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Correction to: Impact of 2021 ESC Guidelines for Cardiovascular Disease Prevention on Hypertensive Patients Risk: Secondary Analysis of Save Your Heart Study. 更正:2021年ESC心血管疾病预防指南对高血压患者风险的影响:Save Your Heart研究的二次分析。
IF 3 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.1007/s40292-023-00599-w
Rita Del Pinto, Corrado Giua, Enrico Keber, Eleonora Grippa, Marco Tilotta, Claudio Ferri
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引用次数: 0
Anthropometric Measures of Adiposity as Markers of Kidney Dysfunction: A Cross-Sectional Study. 人体测量作为肾脏功能障碍标志的脂肪含量:一项横断面研究。
IF 3 Q2 Medicine Pub Date : 2023-09-01 Epub Date: 2023-09-27 DOI: 10.1007/s40292-023-00600-6
Sara Vela-Bernal, Rita Facchetti, Raffaella Dell'Oro, Fosca Quarti-Trevano, Empar Lurbe, Giuseppe Mancia, Guido Grassi

The present study was designed to provide information on the ability of several different anthropometric markers to reflect the renal impairment associated with body weight increase and to predict the development of renal alterations linked to overweight and obesity. In 574 subjects representative of the general population of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, with an age range between 57 and 73 years, we investigated the association between different anthropometric markers of body fat, as alternative to body mass index, and renal failure, to obtain information useful for determining their potential predictive value. Renal dysfunction was significantly associated with almost all anthropometric markers of adiposity related to body weight and body shape. After adjustment for confounders, such as age, sex, office blood pressure, serum glucose, antihypertensive drugs and smoking habit, association remained significant only for waist-to-hip ratio (WHR), lipid accumulation product (LAP) and visceral adiposity index (VAI). These 3 markers also displayed at the receiver operating curves (ROC) analysis the best ability to detect subjects with or without kidney dysfunction. The results of the present study provide evidence that WHR, LAP and VAI represent the best markers of renal dysfunction associated with visceral body fat accumulation.

本研究旨在提供几种不同人体测量标志物的能力信息,以反映与体重增加相关的肾脏损伤,并预测与超重和肥胖相关的肾脏改变的发展。在574名年龄在57岁至73岁之间的代表Pressioni Arteriose Monitoring e Loro Associazioni(PAMELA)研究普通人群的受试者中,我们调查了不同的体脂人体测量标志物(代替体重指数)与肾衰竭之间的关系,以获得有助于确定其潜在预测价值的信息。肾功能障碍与几乎所有与体重和体型相关的肥胖人体测量标志物显著相关。在校正了年龄、性别、办公室血压、血糖、降压药和吸烟习惯等混杂因素后,只有腰臀比(WHR)、脂质堆积产物(LAP)和内脏肥胖指数(VAI)的相关性仍然显著。这3个标志物在受试者工作曲线(ROC)分析中也显示出检测有或没有肾功能障碍的受试者的最佳能力。本研究的结果提供了证据,证明WHR、LAP和VAI是与内脏脂肪积聚相关的肾功能障碍的最佳标志物。
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引用次数: 0
A Systematic Review and Meta-analysis of the Clinical and Epidemiological Characteristics of Patients with Hypertensive Emergencies: Implication for Risk Stratification. 高血压急症患者临床和流行病学特征的系统回顾和荟萃分析:风险分层的意义。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00586-1
Irina Benenson, Frederick Andrew Waldron, Cheryl Holly

Introduction: Acute severe elevation of blood pressure (BP) is a common clinical event, that can present as hypertensive emergency (HTNE) and hypertensive urgency (HTNU). HTNE results in life-threatening target organ damage, including myocardial infarction, pulmonary edema, stroke, and acute kidney injury. It is associated with high utilization of healthcare and increased cost. HTNU is high BP without acute serious complications.

Aim: The purpose of this review was to examine the clinical-epidemiological characteristics of patients with HTNE and propose a risk stratification framework to differentiate between the two conditions, since prognosis, setting of therapy and treatment is vastly different.

