Search Results (2,583)

Background: The consumption of coffee has been widely debated regarding its effects on health. This study aims to analyze the correlations between daily coffee intake and sleep, blood pressure, anthropometric measurements, and biochemical markers in individuals with type 2 diabetes (T2D) and hypertension over a 12-month period. Methods: An observational study was conducted with 40 participants with T2D and hypertension, comprising 20 females and 20 males. Participants were monitored for their daily coffee consumption over a 12-month period, being assessed every 3 months. Linear regression was utilized to assess interactions and relationships between variables, providing insights into potential predictive associations. Additionally, correlation analysis was performed using Pearson’s and Spearman’s tests to evaluate the strength and direction of linear and non-linear relationships. Statistical significance was set at p < 0.05. Results: Significant changes were observed in fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, body mass index, sleep duration, nocturnal awakenings, and waist-to-hip ratio (p < 0.05) over the 12-month study in both sexes. No significant differences were noted in the remaining parameters (p > 0.05). The coffee consumed by the participants was of the “traditional type” and contained sugar (2g per cup) for 100% of the participants. An intake of 4.17 ± 0.360 cups per day was found at baseline and 5.41 ± 0.316 cups at 12 months (p > 0.05). Regarding correlation analysis, a higher coffee intake was significantly associated with shorter sleep duration in women (r = −0.731; p = 0.037). Conversely, greater coffee consumption correlated with lower LDL cholesterol (LDL-C) levels in women (r = −0.820; p = 0.044). Additionally, a longer sleep duration was linked to lower FBG (r = -0.841; p = 0.031), HbA1c (r = -0.831; p = 0.037), and LDL-C levels in women (r = -0.713; p = 0.050). No significant correlations were observed for the other parameters in both sexes (p > 0.05). Conclusions: In women, coffee consumption may negatively affect sleep duration while potentially offering beneficial effects on LDL-C levels, even when sweetened with sugar. Additionally, a longer sleep duration in women appears to be associated with improvements in FBG, HbA1c, and LDL-C. These correlations emphasize the importance of a balanced approach to coffee consumption, weighing both its potential health benefits and drawbacks in postmenopausal women. However, since this study does not establish causality, further randomized clinical trials are warranted to investigate the underlying mechanisms and long-term implications—particularly in the context of T2D and hypertension. Full article

Objective: This study aimed to determine the possibility of creating a new animal model in which diabetic retinopathy (DR) progresses due to hypertension caused by salt loading. Methods: Male Spontaneously Diabetic Torii (SDT) fatty rats were divided into two groups: one group received 0.3% saline water starting at 8 weeks of age for a duration of 16 weeks (salt SDT fatty group), while the control group was provided with tap water (SDT fatty group). In addition, Sprague-Dawley (SD) rats receiving tap water served as normal controls. Retinal function was assessed by electroretinography (ERG) at 8 and 24 weeks of age. At 24 weeks, following perfusion with fluorescein dextran, the eyes were enucleated, and retinal flat mounts were prepared for vascular evaluation. Retinal thickness and the number of retinal folds were assessed histologically, and ultrastructural changes in the retina were examined using transmission electron microscopy. Results: Saline administration did not lead to significant changes in food consumption or body weight among the groups. In the salt SDT fatty group, blood pressure was significantly elevated, while blood glucose levels showed a slight reduction. ERG analysis showed that the amplitude of oscillatory potential (OP)1 waves was suppressed, and the latencies of OP3, OP4, and OP5 waves were prolonged. Although no significant changes were noted in retinal thickness or the number of retinal folds, thickening of the retinal capillary basement membrane was evident in the salt SDT fatty group. Conclusions: Hypertension induced by 0.3% saline promotes DR progression in SDT fatty rats. This model may help clarify the role of hypertension in DR. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article

