Hypertension Research Center

Bologna, Italy

Hypertension Research Center

Bologna, Italy

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Singh R.B.,Halberg Hospital and Research Institute | Visen P.,University of Toronto | Sharma D.,Halberg Hospital and Research Institute | Sharma S.,Halberg Hospital and Research Institute | And 10 more authors.
Open Nutraceuticals Journal | Year: 2014

Background: Western diet appears to be a risk factor for non-communicable diseases (NCDs), cardiovascular diseases (CVDs), diabetes and cancer whereas dietary supplements of functional foods rich Mediterranean diets are inversely associated, among individuals and populations with underlying lack of general and health education. We have only scanty information about functional foods which may be considered as nutraceuticals. The prevalence of optimal functional food eating behavior pattern in the population is unknown. This study examines the prevalence of optimal functional foods eating behavior as a protective factor among victims dying due to NCDs to find out the accuracy of the verbal autopsy questionnaire. Subjects and Methods: Death records of 2,222 (1,385 men and 837 women) decedents, aged 25-64 years, out of 3,034 death records, were randomly selected and studied by verbal autopsy questionnaires. All the risk factors and protective factors were assessed by questionnaires which were completed with the help of the victim's spouse and a local treating doctor, by a trained scientist. The lack of knowledge on health education about the role of adverse effects of Western foods was assessed by the questionnaires. Functional food intake was considered in presence of fruit, vegetable and legume intake of minimum 250g/day (moderate) and ideally 400g/day consistent with WHO guidelines. Results: The prevalence of optimal prudent foods intake behavior; fruit, vegetable and legume (>250g/day) intake were observed among 51.4% (n=712) men and 50.4% (n=422) women. Western type food (>255g/day)intake was observed among 63.2% (n=875)men and 59.9% (n=502) women. The prevalence of optimal functional food intake was significantly greater among men compared to women (19.4 vs 14.6%, P<0.05). The consumption of functional food not fruits; grapes and apples, guava, stargoose berry and lemon and onion, garlic ginger was significantly greater among men as compared to women. Other functional foods such as soy products, mustard or olive oil, curd or yogurt, nuts and fish, tea and cocoa, spices; turmeric, cumin, coriander seeds and peppers intake showed no significant difference between two sexes. Multivariate logistic regression analysis revealed that after adjustment of age and body weight, total functional foods intakes and fruit, vegetable, legume and nuts intake were significantly inversely associated with deaths due to NCDs, whereas Western type foods (red meat and eggs, refined foods) were positively associated with these causes of deaths, in both sexes. Total spices intake, mustard/olive oil intake and curd or yogurt intake, were inversely but weakly associated with causes of deaths due to NCDs, among both men and women. The prevalence of protective behavior pattern was observed among half of the victims, dying due to injury and accidents where such behaviors were uncommon among decedents dying due to NCDs. Conclusions: It is possible that protective health behavior about functional food intake can be accurately assessed by a verbal autopsy questionnaire administered to a spouse of the decedents among Indians. The consumption of functional food appears to be lower among victims dying due to CVDs and cancer. © Singh et al.; Licensee Bentham Open.


Wilczynska A.,The Tsim Tsoum Institute | Wilczynska A.,Safaric University | Singh R.B.,The Tsim Tsoum Institute | Singh R.B.,Safaric University | And 7 more authors.
Open Nutraceuticals Journal | Year: 2015

