černá1 and Pavel Babál1*
Increase of blood pressure is accompanied by functional and morphological changes in the vascular wall. The presented study explored the effects of curcuma and black pepper compounds on increased blood pressure and remodeling of aorta in the rat model of experimental NO-deficient hypertension.
Wistar rats were administered for 6 weeks clear water or L-NAME (40 mg/kg/day) dissolved in water, piperine (20 mg/kg/day), curcumin (100 mg/kg/day) or their combination in corn oil by oral gavage. The systolic blood pressure was measured weekly. Histological slices of thoracic aorta were stained with hematoxylin and eosin, Mallory's phosphotungstic acid hematoxylin (PTAH), orcein, picrosirius red and van Gieson staining and with antibodies against smooth muscle cells actin. Microscopic pictures were digitally processed and morphometrically evaluated.
The increase of blood pressure caused by L-NAME was partially prevented by piperine and curcumin, but the effect of their combination was less significant. Animals with hypertension had increased wall thickness and cross-sectional area of the aorta, accompanied by relative increase of PTAH positive myofibrils and decrease of elastin, collagen and actin content. Piperine was able to decrease the content of myofibrils and slightly increase actin, while curcumin also prevented elastin decrease. The combination of spices had similar effects on aortic morphology as curcumin itself.
Administration of piperine or curcumin, less their combination, is able to partially prevent the increase of blood pressure caused by chronic L-NAME administration. The spices modify the remodeling of the wall of the aorta induced by hypertension. Our results show that independent administration of curcumin is more effective in preventing negative changes in blood vessel morphology accompanying hypertensive disease.
Source : Nutrition & Metabolism 2011, 8:72 doi:10.1186/1743-7075-8-72
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Hibiscus Sabdariffa L. Tea (Tisane) Lowers Blood Pressure in Prehypertensive and Mildly Hypertensive Adults
- Diane L. McKay 5 , * ,
- C-Y. Oliver Chen 5 ,
- Edward Saltzman 6 , and
- Jeffrey B. Blumberg 5
In vitro studies show Hibiscus sabdariffa L., an ingredient found in many herbal tea blends and other beverages, has antioxidant properties, and, in animal models, extracts of its calyces have demonstrated hypocholesterolemic and antihypertensive properties. Our objective in this study was to examine the antihypertensive effects of H. sabdariffa tisane (hibiscus tea) consumption in humans. A randomized, double-blind, placebo-controlled clinical trial was conducted in 65 pre- and mildly hypertensive adults, age 30–70 y, not taking blood pressure (BP)-lowering medications, with either 3 240-mL servings/d of brewed hibiscus tea or placebo beverage for 6 wk. A standardized method was used to measure BP at baseline and weekly intervals. At 6 wk, hibiscus tea lowered systolic BP (SBP) compared with placebo (−7.2 ± 11.4 vs. −1.3 ± 10.0 mm Hg; P = 0.030). Diastolic BP was also lower, although this change did not differ from placebo (−3.1 ± 7.0 vs. −0.5 ± 7.5 mm Hg; P = 0.160). The change in mean arterial pressure was of borderline significance compared with placebo (−4.5 ± 7.7 vs. −0.8 ± 7.4 mm Hg; P = 0.054). Participants with higher SBP at baseline showed a greater response to hibiscus treatment (r = −0.421 for SBP change; P = 0.010). No effects were observed with regard to age, gender, or dietary supplement use.
These results suggest daily consumption of hibiscus tea, in an amount readily incorporated into the diet, lowers BP in pre- and mildly hypertensive adults and may prove an effective component of the dietary changes recommended for people with these conditions.
Source : The Journal of Nutrition
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Olive leaf extract may help hypertension: Frutarom study
Olive leaf extract is just as effective in lowering blood pressure as other common medical treatments for hypertension, according to a new clinical trial sponsored by Frutarom and Dexa Medica.
The study, published in Phytomedicine, found an olive leaf extract (EFLA 943 from Frutarom, Switzerland) to be as effective in treating high-blood pressure as a common medication blood pressure medication (Captopril/Dexacap from Dexa Medica).
The researchers also found that unlike the drug, olive leaf extract also significantly reduced plasma triglyceride levels.