Methods: Systematic review.

Results: Fourteen full-text studies were included in this review. In comparison with HTNU, patients with HTNE had higher mean systolic (mean difference 2.413, 95% CI 0.477, 4.350) and diastolic BP (mean difference 2.043, 95% CI 0.624, 3.461). HTNE were more prevalent in men (OR 1.390, 95% CI 1.207, 1.601), older adults (mean difference 5.282, 95% CI 3.229, 7.335) and those with diabetes (OR 1.723, 95% CI 1.485, 2.000). Non-adherence to BP medications (OR 0.939, 95% CI 0.647, 1.363) and unawareness of hypertension diagnosis (OR 0.807, 95% CI 0.564, 1.154) did not elevate the risk of HTNE.

Conclusions: Systolic and diastolic BP are marginally higher in patients with HTNE. Given that these differences are not clinically significant, other epidemiological and medical characteristics (older age, male sex, cardiometabolic comorbidities) as well as patient's presentation should be considered to differentiate between HTNU and HTNE.

急性严重血压升高(BP)是一种常见的临床事件,可表现为高血压急症(HTNE)和高血压急症(HTNU)。HTNE可导致危及生命的靶器官损伤,包括心肌梗死、肺水肿、中风和急性肾损伤。它与医疗保健的高利用率和成本增加有关。HTNU为高血压,无急性严重并发症。目的:本综述的目的是检查HTNE患者的临床流行病学特征,并提出一个风险分层框架来区分两种情况,因为预后、治疗环境和治疗方法有很大不同。方法:系统评价。结果:本综述纳入了14项全文研究。与HTNU相比,HTNE患者的平均收缩压(平均差2.413,95% CI 0.477, 4.350)和舒张压(平均差2.043,95% CI 0.624, 3.461)较高。HTNE在男性(OR 1.390, 95% CI 1.207, 1.601)、老年人(平均差异5.282,95% CI 3.229, 7.335)和糖尿病患者(OR 1.723, 95% CI 1.485, 2.000)中更为普遍。不坚持降压药物治疗(OR 0.939, 95% CI 0.647, 1.363)和不了解高血压诊断(OR 0.807, 95% CI 0.564, 1.154)不会增加HTNE的风险。结论:HTNE患者的收缩压和舒张压略高。鉴于这些差异在临床上并不显著,应考虑其他流行病学和医学特征(年龄较大、男性、心脏代谢合并症)以及患者的表现来区分HTNU和HTNE。
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引用次数: 1
Low Perception of Obesity as a Pathological Condition Among Italian Cardiologists. 意大利心脏病专家对肥胖作为一种病理状态的认识较低。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00588-z
Armando Ferrera, Allegra Battistoni, Oreste Lanza, Chiara Rossi, Giuliano Tocci, Massimo Volpe

Introduction: Obesity is not only an important modifiable cardiovascular risk factor but also a chronic disease with relevant consequences on morbidity and mortality in the general population. According to European guidelines, cardiologists must recognize and treat it properly.

Aims: To assess perception of obesity as a modifiable pathological condition and the importance to treat it in a real-world sample of cardiologists and residents in cardiology.

Methods: A nationwide, web-based, epidemiological survey on the perception of obesity as a disease and as a modifiable cardiovascular risk factors was conducted in 137 medical doctors (cardiologists and residents in cardiology). Participants filled with their answers a questionnaire of 31 questions about perception of obesity and strategies on cardiovascular disease prevention in clinical practice.

Results: Of 137 individuals enrolled in our survey only 5 (3.6%) reported to measure waist circumference in their clinical practice and only 3 (2.2%) reported to measure waist-to-hip ratio. One-hundred-twenty participants (87.6%) would not prescribe an anti-obesity drug to a patient with grade II obesity. Sixty-eight (49.6%) participants have never read or heard of a clinical trial on obesity. On the other hand, 134 (97.8%) routinely measured blood pressure in their clinical practice, 129 (94.2%) would prescribe a statin for a hypercholesterolemic patient and 132 (96.4%) subjects have read/heard a clinical trial on type 2 diabetes in their life.