Introduction: Depression and Type A behaviour are important risk factors of death due to cardiovascular disease (CVD) and diabetes. Depression also predisposes deaths due to suicides. In the present study, we examine the association of endogenous depression with causes of deaths and accuracy of the questionnaire for diagnosis, among urban decedents in a lower middle income country. Methods: We studied the randomly selected record1s of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, out of 3034 death records overall from the records at Municipal Corporation, Moradabad, India. All the families of these decedents could be contacted individually to find out the causes of death, by scientist/doctor administered, informed consented, verbal autopsy questionnaire, completed with the help of the spouse and local treating doctor practising in the appropriate health care region. Clinical data and causes of death were assessed by a questionnaire based on available hospital record and verbal autopsy questionnaire, suggested by WHO and International College of Nutrition (ICN). Decedents were classified into mild to moderate and severe depression based on available records and verbal autopsy questionnaire validated for this study by Agnieszka. The association of depression with causes of death was calculated by Mantel-Haesnzel Chi square test. Results: Several of the decedents had mild to moderate depression (n=153, 6.88%) (men 6.64 %, n=92; and women 7.28 %, n=61). The prevalence of severely depressed victims was similar among men (1.08%, n=15) women 1.67% (n=14) with a total of 1.3%(n=29). The total prevalence of depression was 8.19% (n=182). There was an overall increase in diabetes mellitus, hypertension, and CAD among decedents with depression and the trend was significant. The prevalence of depression showed a significant rising trend among decedents dying due to circulatory and suicidal causes of death, both among men and women. Multivariate logistic regression analysis after adjustment of age and body mass index revealed that hypertension and CAD and diabetes mellitus were strongly associated whereas depression and sedentary behaviour were weakly associated with risk of deaths due to CVDs. Social class 3 and 4 were not associated with risk of deaths due to CVDs and diabetes. Depression was an important risk factor of deaths due to CVDs and suicides. Conclusions: The prevalence of depression was substantial among decedents dying due to various causes of death as revealed by the Agnieszka’s questionnaire. Depression may be accurately diagnosed as contributing risk factor among decedents dying due to circulatory diseases and suicides.Larger studies would be necessary to demonstrate the accuracy of the questionnaire in the diagnosis of depression and its association of with causes of death among decedents. © Wilczynska et al.; Licensee Bentham Open.


Hemmati R.,Elam University of Medical science | Gharipour M.,Isfahan University of Medical Sciences | Khosravi A.,Hypertension Research Center | Jozan M.,Hypertension Research Center
International Journal of Hypertension | Year: 2013

Background. The purpose of this study was to answer the question whether a single testing for microalbuminuria results in a reliable conclusion leading costs saving. Methods. This current cross-sectional study included a total of 126 consecutive persons. Microalbuminuria was assessed by collection of two fasting random urine specimens on arrival to the clinic as well as one week later in the morning. Results. In overall, 17 out of 126 participants suffered from microalbuminuria that, among them, 12 subjects were also diagnosed as microalbuminuria once assessing this factor with a sensitivity of 70.6%, a specificity of 100%, a PPV of 100%, a NPV of 95.6%, and an accuracy of 96.0%. The measured sensitivity, specificity, PVV, NPV, and accuracy in hypertensive patients were 73.3%, 100%, 100%, 94.8%, and 95.5%, respectively. Also, these rates in nonhypertensive groups were 50.0%, 100%, 100%, 97.3%, and 97.4%, respectively. According to the ROC curve analysis, a single measurement of UACR had a high value for discriminating defected from normal renal function state (c=0.989). Urinary albumin concentration in a single measurement had also high discriminative value for diagnosis of damaged kidney (c=0.995). Conclusion. The single testing of both UACR and urine albumin level rather frequent testing leads to high diagnostic sensitivity, specificity, and accuracy as well as high predictive values in total population and also in hypertensive subgroups. © 2013 Roholla Hemmati et al.


Zhang W.,Chinese Institute of Clinical Medicine | Sun K.,Chinese Institute of Clinical Medicine | Chen J.,Chinese Institute of Clinical Medicine | Liao Y.,Huazhong University of Science and Technology | And 6 more authors.
Clinical Science | Year: 2010

Plasma homocysteine concentrations have been associated with the risk of stroke, but its relevance to secondary vascular events and mortality after stroke remains unclear because of inconsistent results from clinical trials. The aim of the present study was to investigate whether plasma homocysteine levels and the MTHFR (methylenetetrahydrofolate reductase) variant C677T contributed to the risk of stroke recurrence and all-cause mortality in a large prospective cohort of stroke patients in a Chinese population. A total of 1823 stroke patients (age, 35-74 years) were recruited during 2000-2001 and prospectively followed-up for a median of 4.5 years. During the follow-up, 347 recurrent strokes and 323 deaths from all-causes were documented. After adjustment for age, gender and other cardiovascular risk factors, a high homocysteine concentration was associated with an increased risk of 1.74-fold for stroke recurrence {RR (relative risk), 1.74 [95% CI (confidence interval), 1.3-2.3]; P<0.0001} and 1.75-fold for all-cause mortality [RR, 1.75 (95% CI, 1.3-2.4); P<0.0001] when highest and lowest categories were compared. Spline regression analyses revealed a threshold level of homocysteine for stroke recurrence. By dichotomizing homocysteine concentrations, the RRs were 1.31 (95% CI, 1.10-1.61; P=0.016) for stroke recurrence and 1.47 (95% CI, 1.15-1.88; P<0.0001) for all-cause mortality in patients with homocysteine levels ≥ 16 μmol/l relative to those with levels <16 μmol/l. The association of elevated plasma homocysteine concentrations with all-cause mortality was mainly due to an increased risk of cardiovascular deaths. No significant association was found between MTHFR C677T and stroke recurrence or mortality. In conclusion, our findings suggest that elevated homocysteine concentrations can predict the risk of stroke recurrence and mortality in patients with stroke. © The Authors Journal compilation © 2010 Biochemical Society.