Background: Previous research has linked hypertensive disorders of pregnancy (HDP) and long-term cardiovascular disease (CVD) with assisted reproductive technology (ART). It is not clear whether this reflects the background population cardiovascular profiles or whether ART independently increases the long-term risk for CVD and alters cardiovascular function. Furthermore, CVD has been associated with pathological cardiovascular function before and after the establishment of the disease. The aim of this study was to compare cardiac function in women attending for ART between those who had previous treatment and those who had not after controlling for demographic characteristics which have been shown to affect cardiovascular function. Methods: This was a prospective observational cohort study at a London fertility clinic. Women were consecutively enrolled between May 2021 and March 2022. Maternal demographics and cardiac function using transthoracic echocardiography were assessed before the current treatment cycle in the mid-luteal phase of the menstrual cycle. Maternal demographics included age, body mass index, smoking, race, and parity. Cardiovascular parameters included blood pressure and indices of left-ventricular systolic and diastolic function. Differences between cardiac variables after controlling for maternal demographics and history of previous ART were assessed by multivariate linear regression. Results: There were 232 healthy women who agreed to participate in the study; of those, 153 (58%) had undergone previous ART. After controlling for maternal demographic characteristics, previous assisted reproductive technology was not an independent predictor of cardiac function. Conclusions: Previous ART is not associated with significant changes in cardiac function. Full article

Background/Objectives: While aldosterone excess has a detrimental impact on the left ventricle, no data exist concerning right ventricular (RV) function in primary aldosteronism (PA) patients. We aimed to assess RV structure and function in patients with PA using cardiac magnetic resonance imaging. Methods: Thirty PA patients and 30 age- and sex-matched healthy volunteers were studied. All patients underwent cardiac magnetic resonance with the assessment of RV structure and function. Results: Neither the RV mass index (RVMi) nor the RV ejection fraction (RVEF) correlated with the aldosterone levels (p = 0.36 and p = 0.37, respectively). On the contrary, we found a weak positive correlation between the RV end-diastolic volume index (RVEDVi) and aldosterone concentration (rho = 0.5, p = 0.005). Neither the RVEDVi nor the RVEF differed between the PA patients and the control group (p = 0.077 and p = 0.93, respectively). The RVMi was higher in the PA group, at 18.9 (4.9) g/m², versus 13.6 (3.2) g/m² (SD) in the control group (p < 0.0001). The RVEDVi was positively correlated with the duration of hypertension (rho = 0.4, p = 0.03), and the latter was correlated inversely with the RVEF (rho = −0.47, p = 0.009). The RV global longitudinal strain was impaired in PA patients in comparison with the controls (−16.8 (2.5%) versus −19.6 (2.7%), p = 0.0001). Conclusions: The PA patients exhibited larger RVMi values than the controls. The higher the aldosterone levels were, the higher the observed RVEDVi. Additionally, the longer the duration of hypertension, the higher the observed RVEDVi and the lower the noted RVEF. The PA patients exhibited subclinical RV systolic dysfunction, expressed as impaired RV global longitudinal strain. Full article

The global prevalence of hypertension continues to rise, affecting an estimated one billion worldwide. Regular exercise is well recognized as a non-pharmacological approach for individuals with hypertension due to its blood pressure (BP)-lowering effect, largely attributed to repeated exposure to post-exercise hypotension (PEH). Recent evidence also indicates that aromatherapy can contribute to BP reduction, indicating that combining aromatherapy with exercise may enhance the overall BP-lowering effects. Therefore, this pilot study aimed to investigate the effects of aromatherapy on PEH during the recovery phase following exercise. Fourteen healthy young males (22.7 ± 0.7 yrs) participated in this randomized crossover-designed study. All participants completed two exercise sessions per week, each lasting 30 min, at a target heart rate (HR) of 60–65%. The individuals inhaled either aroma oil or water vapor at 5, 35, 65, and 95 min after exercise. The HR, BP, blood lactate level, and arterial stiffness index were measured before and after the exercise. Our findings revealed the following. (1) PEH occurred in both groups. (2) In the aroma group, PEH was augmented compared with the control group, with the maximum reduction in BP being greater in the aroma group. (3) The reduction in arterial stiffness was greater and longer in the aroma group than in the control group. (4) The changes in the lactate levels after exercise did not differ between the groups. Our findings indicate that aromatherapy can amplify PEH, suggesting that its use after exercise may help maximize the positive effects of exercise on BP reduction. Full article

