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1. Impact of perinatal factors on biomarkers of cardiovascular disease risk in preadolescent children

Author

Mansfield, R, Cecula, P, Pedraz, CT, Zimianiti, I, Elsaddig, M, Zhao, R, Sathiyamurthy, S, McEniery, CM, Lees, C, and Banerjee, J

Subjects
Physiology, Internal Medicine, Cardiology and Cardiovascular Medicine
Abstract

BACKGROUND: This review aims to summarize associations of the perinatal environment with arterial biophysical properties in childhood, to elucidate possible perinatal origins of adult cardiovascular disease (CVD). METHODS: A systematic search of PubMed database was performed (December 2020). Studies exploring associations of perinatal factors with arterial biophysical properties in children 12 years old or less were included. Properties studied included: pulse wave velocity; arterial stiffness or distensibility; augmentation index; intima-media thickness of aorta (aIMT) or carotids; endothelial function (laser flow Doppler, flow-mediated dilatation). Two reviewers independently performed study selection and data extraction. RESULTS: Fifty-two of 1084 identified records were included. Eleven studies explored associations with prematurity, 14 explored maternal factors during pregnancy, and 27 explored effects of low birth weight, small-for-gestational age and foetal growth restriction (LBW/SGA/FGR). aIMT was consistently higher in offspring affected by LBW/SGA/FGR in all six studies examining this variable. The cause of inconclusive or conflicting associations found with other arterial biophysical properties and perinatal factors may be multifactorial: in particular, measurements and analyses of related properties differed in technique, equipment, anatomical location, and covariates used. CONCLUSION: aIMT was consistently higher in LBW/SGA/FGR offspring, which may relate to increased long-term CVD risk. Larger and longer term cohort studies may help to elucidate clinical significance, particularly in relation to established CVD risk factors. Experimental studies may help to understand whether lifestyle or medical interventions can reverse perinatal changes aIMT. The field could be advanced by validation and standardization of techniques assessing arterial structure and function in children.

Published
2023
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3. The cardiovascular phenotype of elevated blood pressure differs markedly between young males and females: The Enigma Study

Author

McEniery, CM, Nardin, Chiara, Maki-Petaja, Kaisa, Miles, Karen, Yasmin, Yasmin, McDonnell, Barry, Cockcroft, John, Wilkinson, Ian, McEniery, Carmel [0000-0003-3636-0705], Maki-Petaja, Kaisa [0000-0001-7312-6200], Wilkinson, Ian [0000-0001-6598-9399], and Apollo - University of Cambridge Repository

Subjects
Adult, Male, Sex Characteristics, hypertension, vascular resistance, Adolescent, cardiac output, Hemodynamics, vascular stiffness, Blood Pressure, Stroke Volume, Pulse Wave Analysis, Young Adult, Heart Rate, Humans, Female
Abstract

Blood pressure in young adults predicts blood pressure in later life. We aimed to identify metabolic, haemodynamic and autonomic characteristics associated with raised blood pressure in young adults and whether these differ between males and females. 3145 healthy subjects, aged 18-40 years, were grouped according to sex and blood pressure category following the recent reclassification of blood pressure as part of American Heart Association/American College of Cardiology 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire, and detailed metabolic, haemodynamic and autonomic assessments. Stage 1 hypertension and normal blood pressure were the most common blood pressure phenotypes in males (29%) and females (68%), respectively. In both sexes, cardiac output was positively associated with increasing blood pressure category (P

Published
2019
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4. Stiffening and ventricular-arterial interaction in the ascending aorta using Magnetic Resonance Imaging: Ageing effects in healthy humans

Author

Li, Y, Hickson, SS, McEniery, CM, Wilkinson, IB, and Hickson, SS

Subjects
haemodynamics, pulse wave velocity, wave intensity analysis, local arterial properties, MRI
Abstract

2018 The Author(s). Objectives: The aim of this study was to investigate the effect of age and sex on nPWV and ndI in the ascending aorta of healthy humans. Background: Local pulse wave velocity (nPWV) and wave intensity (ndI) in the human ascending aorta have not been studied adequately, due to the need for invasive pressure measurements. However, a recently developed technique made the non-invasive determination of nPWV and ndI possible using measurements of flow velocity and arterial diameter. Methods: Diameter and flow velocity were measured at the level of the ascending aorta in 144 healthy subjects (aged 20-77 years, 66 male), using magnetic resonance imaging. nPWV, ndI parameters; forward (FCW); backward (BCW) compression waves, forward decompression wave (FDW), local aortic distensibility (nDs) and reflection index (nRI) were calculated. Results: nPWV increased significantly with age from 4.7±0.3 m/s for those 20-30 years to 6.4±0.2 m/s for those 70-80 years (P

Published
2018

5. Cardiac output in pre eclampsia is associated with the presence of fetal growth restriction, not gestation at onset: a prospective cohort study

Author

Tay, J, Foo, L, Masini, G, Bennett, PR, Mceniery, CM, Wilkinson, IB, and Lees, CC

Subjects
Adult, Cardiac output, hypertension, MATERNAL CARDIOVASCULAR CHANGES, Pregnancy Trimester, Third, PRECONCEPTION, Gestational Age, Pre-Eclampsia, Pregnancy, Humans, Prospective Studies, Obstetrics & Reproductive Medicine, RISK, Science & Technology, Fetal Growth Retardation, vascular resistance, Obstetrics & Gynecology, WOMEN, ARTERIAL, BIRTH-WEIGHT, arterial function, DOPPLER, Cross-Sectional Studies, HYPERTENSIVE DISORDERS, HEMODYNAMICS, Pregnancy Trimester, Second, 1114 Paediatrics and Reproductive Medicine, Female, Life Sciences & Biomedicine
Abstract

BACKGROUND AND OBJECTIVES: Pre-eclampsia (PE) and fetal growth restriction (FGR) are considered to be placentally-mediated disorders. The clinical manifestations are widely held to relate to gestation age at onset with early- and late-onset PE considered to be phenotypically distinct. Recent studies have reported conflicting findings in relation to cardiovascular function, and in particular cardiac output, in PE and FGR. STUDY DESIGN: We investigated maternal cardiovascular function in relation to clinical subtype in 45 pathological pregnancies (14 'PE only', 16 'FGR only', 15 'PE and FGR') and compared these with 107 healthy person observations. Cardiac output (CO) was the primary outcome measure, and was assessed using an inert gas rebreathing method (Innocor®), from which peripheral vascular resistance was derived (PVR); arterial function was assessed by Vicorder ®, a cuff-based oscillometric device. Cardiovascular parameters were normalised for gestational age in relation to healthy pregnancies using Z scores, thus allowing for comparison across the gestational range 24-40 weeks. RESULTS: Compared with healthy control pregnancies, women with PE had higher CO Z scores (1.87 ± 1.35; p=0.0001) and lower PVR Z scores (-0.76± 0.89; p=0.025); those with FGR had higher PVR Z scores (0.57± 1.18; p=0.04) and those with both PE and FGR had lower CO Z scores (-0.80 ± 1.3; p= 0.007) and higher PVR Z scores (2.16 ± 1.96; p=0.0001). These changes were not related to gestational age of onset. All those affected by PE and/or FGR had abnormally raised augmentation index (AIx) and pulse wave velocity (PWV). Furthermore, in PE, low CO was associated with low birthweight and high CO with high birthweight. (r=0.42, p=0.03). CONCLUSIONS: PE is associated with high CO, but if PE presents with FGR, the opposite is true; both conditions are, nevertheless, defined by hypertension. FGR without PE is associated with high PVR. Though 'early' and 'late' gestation PE are considered to be different diseases, we show that the haemodynamic characteristics of PE were unrelated to gestation age at onset, but strongly associated with the presence or absence of FGR. FGR more commonly co-exists with PE at early gestation, thus explaining the conflicting results of previous studies. Furthermore, anti-hypertensive agents act by reducing CO or PVR and are administered without reference to cardiovascular function in PE. The underlying pathology (PE, FGR, PE and FGR) defines cardiovascular phenotype, providing a rational basis for choice of therapy where high or low CO or PVR are the predominant features.

Published
2018

6. Assessment of venous hemodynamics and volume homeostasis during pregnancy: recommendations of the International Working Group on Maternal Hemodynamics

Author

Gyselaers, W, Spaanderman, M, Bruckmann, A, Cockcroft, J, Cornette, J, Duvekot, Jj, Ferrazzi, E, Foo, Fl, Ghossein-Doha, C, Khalil, A, Mceniery, Cm, Lees, C, Meah, V, Novelli, Gp, Stohr, E, Tay, J, Thilaganathan, B, Valensise, H, and Wilkinson, I

Subjects
venous return, Consensus Development Conferences as Topic, Maternal Health, Pregnancy Complications, Cardiovascular, venous hemodynamics, Hemodynamics, Guidelines as Topic, Cardiovascular, Cardiovascular Physiological Phenomena, Pregnancy Complications, Uterine Artery, volume homeostasis, Pregnancy, Settore MED/40, Prenatal Diagnosis, Homeostasis, Humans, Female, Cardiac Output, maternal hemodynamics, plasma volume, pregnancy, Blood Flow Velocity
Abstract

Venous hemodynamics and volume homeostasis are important aspects of cardiovascular physiology. However, today their relevance is still very much underappreciated. Their most important role is maintenance and control of venous return and, as such, cardiac output. A high-flow/low-resistance circulation, remaining constant under physiological circumstances, is mandatory for an uncomplicated course of pregnancy. In this article, characteristics of normal and abnormal venous and volume regulating functions are discussed with respect to normal and pathologic outcomes of pregnancy, and current (non-invasive) methods to assess these functions are summarized. Copyright © 2017 ISUOG. Published by John WileySons Ltd.

