Greater adherence to the Dietary Approaches to Stop Hypertension (DASH) diet during pregnancy reduces the likelihood of having a large-for-gestational-age newborn
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Self-reported hypertension prevalence, risk factors, and knowledge among South Africans aged 24 to 40 years old
Although hypertension is a significant public health burden in South Africa (SA), less is known about its prevalence, risk factors, and possible preventative strategies among young adults. We assessed the prevalence, possible risk factors, and knowledge associated with self-reported hypertension among young adults from SA. A cross-sectional online survey was conducted among 1000 young South African adults (24–40 years; 51.0% women). We administered a socio-demographic questionnaire and collected information on measures of socio-economic status (SES) (e.g. asset wealth index), self-reported medical history, and lifestyle risk factors. Furthermore, a modified version of the hypertension evaluation of lifestyle and management questionnaire was used to assess participants’ hypertension knowledge. The overall prevalence of self-reported hypertension was 24.0%, with significant differences between women and men (27.5% and 20.4% respectively, p = 0.033). Only 16.8% of the respondents had good hypertension knowledge. There was a positive association between good knowledge of hypertension and being hypertensive (OR = 1.43 CI:1.23–3.12), monthly blood pressure check-ups (OR = 2.03 CI:1.78–3.23), knowing the side effects of uncontrolled blood pressure (OR = 1.28 CI:1.07–1.89) and having a biological mother with hypertension (OR = 1.79 CI:1.53–2.21). Being employed full-time (OR = 0.74 CI:0.69–0.80), having a higher SES (wealth index 4 (OR = 0.70 CI:0.59–0.97) and 5 (OR = 0.65 CI:0.48–0.81)), exercising 6 to 7 days per week (OR = 0.83 CI:0.71–0.94), and not consuming alcohol at all (OR = 0.73 CI:0.67–0.89), were all found to be protective against hypertension. The high hypertension prevalence, lack of hypertension knowledge, and reported risk factors among this group highlight the need for early robust preventative strategies to mitigate hypertension risk among this population.
Investigation and management of resistant hypertension: British and Irish Hypertension Society position statement
People living with resistant hypertension (RH) are at high risk of adverse cardiovascular events. The British and Irish Hypertension Society has identified suspected RH as a condition for which specialist guidance may improve rates of blood pressure control and help clinicians identify those individuals who may benefit from specialist review. In this position statement we provide a practical approach for the investigation and management of adults with RH. We highlight gaps in the current evidence and identify important future research questions. Our aim is to support the delivery of high-quality and consistent care to people living with RH across the UK and Ireland.
Epigenomics and transcriptomics association study of blood pressure and incident diagnosis of hypertension in twins
Hypertension is the most frequent health-related condition worldwide and is a primary risk factor for renal and cardiovascular diseases. However, the underlying molecular mechanisms are still poorly understood. To uncover these mechanisms, multi-omics studies have significant potential, but such studies are challenged by genetic and environmental confounding – an issue that can be effectively reduced by studying intra-pair differences in twins. Here, we coupled data on hypertension diagnoses from the nationwide Danish Patient Registry to a study population of 740 twins for whom genome-wide DNA methylation and gene expression data were available together with measurements of systolic and diastolic blood pressure. We investigated five phenotypes: incident hypertension cases, systolic blood pressure, diastolic blood pressure, hypertension (140/90 mmHg), and hypertension (130/80 mmHg). Statistical analyses were performed using Cox (incident cases) or linear (remaining) regression analyses at both the individual-level and twin pair-level. Significant genes (p < 0.05) at both levels and in both types of biological data were investigated by bioinformatic analyses, including gene set enrichment analysis and interaction network analysis. Overall, most of the identified pathways related to the immune system, particularly inflammation, and biology of vascular smooth muscle cell. Of specific genes, lysine methyltransferase 2 A (KMT2A) was found to be central for incident hypertension, ataxia-telangiectasia mutated (ATM) for systolic blood pressure, and beta-actin (ACTB) for diastolic blood pressure. Noteworthy, lysine methyltransferase 2A (KMT2A) was also identified in the systolic and diastolic blood pressure analyses. Here, we present novel biomarkers for hypertension. This study design is surprisingly rare in the field of hypertension.
Dietary protein restriction elevates FGF21 levels and energy requirements to maintain body weight in lean men
Dietary protein restriction increases energy expenditure and enhances insulin sensitivity in mice. However, the effects of a eucaloric protein-restricted diet in healthy humans remain unexplored. Here, we show in lean, healthy men that a protein-restricted diet meeting the minimum protein requirements for 5 weeks necessitates an increase in energy intake to uphold body weight, regardless of whether proteins are replaced with fats or carbohydrates. Upon reverting to the customary higher protein intake in the following 5 weeks, energy requirements return to baseline levels, thus preventing weight gain. We also show that fasting plasma FGF21 levels increase during protein restriction. Proteomic analysis of human white adipose tissue and in FGF21-knockout mice reveal alterations in key components of the electron transport chain within white adipose tissue mitochondria. Notably, in male mice, these changes appear to be dependent on FGF21. In conclusion, we demonstrate that maintaining body weight during dietary protein restriction in healthy, lean men requires a higher energy intake, partially driven by FGF21-mediated mitochondrial adaptations in adipose tissue.
Multi-dimensional evidence from the UK Biobank shows the impact of diet and macronutrient intake on aging
The role of diet in aging is crucial, yet research findings on how specific diets influence human aging remain inconsistent. Understanding the relationship between dietary factors and aging could inform interventions to promote healthier aging outcomes.
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