“Olive leaf extract, at the dosage regimen of 500 mg twice daily, was similarly effective in lowering systolic and diastolic blood pressures in subjects with stage-1 hypertension as Captopril, given at its effective dose of 12.5–25 mg twice daily,” said the authors, led by Prof Endang Susalit, from the University of Indonesia.
The authors declared that their research was supported by PT Dexa Medica and Frutarom Switzerland Ltd.
The authors said that hypertension affects approximately 50 million individuals in the United States, and approximately 1 billion individuals worldwide.
They noted that it is possible to lower blood pressure with several classes of currently available anti-hypertensive drugs, including angiotensin converting enzyme inhibitors (such as Captopril), angitoensin-receptor blockers, and calcium channel blockers.
“Nevertheless, most patients with hypertension will require two or more anti-hypertensive medications to achieve their blood pressure goals … [which] also mean the increment of risks of adverse drug reaction and medication costs,” said the authors.
Susalit and colleagues noted that one alternative may be the use of herbal medicines. They explained that the leaves of the olive tree (Olea europaea L.) “have been used since ancient times to combat high blood pressure, atherosclerosis and diabetes and for other medicinal purposes.”
Olive leaf contains active substances including oleuropein, oleacein and oleanolic acid. They said that the olive lead extract EFLA 943 (from Frutarom) has been previously studied for its safety and anti-hypertensive effects.
At a dose of 1000 mg daily, the extract “was clearly superior to recommendations for life-style changes in reducing mean blood pressure levels from baseline,” said the authors.
“Based on the positive results observed in the pre-clinical and human studies, the current clinical trial was designed to primarily confirm the anti-hypertensive effect of the Olive leaf extract EFLA 943 in comparison with Captopril as one of the standard therapy for hypertension in patients with stage-1 hypertension,” said the authors.
The authors conducted a double-blind, randomized, parallel and active-controlled clinical study to evaluate the anti-hypertensive effect as well as the tolerability of olive leaf extract in comparison with Captopril in patients with stage-1 hypertension.
Olive leaf extract (EFLA 943) was given orally at the dose of 500 mg twice daily for eight weeks, whilst Captopril was given at the dosage regimen of 12.5 mg twice daily at start.
Evaluation of blood pressure was performed every week during the trial, whilst lipid profiles were recorded at four week intervals.
Susalit and his co-workers reported that after eight weeks of treatment, both treatment groups experienced significant reductions in systolic and diastolic blood pressure from baseline. They added that such reductions were not significantly different between groups.
However, they reported that a significant reduction of triglyceride level was observed for the group receiving olive leaf extract, but not in Captopril group.
The researchers said that the mechanism of action by which the olive leaf extract exerts its anti-hypertensive effects remains unknown “and is continuously being studied.”
They speculated that the anti-hypertensive activity “lies probably in its content of oleuropein acting synergistically with other active substances to exert both ACE inhibitory and calcium channel blocking activities.”
The authors concluded that “the anti-hypertensive activity of the extract was comparable to that of Captopril, given at its effective dose of 12.5–25 mg twice daily.”
“Additionally, the beneficial effects of the extract on lipid profile, particularly in reducing plasma LDL-, total-cholesterol and triglyceride levels were strongly indicated by this trial,” said the researchers.
Source: NutraIngredients via Phytomedicine
Volume 18, Issue 4 , Pages 251-258, doi: 10.1016/j.phymed.2010.08.016
“Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: Comparison with Captopril"
Authors: E. Susalit, N. Agus, I. Effendi, R.R. Tjandrawinata, D. Nofiarny, et al
Link to NutraIngredients
Aged Garlic ExtractTM Useful Adjunct Therapy to Conventional Medications in Uncontrolled Hypertension
Reviewed: Ried K, Frank OR, Stocks NP. Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomized controlled trial. Maturitas. 2010 Oct;67(2):144-150.