Published
2018

7. Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure

Author

Wain, Louise V., Verwoert, Germaine C., O'Reilly, Paul F., Shi, Gang, Johnson, Toby, Johnson, Andrew D., Bochud, Murielle, Rice, Kenneth M., Henneman, Peter, Smith, Albert V., Ehret, Georg B., Amin, Najaf, Larson, Martin G., Mooser, Vincent, Hadley, David, Dörr, Marcus, Bis, Joshua C, Aspelund, Thor, Esko, Tõnu, Janssens, A Cecile J. W., Zhao, Jing Hua, Heath, Simon, Laan, Maris, Fu, Jingyuan, Pistis, Giorgio, Luan, Jian'An, Arora, Pankaj, Lucas, Gavin, Pirastu, Nicola, Pichler, Irene, Jackson, Anne U., Webster, Rebecca J., Zhang, Feng, Peden, John F., Schmidt, Helena, Tanaka, Toshiko, Campbell, Harry, Igl, Wilmar, Milaneschi, Yuri, Hottenga, Jouke-Jan, Vitart, Veronique, Chasman, Daniel I., Trompet, Stella, Bragg-Gresham, Jennifer L., Alizadeh, Behrooz Z., Chambers, John C., Guo, Xiuqing, Lehtimäki, Terho, Kühnel, Brigitte, Lopez, Lorna M., Polašek, Ozren, Boban, Mladen, Nelson, Christopher P., Morrison, Alanna C., Pihur, Vasyl, Ganesh, Santhi K., Hofman, Albert, Kundu, Suman, Mattace-Raso, Francesco U. S., Rivadeneira, Fernando, Sijbrands, Eric J. G., Uitterlinden, Andre G., Hwang, Shih-Jen, Vasan, Ramachandran S., Wang, Thomas J., Bergmann, Sven, Vollenweider, Peter, Waeber, Gérard, Laitinen, Jaana, Pouta, Anneli, Zitting, Paavo, McArdle, Wendy L., Kroemer, Heyo K., Völker, Uwe, Völzke, Henry, Glazer, Nicole L., Taylor, Kent D., Harris, Tamara B., Alavere, Helene, Haller, Toomas, Keis, Aime, Tammesoo, Mari-Liis, Aulchenko, Yurii, Barroso, In S., Khaw, Kay-Tee, Galan, Pilar, Hercberg, Serge, Lathrop, Mark, Eyheramendy, Susana, Org, Elin, Sõber, Siim, Lu, Xiaowen, Nolte, Ilja M., Penninx, Brenda W., Corre, Tanguy, Masciullo, Corrado, Sala, Cinzia, Groop, Leif, Voight, Benjamin F, Melander, Olle, O'Donnell, Christopher J, Salomaa, Veikko, D'Adamo, Adamo Pio, Fabretto, Antonella, Faletra, Flavio, Ulivi, Sheila, Del Greco M, Fabiola, Facheris, Maurizio, Collins, Francis S., Bergman, Richard N., Beilby, John P., Hung, Joseph, Musk, A William, Mangino, Massimo, Shin, So-Youn, Soranzo, Nicole, Watkins, Hugh, Goel, Anuj, Hamsten, Anders, Gider, Pierre, Loitfelder, Marisa, Zeginigg, Marion, Hernandez, Dena, Najjar, Samer S., Navarro, Pau, Wild, Sarah H., Corsi, Anna Maria, Singleton, Andrew, De Geus, Eco J. C., Willemsen, Gonneke, Parker, Alex N., Rose, Lynda M., Buckley, Brendan, Stott, David, Orru, Marco, Uda, Manuela, Van Der Klauw, Melanie M., Zhang, Weihua, Li, Xinzhong, Scott, James, Chen, Yii-Der Ida, Burke, Gregory L, Kähönen, Mika, Viikari, Jorma, Döring, Angela, Meitinger, Thomas, Davies, Gail, Starr, John M., Emilsson, Valur, Plump, Andrew, Lindeman, Jan H., Hoen, Peter A. C. T., König, Inke R., Felix, Janine F., Clarke, Robert, Hopewell, Jemma C., Ongen, Halit, Breteler, Monique, Debette, Stéphanie, Destefano, Anita L., Fornage, Myriam, Mitchell, Gary F., Smith, Nicholas L., Holm, Hilma, Stefansson, Kari, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Samani, Nilesh J., Preuss, Michael, Rudan, Igor, Hayward, Caroline, Deary, Ian J., Wichmann, H-Erich, Raitakari, Olli T., Palmas, Walter, Kooner, Jaspal S., Stolk, Ronald P., Jukema, J Wouter, Wright, Alan F., Boomsma, Dorret I., Bandinelli, Stefania, Gyllensten, Ulf B., Wilson, James F., Ferrucci, Luigi, Schmidt, Reinhold, Farrall, Martin, Spector, Tim D., Palmer, Lyle J., Tuomilehto, Jaakko, Pfeufer, Arne, Gasparini, Paolo, Siscovick, David, Altshuler, David, Loos, Ruth J. F., Toniolo, Daniela, Snieder, Harold, Gieger, Christian, Meneton, Pierre, Wareham, Nicholas J., Oostra, Ben A., Metspalu, Andres, Launer, Lenore, Rettig, Rainer, Strachan, David P., Beckmann, Jacques S., Witteman, Jacqueline C. M., Erdmann, Jeanette, Van Dijk, Ko Willems, Boerwinkle, Eric, Boehnke, Michael, Ridker, Paul M., Jarvelin, Marjo-Riitta, Chakravarti, Aravinda, Abecasis, Goncalo R., Gudnason, Vilmundur, Newton-Cheh, Christopher, Levy, Daniel, Munroe, Patricia B., Psaty, Bruce M., Caulfield, Mark J., Rao, Dabeeru C., Tobin, Martin D., Elliott, Paul, Van Duijn, Cornelia M. McEniery CM, Wilkinson IB, Cockcroft JR, O'Shaughnessy KM, Newhouse SJ, Yasmin, Smith AV, Eiriksdottir G, Launer LJ, Sigurdsson S, Aspelund T, Gudnason V, De Bacquer D, Rietzschel ER, De Backer GG, Van Bortel L, De Buyzere ML, Segers P, Bekaert S, Gillebert TC, De Meyer T, Ferrucci L, Tanaka T, Johnson AD, Levy D, Benjamin EJ, Mitchell GF, Vita JA, Larson MG, Hamburg NM, Vasan RS, Isaacs A, Schut AF, Oostra BA, van Duijn CM, van Rijn MJ, Sie MP, Newman AB, Herrington DM, Andrews JS, Ding J, Sutton-Tyrrell KC, Harris TB, Howard TD, Liu Y, Parsa A, Shuldiner AR, McArdle PF, Gibson Q, Post WS, Dehghan A, Hofman A, Uitterlinden AG, Sijbrands EJ, Rivadeneira F, Mattace-Raso FU, Verwoert GC, Witteman JC, Scuteri A, Lakatta EG, Jewell E, Abecasis GR, Tarasov KV, Uda M, Najjar SS, Sanna S, Attwood T, Belz S, Braund P, Cambien F, Cooper J, Crisp-Hihn A, Deloukas P, Foad N, Eardman J, Goodall AH, Gracey J, Gray E, Gulde S, Gwilliams R, Heimerl S, Hengstenberg C, Jolley J, Krishnan U, Linsel-Nitschke P, Lloyd-Jones H, Lugauer I, Lundmark P, Maouche S, Moore JS, Muir D, Murray E, Nelson CP, Neudert J, Niblett D, O'Leary K, Ouwehand WH, Pollard H, Rankin A, Rice CM, Sager H, Samani NJ, Sambrook J, Schmitz G, Scholz M, Schroeder L, Schunkert H, Syvannen AC, Wallace C, Kathiresan S, Reilly MP, Erdmann J, Assimes TL, Boerwinkle E, Hall A, König IR, Laaksonen R, McPherson R, Thompson JR, Thorsteinsdottir U, Ziegler A, Absher D, Chen L, Cupples LA, Halperin E, Li M, Musunuru K, Preuss M, Schillert A, Thorleifsson G, Voight BF, Wells GA, Assime TL, Holm H, Roberts R, Stewart AF, Fortmann S, Go A, Hlatky M, Iribarren C, Knowles J, Myers R, Quertermous T, Sidney S, Risch N, Tang H, Blankenberg S, Zeller T, Wild P, Schnabel R, Sinning C, Lackner K, Tiret L, Nicaud V, Bickel C, Rupprecht HJ, Perret C, Proust C, Münzel T, Barbalic M, Bis J, Chen IY, Cupples L, Demissie-Banjaw S, Folsom A, Glazer N, Harris T, Heckbert S, Lumley T, Marciante K, Morrison A, O' Donnell CJ, Psaty BM, Rice K, Rotter JI, Siscovick DS, Smith N, Smith A, Taylor KD, van Duijn C, Volcik K, Whitteman J, Ramachandran V, Uitterlinden A, Gretarsdottir S, Gulcher JR, Kong A, Stefansson K, Thorgeirsson G, Andersen K, Fischer M, Grosshennig A, Lieb W, Stark K, Schreiber S, Wichmann HE, Aherrahrou Z, Bruse P, Doering A, Illig T, Klopp N, Loley C, Medack A, Meisinger C, Meitinger T, Nahrstedt J, Peters A, Wagner AK, Willenborg C, Böhm BO, Dobnig H, Grammer TB, Hoffmann MM, Kleber M, März W, Meinitzer A, Winkelmann BR, Pilz S, Renner W, Scharnagl H, Stojakovic T, Tomaschitz A, Winkler K, Guiducci C, Burtt N, Gabriel SB, O'Donnell CJ, Elosua R, Peltonen L, Salomaa V, Schwartz SM, Melander O, Altshuler D, Dandona S, Jarinova O, Qu L, Wilensky R, Matthai W, Hakonarson HH, Devaney J, Burnett MS, Pichard AD, Kent KM, Satler L, Lindsay JM, Waksman R, Knouff CW, Waterworth DM, Walker MC, Mooser V, Epstein SE, Rader DJ, Braund PS, Wright BJ, Balmforth AJ, Ball SG, Hall AS, Smith NL, Felix JF, Morrison AC, Demissie S, Glazer NL, Loehr LR, Rosamond WD, Bis JC, Folsom AR, Benjamin E, Aulchenko YS, Haritunians T, Couper D, Murabito J, Yang YA, Stricker BH, Gottdiener JS, Chang PP, Wang TJ, Rice KM, Heckbert SR, Fox ER, Willerson JT, Köttgen A, Pattaro C, Böger CA, Fuchsberger C, Olden M, Gao X, Yang Q, O'Connell JR, Schmidt H, Ketkar S, Hwang SJ, Teumer A, Paré G, Atkinson EJ, Lohman K, Cornelis MC, Probst-Hensch NM, Kronenberg F, Tönjes A, Hayward C, Rampersaud E, Mitchell BD, Arking DE, Struchalin M, Cavalieri M, Singleton A, Giallauria F, Metter J, de Boer IH, Siscovick D, Zillikens MC, Feitosa M, Province M, de Andrade M, Turner ST, Wild PS, Schnabel RB, Wilde S, Munzel TF, Leak TS, Koenig W, Zgaga L, Zemunik T, Kolcic I, Minelli C, Hu FB, Johansson A, Igl W, Zaboli G, Wild SH, Wright AF, Campbell H, Ellinghaus D, Imboden M, Nitsch D, Brandstätter A, Kollerits B, Kedenko L, Mägi R, Stumvoll M, Kovacs P, Boban M, Campbell S, Endlich K, Völzke H, Kroemer HK, Nauck M, Völker U, Polasek O, Vitart V, Badola S, Parker AN, Ridker PM, Kardia SL, Curhan GC, Franke A, Rochat T, Paulweber B, Prokopenko I, Wang W, Coresh J, Schmidt R, Shlipak MG, Borecki I, Krämer BK, Rudan I, Gyllensten U, Wilson JF, Pramstaller PP, Rettig R, Hastie N, Chasman DI, Kao WH, Heid IM, Fox CS, Felix SB, Watzinger N, Homuth G, Aragam J, Dörr M, Zweiker R, Lind L, Rodeheffer RJ, Greiser KH, Deckers JW, Stritzke J, Lackner KJ, Ingelsson E, Kullo I, Haerting J, Reffelmann T, Redfield MM, Werdan K, Arnett DK, Blettner M, Friedrich N, Chambers JC, Zhang W, Lord GM, van der Harst P, Lawlor DA, Sehmi JS, Gale DP, Wass MN, Ahmadi KR, Bakker SJ, Beckmann J, Bilo HJ, Bochud M, Brown MJ, Caulfield MJ, Connell JM, Cook HT, Cotlarciuc I, Davey Smith G, de Silva R, Deng G, Devuyst O, Dikkeschei LD, Dimkovic N, Dockrell M, Dominiczak A, Ebrahim S, Eggermann T, Farrall M, Floege J, Forouhi NG, Gansevoort RT, Han X, Hedblad B, Homan van der Heide JJ, Hepkema BG, Hernandez-Fuentes M, Hypponen E, Johnson T, de Jong PE, Kleefstra N, Lagou V, Lapsley M, Li Y, Loos RJ, Luan J, Luttropp K, Maréchal C, Munroe PB, Nordfors L, Penninx BW, Perucha E, Pouta A, Roderick PJ, Ruokonen A, Schalling M, Schlessinger