Author Interviews, Blood Pressure - Hypertension, JAMA, OBGYNE / 04.05.2022

MedicalResearch.com Interview with: Richard McManus MA PhD MBBS FRCGP FRCP Professor of Primary Care Dr. McManus chairs the Blood Pressure Monitoring Working Party of the British Hypertension Society Nuffield Department of Primary Care Health Sciences  MedicalResearch.com:  What is the background for this study?  Response: About one in ten people who are pregnant develop high blood pressure and almost half of these go onto to have pre-eclampsia. Many pregnant women and individuals are already measuring their own blood pressure – well over half of those with high blood pressure in a recent large survey in the UK but until recently there were no data to support this. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues / 05.04.2022

MedicalResearch.com Interview with: Dr. Yangfeng Wu Peking University Clinical Research Institute Peking University MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: It is well-established that elevated blood pressure (BP) at single time point can contribute to increased risks of suffering accelerated cognitive decline, dementia, and mortality. Nevertheless, BP levels could experience significant alterations as time goes, indicating the necessity of monitoring BP longitudinally. In other words, using blood pressure levels measured at baseline to predict future outcomes in a longitudinal cohort with a long-term follow-up period ≥20 years, becomes controversial. Cumulative BP levels have been indicated as a feasible approach for evaluating long-term exposure of BP levels, which might have the ability to respond to this controversy. This is the main reason why we performed this research to evaluate the predictive values of cumulative BP levels, especially additional values beyond baseline blood pressure levels, for future neurocognitive and longevity outcomes. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 18.03.2022

MedicalResearch.com Interview with: Paolo Palatini, M.D. Professor of Internal Medicine University of Padova Padova, Italy  MedicalResearch.com:  What is the background for this study?  Response: Up to now doctors measured blood pressure (BP) on standing only in elderly people on pharmacological treatment with the purpose of detecting orthostatic hypotension. In young-to-middle-age people BP is currently measured only in the lying or the sitting posture. Our starting point was that young borderline hypertensive people have an increased sympathetic activity and thus they might be hyperreactive to physical stimuli such as assuming the orthostatic posture which may be deleterious in the long run. This hypothesis was tested in the HARVEST, a study initiated in Italy in 1990, in which over 1200 young patients screened for stage 1 hypertension were enrolled. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, NIH / 12.03.2022

MedicalResearch.com Interview with: Lenore J. Launer, Ph.D. Chief, Laboratory of Epidemiology and Population Sciences Intramural Research Program, National Institute on Aging. MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Identifying early risk factors and early changes in the brain will have a major impact on future clinical and public health priorities related to the looming epidemic of dementia. Several studies based on older populations suggest mid-life is an important period to start prevention measures. To date control of blood pressure levels has been the most robust and promising candidate to target for prevention of future cognitive impairment. Although several studies have looked at levels of blood pressure and risk for cognitive impairment, it was not known whether trajectories from young adulthood to middle age studies provided additional information about risk. To investigate possible biomarkers of future risk, we chose to examine the association of the mean arterial blood pressure trajectories to indicators of pathology seen on MRI and that are associated with cognition. We highlight the results of the mean arterial blood pressure (MAP) measure, which is an integrated measure of systolic and diastolic blood pressure. (more…)
AHA Journals, Blood Pressure - Hypertension, Dental Research, Menopause / 07.03.2022

MedicalResearch.com Interview with: Michael J. LaMonte, PhD, MPH Research Professor (epidemiology) Department of Epidemiology and Environmental Health School of Public Health and Health Professions Women’s Health Initiative Northeast Regional Center University at Buffalo – SUNY Buffalo, NY 14214 MedicalResearch.com:  What is the background for this study?  What are the main findings? Dr. LaMonte:  The rationale for this study was based on existing study results showing
  • (1) oral bacteria are involved with conversion of dietary nitrate (e.g., from leafy greens and beets) to nitric oxide which is a chemical involved keeping arteries healthy and maintaining blood pressure;
  • (2) rinsing the mouth with antiseptic solution (mouthwash) kills oral bacteria and results in rapid increases in systolic and diastolic blood pressure; and
  • (3) a very limited amount of epidemiological data suggest that the oral bacteria found beneath the gums (responsible for gingivitis and periodontal disease) are associated with blood pressure and history of hypertension in middle-aged adults.
Thus, we conducted our study to determine whether oral bacteria (beneath the gums) would be predictive of developing hypertension among women who were without this condition at the time the bacteria were measured. Because the bacteria (exposure) would be known to precede development of hypertension (disease), an association seen in our study would be strongly suggestive of a role for oral bacteria in the development of high blood pressure. Our primary result was for statistically significant higher risks of developing hypertension associated with 10 bacterial species, and significantly lower risks of developing hypertension associated with 5 bacterial species. Our findings were evident even after we accounted for differences in demographic factors, lifestyle factors, and clinical factors, and generally were of consistent magnitudes we examined across subgroups of older and younger women, white and black women, normal weight and overweight/obese women, those with normal or slightly elevated blood pressure at study enrollment, and those who were using or not using menopausal hormone therapy at baseline. Therefore, while our observational study evidence for an association is not equivalent to causation, the robustness of the associations between oral bacteria and hypertension risk supports a need to further understand this relationship, ideally with a clinical trial design that would provide definitive evidence to support or refute causation.  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Race/Ethnic Diversity, Social Issues / 03.02.2022