Background: Hypertension is a serious global health issue affecting over one billion adults and leading to severe complications if left unmanaged. Despite medical advancements, only a fraction of patients effectively have their hypertension under control. Among the factors that hinder adherence to hypertensive drugs are the debilitating side effects of the drugs. The lack of adherence results in poorer patient outcomes as patients opt to live with their condition, instead of having to deal with the side effects. Hence, there is a need to discover new hypertension drug molecules with better side effects to increase patient treatment options. To this end, computational methods such as artificial intelligence (AI) have become an exciting option for modern drug discovery. AI-based computational drug discovery methods generate numerous new lead antihypertensive drug molecules. However, predicting their potential side effects remains a significant challenge because of the complexity of biological interactions and limited data on these molecules. Methods: This paper presents a machine learning approach to predict the potential side effects of computationally synthesised antihypertensive drug molecules based on their molecular properties, particularly functional groups. We curated a dataset combining information from the SIDER 4.1 and ChEMBL databases, enriched with molecular descriptors (logP, PSA, HBD, HBA) using RDKit. Results: Gradient Boosting gave the most stable generalisation, with a weighted F1 of 0.80, and AUC-ROC of 0.62 on the independent test set. SHAP analysis over the cross-validation folds showed polar surface area and logP contributing the largest global impact, followed by hydrogen bond counts. Conclusions: Functional group patterns, augmented with key ADMET descriptors, offer a first-pass screen for identifying side-effect risks in AI-designed antihypertensive leads. Full article

Metabolic syndrome (MetS) is defined as a group of metabolic defects that include hypertension, insulin resistance, visceral obesity, fatty liver disease, and atherosclerotic cardiovascular disease (CVD). The first step in controlling the progression of MetS is lifestyle changes, including dietary modification. Regular consumption of fruits, vegetables, whole grains and other plant foods negatively correlates with the risk of developing chronic diseases. Green leafy vegetables (GLVs) are a key element of healthy eating habits and an important source of vitamins C and E, carotenoids—mainly β-carotene and lutein—and minerals. This review discusses and summarizes the current knowledge on the health benefits of consuming GLVs in the prevention and treatment of MetS to provide a compendium for other researchers investigating new natural products. Full article

Background: Chronic Kidney Disease (CKD) is a major global health issue, with diabetes being its primary cause and cardiovascular disease contributing significantly to patient mortality. Recently, two classes of medications—sodium–glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs)—have shown promise in protecting both kidney and heart health beyond their effects on blood sugar control. Methods: We conducted a narrative review summarizing the findings of different clinical trials and mechanistic studies evaluating the effect of SGLT2i and GLP-1 RAs on kidney function, cardiovascular outcomes, and overall disease progression in patients with CKD and DKD. Results: SGLT2i significantly mitigate kidney injury by restoring tubuloglomerular feedback, reducing intraglomerular hypertension, and attenuating inflammation, fibrosis, and oxidative stress. GLP-1 RAs complement these effects by enhancing endothelial function, promoting weight and blood pressure control, and exerting direct anti-inflammatory and anti-fibrotic actions on renal tissues. Landmark trials—CREDENCE, DAPA-CKD, and EMPA-KIDNEY—demonstrate that SGLT2i reduce the risk of kidney failure and renal or cardiovascular death by 25–40% in both diabetic and non-diabetic CKD populations. Likewise, trials such as LEADER, SUSTAIN, and AWARD-7 confirm that GLP-1 RAs slow renal function decline and improve cardiovascular outcomes. Early evidence suggests that using both drugs together may offer even greater benefits through multiple mechanisms. Conclusions: SGLT2i and GLP-1 RAs have redefined the therapeutic landscape of CKD by offering organ-protective benefits that extend beyond glycemic control. Whether used individually or in combination, these agents represent a paradigm shift toward integrated cardiorenal-metabolic care. A deeper understanding of their mechanisms and clinical utility in both diabetic and non-diabetic populations can inform evidence-based strategies to slow disease progression, reduce cardiovascular risk, and improve long-term patient outcomes in CKD. Full article

