Semicarbazide-sensitive amine oxidase (SSAO, EC 1.4.3.6) belongs to a family of copper-containing amine oxidases. SSAO exists as a membrane bound protein in endothelial-, smooth muscle-, and adipose cells as well as soluble in plasma. SSAO catalyses oxidative deamination of primary monoamines, which results in the production of corresponding aldehydes, hydrogen peroxide and ammonia. These compounds are very reactive and potentially cytotoxic, and are able to induce vascular damage if produced in high levels. Patients with diabetes mellitus, and with diabetic complications in particular, have a higher SSAO activity in plasma compared to healthy controls. It has therefore been speculated that high SSAO activity is involved in the development of vascular complications associated with diabetes. The aim of this thesis is to investigate the importance of SSAO in the development of disorders of a vascular origin. We have studied the transcriptional regulation of the SSAO gene, by inducing diabetes in NMRI and in transgenic mice, overexpressing the human form of SSAO in smooth muscle cells. We found that the increase in SSAO activity in diabetes is accompanied by reduced mRNA levels of the endogenous mouse gene, suggesting a negative feedback on the transcription of the SSAO gene. In addition, the transgenic mice exhibited an abnormal phenotype in the elastic tissue of aorta and renal artery. These mice have a lower mean artery pressure and an elevated pulse pressure. These results indicate that high SSAO activity in smooth muscle cells is associated with a change in the morphology of large arteries. This is likely contributing to the development of vascular complications in diabetes.

Hypertoni är vanligt förekommande i dagens samhälle och anses därför ha blivit en folksjukdom. Uppskattningsvis har 1,8 miljoner av Sveriges vuxna befolkning hypertoni. Hypertoni står för cirka 13 procent av den totala dödligheten i världen, och ses som en riskfaktor till ett stort antal hjärt- och kärlsjukdomar. Idag finns det internationella riktlinjer för vård av hypertoni i bland annat England och USA. Dock saknas det specifika svenska riktlinjer för vård av hypertoni. Syftet med litteraturstudien var att belysa hur hälsofrämjande åtgärder kan påverka blodtrycket hos personer med hypertoni. Litteraturstudiens resultat bygger på en genomgång av 16 vetenskapliga artiklar som söktes utifrån litteraturstudiens syfte och problemformulering. De hälsofrämjande åtgärder som kan påverka blodtrycket hos personer med hypertoni belyses i resultatet. Dessa åtgärder handlar om viktminskning, fysisk aktivitet, kost, alkohol, rökning, stress och stöd. Effekten av de hälsofrämjande åtgärderna har visat att en blodtryckssänkning kan ske vid livsstilsförändringar. En bromsning i utvecklandet av hypertoni kan leda till hälsoekonomiska besparingar för samhället. Nationella riktlinjer samt vårdprogram för behandling av hypertoni bör utvecklas för att en bromsning av hypertoni ska kunna ske. / Hypertension is common in today's society and is therefore considered to have become a national disease. An estimated 1.8 million of Sweden's adult population have hypertension. Hypertension accounts for about 13 percent of the total mortality in the world, and is seen as a risk factor for numerous cardiovascular diseases. Today there are international guidelines for the treatment of hypertension in, England and USA. However, there are no specific Swedish guidelines for treatment of hypertension. The purpose of this study was to elucidate how health interventions can influence blood pressure in people with hypertension. The results of this literature study are based on a review of 16 scientific articles which was based on literature review and order problem. The health-promoting interventions that can affect blood pressure in people with hypertension are highlighted in the results. Such interventions are weight loss, physical activity, diet, alcohol, smoking, stress and support. The effect of health promotion interventions has shown that lowering blood pressure can occur if lifestyle changes are implemented and carried out. A braking in the development of hypertension can lead to health-economic benefits to the community. National guidelines and care programs for the treatment of hypertension should be developed to a braking of hypertension to happen.

No description available.

Kardiovaskulära sjukdomar och hypertoni blir allt mer vanligt i västvärlden. Trots livsstilsrekommendationer ökar antalet insjuknanden i hjärt-kärlsjukdomar, vilket har blivit en av de vanligaste dödsorsakerna i Sverige. Syftet med litteraturstudien var att undersöka om flavanol i kosten kan användas blodtryckssänkande samt att klargöra om flavanol påverkar den kardiovaskulära ohälsan. Metoden som användes var en litteraturstudie av redan publicerade vetenskapliga artiklar inom ämnet. Flertalet studier visar på att flavanol har en blodtryckssänkande likväl som andra positiva effekter. Många studiers resultat visar att flavanol har större effekt på de grupper som redan har kardiovaskulär ohälsa samt högt blodtryck. Forskningen är ny och har än inte hunnit utvärderas ordentligt, men den positiva påverkan hos flavanol är tydlig och det är inte svårt att se användbara områden för flavanol som terapeutisk metod, men även i hälsopromoterande syfte. Detta är något som skulle rimma väl med sjuksköterskans professionella ansvar att främja hälsa och motverka sjukdom. Trots de i dagsläget erhållna resultaten krävs mer och framför allt forskning med hög kvalitet.

