ABSTRACT
Objective: To investigate the gene expression characteristics of peripheral blood mononuclear cells from patients with high altitude pulmonary hypertension (HAPH) in Naxi residents living in Lijiang, Yunnan, and to explore the underlying pathogenesis and value for potential drug selection. Methods: This is a case-control study. Six patients with HPAH (HPAH group) and 4 normal subjects (control group) were selected from the Naxi residents who originally lived in Lijiang, Yunnan Province. The general clinical data of the two groups were collected, and the related indexes of pulmonary artery pressure were collected. Peripheral blood mononuclear cells of the subjects were collected for RNA sequencing. The differences on gene expression, regulatory network of transcription factors and drug similarity between the two groups were compared. The results were compared with the public data of idiopathic pulmonary arterial hypertension (IPAH). Biological processes and signal pathways were analyzed and compared between HPAH and IPAH patients. Results: The age of 6 patients with HAPH was (68.1±8.3) years old, and there were 2 males (2/6). The age of 4 subjects in the control group was (62.3±10.9) years old, and there were 2 males (2/4). Tricuspid regurgitation velocity, tricuspid pressure gradient and pulmonary systolic pressure in HAPH group were significantly higher than those in control group (all P<0.05). The results of RNA sequencing showed that compared with the control group, 174 genes were significantly upregulated and 169 genes were downregulated in peripheral blood mononuclear cells of HAPH group. These differentially expressed genes were associated with 220 biological processes, 52 molecular functions and 23 cell components. A total of 21 biological processes and 2 signal pathways differed between HPAH and IPAH groups, most of which were related to inflammation and immune response. ZNF384, SP1 and STAT3 were selected as highly correlated transcription factors by transcription factor prediction analysis. Trichostatin A and vorinostat were screened out as potential drugs for the treatment of HAPH by drug similarity analysis. Conclusions: There are significant differences in gene expression in peripheral blood monocytes between HAPH patients and normal population, and inflammation and immune dysfunction are the main pathogenic factors. Trichostatin A and Vorinostat are potential drugs for the treatment of HAPH.
Subject(s)
Aged , Humans , Male , Middle Aged , Altitude , Altitude Sickness/genetics , Case-Control Studies , China , Familial Primary Pulmonary Hypertension/genetics , Hydroxamic Acids/therapeutic use , Hypertension, Pulmonary/genetics , Inflammation , Leukocytes, Mononuclear/pathology , Transcription Factors , Transcriptome/genetics , Vorinostat/therapeutic useABSTRACT
Objective To investigate the knowledge, attitude, practice (KAP)status of patients under hypertension management in Huamu Street, Shanghai. Methods According to the method of cluster random sampling, 220 hypertension patients in Huamu Street were selected and investigated by questionnaire, and the latest weight and blood pressure monitoring data were obtained from the patients of the hypertension management information system. Results Of the respondents, 59.55% were hypertension patients complicated with diabetes or other cardiovascular diseases.Overweight or obesity (BMI≥24) accounted for 47.72%, and the blood pressures between overweight and normal weight patients were significantly different(χ2 =4.05, P < 0.05).It was found that there were significant difference in prevention and treatment of hypertension among patients with different cultural levels; 28.18% of respondents did not know the diagnostic criteria of hypertension; 36% of respondents did not know that poor blood pressure control could cause a variety of systemic diseases; 33.18% of the respondents did not know the risk factors of hypertension, and 6.36% of respondents could not keep on regular blood pressure measurement.However, 45% of the subjects started to concern their eating habits.85.91% of respondents were willing to improve their lifestyle and control blood pressure by participating in self-management activities for hypertension. Conclusion Hypertensive patients in Huamu Street have poor basic knowledge of hypertension.According to the needs of patients, self-management team construction should be further strengthened to rapidly improve the effect of hypertension management.
ABSTRACT
Objective To investigate the knowledge, attitude, practice (KAP)status of patients under hypertension management in Huamu Street, Shanghai. Methods According to the method of cluster random sampling, 220 hypertension patients in Huamu Street were selected and investigated by questionnaire, and the latest weight and blood pressure monitoring data were obtained from the patients of the hypertension management information system. Results Of the respondents, 59.55% were hypertension patients complicated with diabetes or other cardiovascular diseases.Overweight or obesity (BMI≥24) accounted for 47.72%, and the blood pressures between overweight and normal weight patients were significantly different(χ2 =4.05, P < 0.05).It was found that there were significant difference in prevention and treatment of hypertension among patients with different cultural levels; 28.18% of respondents did not know the diagnostic criteria of hypertension; 36% of respondents did not know that poor blood pressure control could cause a variety of systemic diseases; 33.18% of the respondents did not know the risk factors of hypertension, and 6.36% of respondents could not keep on regular blood pressure measurement.However, 45% of the subjects started to concern their eating habits.85.91% of respondents were willing to improve their lifestyle and control blood pressure by participating in self-management activities for hypertension. Conclusion Hypertensive patients in Huamu Street have poor basic knowledge of hypertension.According to the needs of patients, self-management team construction should be further strengthened to rapidly improve the effect of hypertension management.
ABSTRACT
Objective To evaluate the new model of "1+2+X" in the self-management of hypertension in community. Methods A total of 205 patients with hypertension were enrolled in the hypertension self-management group in Huamu subdistrict of Pudong New Area, Shanghai.The patients were randomly divided into intervention group and control group.The control group used the traditional self-management group model, whereas the intervention group implemented a new mode of "1" group leader plus "2" deputy group leaders plus "X" social resources to participate in the self-management.Changes in the patients′ knowledge, awareness, behavior, blood pressure control, and group activity satisfaction were collected by questionnaires and then compared before and after the implementation of the self-management. Results After one-year implementation, the proportion of the patients being aware of knowledge in the intervention group and control group was 92.23% and 70.59%, respectively; the qualified proportion of patients′ confidence on blood pressure control was 77.67% and 60.78%, respectively; the qualified proportion of health behavior was 77.67% and 72.55%, respectively; and the proportion of being satisfied with self-management was 76.70% and 61.76%, respectively.In all the results, the intervention group was better than the control group, with statistical significance (P < 0.05). Conclusion The new management model of "1+2+X" effectively improves the efficiency of hypertension self-management, which could be recommended in community-based hypertension self-management.