Conclusions: Although obesity is a chronic disease and an important modifiable cardiovascular risk factor such as arterial hypertension, hypercholesterolemia, cigarette smoke and diabetes, cardiologists and residents in cardiology substantially underestimate it ignoring that it should be treated as a proper disease.

简介:肥胖不仅是一个重要的可改变的心血管危险因素,而且是一种慢性疾病,对普通人群的发病率和死亡率有相关的影响。根据欧洲的指导方针,心脏病专家必须正确认识和治疗它。目的:评估肥胖作为一种可改变的病理状况的认知,以及在现实世界中心脏病专家和心脏病学住院医生治疗肥胖的重要性。方法:对137名医生(心脏病专家和住院医师)进行了一项全国性的、基于网络的流行病学调查,调查对象是肥胖症作为一种疾病和可改变的心血管危险因素的看法。参与者填写了一份关于临床实践中对肥胖的认知和心血管疾病预防策略的31个问题的问卷。结果:在我们调查的137个人中,只有5人(3.6%)报告在临床实践中测量腰围,只有3人(2.2%)报告测量腰臀比。120名参与者(87.6%)不会给II级肥胖患者开抗肥胖药物。68名(49.6%)参与者从未读过或听说过有关肥胖的临床试验。另一方面,134人(97.8%)在他们的临床实践中常规测量血压,129人(94.2%)会给高胆固醇血症患者开他汀类药物,132人(96.4%)在他们的生活中读过或听过关于2型糖尿病的临床试验。结论:虽然肥胖是一种慢性疾病,与动脉高血压、高胆固醇血症、吸烟和糖尿病一样,是一种重要的可改变的心血管危险因素,但心脏病专家和心脏病学居民严重低估了它,忽视了它应该作为一种适当的疾病来对待。
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引用次数: 0
Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults. 焦虑和抑郁对美国低收入成人临床高血压的影响
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00584-3
Rohan M Shah, Sahil Doshi, Sareena Shah, Shiv Patel, Angela Li, Joseph A Diamond

Introduction: Depression and anxiety are common leading causes of disability and are associated with systemic effects including cardiovascular comorbidities. Low-income populations may experience higher frequencies of depressive or anxiety-related symptoms, and be at greater risk for developing hypertension.

Aim: We performed a cross-sectional study of low-income participants who completed hypertension and disability questionnaires as part of the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES) to identify associations between depressive/anxiety-related symptoms and hypertension status.

Methods: Multivariable logistic regressions were performed to identify whether (1) frequency of depressive symptoms, (2) frequency of anxiety-related symptoms, (3) self-reported depression medication use, or (4) self-reported anxiety medication use predicted previous hypertension diagnosis.

Results: A total of 74,285,160 individuals were represented in our cohort. Participants that reported taking depression (OR 2.72; 95% CI 1.41-5.24; P = 0.009) and anxiety (OR 2.50; 95% CI 1.42-4.41; P = 0.006) medications had greater odds of hypertension. Individuals with depressive feelings daily, monthly, and few times per year were more likely to have hypertension. Respondents with daily (OR 2.28; 95% CI 1.22-4.24; P = 0.021) and weekly (OR 1.88; 95% CI 1.05-3.38; P = 0.040) anxiety symptoms were more likely to have hypertension.

Conclusions: Low-income adults in the United States with symptoms of anxiety or depression have higher likelihood of hypertension than those with no symptoms. Respondents who indicated taking medication for anxiety disorders or depression were more likely to have been diagnosed with hypertension.