<p>Hypertension is one of the most common non-communicable diseases, and it is the leading cause of cardiovascular diseases, death and disability worldwide, especially in developing countries. Physical activity has been regarded as a commonly accepted modality for preventing and treating hypertension. However, despite its known benefits, this modality of treatment and prevention of&nbsp / hypertension continues to be underused. The present study aimed to determine the demographic, social and health-related factors that are associated with levels of physical activity participation among adults with hypertension in Kigali, Rwanda. This cross-sectional study was conducted with 252 adults with hypertension and 87 healthcare professionals through the Godin Leisure-Time&nbsp / Exercise Questionnaire (GLTEQ) and Physical Activity Exit Interview (PAEI). Two thirds of the participants (69.44%) were classified as sedentary. The following factors were found to be significantly&nbsp / (P&lt / 0.05) associated with the levels of physical activity: age, marital status, and level of education, residence, tobacco / past and current users, alcohol / current user, diabetes mellitus, BMI, perceived health status, self-efficacy, and blood pressure. None of the healthcare professionals were considered good physical activity counsellor. The findings of the present study highlight the need for the implementation of health promotion strategies aimed at promoting physical activity lifestyle among individuals with hypertension in Rwanda. Efforts should be made in educating people with hypertension on the benefits of integrating regular physical&nbsp / activity in their daily lives. Furthermore, healthcare professionals should be educated concerning how to promote physical&nbsp / activity to all patients especially those with hypertension.</p>

Hypertension occurs in nearly 10% of pregnancies, and is associated with infant and maternal morbidity and mortality. Prior studies of non-pregnant adults have demonstrated the effectiveness of a variety of relaxation therapies in reducing blood pressure. A pilot randomized controlled trial was conducted, the purposes of which were 1) to provide preliminary evidence regarding the usefulness of guided imagery (GI) in reducing blood pressure in hypertensive pregnant women, and 2) to answer feasibility questions for a larger trial. Pregnant women with hypertension prior to 37 weeks gestation (n = 69) were randomized to either 15-minute periods of guided imagery (n = 34), or of quiet rest (QR) (n = 35), twice daily for four weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure (MAP), systolic and diastolic blood pressures, anxiety, rest and GI use were measured weekly, to a maximum of four weeks. Sixty women completed at least one week in the study; 46.4% completed four weeks. Compliance was excellent. Intention to treat analysis was used. In the unadjusted analysis, women allocated to GI had significantly lower average daytime ambulatory mean MAP elevations from baseline to their last week of study participation than women allocated to quiet rest (GI: M = 1.58 mmHg, SD = 7.63; QR: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = .02). However, the effect was no longer statistically significant (p = 0.14) when adjusted for baseline mean arterial pressure and gestation. There was no statistically significant difference in the numbers of women who were prescribed antihypertensive medication after randomization (GI: n = 16, QR: n = 13, X2 = 0.74, p = .46). There was also no evidence of an effect of guided imagery on anxiety. Nearly 90% (n = 26) of the guided imagery group indicated they would use it again, either in a subsequent pregnancy or during stressful life events. Given the ease of use, low cost, acceptability to women, and lack of risk of guided imagery, an adequately-powered randomized controlled trial is warranted.

