Essential (primary or idiopathic) hypertension is presented as the most prevalent 'cause' of arterial hypertension, which is a paradoxical statement for a condition whose causes are unknown. The consequence of this description is that secondary hypertension is held to be exceptional and, therefore, very rarely sought for in current clinical practice. Labelling a hypertensive patient as 'essential' means that no further investigations will be undertaken to discover the cause of hypertension, therefore neglecting the possibility of long-term cure of hypertension and sentencing the patient to a life-long drug treatment.

We will describe how the notion of essential hypertension has developed and whether scientific evidence from the most recent studies still support the conclusion that it is highly prevalent. The concept of secondary hypertension along with the criteria to be used to define it as such are also being examined.

The evidence that secondary hypertension is highly prevalent, when systematically sought for, should increase the awareness of this condition and lead to a broader search for it, which are fundamental steps to achieve cure or a better control of high blood pressure, thus improving patients' outcome and quality of life.

The present study quantified simultaneous determination of the active components included in Valzomix HCT tablets are hydrochlorothiazide (HCT), valsartan (VAL), and amlodipine (AML). Two chemometric methods-continuous wavelet transform (CWT) and ratio subtraction (RS)-along with a rapid and effective spectrophotometric approach-which does not require preparatory separation-were used to do the analysis. The CWT approach applied the zero-crossing method to analyze several wavelet families and selected the Daubechies 2, Symlet 2, and Biorthogonal 1.3 wavelets. At wavelengths of 215, 224, and 233 nm, respectively, each wavelet was selected based on its unique scale characteristics for the purpose of measuring the medicines. The quantification and detection limits for AML and VAL varied between 0.0406 and 0.3906 μg/mL, with recovery rates sometimes above 97 % and root mean square errors below 2. The RS technique identified satisfactory values between 0.1594 and 0.1663 μg/mL. The recovery rates varied from 99.52 % to 102.70 %, with quantification limits of 0.3064 to 0.7669 μg/mL. Both approaches demonstrated relative standard deviations below 1 % and average recovery rates over 94 % in the sample analysis. A one-way ANOVA with a 95 % confidence interval demonstrated no major variances in the methods.

Evaluating the biomechanical properties of the aorta is crucial for assessing cardiovascular risk and preventing disease progression. The aim of this study was to evaluate the biomechanical properties of the ascending aorta (AA) in severe obstructive sleep apnea syndrome (OSAS) patients with or without hypertension (HT) via velocity vector imaging (VVI).

A total of 68 patients with severe OSAS were selected, 35 of whom were included in the simple OSAS group and 33 of whom were included in the OSAS + HT group, and 40 volunteers without these two disorders who were taken as the control group. AA biomechanical properties, that is, AA longitudinal strain (ALS), AA circumferential strain (ACS), and fractional area change (FAC), were evaluated via VVI. Pulsed Doppler early transmitral peak flow velocity (E), early diastolic mitral annular velocity (e'), left ventricular (LV) global longitudinal strain (GLS), and the AA dimension (AD) were also measured.

ALS (mean ± SD; 32.8% ± 11.9% and 19.7% ± 7.6% vs. 40.6% ± 15.6%, p = 0.006), ACS (mean ± SD; 11.8% ± 3.5% and 8.6% ± 2.7% vs. 16.5% ± 5.8%, p = 0.02), and FAC (mean ± SD; 21.0% ± 5.3% and 12.4% ± 3.8% vs. 32.8% ± 9.7%, p = 0.004) were significantly lower in the patient groups (OSAS and OSAS + HT, respectively) than in the control group. LV systolic and diastolic functions were also impaired in the patient groups. Compared with volunteers without OSAS and HT, these patients had a greater AD and E/e' ratio and a lower GLS (p < 0.01). The aortic biomechanical properties were strongly correlated with the LV function and sleep parameters.

AA biomechanical properties are impaired in patients with severe OSAS, especially those with HT. Impairments in these aortic biomechanical properties are associated with diminished LV function and abnormal sleep parameters. This discovery may help clinicians identify and manage potential cardiovascular risks in OSAS patients. Further large-scale longitudinal studies are needed to confirm the potential predictive value of aortic events (e.g., aortic aneurysm or dissection) in patients with OSAS.

We aimed to evaluate the risks of death and cardiovascular death of different subtypes of masked hypertension, defined by either isolated daytime or nighttime blood pressure (BP) elevation, or both, compared with patients with normal both office and 24-h BP.

We selected 4999 patients with masked hypertension (normal office BP and elevated 24-h BP). They were divided in three different categories: isolated daytime masked hypertension (elevated daytime BP and normal nighttime BP, 800 patients), isolated nighttime masked hypertension (elevated nighttime BP and normal daytime BP, 1069 patients) and daytime and nighttime masked hypertension (elevation of both daytime and nighttime BP, 2989). All-cause and cardiovascular death (median follow-up 9.7 years) were assessed in each of these subtypes in comparison to 10 006 patients with normal both office and 24-h BP. Hazard ratios from Cox models after adjustment for clinical confounders were used for such comparisons.

Compared with patients with normal both office and 24-h BP, isolated daytime masked hypertension was not associated with an increased risk of death in models adjusted for clinical confounders [hazard ratio 1.07; 95% confidence interval (CI): 0.80-1.43]. In contrast, isolated nighttime masked hypertension (hazard ratio: 1.39; 95% CI 1.19-1.63) and daytime and nighttime masked hypertension (hazard ratio: 1.22; 95% CI 1.08-1.37) had an increased risk of death in comparison to patients with BP in the normal range. Similar results were observed for cardiovascular death.

The risk of death in masked hypertension is not homogeneous and requires nocturnal BP elevation, either isolated or with daytime elevation. Isolated daytime masked hypertension is not associated with an increased risk of death.

Long-term complications such as renal diseases are well known in patients with chronic hypoparathyroidism (hypoPT), but risk of cardiovascular comorbidity remains less clear. This study comprehensively assessed cardiovascular parameters in hypoPT compared to matched controls.

Cross-sectional cohort study involving 168 patients with chronic hypoPT.

Patients underwent electrocardiograms, blood pressure measurements, and echocardiography. A 1:3 propensity score matching was performed with individuals from the German population-based Study of Health in Pomerania (SHIP-TREND) and the "Characteristics and Course of Heart Failure Stages A-B" (STAAB) cohort.

