Genetic effects of adiponectin on blood lipids and blood pressure

Objective Results from the published studies on the association of adiponectin gene (ADIPOQ) polymorphisms with blood lipids and blood pressure are conflicting. We investigated the association of three ADIPOQ polymorphisms, +45 T > G (rs2241766), +276 G > T (rs1501299) and ?11377 C > G (rs266729), with these traits in this meta‐analysis. Research design and methods We included 35 studies in this meta‐analysis. Dominant models were used for this meta‐analysis. Results We did not detect a significant association of the ?11377 C > G polymorphism with blood lipids or blood pressure (P > 0·05). The association of the +45 T > G polymorphism with blood lipids and blood pressure was, similarly, not significant (P > 0·05). The meta‐analysis suggested a significant overall association of the +276 G > T polymorphism with lower levels of total cholesterol: weighted mean difference (WMD) = ?0·10, 95% confidence interval (CI, ?0·17, ?0·03), P = 0·005, P_{heterogeneity} = 0·04. This association was marginally significant in East Asians and East Asians with type 2 diabetes: WMD = ?0·10, 95% CI (?0·20, 0·00), P = 0·05, P_{heterogeneity} = 0·002, and WMD = ?0·09, 95% CI (?0·18, ?0·00), P = 0·05, P_{heterogeneity} = 0·80, respectively. After exclusion of a study that was the source of heterogeneity, the association was significant in overall populations and marginally significant in East Asians: WMD= ‐0·06, 95% CI (?0·11, ?0·01), P = 0·01, P_{heterogeneity} = 0·98, and WMD = ?0·06, 95% CI (?0·12, 0·00), P = 0·07, P_{heterogeneity} = 0·83, respectively. However, none of these associations were significant after Bonferroni correction (significant threshold: P < 0·003). Conclusions Our meta‐analysis does not suggest any association of the three ADIPOQ polymorphisms with blood lipids and blood pressure.     

Comparative effects of doxazosin and hydrochlorothiazide on serum lipids and blood pressure in essential hypertension

The efficacy and safety of doxazosin (mean dosage 6.9 mg, range 1 to 16) in the treatment of essential hypertension were compared in a double-blind study with those of hydrochlorothiazide (HCTZ) (mean dosage, 84.6 mg, range 25 to 100) in 104 hypertensive patients treated once daily for 6 months. Thirty-five patients were also assessed for comparative effects of the 2 agents on serum lipid parameters. Doxazosin produced potentially favorable changes from baseline in the concentrations of serum lipid fractions (total triglycerides, total cholesterol, high density lipoprotein [HDL] cholesterol and the derived HDL/total cholesterol ratio) compared with HCTZ. The decreases in total triglyceride and total cholesterol concentrations and an increase in the HDL/total cholesterol ratio were significantly different (p less than 0.006) from the opposite changes observed with HCTZ. Clinically relevant decreases from baseline in supine and standing blood pressures at 24 hours after administration did not significantly differ between the 2 agents. The incidence and severity of side effects were similar for both drugs. Three patients receiving doxazosin and 6 receiving HCTZ were withdrawn due to drug-related clinical side effects including 2 patients receiving HCTZ who were withdrawn because of laboratory test abnormalities. Eight HCTZ- and 1 doxazosin-treated patients developed hypokalemia and 6 HCTZ-treated patients developed hyperuricemia. These findings indicate that doxazosin and HCTZ provide comparable antihypertensive efficacy after 6 months of treatment using a once-daily regimen, but doxazosin produces a beneficial effect on the serum lipid profile as well as fewer biochemical aberrations.     

植物雌激素对血压的影响

目的研究大豆饮食中所含的植物雌激素对健康人血压、血脂谱的影响。方法213名健康受试者(男性108人,绝经后女性105人),年龄50-75岁,随机、双盲接受特定大豆蛋白饮食(试验组)或酪蛋白安慰剂(安慰剂组)干预,为期3个月。建立多变量模型以评价治疗效果。结果饮食干预后,仅在试验组受试者尿液中植物雌激素含量增高。试验组血压较安慰剂组下降明显[收缩压(-7.5±1.2)mm Hg比(-3.6±1.1)mm Hg,P<0.01;舒张压(-4.3±0.8)mm Hg比(-1.9±0.7)mm Hg,P<0.05;平均压(-5.5±1.0)mm Hg比(-0.9±1.0)mm Hg,P<0.008]。试验组血脂水平较安慰剂组有显著改变(P<0.001),其中试验组低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值显著下降[(-0.33±0.10) mmol/L比(0.04±0.10) mmol/L,P<0.05],甘油三酯水平也有显著下降[(-0.20±0.05)mmol/L比(-0.01±0.05)mmol/L,P<0.05],而脂蛋白(a)水平升高(±95%可信区间)[42(17-67)mg/L比4(-22-31)mg/L,P<0.05]。两组中总胆固醇和低密度脂蛋白胆固醇水平均下降,高密度脂蛋白胆固醇水平升高。副作用的发生率两组相似,并且都没有观察到男性激素水平发生改变。结论在正常血压男性和绝经后女性人群中,大豆饮食对血压和血脂水平有改善作用。     

Betaxolol in obese hypertensive patients. Long-term effects on blood pressure and serum lipids.

