BACKGROUND Worldwide, hypertension is the third leading risk factor contributing to death, surpassed only by malnutrition and smoking. 1 Hypertension is common and treatable and because uncontrolled hypertension has serious consequences, preventive measures and control of blood pressure should be a high priority. A healthy lifestyle remains the cornerstone of the management of blood pressure (BP) for all severities of hypertension. It is possible to prevent the development of hypertension and to lower blood pressure levels by simply adopting a healthy lifestyle. 2 Health care workers can assess and contribute to the management of hypertension with exercise adequately if the patient is educated and convinced that lifestyle changes are essential and indeed the most cost effective method of obviating cardiovascular disease. METHODS Patients with hypertension (N=110) were identified from a cohort of patients attending the outpatients department of Carletonville Hospital, a district hospital situated in the mining town of Carletonville, South Africa, and were then invited to participate in the study. A crosssectional descriptive study design was used to determine the knowledge and attitudes of these patients with respect to the importance of lifestyle modification in the management of hypertension. This was achieved by administering a questionnaire. Descriptive and inferential statistical methods were employed to analyze the data. RESULTS The largest number of respondents fell in the 50-59 year old age groups (28%). Females (62%) made up a significant majority of the study population. The population breakdown included the following: Black respondents were 75%, while 24 % were white and 1% coloured. Body Mass Index was more than 25 in 81% of the respondents and 84% of the population had schooling levels below high school. Fifty seven percent (57%) of the respondents ate fried foods regularly, 70 % cooked with salt, 18% add salt to their food, while 14% ate red meat regularly and 26 % consumed alcohol, with 6 % having more than 3 beers/day. The majority of participants led sedentary lifestyles according to the physical activity score, with 74% having little or no activity. At the time of the study 69% had blood pressure (BP) levels above 140/90 mmHg with only 42% knowing what their normal BP should be. Seventy seven percent (77%) believed that exercise lowers BP, and only 30% reported having received such advice from a medical professional. Ninety five percent (95%) believed that a balanced diet is important in controlling hypertension and fifty one percent (51%) reported having being advised by a medical professional about a balanced diet. Ninety four percent (94%) knew that adding salt to food affects BP and sixty nine percent (69%) reported having being told by a medical professional about the effects of excessive salt intake in their diets. Eighty percent (80%) believed that alcohol affects blood pressure and forty four percent (44%) reported having received such information from a medical professional. Seventy five percent (75%) believed that smoking affects BP and thirty six percent (36%) got this information from a medical professional. DISCUSSION The results indicate that respondents reported having received advice about lifestyle modification from medical professionals. The advice varied between areas of lifestyle change, which included education on diet, alcohol, smoking and exercise. The most frequently given advice was on diet and salt intake, with exercise being the least often information provided to the patients by medical professionals. Reduced salt intake advice was the most frequently reported (69%), followed by a balanced diet (51%), reduced alcohol intake (44%), not smoking (35%) and benefits of exercise (30%).Despite this most of the respondents were leading sedentary lifestyles, were overweight (BMI>25) and had BP`s greater than 140/90 mmHg . The reasons provided for not exercising varied from “not being used to it”, “no- time” to “body pain”. Twenty one percent (21%) were not on a proper diet due to financial reasons, 16% stated lack of information as the reason and 9% just found unhealthy food to be very tempting. CONCLUSION The results of this study suggest that although patients do receive advice on lifestyle modification, it is not effective in changing patient behavior, and may therefore be inadequate and not emphasized enough and also not all patients are advised by medical professionals about lifestyle change. The reason for this is not known. Greeff (2006) in his study emphasized that building a trusting relationship between the healthcare worker and the patient is one of the most important aspects when motivating patients. 2

