Saline stress effect on cowpea beans growth under biofertilizer correction / Efeito do estresse salino no crescimento do feijão-caupi sob a correção de biofertilizante

New strategies to increase growth and food crops productivity in saline soils are priorities in the research. The experiment was carried out in a pot to investigate the growth of cowpea cv. Canapu in response to saline stress under the correction of a mixed biofertilizer. Five irrigation water salinity levels and three doses of the mixed biofertilizer were tested, with four replicates at each level. The increase in salinity level resulted in reductions in stem diameter, leaves number, shoot biomass and roots. The mixed biofertilizer use was able to minimize the effect of salinity in all analyzed variables, improving the cowpea growth and development, protecting from saline stress negative impacts. In addition, the mixed biofertilizer use may be an option to improve crop growth and productivity in salt affected soils.

Novas estratégias para aumentar o crescimento e a produtividade de plantas cultivadas em solos salinos representam prioridades na pesquisa. O experimento foi conduzido em vaso, para investigar o crescimento do Feijão-Caupi em resposta ao estresse salino sob a correção de um biofertilizante misto. Cinco níveis de salinidade da água de irrigação e três doses do biofertilizante misto foram testados, com quatro repetições cada nível. O biofertilizante misto foi capaz de minimizar o estresse salino.O aumento do nível de salinidade resultou em reduções no diâmetro do caule, número de folhas, biomassa da parte aérea e das raízes. O uso do biofertilizante misto minimizou o efeito da salinidade em todas as variáveis analisadas, melhorando o crescimento e desenvolvimento do feijão caupi, protegendo-o dos impactos negativos do estresse salino. O uso de biofertilizante misto pode ser uma opção para melhorar o crescimento da cultura e a produtividade em solos afetados por sais.

Estimation of populational 24-h urinary sodium and potassium excretion from spot urine samples: evaluation of four formulas in a large national representative population.

OBJECTIVE: The aim of this study was to assess the validity of the estimation of 24-h urinary sodium (UNa) and urinary potassium (UK) excretion obtained through four formulae based on occasional urine samples. DESIGN AND METHODS: We analysed 2399 individuals (51% females) aged 18 to 96 years representatives of Portuguese population. Tanaka, Kawasaki, INTERSALT and NHANES formulae were used to predict 24-h UNa and UK excretions from spot morning urinary samples (OUrS). We compared it with validated real 24-h urine samples (VUrS) (24-h UNa: 4052 ±â€Š1432 mg/day, 24-h UK = 2928 ±â€Š1004 mg/day). We compared observed vs. estimated measurements by examining bias (observed minus predicted UNa and UK), the correlation and intraclass correlation (ICC) coefficients between measurements, and Bland-Altman plots. We analysed the differences between observed and estimated Na and K excretion across subgroups defined by quintiles of observed Na and K excretion and subgroups defined hypertension status and control. The area under the ROC curve was used to assess the discriminatory capacity of formulas between high-intake salt individuals from low-intake individuals, taking the arbitrary values 3000 and 3900 mg/day for, respectively, Na and K intake. RESULTS: Formulas produced significant mean bias for UNa: Kawasaki-1277, INTERSALT-569, NHANES-116 and for UK Tanaka-754, Kawasaki-95 mg/day. Correlation coefficients were less than 0.360 and ICC coefficients were all less than 0.458 for both UNa and UK estimations. Bias varied across quintiles with overestimation of UNa at lower quintiles (by 29-105%) and underestimation at higher quintile (by 7-37%) regardless of formula. The Bland-Altman plots indicated a high dispersion of the estimates biases regardless of the formulae and normotension/hypertension condition particularly at higher levels. All formulas exhibited an area under the receiver operating characteristic curve below 0.67 both in normotensive individuals and hypertensive individuals. CONCLUSION: We found a poor agreement between estimated and observed measurements of UNa and UK in our large population. All these formulas incur in over- or underestimations of UNa and UK excretion that may be unreliable for clinical evaluation of individual's and mean population daily UNa and UK excretion.

Prevalence of microalbuminuria in hypertensive patients with or without type 2 diabetes in a Portuguese primary care setting: The RACE (micRoAlbumin sCreening survEy) study.