Objectives: This study sought to assess the impact of diabetes and hypertension on wound healing and recovery in orthopedic patients, with an emphasis on laboratory correlations. Materials and Methods: This study included 67 orthopedic patients, divided into a geriatric group (n = 49, ≥65 years) and a control group (n = 18). Clinical and laboratory assessments were performed at admission and discharge. Data were analyzed statistically. Results: Geriatric patients showed a higher triglyceride glucose-body mass index (TyG-BMI), glucose, cholesterol, C-reactive protein (CRP), interleukin-6 (IL-6), and leukocytes and lower hemoglobin and platelets (PLTs), with poorer healing and well-being. Elevated CRP, IL-6, and urea and decreased protein and hemoglobin persisted in this group. Diabetes improved outcomes in older adults, while hypertension worsened them in younger patients. Favorable outcomes correlated with higher triglycerides, fibrinogen, hemoglobin, and red blood cells (RBCs), while they did not correlate with elevated CRP, IL-6, leptin, urea, creatinine, and white blood cells (WBCs). Conclusions: Key predictors of healing and well-being included CRP, hemoglobin, RBC, and hematocrit in older patients and hypertension, CRP, hemoglobin, and leptin in younger individuals. Age-specific metabolic and inflammatory profiles influence recovery trajectories and may be used to predict problems in both recovery and patients’ well-being. Further research is required to better understand the correlations between these factors. Full article

Background and Objectives: A commonly observed phenomenon in outpatient oncological patients is the appearance of hypotension not attributable to other causes in hypertensive patients undergoing oncological treatment. Once antihypertensive treatment is discontinued, patients remain normotensive after the oncological treatment ends. The objective of this research is to analyze our experience with this phenomenon and try to provide an explanation. Materials and Methods: A retrospective case-control study was conducted with a total sample of 302 hypertensive oncological patients, with cases presenting symptomatic hypotension and controls not. Descriptive and inferential statistics were performed, with the latter focusing on studies by Odds Ratio, Chi-square, Z test for comparison of two proportions, and multivariate regression. Results: Regarding the results obtained, it is noteworthy that in both the univariate and multivariate models, treatment with cisplatin showed statistical significance (Univariate, OR 3.06 (CI 1.82–5.11). Z 4.45, p < 0.0001; multivariate, p < 0.001, Nagelkerke R2 74.8%). Cisplatin treatment and the study phenomenon were correlated with magnesium levels (Chi-square 8.2, p = 0.017), relating hypotension to hypertensive patients with low magnesium levels. Conclusions: CDDP treatment is associated with hypotension or normotension in previously hypertensive cancer patients. This may be related to peripheral vascular fragility induced by oncological drugs, leading to reduced vascular resistance. Although magnesium deficiency is generally linked to hypertension, chemotherapy-related shifts in magnesium levels due to impaired renal handling may play a role. These findings may help improve the understanding of blood pressure regulation in oncology patients. Full article

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Phosphodiesterase type 5 (PDE5) inhibitors, including sildenafil, tadalafil, and vardenafil, are primarily prescribed for erectile dysfunction and pulmonary hypertension. Emerging evidence suggests they may also modulate inflammatory pathways and improve vascular function, but their effects on inflammatory biomarkers in humans remain incompletely defined. A systematic review and meta-analysis were conducted to evaluate the impact of PDE5 inhibitors on inflammatory and endothelial markers in adult humans. Randomized controlled trials comparing PDE5 inhibition to placebo were identified through electronic database searches. Outcomes included pro-inflammatory markers (TNF-α, IL-6, IL-8, CRP, VCAM-1, ICAM-1, P-selectin) and anti-inflammatory or signalling markers (IL-10, NO, cGMP), assessed at short-term (≤1 week), intermediate-term (4–6 weeks), or long-term (≥12 weeks) follow-up. Risk of bias was assessed using the Cochrane RoB 2 tool. A total of 20 studies comprising 1549 participants were included. Meta-analyses showed no significant short-term effects of PDE5 inhibition on TNF-α, IL-6, or CRP. Long-term treatment was associated with reduced IL-6 (SMD = −0.64, p = 0.002) and P-selectin (SMD = −0.57, p = 0.02), and increased cGMP (SMD = 0.87, p = 0.0003). Effects on IL-10 and nitric oxide were inconsistent across studies. Most trials had low risk of bias. PDE5 inhibitors may exert anti-inflammatory effects in long-term use by reducing vascular inflammation and enhancing cGMP signalling. These findings support further investigation of PDE5 in chronic inflammatory conditions. Full article