Left ventricular hypertrophy (LVH) is more frequently associated with LV dilatation and systolic chamber dysfunction in males than in females. The mechanisms of this effect are uncertain. As excessive adrenergic stimulation may be responsible for LV dilatation and systolic chamber dysfunction in hypertension, in my dissertation I aimed to assess whether gender determines the adverse effects on LV chamber remodeling following 6 months of daily β-adrenergic receptor (AR) stimulation (isoproterenol [ISO] at 0.04 mg.kg-1day-1) in spontaneously hypertensive rats (SHR). LV dilatation was assessed in vivo from LV end diastolic diameter (EDD) (echocardiography) and ex vivo from the volume intercept at 0 mm Hg pressure (V0) of the LV diastolic pressure-volume relationship (isolated, perfused heart technique). LV systolic function was determined in vivo from LV endocardial fractional shortening (FSend) and ex vivo from the slope (LV end systolic elastance [LV Ees]) of the LV end systolic pressure-volume relationship (isolated, perfused heart technique). As compared to saline-treated male SHR (n=13), male SHR receiving ISO for 6 months (n=13) developed an increased LV EDD (Male Saline: 6.56±0.20 mm; Male ISO: 7.78±0.29 mm; p<0.05) and LV V0 (Male Saline: 0.22±0.01 ml; Male ISO: 0.31±0.02 ml; p<0.05). In contrast, ISO administration failed to modify LV EDD (Female Saline, n=13: 6.06±0.15 mm; Female ISO, n=12: 6.33±0.15 mm) or LV V0 (Female Saline: 0.17±0.01ml; Female ISO: 0.17±0.01 ml) in female SHR. In addition, there was a gender-ISO interactive effect on LV Ees (p<0.05; Male Saline: 2268±336 mmHg.ml-1; Male ISO: 1623±164 mmHg.ml-1; Female Saline: 1910±219 mmHg.ml-1; Female ISO: 2302±230 mmHg.ml-1). In conclusion, as compared to female SHR, male SHR are more susceptible to the adverse effects of chronic β-AR activation on LV cavity dimensions and systolic chamber function. These results suggest that the higher prevalence of LV dilatation and systolic chamber dysfunction in males than in females with LVH may be attributed to an increased susceptibility to the adverse effects of adrenergic stimulation.

M.Sc. (Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009

Children with congenital heart defects and patients with faulty or failing valves have the need for a suitable aortic heart valve replacement. Current treatment options have several downfalls and heavy investigation is being done into the design of an engineered valve to find an alternative that would alleviate many of these issues. Understanding the physiology of how cells interact in vivo is crucial to the construction of such valve. This study investigates the effect of cyclic strain in aortic valve endothelial cells on the adhesion molecules, PECAM-1, ƒÒ1-Integrin, VE-Cadherin and Vinculin. Experiments found that cyclic strain plays a role in the development of cell/cell and cell/extracellular matrix adhesions and junctions and is extremely important in the pre-conditioning of a tissue engineered construct. Without this strain the new valve would be more susceptible to inflammation, injury or possible failure after being implanted into the patient.

No description available.

Racial disparities in maternal mortality in the United States are urgently in need of greater attention and research. The prevalence of preeclampsia is higher among African American women than White women by 1.7-fold, and African American women are three times more likely to die from preeclampsia complications. Among African American patients, Apolipoprotein L1 protein (APOL1) gene variants are known to be linked to increased risk for non-diabetic chronic kidney disease (CKD). The Sub-Saharan African population is particularly affected by these risk variants, and they also have one of the highest rates of preeclampsia in the world. Variants in the APOL1 gene are common, with about 40-50% of African American individuals carrying one variant, suggesting that APOL1 may underlie other health conditions that disproportionately affect patients of recent African origin, including preeclampsia. Previous epidemiologic studies support an association between APOL1 variants in the fetus and preeclampsia risk. There are also indications that in the kidney podocytes, these variants increase the endoplasmic reticulum (ER) specific stress protein GRP78, also known to regulate trophoblast syncytialization in the placenta. Although previous studies are suggestive, the mechanisms by which APOL1 variants alter placental function to increase preeclampsia risk are not understood. We utilized immunofluorescence (IF) studies to probe APOL1 expression in first trimester placenta (6-7 weeks gestation), as well as reverse-transcription polymerase chain reaction (RT-PCR) and Western blot studies to probe basal expression of messenger ribonucleic acid (mRNA) and protein of both APOL1 and GRP78 in BeWo cells. Our results have laid the foundation for studies of the role APOL1 plays in the genesis of preeclampsia. / 2026-03-06T00:00:00Z

No description available.

No description available.

No description available.

No description available.