HypoPT showed significantly higher systolic (128 vs 125 mm Hg, P = .02) and diastolic blood pressures (83 vs 77 mm Hg, P < .01). Intake of antihypertensives was similar between groups. The QTc interval was markedly prolonged (438 vs 420 ms, P < .01) with QTc interval prolongation occurring significantly more frequently in hypoPT (24% vs 6%, P < .01). Interestingly, echocardiography revealed significantly lower left ventricular mass index (28 vs 43 g/m2.7, P < .01) and less frequent left ventricular hypertrophy (7%% vs 41%, P < .01) in hypoPT but comparable left ventricular ejection fraction (P = .48). HypoPT patients had higher prevalence of mitral (20 vs 0%, P < .01) and aortic valve stenoses (7 vs 2%, P < .01). Comparison with STAAB confirmed the increased prevalence of arterial hypertension and reduced myocardial mass indices.

Patients with hypoPT exhibit a higher prevalence of QTc interval prolongation despite established therapy and an increased incidence of hypertension. Conversely, echocardiography revealed lower left ventricular mass and less frequent left ventricular hypertrophy in hypoPT, but higher prevalence of valve stenosis. Regular monitoring of hypertension, QTc interval prolongation, and valve stenosis is recommended to reduce the risk of cardiovascular diseases.

NCT05585593.

In patients on chronic peritoneal dialysis (PD), aortic stiffness (AS) is a common cardiovascular condition that can predict cardiovascular events and mortality. Decorin is a small leucine-rich proteoglycan that plays a vital role in extracellular matrix organization and vascular remodeling. The relationship between decorin and AS in patients with PD remains unclear. We enrolled 140 patients on PD and collected their demographic, anthropometric, and biochemical data. Serum decorin levels were measured using enzyme-linked immunosorbent assay. Based on carotid-femoral pulse wave velocity (cfPWV), a diagnosis of AS was established in 42 patients (30%), who were found to be of advanced age and showed higher prevalence rates of systolic blood pressure, diabetes, hypertension, triglyceride, fasting glucose, and lower decorin levels, compared with those who had no AS. After proper adjustment for confounding factors in the multivariable logistic regression model, AS development was associated with decorin, age, and triglyceride levels. Multivariable linear regression analysis showed that decorin, when subjected to logarithmic transformation, can be viewed as a significant independent predictor of cfPWV (β = -0.289; p < 0.001). Low decorin level was significantly and independently associated with AS in patients undergoing chronic PD.

The development of atherosclerotic cardiovascular disease (ASCVD) in middle-aged working groups can be a major contributor to disability-adjusted life years. However, information regarding the current trends in influenza vaccination within this demographic group remains scarce. Thus, we aimed to investigate the recent 11-year trends in influenza vaccination and related factors among these populations in Korea.

Of 42,879 individuals aged 40-64 years enrolled in the Korea National Health and Nutrition Examination Survey between 2010 and 2021, 35,323 were included. We investigated the yearly trend of influenza vaccination rate according to ASCVD risk and factors associated with being unvaccinated in the elevated ASCVD risk group (ASCVD risk score: ≥7.5%).

Among the 35,323 participants, 20,392 (57.7%) were classified into the elevated ASCVD risk group. Over the 11 years, the vaccination rate was significantly higher in the elevated ASCVD risk group than in the low ASCVD risk group (33.8% vs. 25.3%, p<0.001). Factors associated with the unvaccinated status in the elevated ASCVD risk group included younger age (<50 years; adjusted odds ratio, 1.61; 95% confidence interval, 1.31-1.98), male sex (1.43; 1.16-1.76), current smoker status (1.41; 1.13-1.76), residence in an urban area (1.19; 1.01-1.41), and having higher education (1.3; 1.04-1.64).

One in 3 middle-aged working adults with an elevated risk of ASCVD received the influenza vaccination. Although the influenza vaccination rate was higher in participants with an elevated ASCVD risk than in those with low ASCVD risk, the vaccination rate was relatively unsatisfactory.

The IL-33/ST2 pathway plays a crucial role in the development of essential hypertension (EH). This study aimed to investigate the relationship between EH and genetic variations in this pathway in the Chinese Han population.

A total of 1,151 EH patients and 1,135 healthy controls were included in the study. Sixteen single nucleotide polymorphisms (SNPs) in the interleukin-33 (IL-33) and interleukin-1receptor associated protein (IL-1RAcP) genes were genotyped using the Sequenom MassArray and TaqMan assays. Genotype and allele frequencies were compared between the EH patients and controls using logistic regression analysis.

The rs16865597 SNP in the IL-1RAcP gene was found to be associated with the risk of EH. Specifically, the presence of the C allele of rs16865597 was negatively correlated with EH susceptibility in both the additive model (P = 0.014, OR = 0.75, 95% CI = 0.59-0.94) and the recessive model (P = 0.011, OR = 0.72, 95% CI = 0.56-0.93). Additionally, rs16865597 was linked to a reduced risk of EH in specific subgroups, including males (OR add = 0.73, 95% CI = 0.56-0.94, P = 0.015), nonsmokers (OR add = 0.72, 95% CI = 0.54-0.96, P = 0.023), nondrinkers (OR add = 0.70, 95% CI = 0.53-0.93, P = 0.013), and individuals with low BMI (OR add = 0.69, 95% CI = 0.51-0.92, P = 0.013). Moreover, the C genotype of rs16865597 was strongly associated with higher interleukin-10 levels in vivo.

The rs16865597 SNP is significantly associated with a reduced risk of EH in the Chinese Han population, potentially due to its role in immune regulation.

Psychosocial stressors such as childhood trauma have been associated with an increased risk of hypertension. The impact of childhood trauma on vascular dysfunction in Black adults remains less clear. We examined the association between childhood trauma and vascular function in Black adults.

Childhood trauma exposure and vascular function were assessed in a cohort of healthy Black participants without known cardiovascular disease (n=404) from a large metropolitan city. Childhood trauma was assessed using the Early Trauma Inventory Short Form with higher scores indicative of higher traumatic life events assessed before age 18 years. Outcomes of central augmentation index (CAIx) and carotid femoral pulse wave velocity were measured as indices of wave reflections and arterial stiffness using applanation tonometry (Sphygmocor Inc.), and central pulse pressure (CPP) was calculated as the difference between the central aortic systolic and diastolic blood pressures. Relationships between Early Trauma Inventory Short Form and outcomes were assessed using multivariate-adjusted and sex-stratified linear regression models. The mean age of the cohort was 53 (SD=10.3), 61% women. Cumulative childhood trauma was not associated with CAIx, central pulse pressure, or carotid femoral pulse wave velocity in the minimal or fully adjusted models for sociodemographic, sex, clinical factors, medical history, health behaviors, and depression. Significant trauma × sex interactions were identified for CAIx (P=0.003) and central pulse pressure (P=0.025). Childhood trauma was associated with lower CAIx (β=-0.55% [95% CI, -1.07 to -0.03] in men, but higher CAIx (β=0.35% [95% CI, 0.08-0.63]) and central pulse pressure (β=0.23 mm Hg [95% CI, 0.01-0.43]) in women.