Smoking and environmental tobacco smoke (ETS) exposure are major risk factors for cardiovascular disease (CVD), although the exact components and pathophysiological mechanisms responsible for this association remain unclear. Polycyclic aromatic hydrocarbons (PAHs), including benzo[a]pyrene (BaP), are ubiquitous environmental contaminants that form during organic material combustion and are thus found in cigarette smoke, vehicle exhaust particles, and air pollution. We hypothesize that PAHs are key agents responsible for mediating the cigarette smoke effects in the cardiovascular system, including increased oxidative stress, inflammation, and arterial stiffness.<p> Arterial stiffness is a powerful, independent predictor of cardiovascular risk and is regulated, in part, by vasoactive mediators derived from the endothelium. The first objective of this project was to determine whether pulse wave dP/dt collected from radiotelemetry-implanted rats is a reliable indicator of changes in arterial stiffness following administration of vasoactive drugs or acute ETS exposure. Anaesthetized rats were administered a single dose of saline (vehicle control), acetylcholine, norepinephrine, and N(G)-nitro-L-arginine methyl ester (L-NAME) via the tail vein, allowing a washout period between injections. Acetylcholine decreased and norepinephrine increased dP/dt compared to saline vehicle. Injection of the nitric oxide (NO) synthase inhibitor L-NAME decreased plasma nitrate/nitrite (NOx), but transiently increased dP/dt. For the ETS experiment, rats were exposed for one hour to sham, low dose ETS, or high dose ETS. Exposure to ETS did not significantly alter dP/dt or plasma endothelin-1 (ET-1) levels, but increased plasma NOx levels at the high ETS exposure and increased plasma nitrotyrosine levels in both ETS groups. In conclusion, acute changes in NO production via acetylcholine or L-NAME alter the arterial pulse wave dP/dt consistently with the predicted changes in arterial stiffness. Although acute ETS appears to biologically inactivate NO, a concomitant increase in NO production at the high ETS exposure may explain why ETS did not acutely alter dP/dt.<p> The second objective of this project was to compare the effects of subchronic ETS and BaP exposure on circadian blood pressure patterns, arterial stiffness, and possible sources of oxidative stress in radiotelemetry-implanted rats. Pulse wave dP/dt was used as an indicator of arterial stiffness, and was compared to both structural (wall thickness) and functional (NO production and bioactivity, ET-1 levels) features of the arterial wall. In addition, histology of lung, heart, and liver were examined as well as pulmonary and hepatic detoxifying enzyme activity (cytochrome P450 specifically CYP1A1). Daily ETS exposure for 28 days altered the circadian pattern of heart rate and blood pressure in rats, with a loss in the normal dipping pattern of blood pressure during sleep. Subchronic ETS exposure also increased dP/dt in the absence of any structural modifications in the arterial wall. Although NO production and ET-1 levels were not altered by ETS, there was increased biological inactivation of NO via peroxynitrite production (as indicated by increased plasma nitrotyrosine levels). Thus, vascular stiffness and failure of blood pressure to dip precede structural changes in rats exposed to ETS for 28 days. Exposure to ETS also caused increased number of lung neutrophils as well as increased CYP1A1 activity in lung microsomes.<p> Since ETS-induced increases in arterial stiffness occurred as early as day 7, radiotelemetry-implanted rats were exposed daily to intranasal BaP for 7 days. Similar to ETS, BaP exposure altered circadian blood pressure patterns and reduced blood pressure dipping during sleep. Thus, in support of part of our hypothesis, the PAH component of cigarette smoke may be responsible for the ETS-induced increase in blood pressure and the loss of dipping pattern during sleep. Increased neutrophil recruitment was observed in the lungs of both ETS- and BaP-exposed rats, suggesting that lung inflammatory reactions may be involved in the disruption of circadian blood pressure rhythms. Unlike ETS however, BaP exposure did not significantly alter pulse wave dP/dt, endothelial function, or lung CYP1A1 activity. Thus, contrary to our hypothesis, the reduction in NO bioactivity and increased arterial stiffness caused by ETS cannot be explained by BaP at the dose and length of the exposure in the current study. Production of reactive metabolites in the lung following ETS exposure may be responsible, at least in part, for the increases in oxidative stress in the vasculature, leading to reduced NO bioactivity and increased arterial stiffness. Oxidative stress caused by BaP exposure may have been insufficient to reduce NO bioactivity in the peripheral vasculature. Therefore arterial stiffness was not increased and factors other than NO may be responsible for the increase in blood pressure observed with ETS and BaP exposure.

The aim of the work was to investigate the possibility to combine information from PPG and bio-acoustic technology to extract information that is related to the blood pressure. The measurements have been carried out with several different configurations. First the relation between arterial sounds and the PPG-signal was studied. After those measurements with both PPG and the bio- acoustic technique was concluded on people in different positions and after riding a bike. The goal was to vary the blood pressure. The conclusion that can be drawn in this report is that the bio-acoustic and the PPG-signal in peripheral arteries have the same source. That implies that arterial sounds are a product of turbulence when the pulse wave passes by. Further it can be assumed that it is the first heart sound that is represented in the arterial sounds. The time before and after the arterial sound in one heart cycle vary whit the blood pressure. There relationship seems also to vary with the bloodpressure but it vary differently under different conditions.

University of Macau / Faculty of Science and Technology / Department of Electrical and Computer Engineering

The hypothesis that source of protein in a nutritionally adequate diet during gestation, lactation and weaning alters food intake and characteristics of metabolic syndrome in the offspring was investigated. Pregnant Wistar rats were randomized to either the AIN 93-G casein (C) or soy protein (S) diets (n=12/group) during gestation only or during gestation and lactation. Male offspring in each dams’ diet group were weaned to either C or S diets (n=12/group). Food intake, body weight (BW), fat pad mass, systolic (SBP) and diastolic (DBP) blood pressure, and plasma homocysteine (p<0.05) were higher in offspring born to dams fed the S diet. Fasting blood glucose (BG), BG in response to a glucose gavage and Homeostatic Model of Assessment of Insulin Resistance (HOMA-IR) index were higher only in male offspring born to dams fed the S diet. Moreover, gene expression of Agouti Related Protein (AgRP) was higher in offspring born to dams fed the S diet at weaning. Extending the dams’ diet during gestation and lactation magnified the effect of the gestational S diet on BW and composition and glucose metabolism in male offspring. Although composition of the weaning diets interacted with that of the dams’ diets, the latter was the dominant factor in determining metabolic outcomes in the offspring. In conclusion, the soy protein diet, compared to the casein diet when consumed during gestation or throughout gestation and lactation increased food intake and the presence of characteristics of metabolic syndrome in the offspring.