A Nomogram model for the early warning of essential hypertension risks based on the principles of traditional Chinese medicine syndrome elements / 数字中医药（英文）

@#[Objective] To construct a Nomogram model for the prediction of essential hypertension (EH) risks with the use of traditional Chinese medicine (TCM) syndrome elements principles in conjunction with cutting-edge biochemical detection technologies. [Methods] A case-control study was conducted, involving 301 patients with essential hypertension in the hypertensive group and 314 without in the control group. Comprehensive data, including the information on the four TCM diagnoses, general data, and blood biochemical indicators of participants in both groups, were collected separately for analysis. The differentiation principles of syndrome elements were used to discern the location and nature of hypertension. One-way analysis was carried out to screen for potential risk factors of the disease. Least absolute shrinkage and selection operator (LASSO) regression was used to identify factors that contribute significantly to the model, and eliminate possible collinearity problems. At last, multivariate logistic regression analysis was used to both screen and quantify independent risk factors essential for the prediction model. The “rms” package in the R Studio was used to construct the Nomogram model, creating line segments of varying lengths based on the contribution of each risk factor to aid in the prediction of risks of hypertension. For internal model validation, the Bootstrap program package was utilized to perform 1000 repetitions of sampling and generate calibration curves. [Results] The results of the multivariate logistic regression analysis revealed that the risk factors of EH included age, heart rate (HR), waist-to-hip ratio (WHR), uric acid (UA) levels, family medical history, sleep patterns (early awakening and light sleep), water intake, and psychological traits (depression and anger). Additionally, TCM syndrome elements such as phlegm, Yin deficiency, and Yang hyperactivity contributed to the risk of EH onset as well. TCM syndrome elements liver, spleen, and kidney were also considered the risk factors of EH. Next, the Nomogram model was constructed using the aforementioned 14 risk predictors, with an area under the curve (AUC) of 0.868 and a 95% confidence interval (CI) ranging from 0.840 to 0.895. The diagnostic sensitivity and specificity were found to be 80.7% and 85.0%, respectively. Internal validation confirmed the model’s robust predictive performance, with aconsistency index (C-index) of 0.879, underscoring the model’s strong predictive ability. [Conclusion] By integrating TCM syndrome elements, the Nomogram model has realized the objective, qualitative, and quantitative selection of early warning factors for developing EH, resulting in the creation of a more comprehensive and precise prediction model for EH risks.

Serum mir-195-5p exhibits clinical significance in the diagnosis of essential hypertension with type 2 diabetes

OBJECTIVES: Diagnosis and management of essential hypertension (EH) or type 2 diabetes mellitus (T2DM) by combining comprehensive treatment and classificatory diagnosis have been continuously improved. However, understanding the pathogenesis of EH patients with concomitant T2DM and subsequent treatment remain the major challenges owing to the lack of non-invasive biomarkers and information regarding the underlying mechanisms. METHODS: Herein, we collected 200 serum samples from EH and/or T2DM patients and healthy donors (N). Gene-expression profiling was conducted to identify candidate microRNAs with clinical significance. Then, a larger cohort of the aforementioned patients and 50 N were used to identify the correlation between the tumor suppressor miR-195-5p and EH and/or T2DM. The dual-luciferase reporter assay was used to explore the target genes of miR-195-5p. The suppressive effects of miR-195-5p on the 3′-UTR of the dopamine receptor D1 (DRD1) transcript in EH patients with concomitant T2DM were verified as well. RESULTS: Compared with that in other groups, serum miR-195-5p was highly downregulated in EH patients with concomitant T2DM. miR-195-5p overexpression efficiently suppressed DRD1 expression by binding to the two 3′-UTRs. Additionally, two single nucleotide polymorphisms, including 231T-A and 233C-G, in the miR-195-5p binding sites of the DRD1 3′-UTR were further identified. Collectively, we identified the potential clinical significance of DRD1 regulation by miR-195-5p in EH patients with concomitant T2DM. CONCLUSIONS: Our data suggested that miR-195-5p circulating in the peripheral blood served as a novel biomarker and therapeutic target for EH and T2DM, which could eventually help address major challenges during the diagnosis and treatment of EH and T2DM.

Adjuvant treatment of acupoint catgut embedding for essential hypertension and its effects on vascular endothelial function / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of acupoint catgut embedding assisting western medication and simple western medication on blood pressure and vascular endothelial function in patients with essential hypertension (EH), and to explore its mechanism.</p><p><b>METHODS</b>A total of 125 cases were randomly assigned into an observation group (62 cases, 2 dropping) and a control group (63 cases, 3 dropping). Oral administration of lotensin (10 mg, once a day) was applied in the control group. Based on the treatment as the control group, acupoint catgut embedding was applied at Fengchi (GB 20), Ganshu (BL 18), Shenshu (BL 23), Quchi (LI 11), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) in the observation group, once every two weeks, and six treatments was taken as one session. All the patients were treated for 3 months. The blood pressure and the vascular endothelial injury markers, including endothelin-1 (ET-1), nitric oxide (NO), high sensitive C reactive protein (hsCRP) were recorded before and after treatment in the two groups. In addition, the ET-1, NO and hsCRP were collected from 60 cases of healthy participants.</p><p><b>RESULTS</b>The diastolic blood pressure and systolic blood pressure reduced after treatment in the two groups (all <0.05), which were more significant in the observation group (<0.01, <0.05). Before treatment, compared with those of the healthy participants, ET-1 and hsCRP were higher but NO was lower in the observation group and the control group (all <0.05); after treatment, ET-1 and hsCRP were reduced and NO increased in the two groups (all <0.05), which were more significant in the observation group (all <0.05). After treatment, the differences of NO and hsCRP between the observation group and healthy participants were not significant (both >0.05). The marked effective rate was 70.0% (42/60) in the observation group, which was superior to 33.3% (20/60) in the control group (<0.05); the total effective rate was 96.7% (58/60) in the observation group, which was superior to 85.0% (51/60) in the control group (<0.05).</p><p><b>CONCLUSION</b>The vascular endothelial function is injured in EH patients. Based on lotensin treatment, acupoint catgut embedding could significantly improve blood pressure and vascular endothelial function.</p>

Relationship between angiontensin Ⅱ type2-receptor gene polymorphism and essential hypertension in men / 基础医学与临床

Objective To investigate the relationship between AT2-receptor 1675A/G gene polymorphism and essential hypertension in men.Methods The 113 EH male patients and 101 controls were born in Jining.The 1675A/G polymorphism of AGTR2 gene was detected by PCR,HRM and gene sequencing.Results There was difference in genetypes(AA,GG) distribution and allele frenqency of AGTR2 1675A/G between male EH and control group (P＜0.05).Genotypes(AA,GG) distribution in EH group[56(49.6%) and 57(50.4%)]are significantly higher than that in control group [32 (31.7%) and 69 (68.3%)](P＜0.05).Allele frenqency in EH group[A:112(49.6%) and G:114(50.4%)]is significantly higher than that in control group[64(31.7%) and 138(68.3%)](P＜0.05).Conclusion The 1675A/G polymorphism of AGTR2 gene may be associated with male EH in Jining area,Shandong province.