抑郁和焦虑是致残的常见主要原因,并与包括心血管合并症在内的全身效应相关。低收入人群出现抑郁或焦虑相关症状的频率更高,患高血压的风险也更大。目的:我们对低收入参与者进行了一项横断面研究,这些参与者完成了2017-2018年国家健康与营养检查调查(NHANES)的高血压和残疾问卷,以确定抑郁/焦虑相关症状与高血压状态之间的关联。方法:采用多变量logistic回归来确定(1)抑郁症状的频率,(2)焦虑相关症状的频率,(3)自我报告的抑郁药物使用情况,或(4)自我报告的焦虑药物使用情况是否预测既往高血压诊断。结果:我们的队列中共有74285160人。报告患有抑郁症的参与者(OR 2.72;95% ci 1.41-5.24;P = 0.009)和焦虑(OR 2.50;95% ci 1.42-4.41;P = 0.006)。每天、每月和每年几次有抑郁感觉的人更容易患高血压。受访者每日(OR 2.28;95% ci 1.22-4.24;P = 0.021)和每周(OR 1.88;95% ci 1.05-3.38;P = 0.040)焦虑症状者更易患高血压。结论:在美国,有焦虑或抑郁症状的低收入成年人患高血压的可能性高于无症状者。表示服用焦虑症或抑郁症药物的受访者更有可能被诊断患有高血压。
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引用次数: 2
Arterial Stiffness Associated with Sympathetic Hyperactivity in Obese Individuals with Moderate to Severe Obstructive Sleep Apnea. 中度至重度阻塞性睡眠呼吸暂停的肥胖患者动脉僵硬与交感神经亢进有关。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00592-3
Samanta Mattos, Michelle R Cunha, Márcia R S T Klein, Wille Oigman, Mario F Neves

Introduction: Obstructive Sleep Apnea (OSA) is a chronic disorder associated with several risk factors, and increased Body Mass Index (BMI) and waist circumference are correlated with it is severity.

Aim: To evaluate vascular function, central hemodynamics, and autonomic modulation in obese individuals with moderate and severe OSA.

Methods: Individuals of both sexes, aged 40-70 years and BMI ≥ 30 and < 40 kg/m2, were submitted to assessment of heart rate variability, endothelial function by flow-mediated dilatation, central parameters by oscillometry and carotid ultrasound. The sleep study was performed through a portable home sleep test device (WatchPAT).

Results: Patients (n = 76) were divided according to Apnea-Hypopnea Index (AHI): absent-mild group (AHI < 15 events/h, n = 30) and Moderate-Severe (MS) group (AHI ≥ 15 events/h, n = 46). The Low/High Frequency (LF/HF) ratio (0.81  ±  0.48 vs 1.39  ±  1.08 ms2, p = 0.035), Pulse Wave Velocity (PWV; 6.9  ±  0.7 vs 7.7  ±  1.6m/s, p = 0.004), vascular age (48  ±  6 vs 53  ±  9 years, p = 0.05) and mean intima-media thickness (0.59  ±  0.08 vs 0.66  ±  0.13 mm, p = 0.011) were significantly higher in the MS group. AHI was significantly correlated with PWV (r = 0.26, p = 0.024) and LF/HF ratio (r = 0.40, p < 0.001). Only in the MS group, PWV was significantly correlated with SD2/SD1 ratio (r = 0.611, p ≤ 0.001), and flow-mediated dilation with central systolic blood pressure (r = 0.364, p = 0.018), even after adjustment for age and sex.

Conclusion: In this sample of obese individuals, moderate to severe OSA was associated with sympathetic hyperactivity and evidence of accelerated vascular aging with arterial stiffness and subclinical atherosclerosis.

