Clinical,physical, physiological,and dietary patterns of obese and sedentary adults with primary hypertension characterized by sex and cardiorespiratory fitness: EXERDIET-HTA study

The main purpose of this study was to determine some key physical, physiological, clinical, and nutritional markers of health status in obese and sedentary adults (54.0 ± 8.1 years, 141 men and 68 women) with primary hypertension (HTN) characterized by sex and cardiorespiratory fitness (CRF) level. The studied population showed a high cardiovascular risk (CVR) profile including metabolically abnormal obese, with poor CRF level (22.5 ± 5.6 mL·kg^?1·min^?1), exercise-induced HTN (Systolic Blood Pressure>210 mmHg in men and >190 mmHg in women at the end of the exercise test) and with non-healthy adherence to dietary pattern (Dietary Approaches to Stop Hypertension, 46.3%; Mediterranean Diet, 41.1%; and Healthy Diet Indicator, 37.1%). Women showed a better biochemical and dietary pattern profile than men (lower values, P < 0.05, in triglycerides, mean difference = 26.3; 95% CI = 0.9–51.7 mg/dL, aspartate transaminase, mean difference = 4.2; 95% CI = 0.3–8.0 U/L; alanine transaminase, mean difference = 8.2; 95% CI = 1.6–14.8 U/L; gamma-glutamyl transpeptidase, mean difference = 11.0; 95% CI = -1.1–23.2 U/L and higher values, P = 0.002, in high-density lipoprotein cholesterol, mean difference = 5.0, 95% CI = -13.3–3.3 mg/dL), but physical and peak exercise physiological characteristics were poorer. A higher CRF level might contribute to the attenuation of some CVR factors, such as high body mass index, non-dipping profile, and high hepatic fat. The results strongly suggest that targeting key behaviors such as improving nutritional quality and CRF via regular physical activity will contribute to improving the health with independent beneficial effects on CVR factors.     

Thrombotic biomarkers and left ventricle characteristics as short-term predictors of thrombotic events in patients hospitalized for acute decompensated heart failure

BackgroundHospitalized acute decompensated heart failure (ADHF) patients have high risk of thromboembolic events (TE). The aim of this study is to determine the short-term prognostic value of TE for different thrombotic biomarkers (fibrinogen; D-dimer; tissue plasminogen activator antigen, t-PA; and plasminogen-activator inhibitor type 1 antigen, PAI-1) and left ventricle echocardiographic characteristics (diastolic diameter, LVDD; ejection fraction, LVEF) in admitted ADHF patients.Methods and resultsWe included 140 patients with ADHF in NYHA classes III–IV (October 2009 to November 2011). Subjects with anticoagulant drugs, arrhythmias, or thrombosis were excluded. Biochemical and echocardiographic data were obtained within 12 h after admission and all patients were given enoxaparin 40 mg/day. Throughout hospitalization (median, 11 days), 14 subjects (10.0%) with ADHF received a TE diagnosis. Pulmonary embolism (PE, 5.0%), deep-vein thrombosis (DVT, 7.1%), or a combination of these were confirmed in 3, 6 and 4 patients respectively. Cardioembolic stroke was diagnosed in 1 subject (0.7%) associated with left ventricular intracavitary thrombus developed after admission. The following determinations most strongly predicted the short-term risk of TE: fibrinogen > 500 mg/dL (Odds Ratio [OR] 6.19; p = .0019), D-dimer > 600 ng/dL (OR 7.84; p = .0009), t-PA > 10 ng/dL (OR 7.22; p = .0007), PAI-1 > 30 ng/dL (OR 8.70; p < .0006), LVDD > 50 mm (OR 5.67; p = .0039), and LVEF < 30% (OR 5.48; p = .0163).ConclusionsElevated levels of fibrinogen, D-dimer, t-PA and PAI-1 antigens as well as a dilated left ventricle with poor systolic function determined at admission are associated with a significantly high short-term risk of TE.     

Actigraphy-based sleep analysis in sedentary and overweight/obese adults with primary hypertension: data from the EXERDIET-HTA study

Sleep and Breathing - The aim of this study was to analyze actigraphy-based sleep quantity and quality in sedentary and overweight/obese adults with primary hypertension (HTN) divided by sex and...