Insight into the 24‐hour ambulatory central blood pressure in adolescents and young adults

This study attempted to investigate the behavior of 24‐hour central ambulatory blood pressure (ABP) in adolescents and young adults. Adolescents and young adults (age 10‐25 years) referred for elevated blood pressure (BP) and healthy volunteers had simultaneous 24‐hour peripheral (brachial) and central (aortic) ABP monitoring using the same automated upper‐arm cuff device (Mobil‐O‐Graph 24h PWA). Central BP was calculated by the device using two different calibration methods (C1SBP using peripheral systolic (pSBP)/diastolic BP and C2SBP using mean arterial/diastolic BP). A total of 136 participants (age 17.9 ± 4.7 years, 54% adolescents, 77% males, 25% volunteers, 34% with elevated peripheral ABP) were analyzed. Twenty‐four‐hour pSBP was higher than C1SBP, with this difference being more pronounced during daytime than nighttime (16.3 ± 4.5 and 10.5 ± 3.2 mm Hg, respectively, P < .001). Younger age, higher body height, and male gender were associated with greater systolic ABP amplification (pSBP‐C1SBP difference). C1SBP followed the variation pattern of pSBP, yet with smaller nighttime dip (8.4 ± 6.0% vs 11.9 ± 4.6%, P < .001), whereas C2SBP increased (2.4 ± 7.2%) during nighttime sleep (P < .001 for comparison with pSBP change). Older age remained independent determinant of larger nighttime BP fall for pSBP and C1SBP, whereas male gender predicted a larger nighttime C2SBP rise. These data suggest that the calibration method of the BP monitor considerably influences the diurnal variation in central BP, showing a lesser nocturnal dip than pSBP or even nocturnal BP rise, which are determined by the individual''s age and gender.     

Glucose lowering does not necessarily reduce cardiovascular risk in type 2 diabetes

Diabetes mellitus (DM) is a health condition characterized by glucose dysregulation and affects millions of people worldwide. The presentation of heart failure in diabetic cardiomyopathy extends over a wide phenotypic spectrum, commencing from asymptomatic, subclinical structural abnormalities to severely symptomatic biventricular dysfunction with increased mortality risk. Similarly, the spectrum of systolic dysfunction in diabetic-induced heart failure is diverse. DM leads also to cardiac electrical remodeling reacting on various targets. Dipeptidyl peptidase-4 (DPP-4) inhibitors reduce glucagon and blood glucose levels by raising levels of the endogenous hormones glucagon-like-peptide 1 and glucose-dependent insulinotropic peptide and constitute a safe and effective glucose lowering treatment option in patients with type 2 DM. Despite DPP-4 inhibitors’ efficacy regarding glycemic control, their effect on cardiovascular outcomes (myocardial infarction, stroke, hospitalization for heart failure, hospitalization for unstable angina, hospitalization for coronary revascularization, and cardiovascular death) in diabetic patients has been neutral. The potential correlation between atrial flutter and DPP-4 inhibitors administration needs further investigation.     

Multiple behavioral risk factors for chronic diseases in adults aged 50+: regional differences across eleven European countries

Aim

The aim of this study was to estimate the differences in prevalence of multiple behavioral risk factors (MBRFs) for chronic diseases in European adults, from eleven North, Central and South European countries.

Subjects and methods

We used data from 26,656 adults, aged 50+ years, participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). Physical inactivity, high body weight, smoking and risky alcohol consumption were assessed and estimated based on sampling weights, controlling for socioeconomic characteristics.

Results

53.4 % of adults had 2+ MBRFs. Prevalence in the total sample was highest for physical inactivity (71.2 %) and lowest for smoking (18.1 %). The cluster of high body weight and physical inactivity had the highest prevalence of MBRFs (35.4 %), with higher prevalence in Southern Europe (p?<?0.05). Smoking and alcohol consumption presented the greatest degree of clustering (observed to expected ratio?=?2.44). Spain and Greece had the highest prevalence of clustering 2+ MBRFs, whereas Southern European countries had a higher mean number of MBRFs, compared to North and Central European regions (p?<?0.05).

Conclusion

Prevalence of MBRFs varied between countries, with Southern European countries engaging in more risky behaviors. Primary prevention programmes should be developed to reduce MBRFs in this population.     

Mediators of the Disparities in Depression Between Sexual Minority and Heterosexual Individuals: A Systematic Review

Archives of Sexual Behavior - Evidence suggests that sexual minorities (e.g., those identifying as lesbian, gay, or bisexual) experience increased rates of depression compared to heterosexual...     

Language development and emergent literacy in preschool

To promote school readiness, preschool and Head Start teachers are incorporating more emergent literacy activities into their curriculum. This article argues that emergent literacy is subordinate to oral language development, rather than language development being subordinate to emergent literacy. Literature on components of emergent literacy is reviewed and a framework for a preschool curriculum that promotes oral language development and emergent literacy is presented. The article concludes with the recommendation that phonologic sensitivity and letter knowledge be taught in developmentally appropriate ways within the context of a language-rich preschool environment that specifically targets vocabulary enrichment.