梗阻性睡眠呼吸暂停(OSA)是一种与多种危险因素相关的慢性疾病,其严重程度与体重指数(BMI)和腰围的增加有关。目的:评价肥胖伴中重度OSA患者的血管功能、中枢血流动力学和自主神经调节。方法:对年龄在40-70岁、BMI≥30和< 40 kg/m2的男性和女性进行心率变异性、血流调节扩张的内皮功能、振荡测量法和颈动脉超声的中枢参数评估。睡眠研究是通过便携式家庭睡眠测试设备(WatchPAT)进行的。结果:76例患者按呼吸暂停低通气指数(AHI)分为:无症状-轻度组(AHI 2, p = 0.035)、脉搏波速度(PWV;MS组(6.9±0.7 vs 7.7±1.6m/s, p = 0.004)、血管年龄(48±6 vs 53±9年,p = 0.05)、平均内膜-中膜厚度(0.59±0.08 vs 0.66±0.13 mm, p = 0.011)显著高于MS组(p = 0.004)。AHI与PWV (r = 0.26, p = 0.024)和LF/HF比值(r = 0.40, p)显著相关。结论:在该肥胖个体样本中,中度至重度OSA与交感神经过度活跃相关,并伴有血管硬化和亚临床动脉粥样硬化加速血管老化。
{"title":"Arterial Stiffness Associated with Sympathetic Hyperactivity in Obese Individuals with Moderate to Severe Obstructive Sleep Apnea.","authors":"Samanta Mattos,&nbsp;Michelle R Cunha,&nbsp;Márcia R S T Klein,&nbsp;Wille Oigman,&nbsp;Mario F Neves","doi":"10.1007/s40292-023-00592-3","DOIUrl":"https://doi.org/10.1007/s40292-023-00592-3","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive Sleep Apnea (OSA) is a chronic disorder associated with several risk factors, and increased Body Mass Index (BMI) and waist circumference are correlated with it is severity.</p><p><strong>Aim: </strong>To evaluate vascular function, central hemodynamics, and autonomic modulation in obese individuals with moderate and severe OSA.</p><p><strong>Methods: </strong>Individuals of both sexes, aged 40-70 years and BMI ≥ 30 and < 40 kg/m<sup>2</sup>, were submitted to assessment of heart rate variability, endothelial function by flow-mediated dilatation, central parameters by oscillometry and carotid ultrasound. The sleep study was performed through a portable home sleep test device (WatchPAT).</p><p><strong>Results: </strong>Patients (n = 76) were divided according to Apnea-Hypopnea Index (AHI): absent-mild group (AHI < 15 events/h, n = 30) and Moderate-Severe (MS) group (AHI ≥ 15 events/h, n = 46). The Low/High Frequency (LF/HF) ratio (0.81  ±  0.48 vs 1.39  ±  1.08 ms<sup>2</sup>, p = 0.035), Pulse Wave Velocity (PWV; 6.9  ±  0.7 vs 7.7  ±  1.6m/s, p = 0.004), vascular age (48  ±  6 vs 53  ±  9 years, p = 0.05) and mean intima-media thickness (0.59  ±  0.08 vs 0.66  ±  0.13 mm, p = 0.011) were significantly higher in the MS group. AHI was significantly correlated with PWV (r = 0.26, p = 0.024) and LF/HF ratio (r = 0.40, p < 0.001). Only in the MS group, PWV was significantly correlated with SD2/SD1 ratio (r = 0.611, p ≤ 0.001), and flow-mediated dilation with central systolic blood pressure (r = 0.364, p = 0.018), even after adjustment for age and sex.</p><p><strong>Conclusion: </strong>In this sample of obese individuals, moderate to severe OSA was associated with sympathetic hyperactivity and evidence of accelerated vascular aging with arterial stiffness and subclinical atherosclerosis.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9936257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypertension in Pregnancy: A Diagnostic and Therapeutic Overview. 妊娠期高血压:诊断和治疗综述。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00582-5
Renata Cífková

Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality. It is important to distinguish between pre-existing (chronic) hypertension and gestational hypertension, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum. There is a consensus that systolic blood pressure ≥ 170 or diastolic blood pressure ≥ 110 mmHg is an emergency and hospitalization is indicated. The selection of the antihypertensive drug and its route of administration depend on the expected time of delivery. The current European guidelines recommend initiating drug treatment in pregnant women with persistent elevation of blood pressure ≥ 150/95 mmHg and at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria), with pre-existing hypertension with the superimposition of gestational hypertension, and with hypertension with subclinical organ damage or symptoms at any time during pregnancy. Methyldopa, labetalol, and calcium antagonists (the most data are available for nifedipine) are the drugs of choice. The results of the CHIPS and CHAP studies are likely to reduce the threshold for initiating treatment. Women with a history of hypertensive disorders in pregnancy, particularly those with pre-eclampsia, are at high risk of developing cardiovascular disease later in life. Obstetric history should become a part of the cardiovascular risk assessment in women.

