Systolic and diastolic blood pressure percentiles by age and gender in Northeastern Iran.

Hypertension (HTN) is a major risk factor for coronary artery disease. Its frequency is increasing globally. The aim of our study was to evaluate the reference range of blood pressure (BP) in the Iranian population stratified for age and gender. A total of 1449 subjects without diabetes, CVD, dyslipidemia, HTN history and with a normal BMI (18.5 ≤ BMI<25) were recruited in the present study. Participants were enrolled from the Mashhad stroke and heart atherosclerotic disorder study. Anthropometric indices and demographic data were collected by two health care specialists. A quantile regression model was used to estimate the expected systolic BP (SBP) and diastolic BP (DBP) at specific ages. A P-value of <.05 was considered significant for all analyses. All statistical analyses were performed using R (version 3.4.1) and SPSS software. The population included more men than women (51.6% vs. 48.4%). The mean and standard deviation of age in men (47.5 ± 8.4) was 2 years higher than women (45.63 ± 7.9; P < .001). SBP and DBP were higher in men than women (P < .001). By using a quantile regression model, we concluded that the 5th to 90th percentile of SBP in men, aged 30-69 years, ranged from 95 to 148.08 mm Hg and in women ranged from 86.66 to 140 mm Hg. The 5th to 90th percentile of DBP in men, aged 30-69 years, ranged from 60 to 91.66 mm Hg and in women ranged from 60 to 91.22 mm Hg. We have, for the first time, established the BP percentiles (1st, 5th, 10th, 50th, 90th, 95th, 99th) in an Iranian population stratified by age and gender. These data suggest that a local program for health promotion is necessary for the early identification of HTN in adults aged ≥30 years.

Impact of the C1431T Polymorphism of the Peroxisome Proliferator Activated Receptor-Gamma (PPAR-γ) Gene on Fasted Serum Lipid Levels in Patients with Coronary Artery Disease.

BACKGROUND/AIMS: The C1431T polymorphism of peroxisome proliferator activated receptor-γ (PPAR-γ) gene is related to diabetes and metabolic-syndrome. However, studies have been inconclusive about its association with coronary artery disease (CAD) and there have been no studies analyzing the association of this polymorphism with fasted-serum-lipid levels in Iranian-individuals with CAD. We investigated the association of PPAR-γ C1431T-polymorphism with CAD and dyslipidaemia in 787 individuals. METHODS: Anthropometric-parameters and biochemical-measurements were evaluated, followed by genotyping. The association of the genetic-polymorphisms with CAD and lipid-profile was determined by univariate/multivariate-analyses. RESULTS: Patients with CT or CT+TT genotype were at an increased-risk of CAD relative to CC-carriers (adjusted odds ratio: 2.03; 95% confidence interval, 1.01-4.09; p = 0.046). However, in the larger population, CT genotype was present at a higher frequency in the group with a positive angiogram. Furthermore, CT+TT genotypes were associated with an altered fasted-lipid-profile in the initial population sample of patients with a positive angiogram, compared to the group with a negative-angiogram. The angiogram-positive patients carrying the T allele had a significantly higher triglyceride, serum C-reactive protein and fasting-blood-glucose. CONCLUSION: We have found the PPAR-γ C1431T polymorphism was significantly associated with fasted serum lipid profile in individuals with angiographically defined CAD. Since accumulating data support the role of PPAR-γ polymorphisms in CAD, further studies are required to investigate the association of this polymorphism with coronary artery disease.

Effect of melatonin and gabapentin on anxiety and pain associated with retrobulbar eye block for cataract surgery: a randomized double-blind study.