D, Schlieper G, Seelen MA, Sjögren M, Smit JH, Snieder H, Soranzo N, Spector TD, Stenvinkel P, Sternberg MJ, Swaminathan R, Ubink-Veltmaat LJ, Vollenweider P, Waterworth D, Zerres K, Waeber G, Wareham NJ, Maxwell PH, McCarthy MI, Jarvelin MR, Lightstone L, Scott J, Navis G, Elliott P, Kooner JS., Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Life Course Epidemiology (LCE), Lifestyle Medicine (LM), Center for Liver, Digestive and Metabolic Diseases (CLDM), University of Leicester, Department of Genetics [Leicester], Erasmus University Rotterdam, Netherlands Genomics Initiative, Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Washington University in Saint Louis (WUSTL), Queen Mary University of London (QMUL), National Heart, Lung and Blood Institute, Partenaires INRAE, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne = University of Lausanne (UNIL), Department of Biostatistics [Oslo], Institute of Basic Medical Sciences [Oslo], Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO)-Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Leiden University Medical Center (LUMC), Universiteit Leiden, Icelandic Heart Association, Heart Preventive Clinic and Research Institute, University of Iceland [Reykjavik], Johns Hopkins University, School of Medicine, Hôpitaux Universitaires de Genève (HUG), Department of Epidemiology, The Netherlands Cancer Institute, Department of Mathematics, Boston University [Boston] (BU), GlaxoSmithKline, Division of Community Health Sciences, St. George's, University of South Florida [Tampa] (USF), Universität Greifswald - University of Greifswald, University of Washington [Seattle], University of Tartu, Institute of Molecular and Cell Biology, Medical Research Council, Institut de Génomique, Centre National de Génotypage, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), University Medical Center Groningen, Department of Genetics, University Medical Center Groningen [Groningen] (UMCG), Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] (UniSR), Massachusetts General Hospital [Boston], Centro de Regulación Genómica (CRG), Universitat Pompeu Fabra [Barcelona] (UPF), Università degli studi di Trieste = University of Trieste, Universität zu Lübeck = University of Lübeck [Lübeck], Department of Biostatistics, University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, The University of Western Australia (UWA), Department of Twin Research and Genetic Epidemiology, King's College London, London, University of Oxford, Medical University Graz, National Institute on Aging, Centre for population Health Sciences, University of Edinburgh, Uppsala University, Vrije Universiteit Amsterdam [Amsterdam] (VU), Western General Hospital, Harvard Medical School [Boston] (HMS), Brigham and Women's Hospital [Boston], University of Michigan System, University of Groningen, Ealing Hospital, School of Public Health - Department of Epidemiology and Biostatistics, Imperial College London, Medical Genetics Institute, Cedars-Sinai Medical Center, University of Tampere, German Research Center for Environmental Health - Helmholtz Center München (GmbH), Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Split, The University of Texas Health Science Center at Houston (UTHealth), Johns Hopkins University (JHU), Netherlands Consortium for Healthy Aging [Leiden, Netherlands] (NCHA), National Heart, Lung, and Blood Institute [Bethesda] (NHLBI), Swiss Institute of Bioinformatics [Lausanne] (SIB), Finnish Institute of Occupational Health, National Institute of Health and Welfare, University of Oulu, Lapland Central Hospital, University of Bristol [Bristol], Institute for Community Medicine, Unité de Recherche en Epidémiologie Nutritionnelle (UREN), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), US National Institutes of Health, National Heart, Lung, and Blood Institute, European, Epidemiology, Internal Medicine, Public Health, Clinical Genetics, Université de Lausanne (UNIL), LeidenUniversity Medical Centre, University of Iceland, Università degli studi di Trieste, Universität zu Lübeck [Lübeck], University of Western Australia, University of Oxford [Oxford], VU University Amsterdam, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Cité (USPC)-Université Paris 13 (UP13)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut National de la Recherche Agronomique (INRA), Vrije universiteit = Free university of Amsterdam [Amsterdam] (VU), Human genetics, Psychiatry, EMGO - Mental health, NCA - Anxiety & Depression, Epidemiology and Data Science, Medical Research Council (MRC), Louise V., Wain, Germaine C., Verwoert, Paul F., O'Reilly, Gang, Shi, Toby, Johnson, Andrew D., Johnson, Murielle, Bochud, Kenneth M., Rice, Peter, Henneman, Albert V., Smith, Georg B., Ehret, Najaf, Amin, Martin G., Larson, Vincent, Mooser, David, Hadley, Marcus, Dörr, Joshua C., Bi, Thor, Aspelund, Tõnu, Esko, A. Cecile J. W., Janssen, Jing Hua, Zhao, Simon, Heath, Maris, Laan, Jingyuan, Fu, Giorgio, Pisti, Jian'An, Luan, Pankaj, Arora, Gavin, Luca, Pirastu, Nicola, Irene, Pichler, Anne U., Jackson, Rebecca J., Webster, Feng, Zhang, John F., Peden, Helena, Schmidt, Toshiko, Tanaka, Harry, Campbell, Wilmar, Igl, Yuri, Milaneschi, Jouke Jan, Hottenga, Veronique, Vitart, Daniel I., Chasman, Stella, Trompet, Jennifer L., Bragg Gresham, Behrooz Z., Alizadeh, John C., Chamber, Xiuqing, Guo, Terho, Lehtimäki, Brigitte, Kühnel, Lorna M., Lopez, Ozren, Polašek, Mladen, Boban, Christopher P., Nelson, Alanna C., Morrison, Vasyl, Pihur, Santhi K., Ganesh, Albert, Hofman, Suman, Kundu, Francesco U. S., Mattace Raso, Fernando, Rivadeneira, Eric J. G., Sijbrand, Andre G., Uitterlinden, Shih Jen, Hwang, Ramachandran S., Vasan, Thomas J., Wang, Sven, Bergmann, Peter, Vollenweider, Gérard, Waeber, Jaana, Laitinen, Anneli, Pouta, Paavo, Zitting, Wendy L., Mcardle, Heyo K., Kroemer, Uwe, Völker, Henry, Völzke, Nicole L., Glazer, Kent D., Taylor, Tamara B., Harri, Helene, Alavere, Toomas, Haller, Aime, Kei, Mari Liis, Tammesoo, Yurii, Aulchenko, Inês, Barroso, Kay Tee, Khaw, Pilar, Galan, Serge, Hercberg, Mark, Lathrop, Susana, Eyheramendy, Elin, Org, Siim, Sõber, Xiaowen, Lu, Ilja M., Nolte, Brenda W., Penninx, Tanguy, Corre, Corrado, Masciullo, Cinzia, Sala, Leif, Groop, Benjamin F., Voight, Olle, Melander, Christopher J., O'Donnell, Veikko, Salomaa, D'Adamo, ADAMO PIO, Antonella, Fabretto, Flavio, Faletra, Sheila, Ulivi, Fabiola Del Greco, M, Maurizio, Facheri, Francis S., Collin, Richard N., Bergman, John P., Beilby, Joseph, Hung, A., William Musk, Massimo, Mangino, So Youn, Shin, Nicole, Soranzo, Hugh, Watkin, Anuj, Goel, Anders, Hamsten, Pierre, Gider, Marisa, Loitfelder, Marion, Zeginigg, Dena, Hernandez, Samer S., Najjar, Pau, Navarro, Sarah H., Wild, Anna Maria, Corsi, Andrew, Singleton, Eco J. C., de Geu, Gonneke, Willemsen, Alex N., Parker, Lynda M., Rose, Brendan, Buckley, David, Stott, Marco, Orru, Manuela, Uda, Melanie M., van der Klauw, Weihua, Zhang, Xinzhong, Li, James, Scott, Yii Der Ida, Chen, Gregory L., Burke, Mika, Kähönen, Jorma, Viikari, Angela, Döring, Thomas, Meitinger, Gail, Davie, John M., Starr, Valur, Emilsson, Andrew, Plump, Jan H., Lindeman, Peter A. C., 't Hoen, Inke R., König, Janine F., Felix, Robert, Clarke, Jemma C., Hopewell, Halit, Ongen, Monique, Breteler, Stéphanie, Debette, Anita L., Destefano, Myriam, Fornage, Gary F., Mitchell, Nicholas L., Smith, Hilma, Holm, Kari, Stefansson, Gudmar, Thorleifsson, Unnur, Thorsteinsdottir, Nilesh J., Samani, Michael, Preu, Igor, Rudan, Caroline, Hayward, Ian J., Deary, H., Erich Wichmann, Olli T., Raitakari, Walter, Palma, Jaspal S., Kooner, Ronald P., Stolk, J., Wouter Jukema, Alan F., Wright, Dorret I., Boomsma, Stefania, Bandinelli, Ulf B., Gyllensten, James F., Wilson, Luigi, Ferrucci, Reinhold, Schmidt, Martin, Farrall, Tim D., Spector, Lyle J., Palmer, Jaakko, Tuomilehto, Arne, Pfeufer, Gasparini, Paolo, David, Siscovick, David, Altshuler, Ruth J. F., Loo, Daniela, Toniolo, Harold, Snieder, Christian, Gieger, Pierre, Meneton, Nicholas J., Wareham, Ben A., Oostra, Andres, Metspalu, Lenore, Launer, Rainer, Rettig, David P., Strachan, Jacques S., Beckmann, Jacqueline C. M., Witteman, Jeanette, Erdmann, Ko Willems van, Dijk, Eric, Boerwinkle, Michael, Boehnke, Paul M., Ridker, Marjo Riitta, Jarvelin, Aravinda, Chakravarti, Goncalo R., Abecasi, Vilmundur, Gudnason, Christopher Newton, Cheh, Daniel, Levy, Patricia B., Munroe, Bruce M., Psaty, Mark J., Caulfield, Dabeeru C., Rao, Martin D., Tobin, Paul, Elliott, Cornelia M., van Duijn, Biological Psychology, Neuroscience Campus Amsterdam - Anxiety & Depression, EMGO+ - Mental Health, Wain, Louise V., Verwoert, Germaine C., O'Reilly, Paul F., Shi, Gang, Johnson, Toby, Johnson, Andrew D., Bochud, Murielle, Rice, Kenneth M., Henneman, Peter, Smith, Albert V., Ehret, Georg B., Amin, Najaf, Larson, Martin G., Mooser, Vincent, Hadley, David, Dörr, Marcu, Bis, Joshua C, Aspelund, Thor, Esko, Tõnu, Janssens, A Cecile J. W., Zhao, Jing Hua, Heath, Simon, Laan, Mari, Fu, Jingyuan, Pistis, Giorgio, Luan, Jian'An, Arora, Pankaj, Lucas, Gavin, Pichler, Irene, Jackson, Anne U., Webster, Rebecca J., Zhang, Feng, Peden, John