Cicero A.F.,University of Bologna | Cicero A.F.,Hypertension Research Center | Rosticci M.,University of Bologna | Parini A.,University of Bologna | And 4 more authors.
Nutrition Journal | Year: 2015

Abstract Background: Overweight subjects easily develop alterations of the glucose and lipid metabolism and are exposed to an increased cardiometabolic risk. This condition is potentially reversible through the improvement of dietary and behavioural habits. However, a well-assembled nutraceutical would be a useful tool to better improve the metabolic parameters associated to overweight and insulin resistance. Methods: To evaluate the effect of a combined nutraceutical containing berberine, chlorogenic acid and tocotrienols, we performed a double blind, cross-over designed trial versus placebo, in 40 overweight subjects with mixed hyperlipidaemia. After the first 8 weeks of treatment (or placebo), patients were asked to observe a 2-week washout period, and they were then assigned to the alternative treatment for a further period of 8 weeks. Clinical and laboratory data associated to hyperlipidaemia and insulin resistance have been obtained at the baseline, at the end of the first treatment period, after the washout, and again after the second treatment period. Results: Both groups experienced a significant improvement of anthropometric and biochemical parameters versus baseline. However, total cholesterol, LDL cholesterol, triglycerides, non-HDL cholesterol, fasting insulin, HOMA-IR, GOT and Lipid Accumulation Product decreased more significantly in the nutraceutical group versus placebo. Conclusions: This combination seems to improve a large number of metabolic and liver parameters on the short-term in overweight subjects. Further studies are needed to confirm these observations on the middle- and long-term. © 2015 Cicero et al.; licensee BioMed Central.


Cicero A.F.G.,University of Bologna | Cicero A.F.G.,Hypertension Research Center | Morbini M.,University of Bologna | Borghi C.,University of Bologna
Expert Opinion on Pharmacotherapy | Year: 2015

The therapeutic value of omega-3 polyunsaturated fatty acids (PUFAs), mainly (but not only) found in fish oils, eicosapentaenoic and docosahexaenoic acids (EPA and DHA, respectively), has been extensively studied in a wide variety of disease conditions, predominantly in cardiovascular disease. However, the significant difference in efficacy observed in various conditions with different dosages seems to be at least partly related to the large discrepancy in quality of the product and to the bioavailability of the omega-3 PUFA. The research of new sources (e.g., from arctic Krill oil) and pharmaceutical forms of omega-3 PUFA (e.g., omega-3 carboxylic acids) is needed in order to detect the one with the best bioavailability and efficacy, and with a parallel reduction in the production costs. There is also the need to understand if long-term PUFA supplementation could increase the efficacy of the alreadyavailable evidence - based therapies for cardiovascular disease prevention and for the management of the diseases where the use of PUFA could have a possible improving effect. © 2015 Informa UK, Ltd.


Izzo R.,Hypertension Research Center | Stabile E.,Hypertension Research Center | Stabile E.,University of Naples Federico II | Esposito G.,Hypertension Research Center | And 12 more authors.
Journal of Hypertension | Year: 2015

