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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Signature of pre-pregnancy microbiome in infertile women undergoing frozen embryo transfer with gestational diabetes mellitus
This study aims to evaluate differences in gut microbiota structures between infertile women undergoing frozen embryo transfer (FET) with gestational diabetes mellitus (GDM) and healthy controls (HCs), and to identify potential markers. We comprehensively enrolled 193 infertile women undergoing FET (discovery cohort: 38 HCs and 31 GDM; validation cohort: 85 HCs and 39 GDM). Gut microbial profiles of the discovery cohort were investigated during the pre-pregnancy (Pre), first trimester (T1), and second trimester (T2). The microbial community in the HCs group remained relatively stable throughout the pregnancy, while the microbial structure alteration occurred in the GDM group during T2. A model based on ten bacteria and ten metabolites simultaneously was used to predict the risk of GDM developing in the pre-pregnancy state with the ROC value of 0.712. Algorithms on the basis of marker species and biochemical parameters can be used as effective tools for GDM risk evaluation before pregnancy.
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.
Pregnancy outcomes among patients with complex congenital heart disease
Patients with complex congenital heart disease (CCHD) may pose a serious threat to the mother-infant safety. This study intends to explore the influencing factors for adverse pregnancy outcomes in the CCHD population. Totally 108 CCHD patients who terminated pregnancy from January 2013 to January 2023 were recruited. We collected clinical data during the pregnancy from electronic medical records. Among them, 45 patients had adverse pregnancy outcomes (41.7%) and no patient died. 5 patients with no newborn. The incidence rate of adverse pregnancy outcomes was significantly higher in patients with brain natriuretic peptide (BNP) > 100 pg/mL (OR: 2.736; 95%CI: 1.001–7.481, p = 0.049) and hypoxemia (OR: 15.46; 95%CI: 1.689–141.512, p = 0.015) and without undergoing cardiac surgical correction (OR: 3.226; 95%CI: 1.121–9.259, p = 0.03). It was confirmed by propensity score matching that no cardiac surgical correction was an independent risk factor. Maternal patients without undergoing cardiac surgical correction had poorer NYHA cardiac function (p = 0.000) and were more prone to heart failure (p = 0.027), hypoxemia (p = 0.042), pulmonary arterial hypertension (p = 0.038) and postpartum hemorrhage (p = 0.016). Moreover, these patients had prolonged Surgical Intensive Care Unit (SICU) stay (p = 0.000) and significantly higher risk of premature delivery (p = 0.005), low birth weight (p = 0.018), infection and asphyxia (p = 0.043). Corrective cardiac surgery in patients with CCHD before pregnancy significantly reduces the incidence of adverse pregnancy outcomes.
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.
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