F., Schmidt, Helena, Tanaka, Toshiko, Campbell, Harry, Igl, Wilmar, Milaneschi, Yuri, Hottenga, Jouke-Jan, Vitart, Veronique, Chasman, Daniel I., Trompet, Stella, Bragg-Gresham, Jennifer L., Alizadeh, Behrooz Z., Chambers, John C., Guo, Xiuqing, Lehtimäki, Terho, Kühnel, Brigitte, Lopez, Lorna M., Polašek, Ozren, Boban, Mladen, Nelson, Christopher P., Morrison, Alanna C., Pihur, Vasyl, Ganesh, Santhi K., Hofman, Albert, Kundu, Suman, Mattace-Raso, Francesco U. S., Rivadeneira, Fernando, Sijbrands, Eric J. G., Uitterlinden, Andre G., Hwang, Shih-Jen, Vasan, Ramachandran S., Wang, Thomas J., Bergmann, Sven, Vollenweider, Peter, Waeber, Gérard, Laitinen, Jaana, Pouta, Anneli, Zitting, Paavo, Mcardle, Wendy L., Kroemer, Heyo K., Völker, Uwe, Völzke, Henry, Glazer, Nicole L., Taylor, Kent D., Harris, Tamara B., Alavere, Helene, Haller, Tooma, Keis, Aime, Tammesoo, Mari-Lii, Aulchenko, Yurii, Barroso, In S., Khaw, Kay-Tee, Galan, Pilar, Hercberg, Serge, Lathrop, Mark, Eyheramendy, Susana, Org, Elin, Sõber, Siim, Lu, Xiaowen, Nolte, Ilja M., Penninx, Brenda W., Corre, Tanguy, Masciullo, Corrado, Sala, Cinzia, Groop, Leif, Voight, Benjamin F, Melander, Olle, O'Donnell, Christopher J, Salomaa, Veikko, D'Adamo, Adamo Pio, Fabretto, Antonella, Faletra, Flavio, Ulivi, Sheila, Del Greco M, Fabiola, Facheris, Maurizio, Collins, Francis S., Bergman, Richard N., Beilby, John P., Hung, Joseph, Musk, A William, Mangino, Massimo, Shin, So-Youn, Soranzo, Nicole, Watkins, Hugh, Goel, Anuj, Hamsten, Ander, Gider, Pierre, Loitfelder, Marisa, Zeginigg, Marion, Hernandez, Dena, Najjar, Samer S., Navarro, Pau, Wild, Sarah H., Corsi, Anna Maria, Singleton, Andrew, De Geus, Eco J. C., Willemsen, Gonneke, Parker, Alex N., Rose, Lynda M., Buckley, Brendan, Stott, David, Orru, Marco, Uda, Manuela, Van Der Klauw, Melanie M., Zhang, Weihua, Li, Xinzhong, Scott, Jame, Chen, Yii-Der Ida, Burke, Gregory L, Kähönen, Mika, Viikari, Jorma, Döring, Angela, Meitinger, Thoma, Davies, Gail, Starr, John M., Emilsson, Valur, Plump, Andrew, Lindeman, Jan H., Hoen, Peter A. C. T., König, Inke R., Felix, Janine F., Clarke, Robert, Hopewell, Jemma C., Ongen, Halit, Breteler, Monique, Debette, Stéphanie, Destefano, Anita L., Fornage, Myriam, Mitchell, Gary F., Smith, Nicholas L., Holm, Hilma, Stefansson, Kari, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Samani, Nilesh J., Preuss, Michael, Rudan, Igor, Hayward, Caroline, Deary, Ian J., Wichmann, H-Erich, Raitakari, Olli T., Palmas, Walter, Kooner, Jaspal S., Stolk, Ronald P., Jukema, J Wouter, Wright, Alan F., Boomsma, Dorret I., Bandinelli, Stefania, Gyllensten, Ulf B., Wilson, James F., Ferrucci, Luigi, Schmidt, Reinhold, Farrall, Martin, Spector, Tim D., Palmer, Lyle J., Tuomilehto, Jaakko, Pfeufer, Arne, Siscovick, David, Altshuler, David, Loos, Ruth J. F., Toniolo, Daniela, Snieder, Harold, Gieger, Christian, Meneton, Pierre, Wareham, Nicholas J., Oostra, Ben A., Metspalu, Andre, Launer, Lenore, Rettig, Rainer, Strachan, David P., Beckmann, Jacques S., Witteman, Jacqueline C. M., Erdmann, Jeanette, Van Dijk, Ko Willem, Boerwinkle, Eric, Boehnke, Michael, Ridker, Paul M., Jarvelin, Marjo-Riitta, Chakravarti, Aravinda, Abecasis, Goncalo R., Gudnason, Vilmundur, Newton-Cheh, Christopher, Levy, Daniel, Munroe, Patricia B., Psaty, Bruce M., Caulfield, Mark J., Rao, Dabeeru C., Tobin, Martin D., Elliott, Paul, Van, Duijn, Cornelia M., McEniery CM, Wilkinson, Ib, Cockcroft, Jr, O'Shaughnessy, Km, Newhouse, Sj, Yasmin, Smith, Av, Eiriksdottir, G, Launer, Lj, Sigurdsson, S, Aspelund, T, Gudnason, V, De Bacquer, D, Rietzschel, Er, De Backer, Gg, Van Bortel, L, De Buyzere, Ml, Segers, P, Bekaert, S, Gillebert, Tc, De Meyer, T, Ferrucci, L, Tanaka, T, Johnson, Ad, Levy, D, Benjamin, Ej, Mitchell, Gf, Vita, Ja, Larson, Mg, Hamburg, Nm, Vasan, R, Isaacs, A, Schut, Af, Oostra, Ba, van Duijn, Cm, van Rijn, Mj, Sie, Mp, Newman, Ab, Herrington, Dm, Andrews, J, Ding, J, Sutton-Tyrrell, Kc, Harris, Tb, Howard, Td, Liu, Y, Parsa, A, Shuldiner, Ar, Mcardle, Pf, Gibson, Q, Post, W, Dehghan, A, Hofman, A, Uitterlinden, Ag, Sijbrands, Ej, Rivadeneira, F, Mattace-Raso, Fu, Verwoert, Gc, Witteman, Jc, Scuteri, A, Lakatta, Eg, Jewell, E, Abecasis, Gr, Tarasov, Kv, Uda, M, Najjar, S, Sanna, S, Attwood, T, Belz, S, Braund, P, Cambien, F, Cooper, J, Crisp-Hihn, A, Deloukas, P, Foad, N, Eardman, J, Goodall, Ah, Gracey, J, Gray, E, Gulde, S, Gwilliams, R, Heimerl, S, Hengstenberg, C, Jolley, J, Krishnan, U, Linsel-Nitschke, P, Lloyd-Jones, H, Lugauer, I, Lundmark, P, Maouche, S, Moore, J, Muir, D, Murray, E, Nelson, Cp, Neudert, J, Niblett, D, O'Leary, K, Ouwehand, Wh, Pollard, H, Rankin, A, Rice, Cm, Sager, H, Samani, Nj, Sambrook, J, Schmitz, G, Scholz, M, Schroeder, L, Schunkert, H, Syvannen, Ac, Wallace, C, Kathiresan, S, Reilly, Mp, Erdmann, J, Assimes, Tl, Boerwinkle, E, Hall, A, König, Ir, Laaksonen, R, Mcpherson, R, Thompson, Jr, Thorsteinsdottir, U, Ziegler, A, Absher, D, Chen, L, Cupples, La, Halperin, E, Li, M, Musunuru, K, Preuss, M, Schillert, A, Thorleifsson, G, Voight, Bf, Wells, Ga, Assime, Tl, Holm, H, Roberts, R, Stewart, Af, Fortmann, S, Go, A, Hlatky, M, Iribarren, C, Knowles, J, Myers, R, Quertermous, T, Sidney, S, Risch, N, Tang, H, Blankenberg, S, Zeller, T, Wild, P, Schnabel, R, Sinning, C, Lackner, K, Tiret, L, Nicaud, V, Bickel, C, Rupprecht, Hj, Perret, C, Proust, C, Münzel, T, Barbalic, M, Bis, J, Chen, Iy, Cupples, L, Demissie-Banjaw, S, Folsom, A, Glazer, N, Harris, T, Heckbert, S, Lumley, T, Marciante, K, Morrison, A, O' Donnell, Cj, Psaty, Bm, Rice, K, Rotter, Ji, Siscovick, D, Smith, N, Smith, A, Taylor, Kd, van Duijn, C, Volcik, K, Whitteman, J, Ramachandran, V, Uitterlinden, A, Gretarsdottir, S, Gulcher, Jr, Kong, A, Stefansson, K, Thorgeirsson, G, Andersen, K, Fischer, M, Grosshennig, A, Lieb, W, Stark, K, Schreiber, S, Wichmann, He, Aherrahrou, Z, Bruse, P, Doering, A, Illig, T, Klopp, N, Loley, C, Medack, A, Meisinger, C, Meitinger, T, Nahrstedt, J, Peters, A, Wagner, Ak, Willenborg, C, Böhm, Bo, Dobnig, H, Grammer, Tb, Hoffmann, Mm, Kleber, M, März, W, Meinitzer, A, Winkelmann, Br, Pilz, S, Renner, W, Scharnagl, H, Stojakovic, T, Tomaschitz, A, Winkler, K, Guiducci, C, Burtt, N, Gabriel, Sb, O'Donnell, Cj, Elosua, R, Peltonen, L, Salomaa, V, Schwartz, Sm, Melander, O, Altshuler, D, Dandona, S, Jarinova, O, Qu, L, Wilensky, R, Matthai, W, Hakonarson, Hh, Devaney, J, Burnett, M, Pichard, Ad, Kent, Km, Satler, L, Lindsay, Jm, Waksman, R, Knouff, Cw, Waterworth, Dm, Walker, Mc, Mooser, V, Epstein, Se, Rader, Dj, Wright, Bj, Balmforth, Aj, Ball, Sg, Smith, Nl, Felix, Jf, Morrison, Ac, Demissie, S, Glazer, Nl, Loehr, Lr, Rosamond, Wd, Bis, Jc, Folsom, Ar, Benjamin, E, Aulchenko, Y, Haritunians, T, Couper, D, Murabito, J, Yang, Ya, Stricker, Bh, Gottdiener, J, Chang, Pp, Wang, Tj, Rice, Km, Heckbert, Sr, Fox, Er, Willerson, Jt, Köttgen, A, Pattaro, C, Böger, Ca, Fuchsberger, C, Olden, M, Gao, X, Yang, Q, O'Connell, Jr, Schmidt, H, Ketkar, S, Hwang, Sj, Teumer, A, Paré, G, Atkinson, Ej, Lohman, K, Cornelis, Mc, Probst-Hensch, Nm, Kronenberg, F, Tönjes, A, Hayward, C, Rampersaud, E, Mitchell, Bd, Arking, De, Struchalin, M, Cavalieri, M, Singleton, A, Giallauria, F, Metter, J, de Boer, Ih, Zillikens, Mc, Feitosa, M, Province, M, de Andrade, M, Turner, St, Schnabel, Rb, Wilde, S, Munzel, Tf, Leak, T, Koenig, W, Zgaga, L, Zemunik, T, Kolcic, I, Minelli, C, Hu, Fb, Johansson, A, Igl, W, Zaboli, G, Wild, Sh, Wright, Af, Campbell, H, Ellinghaus, D, Imboden, M, Nitsch, D, Brandstätter, A, Kollerits, B, Kedenko, L, Mägi, R, Stumvoll, M, Kovacs, P, Boban, M, Campbell, S, Endlich, K, Völzke, H, Kroemer, Hk, Nauck, M, Völker, U, Polasek, O, Vitart, V, Badola, S, Parker, An, Ridker, Pm, Kardia, Sl, Curhan, Gc, Franke, A, Rochat, T, Paulweber, B, Prokopenko, I, Wang, W, Coresh, J, Schmidt, R, Shlipak, Mg, Borecki, I, Krämer, Bk, Rudan, I, Gyllensten, U, Wilson, Jf, Pramstaller, Pp, Rettig, R, Hastie, N, Chasman, Di, Kao, Wh, Heid, Im, Fox, C, Felix, Sb, Watzinger, N, Homuth, G, Aragam, J, Dörr, M, Zweiker, R, Lind, L, Rodeheffer, Rj, Greiser, Kh, Deckers, Jw, Stritzke, J, Lackner, Kj, Ingelsson, E, Kullo, I, Haerting, J, Reffelmann, T, Redfield, Mm, Werdan, K, Arnett, Dk, Blettner, M, Friedrich, N, Chambers, Jc, Zhang, W, Lord, Gm, van der Harst, P, Lawlor, Da, Sehmi, J, Gale, Dp, Wass, Mn, Ahmadi, Kr, Bakker, Sj, Beckmann, J, Bilo, Hj, Bochud, M, Brown, Mj, Caulfield, Mj, Connell, Jm, Cook, Ht, Cotlarciuc, I, Davey Smith, G, de Silva, R, Deng, G, Devuyst, O, Dikkeschei, Ld, Dimkovic, N, Dockrell, M, Dominiczak, A, Ebrahim, S, Eggermann, T, Farrall, M, Floege, J, Forouhi, Ng, Gansevoort, Rt, Han, X, Hedblad, B, Homan van der Heide, Jj, Hepkema, Bg, Hernandez-Fuentes, M, Hypponen, E, Johnson, T, de Jong, Pe, Kleefstra, N, Lagou, V, Lapsley, M, Li, Y, Loos, Rj, Luan, J, Luttropp, K, Maréchal, C, Munroe, Pb, Nordfors, L, Penninx, Bw, Perucha, E, Pouta, A, Roderick, Pj, Ruokonen, A, Schalling, M, Schlessinger, D, Schlieper, G, Seelen, Ma, Sjögren, M, Smit, Jh, Snieder, H, Soranzo, N, Spector, Td, Stenvinkel, P, Sternberg, Mj, Swaminathan, R, Ubink-Veltmaat, Lj, Vollenweider, P, Waterworth, D, Zerres, K, Waeber, G, Wareham, Nj, Maxwell, Ph, Mccarthy, Mi, Jarvelin, Mr, Lightstone, L, Scott, J, Navis, G, Elliott, P, and Kooner, Js.