妊娠期高血压疾病与孕产妇、胎儿和新生儿发病率和死亡率的风险增加有关。区分既存(慢性)高血压和妊娠期高血压是很重要的,妊娠期高血压发生于妊娠20周后,通常在产后6周内消退。收缩压≥170或舒张压≥110 mmHg为急诊,需要住院治疗。降压药的选择和给药途径取决于预期分娩时间。目前的欧洲指南建议,妊娠期高血压(伴或不伴蛋白尿)、既往高血压合并妊娠期高血压、妊娠期任何时间伴有亚临床器官损害或症状的高血压,持续血压升高≥150/95 mmHg和> 140/90 mmHg的孕妇开始药物治疗。甲基多巴、拉贝他洛尔和钙拮抗剂(硝苯地平的数据最多)是首选药物。CHIPS和CHAP研究的结果可能会降低开始治疗的门槛。怀孕期间有高血压病史的妇女,特别是那些先兆子痫的妇女,在以后的生活中患心血管疾病的风险很高。产科史应成为女性心血管风险评估的一部分。
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引用次数: 3
Correction to: Different Doses of Sacubitril/Valsartan Compared with Olmesartan in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis. 更正:不同剂量的苏比里尔/缬沙坦与奥美沙坦在原发性高血压患者中的比较:一项系统回顾和荟萃分析。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00583-4
Amjaad Ibrahim Almarjan, Sara Abdulaziz Almarjan, Ahmed Taher Masoud
{"title":"Correction to: Different Doses of Sacubitril/Valsartan Compared with Olmesartan in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis.","authors":"Amjaad Ibrahim Almarjan,&nbsp;Sara Abdulaziz Almarjan,&nbsp;Ahmed Taher Masoud","doi":"10.1007/s40292-023-00583-4","DOIUrl":"https://doi.org/10.1007/s40292-023-00583-4","url":null,"abstract":"","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Plasma Lipoprotein(a) Levels in Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis. 血浆脂蛋白(a)水平在多囊卵巢综合征:一个系统回顾和荟萃分析。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00585-2
Walter Masson, Leandro Barbagelata, Martín Lobo, Augusto Lavalle-Cobo, Pablo Corral, Juan Patricio Nogueira

Introduction: The polycystic ovary syndrome (PCOS) may represent an important model of lipid alterations. Lipoprotein(a) [Lp(a)] has emerged as a new marker of cardiovascular risk.

Aim: The main objective of this meta-analysis was to analyze the available evidence on Lp(a) levels in patients with PCOS compared to a control group.

Methods: This meta-analysis was performed according to PRISMA guidelines. A literature search was performed to detect studies that have quantified Lp(a) levels in women with PCOS compared to a control group. The primary outcome was Lp(a) levels expressed in mg/dL. Random effects models were used.

Results: Twenty-three observational studies including 2,337 patients were identified and considered eligible for this meta-analysis. In the overall analysis, the quantitative analysis showed that patients with PCOS have a higher Lp(a) levels (SMD: 1.1 [95% CI: 0.7 to 1.4]; I2=93%) compared to the control group. The results were similar in the analysis of the subgroups of patients according to body mass index (normal weight group: SMD: 1.2 [95% CI: 0.5 to 1.9], I2=95%; overweight group: SMD: 1.2 [95% CI: 0.5 to 1.8], I2=89%). Sensitivity analysis showed that the results were robust.