INTRODUCTION AND OBJECTIVES: To determine the prevalence of microalbuminuria (MAU) in outpatients with hypertension and/or type 2 diabetes mellitus (DM) and in normotensive, non-diabetic outpatients (control group); and, as secondary objectives, to examine the differences in the distribution of MAU in the four subgroups and the association of different clinical and epidemiological variables with MAU. METHODS: RACE (micRoAlbumin sCreening survEy) was a multicenter, descriptive observational cross-sectional study, which enrolled outpatients followed in primary care in Portugal. Patients with potential reasons for a false-positive MAU test were excluded. The main outcome measures were the prevalence of MAU as assessed by Micral(®) test strips and blood pressure. Demographic variables, presence of comorbidities, use of cardiovascular and antidiabetic drugs and biochemical variables were also analyzed. RESULTS: A total of 9198 patients (3769 with hypertension, 3100 with both DM and hypertension, 423 with DM and without hypertension, and 1906 controls), 54.7% women, were included in the primary analysis. Overall prevalence of MAU was 58% in patients with DM and hypertension, 51% in patients with DM, 43% in patients with hypertension, and 12% in controls (chi-square: p<0.001 for all subgroups). In multivariate analysis, predictors for MAU were the presence of DM or hypertension, HbA1C, male gender, age, systolic blood pressure and total cholesterol. CONCLUSIONS: MAU is extremely common in outpatients with DM and/or hypertension followed in primary care, especially in those with both hypertension and DM and high cardiovascular risk. MAU screening would help identify individuals at risk and increase awareness of kidney disease and target organ damage.

Prevalence, awareness, treatment and control of hypertension and salt intake in Portugal: changes over a decade. The PHYSA study.

OBJECTIVE: To determine prevalence, awareness, treatment and control of hypertension and the 24-h sodium excretion (24h-UNa) in the Portuguese adult population and to examine their changes from a similar study done in 2003. DESIGN AND SETTING: A population-based cross-sectional survey conducted in 2011-2012. METHODS: A multistage-stratified (by age and sex) sampling method was used to select a representative sample of the 18-90-year-old population yielding 3720 participants (52.6% women, 97.1% Caucasians). Hypertension was defined as a SBP of at least 140  mmHg or DBP of at least 90  mmHg [average of 2-3 blood pressure (BP) measurements by trained observers with OMRON M6] or reported knowledge or treatment with antihypertensive drugs at the first visit (V1). A complete clinical information was obtained with a standard questionnaire. This procedure was repeated 10-15 days after visit 2 (V2) and 24-h urinary sample was collected for 24h-UNa, 24-h potassium excretion and creatinine excretion. RESULTS: The overall prevalence of hypertension at V1 was 42.2% (44.4% in men, 40.2% in women) (42.1% in 2003). The age-specific prevalence of hypertension was 6.8, 46.9 and 74.9% in people below 35 years, 35-64 years and above 64 years. Comorbidities were 2.2-6.3 times more common in hypertensive patients vs. normotensive individuals. Overall, among the hypertensive patients, 76.6% were aware of the hypertension condition, 74.9% were treated and 42.5% were controlled (BP <140/90  mmHg), that is, respectively, 1.7, 1.9 and 3.8 times higher vs. data in 2003, with lower values in men vs. women and younger vs. older people. Global mean BP was 127.4/74.6 ±â€Š17.7/10.5 vs. 134.7/80.4 ±â€Š21.2/14.1  mmHg in 2003. From V1 to V2, control of hypertension increased on average by 14.8%. Multivariate analysis showed that age and BMI were independently associated with prevalence of hypertension. 24h-UNa (84% valid urinary samples) was 182.5 ±â€Š64.7  mmol/day (10.7  g salt/day) and 24-h potassium excretion 75.2 ±â€Š26.1  mmol/day. 24h-UNa was higher in patients with hypertension than in normotensive individuals (185.4 ±â€Š64.8 vs. 177.8 ±â€Š64.5  mmol/day; P < 0.02) and correlated with SBP (r = 0.05), age (r = 0.08) and BMI (r = 0.10) (P < 0.01). CONCLUSION: Hypertension prevalence among Portuguese adults remained stable in the past decade, but proportions of awareness, treatment and control of hypertension improved significantly. Salt intake is still high being almost double the WHO recommendations.

Global cardiovascular risk stratification of hypertensive patients followed in Portugal in primary care or in hospital care according to the 2007 ESH/ESC guidelines.