Subjects
Netherlands Twin Register (NTR), Linkage disequilibrium, pulse pressure, mean arterial pressure, genome-wide, [SDV]Life Sciences [q-bio], Genome-wide association study, BLOOD-PRESSURE, Blood Pressure, 030204 cardiovascular system & hematology, Linkage Disequilibrium, 0302 clinical medicine, RELEVANCE, CardioGram, Medicine and Health Sciences, Genetics & Heredity, ddc:616, Genetics, 0303 health sciences, Genome-wide association, 11 Medical And Health Sciences, Arteries, ADRENERGIC-RECEPTOR TRAFFICKING, Pulse pressure, EchoGen consortium, Hypertension, HEART-FAILURE, arterial pressure, Case-Control Studie, Life Sciences & Biomedicine, Human, circulatory and respiratory physiology, medicine.medical_specialty, Mean arterial pressure, Arterie, AortaGen Consortium, Cardiogenics consortium, Locus (genetics), Biology, Polymorphism, Single Nucleotide, Article, Follow-Up Studie, 03 medical and health sciences, Internal medicine, medicine, Humans, cardiovascular diseases, METAANALYSIS, 030304 developmental biology, Genetic association, Science & Technology, HYPERTENSION, MORTALITY, Case-control study, CARDIOVASCULAR-DISEASE RISK, 06 Biological Sciences, GENE, MICE, Endocrinology, Blood pressure, CKDGen consortium, Genetic Loci, Case-Control Studies, KidneyGen consortium, CHARGE Consortium Heart Failure Working Group, LifeLines Cohort Study, Developmental Biology, Follow-Up Studies, Genome-Wide Association Study
Abstract