The antihypertensive and metabolic effects of betaxolol (20 mg/day) were monitored in 40 patients (17 male), aged 54 +/- 2 yr (mean +/- SEM), with moderate essential hypertension. In a subgroup, consisting of 35 obese patients with a Quetelet index greater than 25.0, blood pressure, heart rate, side effects and biochemical variables were registered bi-monthly for a period of 6 months and after a placebo run-in and run-out period of 2 weeks. Betaxolol decreased blood pressure from 165 +/- 3/107 +/- 1 to 151 +/- 3/95 +/- 2 mmHg after 2 weeks and further to 151 +/- 3/93 +/- 2 mmHg after 6 months (p less than 0.001). Ninety percent of the patients responded to therapy with betaxolol. Heart rate fell from 77 +/- 2 to 64 +/- 1 bpm (p less than 0.001). No significant changes were observed in levels of total cholesterol, LDL-cholesterol or HDL-cholesterol. Triglycerides tended to increase from 2.2 +/- 0.3 to 2.8 +/- 0.4 mmol/l after 4 months of treatment (NS). Renal function was not influenced by betaxolol. Side effects, recorded on a standard questionnaire, did not differ between betaxolol and placebo. In conclusion, betaxolol in a fixed dose of 20 mg/day is an effective antihypertensive drug in the long-term treatment of obese, hypertensive patients, without adverse effects on lipoproteins.     

Relationship of cigarette smoking to blood pressure and serum lipids

The relationship between cigarette smoking and blood pressure and serum lipids was studied in 1775 men aged 20-59 years, in non-drinkers and drinkers separately, controlling for body mass index and physical fitness (VO2max). While systolic blood pressure was not associated with cigarette smoking, diastolic blood pressure decreased with increasing levels of cigarette smoking in non-drinkers but not in drinkers. Total cholesterol was inversely associated with smoking cigarettes in drinkers and was not associated in non-drinkers. High density lipoprotein (HDL)-cholesterol decreased with an increasing degree of cigarette consumption in non-drinkers but not in drinkers. An increase in total cholesterol/HDL-cholesterol ratio and triglyceride levels was positively associated with smoking cigarettes regardless of drinking habit. The present study suggests that cigarette smoking is a cardiovascular risk factor, partly due to its effect of increasing the atherogenic index, but it remains to be consolidated whether chronic smoking has an effect of lowering diastolic blood pressure.     

The role of insulin in clustering of serum lipids and blood pressure in children and adolescents

Summary In adults hyperinsulinaemia is associated with an atherogenic risk profile including obesity, low levels of HDL-cholesterol, high levels of triglycerides and elevated blood pressure. To examine these associations in the young we studied the cross-sectional relationships of insulin with obesity indices (body mass index, subscapular skinfold thickness), serum lipids and blood pressure in 1,865 children, adolescents and young adults aged 6–24 years. We also used longitudinal data to study the value of a single insulin measurement to predict high risk factor levels and clustering of multiple risk factors after a 6-year follow-up. In cross-sectional analyses the levels of triglycerides, HDL-cholesterol, systolic blood pressure and obesity indices were usually significantly different across the quartiles of fasting insulin in both sexes among children, adolescents and young adults. In general, no associations were seen with total cholesterol or LDL-cholesterol. In prospective analysis elevated baseline insulin was related to the incidence of hypertriglyceridaemia (95th percentile) at the follow-up. This relationship persisted even after adjustments for baseline obesity or 6-year change in obesity status. Moreover, baseline insulin concentration was higher in subjects who subsequently showed clustering of high triglycerides, low HDL-cholesterol and high systolic blood pressure levels at the follow-up. We conclude that high fasting insulin levels measured in children and adolescents predict the development of hypertriglyceridaemia years later. In addition, high insulin levels seem to precede the development of a potentially atherogenic risk factor profile including low HDL-cholesterol, high triglycerides and high systolic blood pressure.Abbreviations SBP Systolic blood pressure - DBP diastolic blood pressure - BMI body mass index     

The effects of antihypertensive agents on serum lipids and lipoproteins

Hypertension is a major risk factor for arteriosclerotic vascular disease. Despite intensive antihypertensive intervention, the risk of cardiovascular disease has not declined appreciably. Many of the antihypertensive agents have been shown to elevate total serum cholesterol and triglyceride levels or lower the high-density lipoprotein-cholesterol level. Thus, the antihypertensive agents chosen may negate the beneficial effects of a lower blood pressure. Our purpose is to review all available antihypertensive medications and their influence on lipoprotein metabolism. Choosing the antihypertensive therapy least likely to worsen or precipitate other known cardiovascular risk factors is important. Cost and side effect profiles must also be considered in choosing the best antihypertensive regimen for your patients.     