INTRODUCTION: Hypertension is one of the major risk factors for cardiovascular (CV) disease. Our aim was to assess and stratify the CV risk of two cohorts of hypertensive patients in Portugal attended in primary care (PC) or in outpatient hospital care (HC) using the global CV risk stratification model of the 2007 ESH/ESC guidelines. METHODS: We retrospectively analyzed the clinical data of hypertensive patients (aged 18-75 years) enrolled in other population studies and attended in PC (n = 2299, 66 +/- 11 years, 64% women) or in HC (n = 2028, 51 +/- 14 years, 54.7% women). Global risk stratification was performed according to the 2007 ESH/ESC guidelines. RESULTS: In patients attended in PC (67% treated with antihypertensive drugs, 31% with BP < 140/90 mmHg, 22% with dyslipidemia and 16% with diabetes), added global CV risk was average or low in 26%, moderate in 31%, high in 27% and very high in 16%; in patients attended in HC (77% treated with antihypertensive drugs, 16% with BP <140/90 mmHg, 47% with dyslipidemia and 26% with diabetes), added global CV risk was average or low in 16%, moderate in 30%, high in 28% and very high in 26%. CONCLUSIONS: The majority of hypertensiv patients attended in PC or HC have a high or very high global CV risk according to the 2007 ESH/ECS guidelines. Thus, global CV risk stratification should be undertaken in all hypertensive patients, as well as the implementation and reinforcement of strategies aimed at adequate control of hypertension and of all other modifiable CV risk factors.

Lack of adequate blood pressure control in the morning and evening periods in medicated hypertensive patients considered to be controlled in the office.

BACKGROUND AND AIM: In hypertensive patients tight blood pressure (BP) control during the critical morning and evening periods may be relevant for preventing cardiovascular events, which most frequently occur at these times of the day. METHODS: In a prospective study we evaluated 24h ambulatory BP (ABP) values (24h, daytime, nighttime, morning period between 6-10 am and evening period between 6-10 pm), in 103 hypertensive patients (HTs), aged between 18-79 years, considered to be controlled in the office in the previous two months (office BP < 140/90 mmHg, 2 x 3 readings, before taking medication), who were being treated with antihypertensive drugs taken once daily in the morning. Based on ABP data, HTs were considered to have good BP control if daytime BP values were < 135/85 mmHg, < 133.1/85.4 mmHg during the morning period, and < 138.1/89.3 mmHg during the evening period. Otherwise control of ABP was considered poor. These limits correspond to the upper 95% confidence limits of BP calculated for each period in a normotensive control population of 210 subjects age-matched to the HTs. RESULTS: Of the 103 HTs, 39 were under monotherapy and the remaining 64 on combination regimens (34 with two drugs, 29 with three and one with four). Based on ABP data of the 103 HTs, poor ABP control was observed in 36 (35%) in the morning period, in 24 (23%) in the evening period and in 29 (28%) for daytime BP values. ABP values during both the morning and evening periods correlated significantly with daytime values (r = 0.72 and r = 0.89 respectively, p < 0.01) but not with office values. CONCLUSIONS: A significant proportion of treated HTs who are considered to be controlled in the office present abnormally high ABP levels, particularly in the critical early morning period, but also during the evening and throughout the daytime period.

Morning rise, morning surge and daytime variability of blood pressure and cardiovascular target organ damage. A cross-sectional study in 743 subjects.

OBJECTIVE: To evaluate in a large population the relationship between cardiovascular target organ damage and values of the night-to-morning rise of systolic blood pressure (MR-BP), the morning surge of BP at the moment of rising (BP surge) and daytime BP variability (standard deviation [SD] of daytime BP). METHODS: This was a cross-sectional study, evaluating 743 subjects, aged 30-75 years, 416 female, with normal renal function and no previous cardiovascular events. The population included: I-174 patients with type 2 diabetes, II-317 hypertensive patients with ongoing treatment over at least the previous 6 months, III-127 hypertensive patients untreated in the last 6 months, IV-125 healthy normotensive subjects. All underwent 24-hour ambulatory BP monitoring to calculate MR-BP, BP surge and SD of daytime BP. Target organ evaluation included: pulse wave velocity (PWV) (an indicator of aortic stiffness) in 711 subjects, left ventricular mass index (LVMI) in 185 subjects and 24-hour albuminuria in 239 subjects. RESULTS: In the population as a whole, BP surge, MR-BP and SD of daytime BP correlated significantly with PWV (r = 0.434, p < 0.0001; r = 0.126, p < 0.001; 0.337, p < 0.001, respectively), with LVMI (r = 0.447, p < 0.0001; r = 0.307, p < 0.001; 0.162, p < 0.05, respectively) and to a lesser degree with albuminuria (r = 0.126, p < 0.05; r = 0.083, NS; 0.082, NS, respectively). In the upper quintile of distribution of BP surge, the percentage of cases with abnormal PWV (>12 m/s) (21%), cardiac hypertrophy (53 %) and microalbuminuria (47 %) was significantly greater (p < 0.03) than that observed in the lower quintile (1%, 14% and 27%, respectively). BP surge correlated more strongly with indices of target organ damage than did MR-BP or SD of daytime BP, independently of night-time BP and nocturnal BP fall. CONCLUSIONS: In this large population, MR-BP, BP surge and daytime BP variability are strongly correlated with target organ damage severity, and are probably related to organ deterioration. Of the three, morning surge of BP at the moment of rising is more strongly related to organ damage than MR-BP, perhaps because unlike MR-BP, BP surge is independent of night-time BP values.