Les affiliations des 100 premiers auteurs sont renseignées dans la notice. Les affiliations des autres auteurs sont disponibles à la fin de la publication.; International audience; Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans(1-3). We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 x 10(-8) to P = 2.3 x 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP.

Published
2016
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8. Isolated systolic hypertension in the young: A position paper endorsed by the European Society of Hypertension

Author

Palatini, P, Agabiti Rosei, E, Avolio, A, Bilo, G, Casiglia, E, Ghiadoni, L, Giannattasio, C, Grassi, G, Jelakovich, B, Julius, S, Mancia, G, Mceniery, C, O’Rourke, M, Parati, G, Pauletto, P, Pucci, G, Saladini, F, Strazzullo, P, Tsioufis, K, Wilkinson, I, Zanchetti, A, McEniery, CM, O’Rourke, MF, Wilkinson, IB, Palatini, P, Agabiti Rosei, E, Avolio, A, Bilo, G, Casiglia, E, Ghiadoni, L, Giannattasio, C, Grassi, G, Jelakovich, B, Julius, S, Mancia, G, Mceniery, C, O’Rourke, M, Parati, G, Pauletto, P, Pucci, G, Saladini, F, Strazzullo, P, Tsioufis, K, Wilkinson, I, Zanchetti, A, McEniery, CM, O’Rourke, MF, and Wilkinson, IB

Abstract

Whether isolated systolic hypertension in the young (ISHY) implies a worse outcome and needs antihypertensive treatment is still a matter for dispute. ISHY is thought to have different mechanisms than systolic hypertension in the elderly. However, findings from previous studies have provided inconsistent results. From the analysis of the literature, two main lines of research and conceptualization have emerged. Simultaneous assessment of peripheral and central blood pressure led to the identification of a condition called pseudo or spurious hypertension, which was considered an innocent condition. However, an increase in pulse wave velocity has been found by some authors in about 20% of the individuals with ISHY. In addition, obesity and metabolic disturbances have often been documented to be associated with ISHY both in children and young adults. The first aspect to consider whenever evaluating a person with ISHY is the possible presence of white-coat hypertension, which has been frequently found in this condition. In addition, assessment of central blood pressure is useful for identifying ISHY patients whose central blood pressure is normal. ISHY is infrequently mentioned in the guidelines on diagnosis and treatment of hypertension. According to the 2013 European Guidelines on the management of hypertension, people with ISHY should be followed carefully, modifying risk factors by lifestyle changes and avoiding antihypertensive drugs. Only future clinical trials will elucidate if a benefit can be achieved with pharmacological treatment in some subgroups of ISHY patients with associated risk factors and/or high central blood pressure.

Published
2018

9. A novel mechanism for buffering dietary salt in humans: Effects of salt loading on skin sodium, VEGF-C and blood pressure

Author

Selvarajah, V, Mäki-Petäjä, KM, Pedro, L, Bruggraber, SFA, Burling, K, Goodhart, AK, Brown, MJ, McEniery, CM, Wilkinson, IB, McEniery, Carmel [0000-0003-3636-0705], Wilkinson, Ian [0000-0001-6598-9399], and Apollo - University of Cambridge Repository

Subjects
skin, stroke volume, blood pressure, vascular endothelial growth factor C, sodium
Abstract

High dietary sodium intake triggers increased blood pressure (BP). Animal studies show that dietary salt loading results in dermal Na+ accumulation and lymphangiogenesis mediated by VEGF-C (vascular endothelial growth factor C), both attenuating the rise in BP. Our objective was to determine whether these mechanisms function in humans. We assessed skin electrolytes, BP, and plasma VEGF-C in 48 healthy participants randomized to placebo (70 mmol sodium/d) and slow sodium (200 mmol/d) for 7 days. Skin Na+ and K+ concentrations were measured in mg/g of wet tissue and expressed as the ratio Na+:K+ to correct for variability in sample hydration. Skin Na+:K+ increased between placebo and slow sodium phases (2.91±0.08 versus 3.12±0.09; P=0.01). In post hoc analysis, there was a suggestion of a sex-specific effect, with a significant increase in skin Na+:K+ in men (2.59±0.09 versus 2.88±0.12; P=0.008) but not women (3.23±0.10 versus 3.36±0.12; P=0.31). Women showed a significant increase in 24-hour mean BP with salt loading (93±1 versus 91±1 mm Hg; P

Published
2017
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10. Functional hemodynamic testing in pregnancy: recommendations of the International Working Group on Maternal Hemodynamics

Author

Meah, Vl, Backx, K, Davenport, Mh, Bruckmann, A, Cockcroft, J, Cornette, J, Duvekot, Jj, Ferrazzi, E, Foo, Fl, Ghossein-Doha, C, Gyselaers, W, Khalil, A, Mceniery, Cm, Lees, C, Meah, V, Novelli, Gp, Spaanderman, M, Stohr, E, Tay, J, Thilaganathan, B, Valensise, H, Wilkinson, I, and Obstetrics & Gynecology

Subjects
Maternal Health, Functional testing, Cardiac Output, Low, Hemodynamics, Blood Pressure, 030204 cardiovascular system & hematology, 0302 clinical medicine, aerobic exercise, cold pressor test, functional testing, hypertensive pregnancy, isometric handgrip, maternal hemodynamics, Adult, Blood Flow Velocity, Cardiovascular Physiological Phenomena, Female, Guidelines as Topic, Hand Strength, Healthy Volunteers, Humans, Hypertension, Pregnancy-Induced, Pregnancy, Vascular Resistance, Exercise Test, 1114 Paediatrics And Reproductive Medicine, Medicine, Cardiac Output, education.field_of_study, Radiological and Ultrasound Technology, Cold pressor test, Obstetrics and Gynecology, General Medicine, Low, Settore MED/40, Hypertension, Gestation, medicine.medical_specialty, Population, Dysfunctional family, Pregnancy-Induced, 03 medical and health sciences, Aerobic exercise, Radiology, Nuclear Medicine and imaging, education, Obstetrics & Reproductive Medicine, business.industry, 030229 sport sciences, medicine.disease, Reproductive Medicine, Physical therapy, business
Abstract

In the general population, functional hemodynamic testing, such as that during submaximal aerobic exercise and isometric handgrip, and the cold pressor test, has long been utilized to unmask abnormalities in cardiovascular function. During pregnancy, functional hemodynamic testing places additional demands on an already stressed maternal cardiovascular system. Dysfunctional responses to such tests in early pregnancy may predict the development of hypertensive disorders that develop later in gestation. For each of the above functional hemodynamic tests, these recommendations provide a description of the test, test protocol and equipment required, and an overview of the current understanding of clinical application during pregnancy. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Published
2017

11. Assessment of arterial function in pregnancy: recommendations of the International Working Group on Maternal Haemodynamics

Author

Foo, FL, McEniery, CM, Lees, C, Khalil, A, International Working Group on Maternal Haemodynamics, Imperial College Healthcare NHS Trust- BRC Funding, Imperial College Healthcare Charity, and Action Medical Research

Subjects
arterial stiffness, endothelial function, International Working Group on Maternal Haemodynamics, 1114 Paediatrics And Reproductive Medicine, Obstetrics & Reproductive Medicine, arterial function, maternal haemodynamics
Abstract

There is strong evidence supporting the role of maternal arterial dysfunction in pregnancy-specific disorders such as pre-eclampsia and intrauterine growth restriction. As more work is focused towards this field, it is important that methods and interpretation of arterial function assessment are applied appropriately. Here, we summarize techniques and devices commonly used in maternal health studies, with consideration of their technical application in pregnant cohorts.

Published
2017

12. Change in maternal cardiac output from pre-conception to mid-pregnancy is associated with birth weight in healthy pregnancies

Author

Mahendru, AA, Foo, FL, McEniery, CM, Everett, TR, Wilkinson, IB, Lees, CC, Lees, CC [0000-0002-2104-5561], and Apollo - University of Cambridge Repository

Subjects
Adult, Technology, ACCURACY, Blood Pressure, HEART-DISEASE, hemodynamics, Fetal Development, REBREATHING TECHNIQUE, PULMONARY BLOOD-FLOW, REPRODUCIBILITY, 1114 Paediatrics And Reproductive Medicine, Humans, Longitudinal Studies, Prospective Studies, Obstetrics & Reproductive Medicine, Science & Technology, vascular resistance, INTRAUTERINE GROWTH RESTRICTION, Radiology, Nuclear Medicine & Medical Imaging, cardiac output, CARDIOVASCULAR CHANGES, Obstetrics & Gynecology, birth weight, Acoustics, PULSE-WAVE ANALYSIS, Pregnancy Trimester, Second, FETAL-GROWTH, Female, pregnancy, ARTERIAL STIFFNESS, Life Sciences & Biomedicine
Abstract