Childhood trauma is independently associated with impaired arterial compliance in Black women.

The appropriate treatment high blood pressure (BP) and low-density lipoprotein cholesterol.(LDL-C), according to clinical guidelines, reduces a patient's risk of a cardiovascular event.

This systematic review aims to evaluate the attainment of BP and LDL-C goals among the Irish population in both primary and secondary prevention of cardiovascular diseases, the level of adherence to prescribing guidelines by doctors and the level of medication adherence among patients.

Five databases were searched in March 2024. Quantitative articles reporting levels of goals attainment, medication adherence or guideline adherence for LDL-C and BP among Irish adults aged ≥18 years were included. The proportion of patients attaining their LDL-Cor BP goals were statistically combined using the random effect model.

Following screening, 23 eligible articles were identified. The achievement of LDL-C <1.8 mmol/L was 41 % (95 % CI 31,52), compared to 69 % of people (95 % CI 62,76) reported to have achieved the less stringent goal of LDL-C < 3 mmol/L. The achievement of BP < 140/90 mmHg was 56 % (95 % CI 46,65). Medication adherence levels ranged between 27 % and 92 %. Guideline adherence findings demonstrated that not all patients who should be on lipid-lowering therapy are and that choice of antihypertensive is not always in line with the guidelines.

Approximately one-third of deaths in Ireland annually are caused by cardiovascular disease, despite being preventable. There is room for improvement in goal attainments in people at risk of CVDs and optimization of medication adherence and guideline adherence may be beneficial in this population.

The prevalence of obesity and diabetes, risk factors for atherosclerotic vascular diseases, is increasing worldwide; therefore, it is desirable to early identify them to reduce cardiovascular events. Thus, we investigated whether the triglyceride-glucose index (TyG index), a new marker of insulin resistance, is associated with incident diabetes in patients with newly diagnosed arterial hypertension. We selected 585 patients with newly diagnosed arterial hypertension referred to our tertiary Clinic of Catanzaro University Hospital for the evaluation of their cardiometabolic risk profile. None of the patients had diabetes mellitus at enrollment and took any drug known to affect glucose metabolism. Patients underwent medical history collection, clinical examination and laboratory tests. The TyG index was calculated as the ln [fasting TG (mg/dl) × FPG (mg/dl)/2], as previously suggested. During the follow-up [mean 8.5 years (range 3.1-10.7)], there were 78 new cases of incident diabetes (1.57% patient-year). Patients who developed diabetes mellitus were older and had a higher body mass index (BMI), baseline blood pressure, fasting glucose, insulin, homeostatis model sssessment (HOMA) index, triglyceride, creatinine and hs-CRP mean values, while estimated glomerular filtration rate values were lower. At the Cox regression analysis, covariates significantly associated with incident diabetes were: BMI (HR = 2.842, 95%CI = 2.299-3.514), TyG index (HR = 2.392, 95%CI = 1.745-3.192), age (HR = 1.944, 95%CI = 1.527-2.474), hs-CRP (HR = 1.409, 95%CI = 1.153-1.722), and HOMA (HR = 1.325, 95%CI = 1,079-1.756). The best estimated cut-off value of TyG index in predicting diabetes was 4.71. In addition, we documented a significant relationship between TyG index and HOMA (r = 0.575; p < 0.0001). Present data demonstrate that TyG index, a simple and cost-effective marker of insulin resistance, is useful in predicting incident diabetes in patients with arterial hypertension.

Several studies have supported the role of innate immune system as a key factor in the sterile inflammation underlying the pathophysiology of atherosclerosis in mice. However, its involvement in humans remains unclear. This study aimed to explore the association between neutrophil count, and the intima-media thickness of common carotid arteries (IMT-CC), as well as the potential impact of long-term dietary interventions on these associations.

A comprehensive analysis was conducted within the framework of the CORDIOPREV study, a long-term secondary prevention study involving dietary interventions with either a Mediterranean or a low-fat diet. The study evaluated the relationship between absolute neutrophil count and neutrophil-related ratios with IMT-CC at baseline and after 5 and 7 years of dietary intervention.

At baseline, patients in the highest tertile of neutrophil count had a higher IMT-CC and number of carotid plaques, when compared to lowest tertile (P < .01 and P < .05, respectively). Logistic regression analyses supported this association. Elevated neutrophil count, neutrophil-to-erythrocyte ratio, and neutrophil-to-HDL ratio were associated with an increased likelihood of having an IMT-CC >.9 mm {odds ratio (OR) 1.17 [95% confidence interval (CI) 1.04-1.35], OR 2.21 (95% CI 1.24-4.12), and OR 1.96 (95% CI 1.09-3.55), respectively}, after adjustment for all variables, which was corroborated by linear regression. Furthermore, a linear mixed-effect model analysis from a longitudinal analysis spanning 5 and 7 years revealed an increase in 1 unit of neutrophils/μl at these time points was associated with a mean increase of .004 (.002) mm in the IMT-CC (P = .031) after adjustment for all variables. Interestingly, in patients exhibiting regression in IMT-CC after 7 years of follow-up, those following a Mediterranean diet showed a significant decrease in neutrophil count after 5 and 7 years (both with P < .05), compared to baseline.

These findings suggest that neutrophils may represent a promising target for preventing atherosclerosis. A Mediterranean diet could serve as an effective dietary strategy to reduce neutrophil levels and potentially slow the progression of atherosclerosis, offering a new neutrophil-reducing therapy concept. Further research is essential to gain deeper insights into the role of neutrophils in the pathophysiology of atherosclerotic cardiovascular disease in humans.

Epidemiological studies reported associations between ozone (O3) exposure and cardiovascular diseases, yet the biological mechanisms remain underexplored. Hypoxia is a shared pathogenesis of O3-associated diseases; therefore, we hypothesized that O3 exposure may induce changes in hypoxia-related markers, leading to adverse cardiovascular effects.

This study aimed to investigate associations of short-term O3 exposure with hypoxic biomarkers and arterial stiffness.