Conclusions: This meta-analysis shows that women with PCOS had higher levels of Lp(a) compared to healthy women used as a control group. These findings were observed in both overweight and non-overweight women.

简介:多囊卵巢综合征(PCOS)可能是脂质改变的一个重要模型。脂蛋白(a) [Lp(a)]已成为心血管风险的新标志。目的:本荟萃分析的主要目的是分析PCOS患者与对照组相比Lp(a)水平的现有证据。方法:根据PRISMA指南进行meta分析。进行文献检索,以检测与对照组相比,PCOS妇女Lp(A)水平量化的研究。主要终点是以mg/dL表示的Lp(a)水平。采用随机效应模型。结果:23项观察性研究,包括2337例患者,被认为符合本荟萃分析。在总体分析中,定量分析显示PCOS患者的Lp(a)水平较高(SMD: 1.1 [95% CI: 0.7 ~ 1.4];I2=93%)与对照组相比。根据体重指数对患者进行亚组分析的结果相似(正常体重组:SMD: 1.2 [95% CI: 0.5 ~ 1.9], I2=95%;超重组:SMD: 1.2 [95% CI: 0.5 ~ 1.8], I2=89%)。敏感性分析表明,结果是稳健的。结论:该荟萃分析显示,与对照组的健康女性相比,PCOS女性的Lp(a)水平较高。这些发现在超重和非超重的女性中都有观察到。
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引用次数: 0
Low Potassium Intake: A Common Risk Factor for Nephrolithiasis in Patients with High Blood Pressure. 低钾摄入:高血压患者肾结石的常见危险因素。
IF 3 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1007/s40292-023-00587-0
Veronica Abate, Anita Vergatti, Antonella Fiore, Angelo Forte, Alessia Attanasio, Nadia Altavilla, Gianpaolo De Filippo, Domenico Rendina, Lanfranco D Elia

Hypertension (Htn) is a crucial cause of cardio-vascular and chronic kidney disease. Moreover, it is an independent risk factor for nephrolithiasis (NL). A diet rich in vegetables and fruits is indicated for both Htn and NL prevention, and the 24-h urinary potassium excretion can be used as a warning light for adherence. The aim of this study is to demonstrate the association between urinary potassium excretion and recurrent nephrolithiasis among patients affected by Htn. We have analyzed medical records of 119 patients affected by Htn and NL (SF-Hs) referring to Bone and Mineral Metabolism laboratory and 119 patients affected by Htn but without NL (nSF-Hs) referring to Hypertension and Organ Damage Hypertension related laboratory, both in Federico II University of Naples. The potassium 24-h urinary levels in SF-Hs were significantly lower compared to nSF-Hs. This difference was confirmed by the multivariable linear regression analysis in the unadjusted model and adjusted model for age, gender, metabolic syndrome, and body mass index. In conclusion, a higher potassium urinary excretion in 24-h is a protective factor against NL in patients affected by Htn and dietary interventions can be considered for kidney protection.

高血压(Htn)是导致心血管和慢性肾脏疾病的重要原因。此外,它是肾结石(NL)的独立危险因素。富含蔬菜和水果的饮食可以预防Htn和NL, 24小时尿钾排泄量可以作为依从性的警示灯。本研究的目的是证明尿钾排泄与Htn患者复发性肾结石之间的关系。我们分析了那不勒斯Federico II大学骨和矿物质代谢实验室119例Htn和NL (SF-Hs)患者和119例Htn但无NL (nSF-Hs)的高血压和器官损伤高血压相关实验室患者的病历。SF-Hs患者24小时尿钾水平明显低于nSF-Hs患者。对年龄、性别、代谢综合征和体重指数进行校正模型和未校正模型的多变量线性回归分析证实了这一差异。综上所述,Htn患者24小时较高的尿钾排泄量是NL的一个保护因素,可以考虑通过饮食干预来保护肾脏。
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引用次数: 0
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High Blood Pressure & Cardiovascular Prevention
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