OBJECTIVE: Birth weight (BW) is thought to be determined by maternal health and genetic, nutritional and placental factors, the latter being influenced by anatomical development and perfusion. Maternal cardiovascular changes contribute to uteroplacental perfusion; however, they have not yet been investigated in relation to fetal growth or BW. Our aim was to explore the relationship between maternal cardiovascular adaptation, fetal growth and BW in healthy pregnancies. METHODS: This was a longitudinal prospective study of women planning to conceive a pregnancy. Maternal cardiac output (CO), cardiac index (CI), pulse-wave velocity, aortic augmentation index, central blood pressure and peripheral vascular resistance were assessed prior to pregnancy and at 6, 23 and 33 weeks' gestation. Fetal growth was assessed using serial ultrasound measurements of biometry. RESULTS: In total, 143 women volunteered to participate and were eligible for study inclusion. A total of 101 women conceived within 18 months and there were 64 live births with normal pregnancy outcome. There were positive correlations between BW and the pregnancy-induced changes in CO (ρ = 0.4, P = 0.004), CI (ρ = 0.3, P = 0.02) and peripheral vascular resistance (ρ = 0.3, P = 0.02). There were significant associations between second-to-third-trimester fetal weight gain and the prepregnancy-to-second-trimester increase in CO (Δ, 0.8 ± 1.2 L/min; ρ = 0.3, P = 0.02) and CI (Δ, 0.4 ± 0.6 L/min/m2 ; ρ = 0.3, P = 0.04) and reduction in aortic augmentation index (Δ, -10 ± 9%; ρ = -0.3, P = 0.04). CONCLUSIONS: In healthy pregnancy, incremental changes in maternal CO in early pregnancy are associated with third-trimester fetal growth and BW. It is plausible that this association is causative as the changes predate third-trimester fetal growth and eventual BW. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Published
2016

13. P94 Cardiorespiratory physiology in patients with copd according to blood eosinophilia: data from the erica cohort

Author

Buss, L, primary, McKeever, TM, additional, Mohan, D, additional, Maki-Petaja, K, additional, Forman, J, additional, McEniery, CM, additional, Cheryian, J, additional, Gale, N, additional, Cockcroft, JR, additional, Calverley, PM, additional, MacNee, W, additional, Tal-Singer, R, additional, Polkey, M, additional, Wilkinson, IB, additional, and Bolton, CE, additional

Published
2017
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14. P57 Soluble receptor for advanced glycation end-products (srage) in patients with copd: the erica study

Author

Siraj, R, primary, McKeever, TM, additional, Buss, L, additional, Mohan, D, additional, Maki-Petaja, K, additional, Forman, J, additional, McEniery, CM, additional, Cheryian, J, additional, Gale, N, additional, Cockcroft, JR, additional, Calverley, PM, additional, MacNee, W, additional, Miller, B, additional, Tal-Singer, R, additional, Polkey, M, additional, Wilkinson, IB, additional, and Bolton, CE, additional

Published
2017
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15. S124 The BODE Index is an independent determinant of arterial stiffness in Chronic Obstructive Pulmonary Disease (COPD): Abstract S124 Table 1

Author

Fisk, M, primary, Gale, NS, additional, Mohan, D, additional, McEniery, CM, additional, Forman, JR, additional, Bolton, CE, additional, MacNee, W, additional, Cockcroft, JR, additional, Fuld, J, additional, Calverley, PMA, additional, Cheriyan, J, additional, Tal-Singer, R, additional, Polkey, MI, additional, and Wilkinson, IB, additional

Published
2015
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16. P129 Skeletal muscle weakness, not arterial stiffness, differs according to GOLD group in COPD: Abstract P129 Table 1.

Author

Fisk, M, primary, Gale, N, additional, Mohan, D, additional, Marchong, MN, additional, Forman, J, additional, Lomas, DA, additional, Cockcroft, JR, additional, Bolton, CE, additional, MacNee, W, additional, Fuld, J, additional, Calverley, CM, additional, McEniery, CM, additional, Tal-Singer, R, additional, Wilkinson, IB, additional, and Polkey, MI, additional

Published
2013
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23. RENAL DISEASE IS ASSOCIATED WITH ACCELERATED VASCULAR AGEING: INITIAL RESULTS OF THE UK RESEARCH ALLIANCE INTO KIDNEY DISEASE AND ARTERIAL STIFFNESS (UREKA) COLLABORATION: 8A.02

Author

Tomlinson, L, primary, Ben-Shlomo, Y, additional, Caplin, B, additional, Delles, C, additional, Ferro, CJ, additional, Goddard, J, additional, Hoefield, R, additional, Holt, SG, additional, Kalra, PA, additional, Mceniery, CM, additional, Mcintyre, CW, additional, Mcquarrie, EP, additional, Rajkumar, C, additional, Savage, T, additional, Taal, MW, additional, Tomson, CR, additional, Townend, JN, additional, Webb, DJ, additional, Wheeler, DC, additional, and Wilkinson, IB, additional

Published
2010
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42. P57 Soluble receptor for advanced glycation end-products (srage) in patients with copd: the erica study

Author

Siraj, R, McKeever, TM, Buss, L, Mohan, D, Maki-Petaja, K, Forman, J, McEniery, CM, Cheryian, J, Gale, N, Cockcroft, JR, Calverley, PM, MacNee, W, Miller, B, Tal-Singer, R, Polkey, M, Wilkinson, IB, and Bolton, CE

Abstract

BackgroundAdvanced glycation endproducts (AGE) in patients with chronic obstructive pulmonary disease (COPD) has been considered in the pathology of the disease and as a biomarker of emphysema severity. In addition, AGE has been implicated in cardiovascular (CV) disease, a common comorbidity in COPD. Whether the soluble receptor for AGE (sRAGE) predicts CV status in COPD is unclear.ObjectiveThe aim of this study was to assess the associations between sRAGE and measures of both lung and CV function in patients with COPD from the ERICA cohort.MethodsPatients with confirmed COPD performed spirometry, blood pressure, aortic pulse wave velocity (PWV), carotid intima media thickness (CIMT) at clinical stability. Blood for sRAGE was taken.ResultsOf the 729 subjects in ERICA, 677 patients had a sRAGE result. 417 patients were male; mean (SD) age was 67.4 (7.8) years and 31% were current smokers. There was a weak association of sRAGE with age (r=0.16, p<0.001), FEV1% predicted (r=0.12, p<0.05) and FEV1/FVC (r=0.15, p<0.001). There was no difference in sRAGE in current or ex-smokers. In multiple linear regression, a lower sRAGE was associated with more severe lung function: FEV1% predicted, (B 4.3 [95% CI 1.6, 6.8, p=0.0012]. No significant relationship was observed between sRAGE and cardiovascular variables: aortic PWV (p=0.418) and CIMT (p=0.596) in the multivariate models. sRAGE in those with concurrent presence of CV disease, diabetes or cerebrovascular disease or not was not different (p=0.579).ConclusionDespite literature supporting the role of AGE in both lung and CV disease, there was no apparent association of sRAGE with CV status in patients with COPD in the ERICA cohort. There were associations with spirometry variables of FEV1% predicted and FEV1/FVC.

Published
2017
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43. P94 Cardiorespiratory physiology in patients with copd according to blood eosinophilia: data from the erica cohort

Author

Buss, L, McKeever, TM, Mohan, D, Maki-Petaja, K, Forman, J, McEniery, CM, Cheryian, J, Gale, N, Cockcroft, JR, Calverley, PM, MacNee, W, Tal-Singer, R, Polkey, M, Wilkinson, IB, and Bolton, CE

Abstract

IntroductionBlood eosinophils level in Chronic Obstructive Pulmonary Disease (COPD) is a candidate biomarker for Regulatory qualification as a drug development tool identifying individuals who may benefit from targeted therapies. Current evidence focused on association with exacerbations and response to therapy, however the association of eosinophilia with cardiorespiratory physiology has not been determined.MethodsThe ERICA (Evaluating the Role of Inflammation in Chronic Airway Disease) study is a large multicentre study of patients with COPD.1Aortic pulse wave velocity (PWV), carotid intimal thickness (CIMT) and spirometry were measured. Health Status (CAT) was recorded. From the full blood count, both absolute and percentage eosinophil counts were considered. We used previously validated cut offs2of 0.3 × 109 cells/L and 2% to compare aortic PWV, CIMT and spirometry variables using a Student’s t-test. A multivariate model was then built to examine the effect after adjusting for confounding factors.Results519 subjects were included in this analysis. Of these, 58% were men, mean (SD) age of 66.9 (7.6) years with a median smoking history of 42 pack years. Mean (SD) resting heart rate was 75 (13)bpm, mean arterial pressure 104 (12) mmHg and percentage predicted FEV152.5 (16.1)%. When comparing high and low eosinophil groups at both 0.3 × 109 cells/L and 2% cut-offs there was no difference in smoking status or pack years, spirometry variables or CAT score. There was no difference in prevalence of ischaemic heart disease, stroke or diabetes. Aortic PWV or CIMT were not different between groups. Multiple regression confirmed this (Table).Abstract P94 Table 1Cardiorespiratory variables *Absolute eosinophil countPercentage eosinophil countBeta co-efficient95% CIp-valueBeta co-efficient 95% CIp-valueAortic PWV(m/s)0.23−1.3 to 1.70.770.090−0.29 to 0.470.64CIMT(mm) Diameter right Diameter left0.16 0.17−0.60 to 0.91 −0.56 to 0.890.69 0.650.04 0.05−0.15 to 0.23 −0.13 to 0.230.71 0.59FEV1(L)0.10−0.11 to 0.510.210.06−0.02 to 0.130.15FVC (L)0.17−0.29 to 0.640.460.120.01 to 0.230.04*Adjustment for sex, age, MAP, HR, FEV1, FVC, smoking pack years, history of diabetes and peripheral vascular diseaseConclusionsA phenotype defined by blood eosinophilia does not relate to cardiorespiratory physiological variables in subjects with COPD.ReferencesMohan Det al. Journal of COPD2015.Negewo Net al. Respirology2017.

Published
2017
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44. Cardiovascular responses to experimental weight gain in humans: a feasibility study.