We conducted a panel study involving 210 young healthy residents in 2 cities at different altitudes on the Qinghai-Tibetan Plateau in China, where O3 concentrations are high and particulate pollution is low. Participants underwent 4 repeated visits to assess ambient O3 exposure levels, hypoxic biomarkers, and arterial stiffness. We applied linear mixed-effects models to assess the associations of O3 exposure (lag1 to lag1-7 days) with hypoxic biomarkers and arterial stiffness, adjusted for confounders. Mediation analyses explored the hypoxia's role in O3-related arterial stiffness changes. We further examined effect modification by residence altitude and the robustness of results by including PM2.5 (particulate matter ≤2.5 μm in aerodynamic diameter) or NO2 in 2-pollutant models.

O3 exposure 1 to 7 days before visits was significantly associated with changes in multiple hypoxic biomarkers. A 10-ppb increase in O3 exposure was linked to significant decreases in oxygen saturation (SpO2) and increases in red blood cell count (RBC), hemoglobin concentration, and hematocrit, with maximum changes by -0.42%, 0.92%, 0.97%, and 1.92%, respectively. Laboratory analysis of mRNA and protein markers consistently indicated that O3 exposure activated the hypoxia-inducible factor 1 (HIF-1) signaling pathway. Additionally, a 10-ppb increase in O3 corresponded to a 1.04% to 1.33% increase in carotid-femoral pulse wave velocity (cfPWV), indicating increased arterial stiffness. RBC, hemoglobin concentration, and hematocrit increases significantly mediated the O3-cfPWV association, whereas the SpO2 reduction had an insignificant mediating effect. Associations of O3 with hypoxic biomarkers varied by altitude. The higher altitude group showed delayed associations with SpO₂ and HIF-1 expression but stronger associations with RBC indices. These associations remained robust after adjusting for copollutants.

O3 exposure may reduce oxygen availability, prompting compensatory increases in red blood cells and hemoglobin, which exacerbate arterial stiffening. These findings provide new insights into the mechanisms underlying O3-induced cardiovascular injury.

This cohort study investigated the possible association between serum zinc (SZn) concentration and the risk of progression to type 2 diabetes (T2D) in subjects with isolated impaired glucose tolerance (iIGT). SZn was measured in 198 subjects with iIGT (mean age: 53.0 ± 14.4 years and 33.8% were men) at baseline (2009-2011), and they were followed for developing T2D up to 2017. A univariate unrestricted regression spline (UVRS) was used to assess the potential non-linear association and identify the best placement of SZn knots related to the incidence of T2D. Multivariable Cox proportional hazard models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident T2D across the best placement of knots. The predictive power of SZn for developing T2D was determined using receiver operating characteristic (ROC) analyses, and the Youden index identified the optimal cut-off values. Mean baseline SZn concentration was 115 ± 42.9 µg/dL. Over a median 6-year follow-up, 27.8% of subjects with iIGT developed T2D. A non-linear association was observed between SZn and the incidence of T2D (pnon-linearity from the likelihood ratio test < 0.001). Higher SZn ≥ 106 µg/dL and ≥ 134 µg/dL was associated with elevated risk of T2D by 127% (HR = 2.27, 95% CI = 1.01-5.10) and 144% (HR = 2.44, 95% CI = 1.05-5.69), respectively. According to the crude and multivariate-adjusted ROC analyses, the optimal cut-off values of SZn to identify incident T2D were ≥ 87.5 µg/dL (sensitivity of 83.6%, specificity of 30.1%) and 151.8 µg/dL (sensitivity of 64.4%, specificity of 76.3%), respectively. Elevated SZn levels at baseline were positively associated with the future risk of T2D in subjects with iIGT.

Background/Objectives: Hypertension (HTN) is a significant risk factor for cardiovascular disease (CVD), and a subset of patients exhibits apparently resistant hypertension (aRHTN), where blood pressure remains inadequately controlled despite treatment. This study aims to assess the prevalence of cardiovascular risk factors in middle-aged Lithuanian men with HTN and aRHTN, as well as to evaluate the effectiveness of hypertension management in these groups. Methods: Data from 52,012 men participating in the Lithuanian High Cardiovascular Risk Programme (LitHiR) between 2009 and 2019 were analysed. Participants were categorised into two groups: treated hypertension (HTN) and apparent resistant hypertension (aRHTN). Despite treatment, the aRHTN group included those who failed to achieve their target blood pressure. The prevalence of cardiovascular risk factors (dyslipidaemia, diabetes, metabolic syndrome, obesity, physical inactivity, and an unbalanced diet) was compared between the groups. Results: The overall prevalence of HTN was 47%, with 9.9% of treated hypertensive men having aRHTN. Dyslipidemia was both groups' most prevalent risk factor (94.1% in HTN vs. 95.5% in aRHTN, p < 0.001). Men with aRHTN exhibited higher rates of diabetes (25.9% vs. 18.5%, p < 0.001), metabolic syndrome (75.3% vs. 66.3%, p < 0.001), and left ventricular hypertrophy (59.4% vs. 43.1%, p < 0.001). Treatment success was significantly lower in the aRHTN group (7.57% vs. 28.4%, p < 0.001). Conclusions: Hypertension affects almost half of the studied population, with 10% of treated hypertensives exhibiting aRHTN. The aRHTN group had a higher number of additional cardiovascular risk factors and lower treatment success rates. Improved management of cardiovascular risk factors is crucial, especially in the aRHTN population, to reduce the burden of CVD.

Numerous studies have demonstrated the benefits of amlodipine and perindopril combination therapy in decreasing blood pressure and improving outcomes for high-risk patients. In order to assess the pharmacokinetics of the 2 drugs along with perindoprilat; the active metabolite of perindopril, a simultaneous LC-MS/MS quantification method of amlodipine (AML), perindopril (PER) and perindoprilat (LAT) in human plasma has been developed and validated using amlodipine D4, perindopril D4 and perindoprilat D4 as internal standards (ISs), respectively. A simple and fast protein precipitation method was used to analyze the three analytes from K3EDTA human plasma. The chromatographic separation included the use of a mixture of methanol and acetonitrile (80:20, v/v) and 0.2 % aqueous formic acid (60:40, v/v) as a mobile phase pumped onto a Zorbax® SB-AQ C18 column. Detection was carried out using a tandem mass spectrometer (MS/MS) in multiple reactions monitoring (MRM) mode. This method exhibited great sensitivity (LLOQ of 0.2 ng/mL for AML and PER and 0.4 ng/mL for LAT), linearity, accuracy (ranging from 97.64 % to 110.28 %), precision (ranging from 2.54 % to 7.60 %), and stability. The method showed good linearity over the range of (0.2-10 ng/mL) for AML, (0.2-160 ng/mL) for PER and (0.4-80 ng/mL) for LAT. The average extraction recoveries of AML, PER and LAT samples were between 81.92 % and 85.07 %. Total elution time was as low as 3 min only. In addition, to ensure the practicality of the developed method, BAGI tool was applied, and the current method has achieved the highest score among the compared methods. Moreover, the sustainability of the proposed method was evaluated using AGREE tool and RGB 12 paradigm showing remarkable sustainability. The developed method is fast, accurate, sensitive, reproducible, ecofriendly, sustainable and suitable for the determination of the concentration of the cited analytes in human plasma. Moreover, it was applied for the bioequivalence study of a generic product to the innovator.