运动对老年高血压患者血压和糖,脂代谢的影响

目的探讨运动对老年高血压患者血压和糖、脂代谢的影响。方法将４３例老年高血压患者随机分为运动组和对照组，两组均接受尼群地平降压治疗，同时运动组进行为期３个月的体育运动。测量两组入组时和３个月后血压、血脂、空腹血糖、胰岛素及负荷后１ｈ和２ｈ血糖及血胰岛素。结果经过３个月规则运动，运动组空腹及糖负荷后１ｈ、２ｈ胰岛素水平、血胆固醇、甘油三酯及低密度脂蛋白较对照组降低（Ｐ值均＜０．０５），高密度脂蛋白较对照组增高（Ｐ＜０．０５）；试验后两组血压均较入组时降低，而运动组服药量较对照组减少（Ｐ＜０．０５）。结论规则的体育运动能降低老年高血压患者空腹及糖负荷后血胰岛素水平，并有利于血脂代谢紊乱的纠正和血压的控制     

Effects of alcohol and caloric restrictions on blood pressure and serum lipids in overweight men.

We have examined the independent and combined effects on blood pressure and blood lipids of alcohol restriction and weight loss in overweight male drinkers with a view to assessing overall effects on cardiovascular risk of two widely promoted nonpharmacological approaches for hypertension. Eighty-six men with a mean age of 44.3 years, a mean regular alcohol intake of 440 ml/wk (five or six standard drinks per day), a mean blood pressure of 137.4 mm Hg systolic and 84.8 mm Hg diastolic, and a mean body mass of 92.5 kg entered a controlled two-way factorial study. The subjects were randomly assigned to four groups for an 18-week intervention in which members of two groups drank only low-alcohol beer, thereby reducing their alcohol intake by 374 ml/wk, while those of the other two groups continued their normal alcohol intake. Within the low and normal alcohol intake groups subjects either continued their usual diet or reduced their caloric intake by 4,200-6,300 kJ/day (1,000-1,500 kcal/day) (with protein, fat, and carbohydrate provided as 15%, 30%, and 55% of total calories, respectively). Calorie reduction and alcohol restriction caused weight losses of 7.5 (p less than 0.001) and 2.1 (p less than 0.01) kg, respectively. Calorie reduction and alcohol restriction were associated with decreases in systolic blood pressure of 5.4 (p less than 0.001) and 4.8 (p less than 0.01) mm Hg, respectively, and in diastolic blood pressure of 4.2 (p less than 0.001) and 3.3 (p less than 0.01) mm Hg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effects of macronutrients on blood pressure and lipids: An overview of the DASH and omniheart trials

Macronutrients are those nutrients (protein, fat, and carbohydrate) that provide energy. The purpose of this review is to highlight findings of three large-scale, isocaloric feeding studies: the Dietary Approaches to Stop Hypertension (DASH) trial, the DASH-Sodium trial, and the Optimal Macro-Nutrient Intake to Prevent Heart Disease (OmniHeart) trial. Each of these trials tested the effects of diets with different macronturient profiles on traditional cardiovascular disease (CVD) risk factors (ie, blood pressure and blood lipids) in the setting of stable weight. The DASH and DASH-sodium trials demonstrated that a carbohydrate-rich diet that emphasizes fruits, vegetables, and low-fat dairy products and that is reduced in saturated fat, total fat, and cholesterol substantially lowered blood pressure and low-density lipoprotein cholesterol. OmniHeart demonstrated that partial replacement of carbohydrate with either protein (about half from plant sources) or with unsaturated fat (mostly monounsaturated fat) can further reduce blood pressure, low-density lipoprotein cholesterol, and coronary heart disease risk. Results from these trials highlight the importance of macronutrients as a determinant of CVD risk. Furthermore, these results also document substantial flexibility that should enhance the ability of individuals to consume a heart-healthy diet.     