Prognostic markers in treated hypertensive diabetic patients. 28-month follow-up.

INTRODUCTION: Diabetes mellitus has a prevalence of about 6 to 10% in western populations, with a rising tendency due to inappropriate increases in calorie intake and decreased physical activity. In diabetic patients hypertension (HT) has a prevalence of over 60% and cerebro- and cardiovascular disease is responsible for two-thirds of the mortality in these patients. PATIENTS AND METHODS: We studied prospectively and consecutively 97 patients (age 63 +/- 8; 39-89) with treated type 2 diabetes and HT. The objective was to identify cardio- and cerebrovascular risk markers. The majority of the patients were evaluated by clinical and laboratory examination, 24h ambulatory blood pressure monitoring (ABPM), HbA1c, total cholesterol, HDL-C and triglycerides, microalbuminuria, echocardiogram (left ventricular mass index) and carotid-femoral pulse wave velocity. Later, the patients were re-evaluated using the same diagnostic methodology after a mean follow-up of 28 months. RESULTS: The population was at high risk for cardio- and cerebrovascular disease (60% dyslipidemic, 39% with previous cerebro- or cardiovascular accidents, 73% nondipper, 69% with decreased vascular distensibility [<12 m/sec] and 35% with microalbuminuria) despite treatment. Diabetes was controlled in only 55% of cases and blood pressure (BP) in 10%, although by ABPM it was controlled in 40% of cases. Simultaneous control of diabetes and HT was present in only one third of the patients. At the end of follow-up these values had not changed significantly, which can only be considered positive in respect of reduction in microalbuminuria (due to ACEIs and AIIRAs). Thirty cardio- and cerebrovascular events occurred (5 deaths), related to inadequate control of diabetes at initial evaluation (p=0.012), night-time systolic BP (SBP) and nondipper status (p=0.02) and vascular distensibility at the end of the study (p=0.03). On multiple linear regression (stepwise) analysis the only variable which was significantly associated with cardio- and cerebrovascular mortality and morbidity was night-time SBP. CONCLUSIONS: Overall analysis of the data confirmed the elevated risk of these patients and the importance of more frequent and aggressive control. The study also confirms the importance of evaluation by ABPM in these patients, which may lead to more efficacious, tailor-made treatment.

Does orthostatic hypotension predict the occurrence of nocturnal arterial hypertension in the elderly patient?

OBJECTIVE: To determine whether the presence of orthostatic hypotension--which, in this age-group, could be due to varying degrees of autonomic dysfunction--is an indicator of nocturnal arterial hypertension. PATIENTS: Between 1999 and 2001 we prospectively and consecutively studied 93 elderly patients with untreated (office) arterial hypertension, 65 (70%) of whom were true hypertensives according to 24 h ambulatory blood pressure monitoring (ABPM). INTERVENTIONS: The patients were studied by clinical examination including blood pressure (BP) measurement in dorsal decubitus and orthostatic position, 24 h ABPM, evaluation of vascular distensibility by carotid-femoral pulse wave velocity (PWV) and Doppler echocardiography. For this study we analyzed especially the ambulatory behavior of BP, so we could relate the variation of systolic blood pressure (SBP) during orthostatism with non-dipper status for SBP and absolute nocturnal values of SBP. MEASUREMENTS AND RESULTS: The results indicated that a greater decrease of blood pressure with orthostatism corresponded to a greater probability of nocturnal hypertension (p = 0.005) and of non-dipper status (p = 0.02). These results are in agreement with those subsequently found by other authors (Kario et al., 2002). CONCLUSIONS: In this way, by means of a simple clinical maneuver that should always be performed in an elderly hypertensive patient, we can suspect the presence of nocturnal hypertension--which is a high-risk cardiovascular situation--and use this information to help select patients to undergo 24 hour-ABPM.

[Pulmonary hypertension. Topic review. 2 clinical cases]. / Hipertensão pulmonar. Revisão do tema. A propósito de dois casos clínicos.

The authors describe two cases of pulmonary hypertension (PHT). In the first case it is secondary to pulmonary thromboembolism, a frequent and serious occurrence, witch is well known as a cause of PHT. In the second case the PHT is probably secondary to infection by human immunodeficiency virus, also a serious and frequent condition in clinical practice but which was only recently identified as a cause of PHT. Formerly these patients were considered as suffering from primary PHT. The authors make a brief review of the literature on pulmonary hypertension.