Metabolic syndrome (MetS) in low-resource settings contributes to accentuated risk of cardiovascular disease, including stroke. The study objective was to estimate the prevalence, determinants and treatment status of MetS in an urban slum resettlement population in Delhi, India.

This study was conducted from February to May 2023. Multiphase sampling was conducted with 1910 individuals screened for abdominal obesity (AO), with 996 detected as having AO, of which, 400 were selected by simple random sampling and further evaluated for triglycerides (TGs), high-density lipoprotein (HDL) and fasting glucose levels.

Among the 400 participants detected as having AO, 211 had evidence of MetS (52.75% [95% confidence interval 47.83 to 57.62]). The most prevalent combination of MetS clustering was for all five components (AO, diabetes mellitus [DM], hypertension [HTN], low HDL and high TGs; 14.69%), followed by AO, DM and HTN (12.32%). On adjusted analysis, the odds of having MetS was found to be independently associated with increasing age (≥40 y) but not sex.

A high burden of MetS and suboptimal treatment status is prevalent in urban slum populations. Screening of individuals with AO, especially in those >40 y of age, can be an effective programmatic strategy for early diagnosis and management of MetS and its underlying components.

Obesity remains a global health concern and is associated with increased risk of type 2 diabetes, hypertension, and cardiovascular disease overall. Dissimilar hypertension guidelines are available for clinicians, namely those prepared by the American Heart Association (AHA) and the European Society of Cardiology (ESC), which may lead to distinctive appreciation of health outcomes of patients with obesity after bariatric and metabolic surgery, such as hypertension remission. The main goal of this study was to compare the effects of applying stricter (AHA) versus looser (ESC) blood pressure criteria on hypertension diagnosis pre-bariatric surgery and remission assessment one year post-op.

A retrospective analysis of clinical data from patients who underwent surgical treatment for obesity at a single university hospital was performed. To evaluate the hypertension improvement or remission, two different types of blood pressure (BP) categorization were considered (based on AHA and ESC guidelines), in which each patient would fit according to their BP values pre- (m0) and 12 months postoperative (m12).

From a sample of 153 patients submitted for surgical treatment of obesity, more patients were considered with hypertension based on the AHA guideline (130 vs. 102; p < 0.001), while a higher rate of hypertension remission at 12 months after bariatric surgery was observed when following the ESC guideline (58.82 vs. 53.08%). Baseline patients' clinical characteristics based on each hypertension outcome were mostly independent of the guideline used (p > 0.05), where only age and systolic blood pressure were relatively higher in "ESC groups".

We conclude that only minor differences exist between the two guidelines used. If evaluated based on ESC guidelines, it is expected that less patients are considered with hypertension, and the remission rate may be, at least numerically, higher.

Although anti-hypertensive medications, including thiazides and β-blockers (BBs) in particular, have been suggested to cause erectile dysfunction (ED) their real contribution is still conflicting. The aim of this paper is to summarize available evidence providing an evidence-based critical analysis of the topic.

An overall comprehensive narrative review was performed using Medline, Embase and Cochrane search. In addition, to better understand the impact of BBs on ED a specific systematic review was also performed.

The negative role of centrally acting drugs, such as clonidine and α-methyldopa, is well documented althuogh limited controlled trials are available. Angiotensin-converting enzyme inhibitors (ACEis), angiotensin receptor blockers (ARBs), and calcium-channel-blockers (CCBs) have neutral (CCBs) or even positive (ACEis and ARBs) effects on erectile function. Despite some preliminary negative reports, more recent evidence does not confirm the negative impact of thiazides. BBs should be still considered the class of medications more often associated with ED, although better outcomes can be drawn with nebivolol.

Sexual function should be assessed in all patients with arterial hypertension, either at diagnosis or after the prescription of specific medications. A close related patient-physician interaction and discussion can overcome possible negative outcomes allowing a successful management of possible side effects.

Hypertension, often known as high blood pressure, is a major concern to millions of individuals globally. Recent studies have demonstrated the significant efficacy of naturally derived peptides in reducing blood pressure. Hypertension is one of the risks associated with cardiovascular disorders and other health problems. Naturally sourced bioactive peptides possessing antihypertensive properties provide considerable potential as viable substitutes for conventional pharmaceutical medications. Currently, thorough examination of antihypertensive peptide (AHTPs), by using traditional wet-lab methods is highly expensive and labours. Therefore, in-silico approaches especially machine-learning (ML) algorithms are favourable due to saving time and cost in the discovery of AHTPs. In this study, a novel ML-based predictor, called StackAHTP was developed for predicting accurate AHTPs from sequence only. The proposed method, utilise two types of feature descriptors Pseudo-Amino Acid Composition and Dipeptide Composition to encode the local and global hidden information from peptide sequences. Furthermore, the encoded features are serially merged and ranked through SHapley Additive explanations (SHAP) algorithm. Then, the top ranked are fed into three different ensemble classifiers (Bagging, Boosting, and Stacking) for enhancing the prediction performance of the model. The StackAHTPs method achieved superior performance compare to other ML classifiers (AdaBoost, XGBoost and Light Gradient Boosting (LightGBM), Bagging and Boosting) on 10-fold cross validation and independent test. The experimental outcomes demonstrate that our proposed method outperformed the existing methods and achieved an accuracy of 92.25% and F1-score of 89.67% on independent test for predicting AHTPs and non-AHTPs. The authors believe this research will remarkably contribute in predicting large-scale characterisation of AHTPs and accelerate the drug discovery process. At https://github.com/ali-ghulam/StackAHTPs you may find datasets features used.