Background and purpose: Carotid atherosclerotic plaques (CAPs) can develop despite appropriate antihypertensive therapy. In this observational study, we assessed characteristics associated with risk of incident CAP in a large hypertensive registry. Methods: We evaluated 2143 hypertensive patients without evidence of CAP. Incident CAP was censored at the time of the first ultrasound control in which CAP was detected. CAP was defined according to European Society of Hypertension/European Society of Cardiology guidelines. Results: At a median follow-up period of 56.6 months, about one-third of patients (32%; N=688) exhibited new CAP. Those patients were older, more frequently smokers, diabetic, more often with metabolic syndrome, chronic kidney disease (CKD), longer hypertension history, higher baseline SBP, pulse pressure (PP), fasting glucose, total cholesterol and triglycerides, greater left ventricular mass index, higher PP/stroke index ratio and carotid intima-media thickness (IMT; all P<0.05). In-treatment BP control was similar in both groups. In multivariable Cox regression, CAP was predicted by older age, diabetes, smoking habit, CKD and higher value of initial IMT (all P<0.02), independently of BP control during follow-up, antihypertensive therapy and other confounders. Conclusion: In this registry of treated hypertensive patients, after adjusting for age and other confounders, risk of incident CAP did not depend on BP control and type of antihypertensive therapy, whereas it was independently related to the magnitude of initial IMT, independently of significant effect of prevalent diabetes and smoking habit. These findings suggest that antihypertensive treatment strategy to stop progression of cardiovascular disease might be difficult to achieve, once target organ damage is established. © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Waib P.H.,Hypertension Research Center | Goncalves M.I.,Hypertension Research Center | Barrile S.R.,Hypertension Research Center
Journal of Clinical Hypertension | Year: 2011

To verify whether there are relationships between vascular and hormonal responses to aerobic training in hypertensive persons, sedentary hypertensive patients were randomized to an aerobic training or a callisthenic exercise group. The patients' 24-hour blood pressure, arterial compliance, forearm blood flow, and hormonal profile were evaluated at baseline and after 3-month training protocols. Mean maximal oxygen consumption (VO 2max) increased by 8% in the aerobic group (P<.001), while no change was observed in the control group. There was a decrease in insulin resistance (homeostatic model assessment of insulin resistance, P=.039) and plasma cortisol (P=.006) in the aerobic group only, that also demonstrated an increase in forearm blood flow (P<.001) after training. No relationship was observed between change in blood pressure or change in body mass and other parameters. Aerobic training can promote a decrease in cardiovascular risk in hypertensive adults by improving vascular function and insulin resistance, despite no changes in ambulatory blood pressure after a 3-month intervention. © 2010 Wiley Periodicals, Inc.


PubMed | Isfahan University of Medical Sciences, Hypertension Research Center and Isfahan Cardiovascular Research Center
Type: Journal Article | Journal: Indian journal of endocrinology and metabolism | Year: 2014

Metabolic syndrome (MetS) is more prevalent among Iranian adolescences. This study aimed to find the relationship between obesity and MetS among different education grades of Iranian adolescence.Overall, 1039 junior high school and 953 high school students were selected using multistage random sampling. Fasting blood sugar, total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDL) were measured. Trained individuals measured waist circumference and blood pressure. MetS was defined according to the De Ferranti definition.The prevalence of overweight and obesity was 12.6% and 6.2% in junior and 11.5% and 4.3% in high school students, respectively. Obese subjects in both grades have higher waist circumference, systolic and diastolic blood pressure, and triglyceride than comparable groups. Multiple logistic regression models showed that overweight and obesity were strongly associated with MetS components analyzed. Compared to normal-weight children, overweight and obese in junior high school students were 1.47 and 2.23 times more likely to be having high TG, respectively, whereas overweight and obese in high school-students were also more likely to have elevated TG [ORs 1.94 (1.28-2.94), 4.96 (2.39-10.3) respectively].Obese children have the highest prevalence of MetS. Prevalence of MetS-related components has reached high level among Iranian adolescences that were overweight or obese.


PubMed | Hypertension Research Center
Type: Journal Article | Journal: Journal of clinical hypertension (Greenwich, Conn.) | Year: 2011

To verify whether there are relationships between vascular and hormonal responses to aerobic training in hypertensive persons, sedentary hypertensive patients were randomized to an aerobic training or a callisthenic exercise group. The patients 24-hour blood pressure, arterial compliance, forearm blood flow, and hormonal profile were evaluated at baseline and after 3-month training protocols. Mean maximal oxygen consumption (VO(2) max) increased by 8% in the aerobic group (P<.001), while no change was observed in the control group. There was a decrease in insulin resistance (homeostatic model assessment of insulin resistance, P=.039) and plasma cortisol (P=.006) in the aerobic group only, that also demonstrated an increase in forearm blood flow (P<.001) after training. No relationship was observed between change in blood pressure or change in body mass and other parameters. Aerobic training can promote a decrease in cardiovascular risk in hypertensive adults by improving vascular function and insulin resistance, despite no changes in ambulatory blood pressure after a 3-month intervention.

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