Kidney transplant recipients face a substantial burden of premature mortality and morbidity, primarily due to persistent inflammation, cardiovascular risk, and nutritional deficiencies. Traditional nutritional interventions in this population have either focused on supplementing individual nutrients—often with limited efficacy—or required comprehensive dietary overhauls that compromise patient adherence. In this narrative review, we explore the rationale for dietary nut enrichment as a feasible, multi-nutrient strategy tailored to the needs of kidney transplant recipients. Nuts, including peanuts and tree nuts with no added salt, sugar, or oil, are rich in beneficial fats, proteins, vitamins, minerals, and bioactive compounds. We summarize the multiple post-transplant challenges—including obesity, sarcopenia, dyslipidemia, hypertension, immunological dysfunction, and chronic inflammation—and discuss how nut consumption may mitigate these issues through mechanisms involving improved micro-nutrient intake (e.g., magnesium, potassium, selenium), lipid profile modulation, endothelial function, immune support, and gut microbiota health. Additionally, we highlight the scarcity of randomized controlled trials in high-risk populations such as kidney transplant recipients and make the case for studying this group as a model for investigating the clinical efficacy of nuts as a nutritional intervention. We also consider practical aspects for future clinical trials, including the choice of study population, intervention design, duration, nut type, dosage, and primary outcome measures such as systemic inflammation. Finally, potential risks such as nut allergies and oxalate or mycotoxin exposure are addressed. Altogether, this review proposes dietary nut enrichment as a promising, simple, and sustainable multi-nutrient approach to support cardiometabolic and immune health in kidney transplant recipients, warranting formal investigation in clinical trials. Full article

Background/Objectives: Glucocorticoids (GCs) are frequently prescribed to control disease in Rheumatoid Arthritis (RA). However, long-term GC therapy with high daily doses is associated with bone involvement, which is considered the main extra-articular complication of RA. The trabecular bone score (TBS) has proven useful in assessing vertebral trabecular bone quality and fracture risk. To identify whether the long-term treatment of low doses of GCs are associated with low vertebral TBS in RA patients. Methods: A cross-sectional study, including 203 women with RA (ACR, 1987). Clinical, epidemiologic, and therapeutic variables were assessed. We identified the current daily dose, duration, and cumulative dose of GCs. Vertebral bone quality was assessed by TBS. Low vertebral trabecular bone quality was defined as TBS ≤ 1.300. Multivariate logistic regression analyses were used to identify risk factors of low TBS. Results: Prevalence of low TBS in RA women was 52%. RA + low TBS were older (61.9 vs. 55.5, p < 0.001) and had higher prevalence of menopause (90% vs. 75%, p = 0.004), hypertension (50% vs. 34%, p ≤ 0.02), and diabetes mellitus (13% vs. 4%, p = 0.02). There were no associations between GC use, neither doses or cumulative doses, and TBS. Multivariate analyses showed the following: age (OR: 1.05, 95% CI: 1.02–1.08) and the presence of diabetes mellitus (OR: 3.30, 95% CI: 1.03–10.60) were associated with a high risk of low vertebral trabecular bone quality in RA. Conclusions: Half of the RA patients had low trabecular bone quality. Older age and diabetes mellitus are important risk factors for low trabecular bone quality in RA. These findings should give alert to early detection of low TBS, establishing strategies aimed at avoiding the consequences of this complication, including vertebral fractures. Full article