For adopting recently introduced hypertension phenotypes categorized using office and out of office blood pressure (BP) for the diagnosis of hypertension and antihypertension drug therapy, it is mandatory to define the corresponding out of office BP with the specific target BP recommended by the major guidelines. Such conditions include white-coat hypertension (WCH), masked hypertension (MH), white-coat uncontrolled hypertension (WUCH), and masked uncontrolled hypertension (MUCH). Here, the authors review the relevant literature and discuss the related issue to facilitate the use of corresponding BPs for proper diagnosis of WCH, MH, WUCH, and MUCH in the setting of standard target BP as well as intensive target BP. The methodology of deriving the corresponding BP has evolved from statistical methods such as standard deviation, percentile value, and regression to an outcome-based approach using pooled international cohort study data and comparative analysis in randomized clinical trials for target BPs such as the SPRINT and STEP studies. Corresponding BPs to 140/90 and 130/80 mm Hg in office BP is important for safe and strict achievement of intensive BP targets. The corresponding home, daytime, and 24-h BPs to 130/80 mm Hg in office BP are 130/80, 130/80, and 125/75 mm Hg, respectively. However, researchers have found some discrepancies among the home corresponding BPs. As tentative criterion for de-escalation of antihypertensive therapy as shown in European guidelines was 120 mm Hg in office BP, corresponding home, daytime, and 24-h systolic BPs to 120 mm Hg in office systolic BP are 120, 120, and 115 mm Hg, respectively.

Dynapenic obesity is a condition characterized by high adiposity levels combined with muscle dysfunction. Although high adiposity and muscle loss/dysfunction are thought to synergistically increase the risk of cardiovascular disease (CVD), few studies have addressed the association between dynapenic and sarcopenic obesity and CVD. We aimed to investigate the association of dynapenic obesity with incident CVD events using the data from a population-based prospective longitudinal study in Japan.

A total of 2490 community-dwelling Japanese aged 40-79 years (42.5% males, mean age 57.7 ± 10.6 years) without a history of CVD were followed up for a median of 24 years. Handgrip strength was classified as low, medium, or high by age- and sex-specific tertiles. Body mass index (BMI) levels were categorized as lean (<18.5 kg/m2), normal (18.5-24.9 kg/m2), or obese (≥25.0 kg/m2). Dynapenic obesity was defined as having both low handgrip strength and obesity. The outcomes were defined as the first-ever development of CVD (defined as stroke or coronary heart disease). The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the development of CVD were estimated using a Cox proportional hazards model, in which participants with high handgrip strength and normal BMI were used as a reference group. Mediation analyses used serum high-sensitivity C-reactive protein (hs-CRP) and homeostatic model assessment for insulin resistance (HOMA-IR) as mediators.

During the follow-up period, 482 participants developed CVD events (324 cases of stroke and 209 of coronary heart disease). The multivariable-adjusted risk of CVD increased significantly among participants with dynapenic obesity compared with the reference group (HR 1.49, 95% CI 1.03-2.17). An analysis by age groups showed a further increase in the risk of CVD among participants with dynapenic obesity aged less than 65 years (HR 1.66, 95% CI 1.04-2.65). In mediation analyses for participants aged less than 65 years, serum hs-CRP was shown to be a significant mediator explaining 13.8% of the association between dynapenic obesity and the development of CVD, while HOMA-IR explained 12.2% of this relationship.

Dynapenic obesity was a significant risk factor for the development of CVD in a general Japanese population. This association was more pronounced among those aged <65 years. Inflammation, and possibly glucose metabolism, might partly mediate this association. Our findings suggest that preventing muscle dysfunction as well as appropriate weight control, especially in middle-age, are important for preventing the development of CVD.

The European Society of Hypertension (ESH) was established 35 years ago. Since then, it promoted and coordinated a number of activities which include educational projects, epidemiological surveys and research investigations whose main focus includes different clinical and therapeutic aspects of the hypertensive disease. This article, which is based on data presented during the Presidential lecture held during the 33rd ESH Meeting in Berlin, will provide an overview of the main organization and structure of the ESH. Emphasis will be given to the relevance of the different society bodies, with a particular focus on the educational and research activities, such as the 15 working groups and the more than 120 excellence centers located in European and extra-European countries. Other main activities of the Society refer to the ESH Hypertension Specialist Program, the ESH Summer School, the ESH Young Fellow Program and the Annual Scientific Meeting of the Society. A special emphasis will be given to the central role of the Society in the organization of the various research projects and in the development and dissemination of the ESH Guideline document on hypertension diagnosis and treatment. Finally, the future perspectives of the ESH in the context of the European scientific framework will be highlighted.

Obesity in adults is a known risk factor for cardiovascular events and is associated with a decline in arterial elasticity. This study aims to evaluate the utility of pulse wave analysis (PWA) parameters in routine clinical practice for the primary prevention of cardiovascular events by developing a prediction model for arterial stiffness among obese and overweight individuals.

The study enrolled 84 adult patients, aged 18 to 85 years, with varying degrees of weight status, including optimal weight, overweight, and obesity. The lifestyle habits, the personal and family history of cardiometabolic diseases, as well the clinical evaluation that included BMI (body mass index), WHR (waist-to-hip ratio), WC (waist circumferance) were performed. PWA evaluation was conducted using the Mobil-O-Graph device, assessing the following parameters: pulse wave velocity (PWV), augmentation index (AIx), heart rate (HR), central pulse pressure (cPP), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP). Body composition analysis was performed using the TANITA BC-418 body analyzer. Laboratory results from the past 3 months were also collected during initial nutritional consultations for each patient.

Family history of cardiovascular events showed positive correlations with all PWA parameters, while diabetes history only with PWV and family history of obesity with PWV, DBP, and cSBP. Insufficient sleep duration showed positive associations with all arterial stiffness parameters except cDBP. Smoking status correlated with significantly elevated PWV and Aix values, while insufficient physical activity was associated solely with PWV. Positive correlations were showed between current weight and PWV, while WC demonstrated positive associations with PWV, SBP, and cSBP. Body composition analysis revealed significant associations between trunk adipose tissue mass (%) and PWV, SBP, and cSBP. Hydration status (%) emerged as an independent predictor for PWV, exhibiting an inverse relationship. HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) showed a strong positive correlation with PWV. Negative associations were observed with HDL-c and vitamin D. Threshold values for age, cDBP and Cardiac Index providing positive diagnostic for vascular impairment.

The assessment of arterial stiffness can be considered a reliable approach to prevent obesity-related cardiovascular events and facilitate the comprehensive management of such pathologies.

The exclusion of causes of hypertension is not systematically exploited in clinical practice. Therefore, essential hypertension is consistently presented as the most prevalent 'cause'. The paradox of a condition with unknown causes being described as a common cause of hypertension translates into a diagnosis of essential hypertension in most patients, which precludes the detection of a curable cause of hypertension. The aim of this review is to investigate how the notion of essential hypertension has developed and whether scientific evidence still support the notion of its high prevalence by examining the most recent studies. These studies provided solid scientific evidence that, when systematically sought for, secondary hypertension is quite common and that secondary hypertension is highly prevalent. The increased awareness should lead to a systematic search for, with the goal of curing or achieving a better control of high blood pressure, and ultimately improving patients' quality of life.