OBJECTIVES: To compare the effect of melatonin and gabapentin on anxiety, pain, sedation scores, and satisfaction of surgeon in patients of cataract surgery. MATERIALS AND METHODS: One hundred thirty patients aged between 35 and 85 years scheduled for cataract surgery were randomly allocated to three study groups to receive melatonin (6 mg), gabapentin (600 mg) or placebo 90 min before arrival in the operating room. Pain, anxiety, and sedation scores during block and surgery as well as the surgeon's satisfaction with the surgery were assessed. RESULTS: Anxiety scores decreased significantly in melatonin and gabapentin groups compared to the placebo group after premedication and extended to early postoperative period. The level of anxiety showed no statistically significant difference between melatonin and gabapentin groups at any time of measurement. There were significant differences between the pain scores during retrobulbar placement in gabapentin versus placebo (95% CI 3 to 4; P = 0.001) and melatonin (95% CI 3 to 4; P = 0.040) groups. Also, there were significant differences between the sedation scores during retrobulbar placement in gabapentin and placebo groups (95% CI 2 to 2.5; P = 0.046). The difference in sedation scores during retrobulbar placement in melatonin versus gabapentin and placebo groups was not significant. Neither the intraoperative pain scores nor the postoperative pain scores were different between the three groups. The surgeon reported similar quality of operation conditions during surgery for the three study groups. CONCLUSION: The level of anxiety was significantly lower with both anxiolytic drugs compared to placebo. Furthermore, gabapentin decreased the pain and improved the sedation scores only during retrobulbar placement compared to the placebo.

Association of angiotensin II type 1 receptor gene A1166C polymorphism with the presence of diabetes mellitus and metabolic syndrome in patients with documented coronary artery disease.

BACKGROUND: There are relatively limited data available on the genetic susceptibility to diabetes mellitus and metabolic syndrome in the Iranian population. We have therefore investigated the association between the angiotensin II type I receptor gene polymorphism (AT(1)R/A1166C) and the presence of diabetes mellitus and metabolic syndrome in a well defined group of patients. METHODS: Patients with angiographically defined coronary artery disease (CAD) (n=309) were evaluated for the presence of AT(1)R/A1166C polymorphism. These patients were classified into subgroups with (n=164, M/F: 109/55) and without (n=145, M/F: 84/61) diabetes mellitus. The AT(1)R polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) based method. RESULTS: There was a higher frequency of polymorphic genotypes (AC+CC) in the diabetic compared with the non-diabetic group (p=0.01). When determined for each gender separately, this difference remained significant in the males (p=0.04) but not in females (p=0.09). With regard to the allele frequencies, the C allele was significantly higher and the A allele frequency was lower in the diabetic group (p=0.01). This remained significant after gender segregation for males (p=0.01) but not females. In the binary logistic regression analysis, only serum fasting glucose was found as the independent predictor for the presence of diabetes in the CAD patients (ß=1.16, p<0.001 for total population and ß=1.29, p<0.001 for male subjects). There was no significant difference in genotype or allele frequencies between subgroups with and without metabolic syndrome, this being unaffected by gender or the definition of metabolic syndrome used apart from a significantly lower frequency of C allele in male subjects with metabolic syndrome defined by the NCEP ATP III criteria (p=0.04). CONCLUSION: The AT(1)R/A1166C polymorphism may be associated with the presence of diabetes mellitus in male subjects with documented CAD.

Effect of supplementation with selenium on postpartum depression: a randomized double-blind placebo-controlled trial.

OBJECTIVE: Postpartum depression is a common complication of childbirth, and its prevention is an important public-health issue because of its negative effects on mother, infant, and family. The present randomized, double-blind, placebo-controlled trial was conducted to examine the effect of prenatal selenium supplementation on the postpartum depression level in Iranian women. DESIGN: A total of 166 primigravid pregnant women in the first trimester of pregnancy, were randomized to receive 100 µg of selenium (n = 83) or a placebo (n = 83) per day until delivery. The symptoms of postpartum depression were evaluated during the eight weeks following delivery by means of the Edinburgh Postnatal Depression Scale (EPDS). Serum selenium concentrations were measured at baseline and at the end of study. RESULTS: There was no significant difference in demographic characteristics and perceived social support between the selenium and control groups at baseline (p > 0.05). There were 22 drop-outs in the selenium-supplemented group and 19 in the placebo group. Forty-four women in the selenium group and 41 women in the placebo group completed the trial and the EPDS questionnaire. Selenium supplementation was associated with a significant increase in mean serum selenium concentration at term (p < 0.001) but remained unchanged in the control group. The mean EPDS score in the selenium group was significantly lower than that of the control group (p < 0.05). CONCLUSION: These findings suggest that supplementation with selenium during pregnancy might be an effective approach for the prevention of postpartum depression.

Association between angiotensin II type 1 receptor gene polymorphism and metabolic syndrome in a young female Iranian population.