Garlic (Allium sativum, Alliaceae) supplements have been associated with a clinically significant blood pressure-lowering effect in patients with untreated hypertension (systolic blood pressure [SBP] ≥ 140 mm Hg or diastolic blood pressure [DBP] ≥ 90 mm Hg) similar to that achieved by first-line treatment with antihypertensive medication according to 2 systematic reviews and meta-analyses of randomized controlled clinical trials (RCTs) published in 2008.1,2 A 2009 systematic review questioned the methodological quality of some of these RCTs.3
The antihypertensive properties of garlic have been linked to stimulation of intracellular nitric oxide (NO) and hydrogen sulfide (H2S) production, as well as blockage of angiotensin II production, which promotes vasodilation and reduction in BP.
This double-blind, parallel, randomized, placebo-controlled clinical trial was conducted in Adelaide, South Australia, between March and September 2009 to investigate the effect, tolerability, and acceptability of Aged Garlic ExtractTM (AGE) as an adjunct treatment to existing antihypertensive medication in patients with treated, uncontrolled hypertension. Fifty adult patients (mean age ± standard deviation [SD]: 66 ± 9 years) treated with conventional antihypertensive medications were randomly allocated to the treatment or placebo group for 12 weeks. Patients in the treatment group were assigned 4 capsules daily of Kyolic® AGE (Garlic High Potency Everyday Formula112, Wakunaga/Wagner®; Vitaco Health [NZ] Ltd; Auckland, New Zealand) containing 960 mg of AGE, equivalent to 2.4 mg SAC. Placebo capsules were matched to the active capsules in number, size, color, and odor. Comparison of baseline characteristics revealed no significant difference between placebo and treatment groups in most parameters and borderline significance in the mean number of BP medication classes prescribed.
Primary outcome measures were SBP and DBP at 4, 8, and 12 weeks compared with baseline. Tolerability of the trial medication was monitored by questionnaire at the 4 weekly appointments, while acceptability and willingness to continue the treatment long term were explored by an exit questionnaire using 5-point Likert-scales and open-ended questions. Statistical significance was set at P < 0.05. Differences between groups at baseline in continuous variables were assessed by Student’s t-test, while categorical variables were assessed by chi-square test, and absolute CVD (cardiovascular disease) risk by Fisher’s Exact test.
A significant treatment effect over 12 weeks was apparent between garlic and control groups in patients with uncontrolled hypertension at baseline (mean difference in SBP ± SD: −10.2 ± 4.3; P = 0.0361), while no significant differences were found in the subgroup of patients with controlled hypertension. Tolerability of trial capsules was generally high, with 24% of the garlic group reporting minor adverse effects including belching, reflux, and taste sensations (P = 0.25). Most of the participants found the treatment easy (93%) and acceptable (92%). Ninety-two percent (92%) of participants in the garlic group were willing to continue taking garlic supplements compared to two-thirds (66%) in the control group.
The authors conclude that AGE’s effectiveness in lowering SBP in patients with uncontrolled, treated hypertension is significantly superior to placebo and similar to common antihypertensive medication. Further research is needed to determine the effectiveness of lower dosages of AGE that would have the benefit of improved tolerability and blinding, as well as reduced costs of treatment. Future larger trials are needed to investigate dose-response relationships and to examine the effect of AGE in association with different conventional BP medication classes.
—Silvia Giovanelli Ris References
- Reinhart KM, Coleman CI, Teevan C, Vachhani P, White CM. Effects of garlic on blood pressure in patients with and without systolic hypertension: a meta-analysis. Ann Pharmacother. 2008;42(12):1766-1771.
- Ried K, Frank OR, Stocks NP, Fakler P, Sullivan T. Effect of garlic on blood pressure: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2008;8:13.
- Simons S, Wollersheim H, Thien T. “A systematic review on the influence of trial quality on the effect of garlic on blood pressure.” Neth J Med. 2009 Jun;67(6):212-9.
Source : Herbal Gram (ABC)
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Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: A randomised controlled trial
- Daily for 12 weeks 50 patients with treated but uncontrolled hypertension took either a placebo or 4 capsules of aged garlic extract (containing 2.4mg S-allylcysteine) in addition to their existing antihypertensive medication.
- Over the 12-week treatment period garlic significantly reduced systolic blood pressure compared with the placebo in patients who had unacceptably high systolic blood pressure at the beginning of the study.
- Therefore aged garlic extract was superior to the placebo in lowering systolic blood pressure in patients with treated but uncontrolled hypertension.
Source : Maturitas Journal
Link to Source - Abstract