Retrospective data suggest an association between bevacizumab efficacy and the incidence of arterial hypertension (AHT). Additionally, epigenetic mechanisms have been related to AHT.

This prospective observational study conducted by GEICAM Spanish Breast Cancer Research Group included metastatic breast (MBC) or colorectal (mCRC) cancer patients treated with bevacizumab-containing chemotherapy as first-line treatment. Blood pressure (BP) levels were measured (conventional and 24-h Holter monitoring) at baseline and up to cycle 3. Primary endpoint assessed BP levels increase as predictive factor for progression-free survival (PFS). Germline DNA methylation profile was explored in pre-treatment blood samples; principal component analysis was used to define an epigenetic predictive score for increased BP levels.

From Oct-2012 to Jul-2016, 143 (78 MBC and 65 mCRC) patients were included. The incidence of AHT according to guidelines was neither predictive of PFS nor of best overall tumor response (BOR). No statistically significant association was observed with systolic BP nor diastolic BP increment for PFS or BOR. Grade 3 and 4 adverse events were observed in 37 and 5% of patients, respectively. We identified 27 sites which baseline methylation status was significantly associated to BP levels increase secondary to bevacizumab-containing chemotherapy.

Neither the frequency of AHT nor the increase of BP levels were predictive of efficacy in MBC and mCRC patients treated with bevacizumab-containing chemotherapy.

ClinicalTrials.gov Identifier: NCT01733628.

Pauci-immune necrotizing glomerulonephritis (PING) is commonly associated with the presence of antineutrophilic cytoplasmic antibodies (ANCAs) but a significant number of patients do not have these antibodies. The significance of ANCA-negativity in the context of Berden's classification of PING is not known.

A retrospective analysis was conducted on all patients with histopathological diagnosis of idiopathic PING irrespective of ANCA status diagnosed between January 1998 to December 2018 and followed up at renal clinic for > 12 months. All biopsies were reclassified by Berden's classification. Clinicopathological characteristics and renal outcomes of ANCA-positive and ANCA-negative patients were compared.

Out of 134 patients, 66 (49.5%) were ANCA-negative. The mean age was 34.76 ± 13.3 years. Compared with the ANCA-positive patients, ANCA-negative patients had significantly greater prevalence of nephrotic-range proteinuria (74.23% Vs 57.9%, P = 0.036) with less extra-renal manifestations (P < 0.05)). On histology, focal and crescentic classes dominated with less number of globally sclerosed glomeruli (2.7% Vs 5.07%, P = 0.02) and more mesangial proliferation (22.7% Vs 4.41%, P = 0.002) in the ANCA-negative group, whereas sclerotic was predominant in the ANCA-positive group (P = 0.05). More patients achieved complete and partial recovery in ANCA-negative patients (42.4% Vs 20.5%, P < 0.05) with better renal survival (27.27% Vs 16.17%, log-rank test: P = 0.03) and less patient mortality (13.63% vs 30.8%, log-rank test: P = 0.04) at 2 years.

Our study confirms high prevalence of ANCA negativity among our cohort and this group presents with isolated renal involvement with better renal and patient survival. The ANCA-positive group showed significantly more patients in the sclerotic class, lower 2-year renal survival, and higher 2-year mortality as compared to the ANCA-negative group. However, the complete and partial responses to treatment were significantly better in the ANCA-negative group. Key Points • This study shows a high prevalence of ANCA negativity in cases of PING in Pakistani population, as almost half of patients in this study did not have these antibodies. • This negativity is more prevalent in the Asian populations but its significance in the context of Berden's classification of PING is unknown. • ANCA-negative group exhibited less severe phenotype and better outcomes compared with ANCA-positive group.

The COVID-19 has been shown to have negative effects on the cardiovascular system, but it is unclear how long these effects last in college students. This study aimed to assess the long-term impact of COVID-19 on arterial stiffness, endothelial function, and blood pressure in college students.

We enrolled 37 college students who had been infected with COVID-19 for more than 2 months. Brachial artery flow-mediated dilation (FMD) was used to assess endothelial function, while arterial stiffness was evaluated using the ABI Systems 100, including variables such as ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), heart rate (HR), and blood pressure (BP).

Our results showed that FMD was significantly impaired after COVID-19 infection (p < 0.001), while cfPWV and systolic blood pressure (SBP) were significantly increased (p < 0.05). Simple linear regression models revealed a significant negative correlation between post-COVID-19 measurement time and baPWV change (p < 0.01), indicating an improvement in arterial stiffness over time. However, there was a significant positive correlation between post-COVID-19 measurement time and diastolic blood pressure (DBP) change (p < 0.05), suggesting an increase in BP over time. There were no significant differences in ABI and HR between pre- and post-COVID-19 measurements, and no significant correlations were observed with other variables (p > 0.05).

Our study demonstrated that COVID-19 has long-term detrimental effects on vascular function in college students. However, arterial stiffness tends to improve over time, while BP may exhibit the opposite trend.

While alcohol consumption is implicated in the development of aortic dissection, the impact of alcohol use disorder (AUD) on the outcomes of type A aortic dissection (TAAD) repair is still largely unexplored. This study aimed to conduct a comprehensive, population-based analysis of effect of AUD on in-hospital outcomes following TAAD repair using National/Nationwide Inpatient Sample, the largest all-payer database in the United States.

Patients undergoing TAAD repair were identified in National/Nationwide Inpatient Sample from Q4 2015-2020. Demographics, comorbidities, hospital characteristics, primary payer status, and transfer-in status between patients with and without AUD were matched by a 1:3 propensity-score matching. In-hospital outcomes were examined.

There were 220 patients with AUD who underwent TAAD repair. Meanwhile, 4062 non-AUD patients went under TAAD repair, where 646 of them were matched to all AUD patients. After propensity-score matching, AUD patients had a lower risk of in-hospital mortality (7.76% vs 13.31%, P = 0.03) while there was no difference in transfer-in status or time from admission to operation. However, patients with AUD had a higher rate of respiratory complications (27.40% vs 19.66%, P = 0.02) and a longer hospital length of stay (16.20 ± 11.61 vs 11.72 ± 1.69 days, P = 0.01). All other in-hospital outcomes were comparable between AUD and non-AUD patients.

AUD patients had a lower risk of in-hospital mortality but a higher rate of respiratory complications and a longer LOS. These findings can provide insights into preoperative risk stratification of these patients. Nonetheless, reasons underlying the lower mortality rate in AUD patients and their long-term prognosis require further investigation.

