There is a strong association between metabolic syndrome (MS) and increased risk of end-organ damage, cardiovascular disease, stroke, and cardiovascular mortality. Moreover, non-dipping (< 10% decline in the asleep relative to the awake blood pressure [BP] mean) and elevated ambulatory pulse pressure (PP), among other factors related to the circadian BP pattern, have also been associated with increased cardiovascular morbidity and mortality. This cross-sectional study investigated the circadian BP pattern in 2,045 non-diabetic untreated patients with uncomplicated essential hypertension (941 men/1,099 women), 48.7 ± 11.9 yrs of age, classified by the presence or absence of MS. BP was measured by ambulatory monitoring for 48 consecutive hours to substantiate reproducibility of the dipping pattern. Physical activity was simultaneously monitored every min by wrist actigraphy to accurately calculate mean BP when awake and asleep for each subject. MS was present in 40.7% of the patients. Patients with MS were characterized by a significantly higher 24 h mean of systolic BP and a lower diastolic BP compared to patients without MS. Accordingly, ambulatory PP was significantly elevated the entire 24 h in MS patients. The prevalence of an altered non-dipper BP profile was significantly higher in MS patients (48.4 vs. 36.1% in patients without MS, p < 0.001). MS patients were characterized, among other risk factors, by significantly higher uric acid, fibrinogen, leukocyte count, hemoglobin and globular sedimentation velocity, plus lower estimated glomerular filtration rate. Apart from corroborating the significant increased prevalence of a blunted nocturnal BP decline in MS, this study documents ambulatory PP is higher in MS, without differences between groups in mean arterial pressure. This elevated PP might reflect increased arterial stiffness in MS. MS patients were also characterized by elevated values of relevant markers of cardiovascular risk, including fibrinogen and globular sedimentation velocity. These collective findings indicate that MS should be included among the clinical situations in which ambulatory BP monitoring is recommended. (Author correspondence: rhermida@uvigo.es)
Objectives: Several studies have consistently documented differences in blood pressure (BP)-lowering efficacy, duration of action, safety profile and/or effects on the circadian BP pattern depending on the administration-time of antihypertensive medication. Clinical trials and epidemiological observations have also indicated that elevated fibrinogen is strongly correlated with an increased frequency of vascular events. Accordingly, we investigated the potential influence of time of day of antihypertensive treatment on the relationship between fibrinogen and ambulatory BP (ABPM) in subjects with essential hypertension. Methods: We studied 5000 hypertensive subjects (2392 men), 53.2 ± 13.6 years of age. Among them, 1672 patients were untreated at the time of the study, 1963 were treated with all drugs on awakening, and 1365 were receiving treatment at bedtime. BP was measured every 20-min from 07:00 to 23:00 h and every 30-min at night for 48 h. Blood samples were obtained in the early morning after nocturnal fasting, within the same week before starting ABPM. Results: For all three groups of subjects, independently of treatment scheme, plasma fibrinogen was comparable between extreme-dippers and dippers, but significantly elevated in non-dippers and, to a larger extent, in risers (P < 0.001 compared to all other groups). Compared with untreated subjects (315 mg/dl), fibrinogen was much higher among those treated with all drugs on awakening (330 mg/dl) than among those receiving treatment at bedtime (323 mg/dl). On the contrary, the sleep-time relative BP decline was significantly lower in subjects treated with all drugs on awakening (8.4%) compared to untreated subjects (10.9%, P < 0.001), and was highest among subjects treated with all drugs at bedtime (11.1%). Conclusions: Plasma fibrinogen is significantly correlated with the progressive loss in asleep BP regulation towards a more non-dipper or even riser profile. Compared with subjects receiving all their prescribed antihypertensive medication on awakening, treatment at bedtime was associated with higher sleep-time relative BP decline, significantly lower prevalence of non-dipping, and, simultaneously, lower plasma fibrinogen levels, what could all provide a diminished cardiovascular risk.
Reproduction is a complex process that is substantially affected by environmental cues, specifically feed/diet and its components. Farm animals as herbivorous animals are exposed to a large amount of polyphenols present in their natural feeding system, in alternative feed resources (shrubs, trees, and agro-industrial byproducts), and in polyphenol-enriched additives. Such exposure has increased because of the well-known antioxidant properties of polyphenols. However, to date, the argumentation around the impacts of polyphenols on reproductive events is debatable. Accordingly, the intensive inclusion of polyphenols in the diets of breeding animals and in media for assisted reproductive techniques needs further investigation, avoiding any source of reproductive waste and achieving maximum benefits. This review illustrates recent findings connecting dietary polyphenols consumption from different sources (conventional and unconventional feeds) with the reproductive performance of farm animals, underpinned by the findings of in vitro studies in this field. This update will help in formulating proper diets, optimizing the introduction of new plant species, and feed additives for improving reproductive function, avoiding possible reproductive wastes and maximizing possible benefits.
1st Annual Meeting of the One Health European Join Programme on Foodborne zoonoses, antimicrobial resistance and emerging threats, Dublin, 22-24 May 2019