MedicalResearch.com Interview with: Xing Gao, MPH, lead author and doctoral candidate in Dr. Mujahid's research group Mahasin Mujahid, MS, PhD, FAHA Lillian E. I. and Dudley J. Aldous Chair in the School of Public Health Associate Professor of Epidemiology Director, Epidemiology & Biostatistics Master of Public Health Program UC Berkeley, School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings?
  • ​​Hypertension is a major risk factor for cardiovascular diseases, and persistent racial and ethnic inequities in hypertension remain an urgent public health challenge.
  • Public health researchers need a more nuanced understanding of how structural factors contribute to these inequities, which has a direct application to improving the cardiovascular health of marginalized populations.
  • This study examined associations between racial residential segregation, a product of historical and contemporary racially discriminatory policies, and hypertension in a multi-racial cohort of middle-aged and older adults. 
(more…)
Aging, Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, JAMA / 14.12.2021

MedicalResearch.com Interview with: Jan Willem van Dalen, PhD Department of Neurology Donders Institute for Brain, Behaviour and Cognition Radboud University Medical Centre Nijmegen Department of Neurology The Netherlands3Department of Public and Occupational Health Amsterdam UMC, University of Amsterdam, Amsterdam   MedicalResearch.com: What is the background for this study? Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk. This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases. Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals. (more…)
Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, Heart Disease, JAMA / 05.08.2021

MedicalResearch.com Interview with: Fernando Ribeiro PhD School of Health Sciences Institute of Biomedicine - iBiMED University of Aveiro Aveiro, Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Resistant hypertension is a puzzling problem without a clear solution. The available treatment options to lower blood pressure, namely medication and renal denervation, have had limited success, making nonpharmacological strategies good candidates to optimize the treatment of this condition. Exercise training is consistently recommended as adjuvant therapy for patients with hypertension, yet, it is with a great delay that the efficacy of exercise training is being tested in patients with resistant hypertension. Having that in mind, the EnRicH trial was designed to address whether the benefits of an exercise intervention with proven results in hypertensive individuals are extended to patients with resistant hypertension, a clinical population with low responsiveness to drug therapy. Exercise training was safe and associated with a significant and clinically relevant reduction in 24-hour, daytime ambulatory, and office blood pressure compared with control (usual care). (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Kidney Disease / 04.08.2021

MedicalResearch.com Interview with: Maria Luisa S. Sequeira Lopez, MD, FAHA Harrison Distinguished Professor in Pediatrics and Biology University of Virginia Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? Response: The renin-angiotensin system (RAS) is crucial in the regulation of the blood pressure (BP). Synthesis and secretion of renin is the key regulated event in the operation of the RAS. One of the main mechanisms that control renin synthesis and release is the baroreceptor mechanism whereby a decrease in blood pressure results in increased release of renin by juxtaglomerular (JG) cells. In spite of its enormous importance, the nature and location of the renal baroreceptor was still unknown. This was due in great part to the lack of appropriate in vitro and in vivo models to confidently allow tracking of the fate and isolation of renin cells, and the lack of tools to study the chromatin in scarce cells. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Memory / 21.06.2021

MedicalResearch.com Interview with: Daniel A. Nation, Ph.D., Associate Professor of Psychological Science Institute for Memory Impairments and Neurological Disorders University of California, Irvin MedicalResearch.com: What is the background for this study? Response: Hypertension is a risk factor for cognitive decline and dementia, and treatment of hypertension has been linked to decreased risk for cognitive impairment. Prior studies have attempted to identify which specific type of antihypertensive treatment conveys the most benefit for cognition, but findings have been mixed regarding this question.  We hypothesized that antihypertensive drugs acting on the brain angiotensin system may convey the greatest benefit since they affect the brain angiotensin system that has been implicated in memory function. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, USPSTF / 07.05.2021

MedicalResearch.com Interview with: John B. Wong, M.D. Chief Scientific Officer Vice chair for Clinical Affairs Chief of the Division of Clinical Decision Making and Primary care Clinician Department of Medicine at Tufts Medical Center   MedicalResearch.com: What is the background for this study? Response: Hypertension affects nearly half of all adults in the United States and is a major risk factor for many serious health conditions. Fortunately, by screening all adults for hypertension, clinicians can improve their patient’s health. The Task Force continues to recommend screening all adults for hypertension so that they can get the care they need to help prevent health conditions such as heart attack, stroke, and kidney failure. (more…)
AHA Journals, Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Microbiome / 30.04.2021

MedicalResearch.com Interview with: David J. Durgan, PhD Department of Anesthesiology Baylor College of Medicine Houston, TX  MedicalResearch.com: What is the background for this study? Response: Our lab and others had previously shown that gut dysbiosis is not only associated with hypertension, but actually plays a causal role. For example we have shown in both a genetic model of hypertension as well as an obstructive sleep apnea induced model of hypertension, that transplantation of their dysbiotic microbiota into normotensive recipients induced elevations in blood pressure. With this understanding our focus shifted to two new questions 1) How can we manipulate the microbiota to improve/prevent hypertension, and 2) What are the signals originating from the microbiota that have the capability to influence host blood pressure? These questions lead to the experimental design of this study. (more…)