It has been suggested that a blunted nocturnal blood pressure (BP) decline is associated with a poor prognosis. Nevertheless, it remains unclear if an abnormal dipping is deleterious per se or it merely reflects an elevated BP during sleep. We aimed to assess the prognostic value of nocturnal BP decline, with or without concomitant elevated nocturnal BP.

Vital status and cause of death were obtained from death certificates in 59 124 patients, enrolled in the Spanish ABPM Registry between 2004 and 2014 (median follow-up: 10 years). The association between night-to-day ratio (NDR) and dipping patterns (extreme dippers, dippers, reduced dippers, and risers) with all-cause and cardiovascular mortality were evaluated by Cox-proportional models adjusted for clinical confounders and 24 h blood pressure.

NDR was associated with all-cause mortality [hazard ratio for 1SD change: 1.15; 95% confidence interval (CI) 1.13-1.17]. Reduced dippers (1.13; 1.06-1.20) and risers (1.41; 1.32-1.51) were associated with an increased risk of all-cause death, whereas extreme dippers (0.90; 0.79-1.02) were not. Elevated NDR (≥0.9) in the absence of elevated night SBP (<120 mmHg) was associated with an increased risk of death (1.13; 1.04-1.22), as well as elevated night SBP but normal NDR (1.38; 1.26-1.50), and the combination of both abnormalities (1.56; 1.46-1.66). Similar results were obtained for cardiovascular mortality.

Abnormalities in the circadian pattern are associated with an increased risk of all-cause and cardiovascular mortality. This is maintained even in the absence of nocturnal BP elevation.

Cystatin C is increasingly used as a marker of renal function as a complement to serum creatinine and glomerular filtration rate (GFR). We have assessed its efficacy as a predictor of mortality in a group of patients with increased cystatin C but GFR> 60mL/min.

We included 608 patients, 65.9% male, 34.6% had diabetes mellitus. The mean age was 58.5±14.5 years and a mean GFR of 64.1±33.5mL/min. Patients were divided into 3 groups: CONTROL (normal cystatin C and GFR> 60mL/min, age 53.3±12.8years, GFR 96.6±22.4mL/min,n=193), INCREASED CYSTATIN (cystatin C>1.03mg/l and GFR>60mL/min, age 58.9±13,1years, GFR 72.2±10.4mL/min, n=40) and CKD (chronic kidney disease, increased cystatin C and GFR <60mL/min, age 61.4±14.8years, GFR 36.0±12.7mL/min, n=160). The relationship with overall mortality was analyzed using the Kaplan-Meier method.

Mean cystatin C was 0.75±0.13 versus 1.79±0.54 in CKD group and 1.14±0.14mg/l, p <0.001). In CONTROL group survival was 93.9% at 5y, compared to 78.8% in the ERC group and 82.3% in the INCREASED CYSTATIN group (p <0.001) Five-year survival before renal replacement therapy was also different for the ERC group (73%, p <0.001 Log Rank) but not between the other two groups (CONTROL 99.0%, INCREASED CYSTATIN 94.3% p=0.08).

Increased plasmatic levels of cystatin C in patients with GFR> 60mL/min was a predictor of increased mortality but not of progression to end-stage renal failure. These results confirm the interest of routinely measuring cystatin C.

Recent reports indicate a potential oncogenic role of antihypertensive drugs in common cancers. However, it remains uncertain whether this phenomenon influences the risk of glioblastoma multiforme (GBM). This study aimed to assess the potential causal effects of blood pressure (BP) and antihypertensive drugs on GBM. Genome-wide association study (GWAS) summary statistics for systolic blood pressure (SBP), diastolic blood pressure (DBP), and GBM in Europeans were downloaded. To represent the effects of antihypertensive drugs, we utilized single nucleotide polymorphisms (SNPs) associated with SBP/DBP adjacent to the coding regions of different antihypertensive drugs as instrumental variables to model five antihypertensive drugs, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, β-receptor blockers (BBs), and thiazide diuretics. Positive control studies were performed using GWAS data in chronic heart failure. The primary method for causality estimation was the inverse-variance-weighted method. Mendelian randomization analysis showed that BBs with the β1-adrenergic receptor (ADRB1) as a therapeutic target could significantly reduce the risk of GBM by mediating DBP (OR = 0.431, 95% CI: 0.267-0.697, p < .001) and that they could also significantly reduce the risk of GBM by mediating SBP (OR = 0.595, 95% CI: 0.422-0.837, p = .003). Sensitivity analysis and colocalization analysis reinforced the robustness of these findings. Finally, the low expression of the ADRB1 gene in malignant gliomas was found by GBM data from TCGA and single-cell RNA sequencing, which most likely contributed to the poor prognosis of GBM patients. In summary, our study provides preliminary evidence of some causal relationship between ADRB1-targeted BBs and glioblastoma development. However, more studies are needed to validate these findings and further reveal the complex relationship between BP and GBM.

Epicardial adipose tissue (EAT) is the cardiac visceral fat depot proposed to play a role in the etiology of various cardiovascular disease outcomes. Little is known about EAT determinants in a general population. We examined cardiometabolic, dietary, lifestyle and socioeconomic determinants of echocardiograpghically measured EAT in early adulthood. Data on cardiometabolic, dietary, lifestyle and socioeconomic factors were collected from participants of the Cardiovascular Risk in Young Finns Study (YFS; N = 1667; age 34-49 years). EAT thickness was measured from parasternal long axis echocardiograms. Multivariable regression analysis was used to study potential EAT determinants. Possible effect modification of sex was addressed. Mean EAT thickness was 4.07 mm (95% CI 4.00-4.17). Multivariable analysis [β indicating percentage of change in EAT(mm) per one unit increase in determinant variable] indicated female sex (β = 11.0, P < 0.0001), type 2 diabetes (β = 14.0, P = 0.02), waist circumference (cm) (β = 0.38, P < 0.0001), systolic blood pressure (mmHg) (β = 0.18, P = 0.02) and red meat intake (g/day) (β = 0.02, P = 0.05) as EAT determinants. Sex-specific analysis revealed age (year) (β = 0.59, P = 0.01), alcohol intake (drinks/day) (β = 4.69, P = 0.006), heavy drinking (yes/no) (β = 30.4, P < 0.0001) as EAT determinants in women and fruit intake (g/day) (β = -1.0, P = 0.04) in men. In the YFS cohort, waist circumference, systolic blood pressure and red meat intake were directly associated with EAT among all participants. In women, age, alcohol intake, heavy drinking and type 2 diabetes associated directly with EAT, while an inverse association was observed between fruit intake and EAT in men.