The effects of macronutrients on blood pressure and lipids: An overview of the DASH and OmniHeart trials

Macronutrients are those nutrients (protein, fat, and carbohydrate) that provide energy. The purpose of this review is to highlight findings of three large-scale, isocaloric feeding studies: the Dietary Approaches to Stop Hypertension (DASH) trial, the DASH-Sodium trial, and the Optimal Macro-Nutrient Intake to Prevent Heart Disease (OmniHeart) trial. Each of these trials tested the effects of diets with different macronturient profiles on traditional cardiovascular disease (CVD) risk factors (ie, blood pressure and blood lipids) in the setting of stable weight. The DASH and DASH-sodium trials demonstrated that a carbohydrate-rich diet that emphasizes fruits, vegetables, and low-fat dairy products and that is reduced in saturated fat, total fat, and cholesterol substantially lowered blood pressure and low-density lipoprotein cholesterol. OmniHeart demonstrated that partial replacement of carbohydrate with either protein (about half from plant sources) or with unsaturated fat (mostly monounsaturated fat) can further reduce blood pressure, low-density lipoprotein cholesterol, and coronary heart disease risk. Results from these trials highlight the importance of macronutrients as a determinant of CVD risk. Furthermore, these results also document substantial flexibility that should enhance the ability of individuals to consume a heart-healthy diet.     

广西黑衣壮族人群血压和血脂水平调查

目的探讨广西黑衣壮族人群的血压和血脂水平及其高血压与高脂血症的关系。方法采用整群抽样方法对1056例黑衣壮族人群的血压、身高、体重、体重指数、血脂及载脂蛋白（Apo）进行测定,并将其结果与925例当地的汉族人群作比较。结果黑衣壮族人群收缩压和脉压水平显著高于汉族人群（P〈0．001）,单纯收缩期高血压和高血压的患病率也明显高于汉族人群（P〈0．001）;而总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白一胆固醇和ApoB水平则显著低于汉族人群（P〈0．05～0．001）,高胆固醇血症和高脂血症患病率也显著低于汉族人群（P〈0．05）,但高密度脂蛋白胆固醇水平和Apo A1／B比值则显著高于汉族人群（P〈0．001）。黑衣壮族人群高血压患病率与TG呈显著正相关（r=0．425,P〈0．05）,而汉族人群高血压患病率则与TC呈显著正相关（r=0．623,P〈0．001）。结论黑衣壮族人群的血压和血脂水平与汉族人群存在显著差异,高血压和高脂血症患病率有密切关系。     

瑞舒伐他汀对老年高血压患者血压及血清C-反应蛋白水平的影响

原发性高血压是一种常见的体循环动脉血压升高为主要特征,诱发心血管疾病的主要危险因素。近年来研究证实,高敏C-反应蛋白（hs-CRP）与高血压独立相关,在高血压众多危险因子中,hs-CRP的敏感性及特异性最高。他汀类调脂药是临床常用的调脂药,除具有调脂作用外,还具有抗炎等作用。本研究旨在探讨瑞舒伐他汀对原发性高血压患者的血压与hs—CRP水平的影响。     

Acute effects of salt on blood pressure are mediated by serum osmolality

It is classically thought that it is the amount of salt that is critical for driving acute blood pressure responses. However, recent studies suggest that blood pressure responses, at least acutely, may relate to changes in serum osmolality. Here, we test the hypothesis that acute blood pressure responses to salt can be altered by concomitant water loading. Ten healthy patients free of any disease and medication underwent 4 interventions each a week apart in which they took 300 mL of lentil soup with no salt (visit 1), lentil soup with 3 g salt (visit 2), or lentil soup with 3 g salt and 500 mL water (visit 3) or 750 mL water (visit 4). At each visit, hourly blood measurements and blood pressure measurements (baseline, 1st, 2nd, 3rd, and 4th hour) were performed and plasma osmolarity, sodium and copeptin levels were measured. Patients receiving the 3 g salt showed a 6 mOsm/L change in osmolality with a 2.5 mmol/L change in plasma sodium and 10 mm Hg rise in systolic blood pressure at 2 hours. When the same patients drank salty soup with water, the changes in plasma osmolarity, plasma sodium, and blood pressure were prevented. The ability to raise blood pressure acutely with salt appears dependent on changes in plasma osmolality rather than the amount of salt. Our findings suggest that concurrent intake of water must be considered when evaluating the role of salt in blood pressure.     

Acute effects of prolonged exercise on serum lipids

The acute effects of a single prolonged exercise session on the serum concentrations of cholesterol, triglycerides (TG), glycerol, high density lipoprotein (HDL) cholesterol, and the major HDL protein, apolipoprotein A-I (apoA-I), were examined in 12 trained male runners participating in a 42-km footrace. Serum TG levels were unchanged up to 4 h after the race, but at 18, 42, and 66 hr mean reductions of 65%, 39%, and 32% were observed. Free glycerol concentrations were increased fivefold immediately after the race, but did not differ from prerace levels by 4 hr. Total cholesterol concentration did not change immediately after exercise, but unexpected significant reductions of 6%–10% were found at 4–66 hr. Only small and transient increases in HDL cholesterol and apoA-I levels were noted after exercise. These results suggest that prolonged exercise acutely lowers TG and total cholesterol, but has little effect on HDL mass.