BACKGROUND AND AIMS: The overall prevalence of obesity and metabolic syndrome (MetS) is increasing among children and adolescents and can predispose to type II diabetes mellitus and cardiovascular disease. There are reported associations between an angiotensin II type I receptor gene polymorphism (AT(1)R/A1166C) with hypertension, myocardial infarction, insulin resistance and cardiovascular disease risk. In the present study, we aimed to investigate whether the AT(1)R/A1166C polymorphism was associated with MetS among adolescent Iranian girls. METHODS: A total of 350 adolescent girls aged 15-17 years from high schools and different educational zones of Mashhad city participated in this population-based, genetic association study. Of these individuals, 101 patients had MetS (defined by the NCEP-ATP III criteria); the remaining 249 age-matched girls were considered as the control group. All subjects were genotyped for the AT(1)R/A1166C polymorphism using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. RESULTS: Frequencies of the AA, AC and CC genotypes were 164 (65.9%), 80 (32.1%) and 5 (2.0%) in the control group and 79 (78.2%), 20 (19.8%) and 2 (2.0%) in patients, which were not consistent with the Hardy-Weinberg equilibrium (p <0.05 and p <0.001, respectively). Frequency of the AT(1)R C allele was found to be significantly lower in patients compared with controls (p <0.05). CONCLUSIONS: Our findings suggested that the 1166C allele of AT(1)R gene may be associated with a decreased risk of MetS in adolescent Iranian females.

Selenium supplementation and the incidence of preeclampsia in pregnant Iranian women: a randomized, double-blind, placebo-controlled pilot trial.

OBJECTIVE: Recent studies have reported that antioxidant status, including serum selenium concentrations, is altered in women who develop preeclampsia. We wished to examine the effects of selenium supplementation in the prevention of preeclampsia in high-risk pregnant women. DESIGN: We carried out a randomized, double-blind, placebo-controlled pilot trial. A total of 166 primigravid pregnant women, who were in the first trimester of pregnancy, were randomized to receive 100 microg of selenium (n = 83; dropouts, n = 22) or a placebo (n = 83; dropouts, n = 19) per day until delivery. The incidence of preeclampsia, serum selenium concentrations, lipid profile and high-sensitivity C-reactive protein status were evaluated at baseline and at the end of the study. RESULTS: Supplementation with selenium was not associated with any reported major side effects and was associated with a significant increase in mean serum selenium concentrations at term (p < 0.001). In contrast, mean serum selenium concentrations remained unchanged in the control group (p = 0.63). The incidence of preeclampsia was lower in the selenium group (n = 0) than in the control group (n = 3), although this was not statistically significant (p > 0.05). After treatment, systolic and diastolic blood pressure, serum total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were significantly increased in both groups compared with pretreatment levels (p < 0.05). CONCLUSION: Our findings indicate that selenium supplementation in pregnant women may be associated with a lower frequency of preeclampsia.

Prooxidant-antioxidant balance in pregnancy: a randomized double-blind placebo-controlled trial of selenium supplementation.

OBJECTIVE: We assessed the impact of selenium, a trace element with antioxidant properties on a simple measure of oxidative stress in pregnant women. STUDY DESIGN: A novel assay of prooxidant-antioxidant balance (PAB) was applied in a double-blind, placebo-controlled study of selenium supplementation in pregnancy. We measured the prooxidant burden and the antioxidant capacity simultaneously in one assay, thereby calculating a redox index. A total of 166 primigravid pregnant women in the first trimester of pregnancy, were randomized to receive 100 microg of selenium (n=83) or placebo (n=83) per day until delivery. PAB values and serum selenium concentrations were measured at baseline and at the end of study. RESULTS: Pretreatment demographic data and biochemical indices including serum selenium concentrations did not differ significantly between the groups. The drop-out rates for the groups were 22/83 and 19/83 for the selenium and placebo groups, respectively. Supplementation with selenium was associated with a significant increase in mean serum selenium concentration (P<0.001) but without significant change in mean PAB value. In contrast, mean serum selenium concentration remained unchanged and mean PAB values increased significantly (P<0.05 in the control group). CONCLUSION: Our findings suggest that selenium supplementation may reduce oxidative stress associated with pregnancy.