Author

Cseh D, Middlemiss JE, Mäki-Petäjä KM, Hubsch A, Wilkinson IB, and McEniery CM

Subjects
Humans, Male, Adult, Vascular Resistance, Young Adult, Heart Rate physiology, Cardiac Output physiology, Obesity physiopathology, Weight Gain, Feasibility Studies, Blood Pressure physiology
Abstract

Objective: Obesity and hypertension share a well known association. However, the mechanisms underlying their relationship are not well understood. Our goal was to assess the feasibility of a longitudinal, interventional weight gain study with detailed cardiovascular measurements in humans., Methods: Sixteen healthy, normotensive, young, male volunteers (28 ± 7 years) were enrolled. Body composition, biochemical and cardiovascular data were obtained at baseline, and after an 8-week period of overfeeding (800-1000 kcal/day). Blood pressure (BP), cardiac output (CO) and peripheral vascular resistance (PVR) were determined, as were the minimum forearm vascular resistance (MFVR), forearm blood flow (FBF) response to mental stress and heart rate variability (HRV) parameters., Results: Overfeeding resulted in a median weight gain of 5.6 kg [interquartile range (IQR) 4.6-6.4 kg; P  < 0.001]. Seated systolic and diastolic BP were significantly increased by 10 ± 9 and 4 ± 6 mmHg, respectively, after weight gain ( P  < 0.001 and P  = 0.011, respectively). CO also increased and PVR decreased significantly as a result of weight gain ( P  = 0.032 and P  = 0.044, respectively). MFVR was also significantly decreased after weight gain ( P  = 0.023). The FBF response to mental stress was blunted significantly ( P  = 0.002), and sympathovagal balance and responsiveness to orthostatic challenge altered moderately after weight gain., Conclusion: Our overfeeding regimen resulted in moderate weight gain and significant increases in BP. An increase in CO is likely to be the dominant mechanism underlying the observed BP changes, with decreases in PVR partially compensating for these effects. Experimental weight gain, coupled with detailed cardiovascular phenotyping, is a feasible model to examine potential mechanisms underlying obesity-associated hypertension in young adults., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Published
2024
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45. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases.

Author

Mazzolai L, Teixido-Tura G, Lanzi S, Boc V, Bossone E, Brodmann M, Bura-Rivière A, De Backer J, Deglise S, Della Corte A, Heiss C, Kałużna-Oleksy M, Kurpas D, McEniery CM, Mirault T, Pasquet AA, Pitcher A, Schaubroeck HAI, Schlager O, Sirnes PA, Sprynger MG, Stabile E, Steinbach F, Thielmann M, van Kimmenade RRJ, Venermo M, and Rodriguez-Palomares JF

Subjects
Humans, Practice Guidelines as Topic, Europe, Aortic Diseases therapy, Aortic Diseases diagnosis, Peripheral Arterial Disease therapy, Peripheral Arterial Disease diagnosis
Published
2024
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47. Investigation and management of young-onset hypertension: British and Irish hypertension society position statement.

Author

Kulkarni S, Faconti L, Partridge S, Delles C, Glover M, Lewis P, Gray A, Hodson E, Macintyre I, Maniero C, McEniery CM, Sinha MD, Walsh SB, and Wilkinson IB

Subjects
Humans, Ireland epidemiology, United Kingdom epidemiology, Antihypertensive Agents therapeutic use, Adult, Blood Pressure drug effects, Hypertension diagnosis, Hypertension therapy, Hypertension drug therapy, Hypertension epidemiology, Age of Onset
Abstract

National and international hypertension guidelines recommend that adults with young-onset hypertension (aged <40 years at diagnosis) are reviewed by a hypertension specialist to exclude secondary causes of hypertension and optimise therapeutic regimens. A recent survey among UK secondary care hypertension specialist physicians highlighted variations in the investigation of such patients. In this position statement, the British and Irish Hypertension Society seek to provide clinicians with a practical approach to the investigation and management of adults with young-onset hypertension. We aim to ensure that individuals receive consistent and high-quality care across the UK and Ireland, to highlight gaps in the current evidence, and to identify important future research questions., (© 2024. The Author(s).)

Published
2024
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48. Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study.

Author

Zamaladi I, Ruvuma S, Mceniery CM, Kwaga T, Wilkinson IB, Atwine D, and Lugobe HM

Subjects
Female, Humans, Pregnancy, Cross-Sectional Studies, Uganda epidemiology, Hospitals, Prevalence, Hypertension, Pregnancy-Induced epidemiology, Retinal Diseases
Abstract

Objective: Retinopathy is one of the complications occurring among women with hypertensive disorders of pregnancy. We sought to determine the prevalence and factors associated with retinopathy among women with hypertensive disorders of pregnancy in southwestern Uganda., Design: This was a hospital-based cross-sectional study from November 2019 to March 2020., Setting: Three selected hospitals in Mbarara city, south-western Uganda., Participants: The study included all pregnant women with hypertensive disorders of pregnancy., Primary and Secondary Outcome Measures: The participants were screened for retinopathy using a fundus camera. Data on participant's sociodemographics, obstetrics and medical factors were collected. The prevalence of retinopathy was determined and multivariable logistic regression was used to determine the independent factors associated with retinopathy., Results: A total of 216 women with hypertensive disorders of pregnancy were enrolled in this study. The prevalence of retinopathy was 60.2% (130/216). The most common retinal lesions were grade 1 retinopathy (narrowing of arterioles) accounting for 86.9% (113/130), grade 3 (retinal haemorrhages) was present in 10% (13/130) of women and grade 4 (papilloedema) in 3% (4/130). In an adjusted analysis, severe hypertension was significantly associated with retinopathy (aOR=2.8; 95% CI: 1.36 to 5.68). Grandmultigravida women were also associated with retinopathy (aOR=2.4; 95% CI: 0.99 to 5.72) with a tendency towards significancy, p=0.051., Conclusions: In our study, retinopathy was common among women with hypertensive disorders of pregnancy. Women presenting with severe hypertension were likely to have retinopathy. There is a need to integrate screening for retinopathy in the care cascade of women with hypertensive disorders of pregnancy., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Published
2023
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49. Placental syndromes and maternal cardiovascular health.

Author

Casey H, Dennehy N, Fraser A, Lees C, McEniery CM, Scott K, Wilkinson IB, and Delles C

Subjects
Pregnancy, Female, Humans, Syndrome, Placenta, Cardiovascular Diseases etiology, Pre-Eclampsia, Cardiovascular System
Abstract

The placental syndromes gestational hypertension, preeclampsia and intrauterine growth restriction are associated with an increased cardiovascular risk to the mother later in life. In this review, we argue that a woman's pre-conception cardiovascular health drives both the development of placental syndromes and long-term cardiovascular risk but acknowledge that placental syndromes can also contribute to future cardiovascular risk independent of pre-conception health. We describe how preclinical studies in models of preeclampsia inform our understanding of the links with later cardiovascular disease, and how current pre-pregnancy studies may explain relative contributions of both pre-conception factors and the occurrence of placental syndromes to long-term cardiovascular disease., (© 2023 The Author(s).)

Published
2023
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50. Circulating testosterone levels and health outcomes in chronic obstructive pulmonary disease: results from ECLIPSE and ERICA.

Author

Pavey H, Polkey MI, Bolton CE, Cheriyan J, McEniery CM, Wilkinson I, Mohan D, Casaburi R, Miller BE, Tal-Singer R, and Fisk M

Subjects
Female, Humans, Male, Clinical Relevance, Hospitalization, Inflammation, Cardiovascular Diseases, Pulmonary Disease, Chronic Obstructive
Abstract

The relationship of circulating testosterone levels with health outcomes in people with chronic obstructive pulmonary disease (COPD) is unknown., Aim: To determine whether serum testosterone levels predict hospitalised acute exacerbations of COPD (H-AECOPD), cardiovascular disease outcome, and mortality in people with COPD., Methods: Separate analyses were carried out on two observational, multicentre COPD cohorts, Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) and Evaluation of the Role of Inflammation in Chronic Airways Disease (ERICA), both of which had serum testosterone measured using a validated liquid chromatography assay at the same laboratory. Data from 1296 male participants in ECLIPSE and 386 male, 239 female participants in ERICA were analysed. All analyses were sex-specific. Multivariate logistic regression was used to determine associations with H-AECOPD during follow-up (3 years ECLIPSE, 4.5 years ERICA), a composite endpoint of cardiovascular hospitalisation and cardiovascular death, and all-cause mortality., Results: Mean (SD) testosterone levels were consistent across cohorts; 459 (197) and 455 (200) ng/dL for males in ECLIPSE and ERICA, respectively, and in ERICA females: 28 (56) ng/dL. Testosterone was not associated with H-AECOPD (ECLIPSE: OR: 0.76, p=0.329, ERICA males: OR (95% CI): 1.06 (0.73 to 1.56), p=0.779, ERICA females: OR: 0.77 (0.52 to 1.12), p=0.178) or cardiovascular hospitalisation and death. Testosterone was associated with all-cause mortality in Global Initiative for Obstructive Lung Disease (GOLD) stage 2 male patients only, in ECLIPSE (OR: 0.25, p=0.007) and ERICA (OR: (95% CI): 0.56 (0.32 to 0.95), p=0.030)., Conclusions: Testosterone levels do not relate to H-AECOPD or cardiovascular outcome in COPD, but are associated with all-cause mortality in GOLD stage 2 COPD male patients, although the clinical significance of this finding is uncertain., Competing Interests: Competing interests: DM is a current shareholder and employee of Genentech/Roche and was an employee of GSK at the time of study planning. IW held research grants with GSK and TSB. RT-S is a GSK retiree and current shareholder. She reports personal fees from COPD Foundation, Immunomet, VOCALIS Health, Teva and ENA Respiratory. She holds share options in ENA Respiratory. JC has received support from GSK, Evelo Biosciences, Astrazeneca, Alexion and Eli Lilly. JC is a full time employee of Cambridge University Hospitals NHS Foundation Trust, but was seconded by the Trust for 50% of his NHS salaried time to work on GSK clinical trials until October 2020. He received no employee benefits or shares/dividends or income from GSK. BEM is a former employee and current shareholder of GSK., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Published
2023
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