https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)17741-1.pdf

Global burden of hypertension: analysis of worldwide data

Acute kidney injury (AKI) is a complex disorder for which currently there is no accepted definition. Having a uniform standard for diagnosing and classifying AKI would enhance our ability to manage these patients. Future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information via multidisciplinary joint conferences and publications, and improved translation of knowledge from pre-clinical research. We describe an initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI. Members representing key societies in critical care and nephrology along with additional experts in adult and pediatric AKI participated in a two day conference in Amsterdam, The Netherlands, in September 2005 and were assigned to one of three workgroups. Each group's discussions formed the basis for draft recommendations that were later refined and improved during discussion with the larger group. Dissenting opinions were also noted. The final draft recommendations were circulated to all participants and subsequently agreed upon as the consensus recommendations for this report. Participating societies endorsed the recommendations and agreed to help disseminate the results. The term AKI is proposed to represent the entire spectrum of acute renal failure. Diagnostic criteria for AKI are proposed based on acute alterations in serum creatinine or urine output. A staging system for AKI which reflects quantitative changes in serum creatinine and urine output has been developed. We describe the formation of a multidisciplinary collaborative network focused on AKI. We have proposed uniform standards for diagnosing and classifying AKI which will need to be validated in future studies. The Acute Kidney Injury Network offers a mechanism for proceeding with efforts to improve patient outcomes.

Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury

PurposeTo examine the prevalence and the level of awareness, treatment and control of hypertension in different world regions.Study selectionA literature search of the MEDLINE database, using the Medical Subject Headings prevalence, hypertension, blood pressure and cross-sectional studies, was condu

Worldwide prevalence of hypertension: a systematic review.

Objective. —To assess the effects of supplementation with oral potassium on blood pressure in humans. Design. —Meta-analysis of randomized controlled trials. Data Sources. —English-language articles published before July 1995. Study Selection. —Thirty-three randomized controlled trials (2609 participants) in which potassium supplementation was the only difference between the intervention and control conditions. Data Extraction. —Using a standardized protocol, 2 of us independently abstracted information on sample size, duration, study design, potassium dose, participant characteristics, and treatment results. Results. —By means of a random-effects model, findings from individual trials were pooled, after results for each trial were weighted by the inverse of its variance. An extreme effect of potassium in lowering blood pressure was noted in 1 trial. After exclusion of this trial, potassium supplementation was associated with a significant reduction in mean (95% confidence interval) systolic and diastolic blood pressure of-3.11 mm Hg (-1.91 to-4.31 mm Hg) and-1.97 mm Hg (-0.52 to-3.42 mm Hg), respectively. Effects of treatment appeared to be enhanced in studies in which participants were concurrently exposed to a high intake of sodium. Conclusions. —Our results support the premise that low potassium intake may play an important role in the genesis of high blood pressure. Increased potassium intake should be considered as a recommendation for prevention and treatment of hypertension, especially in those who are unable to reduce their intake of sodium.

https://jamanetwork.com/journals/JAMA/articlepdf/416446/jama_277_20_033.pdf

Effects of Oral Potassium on Blood Pressure: Meta-analysis of Randomized Controlled Clinical Trials

Psidium guajava: a review of its traditional uses, phytochemistry and pharmacology.

A randomized, single-blind, controlled trial was conducted to examine the effects of guava fruit intake on BPs and blood lipids in patients with essential hypertension. Of 145 hypertensives that entered the trial, 72 patients were assigned to take a soluble fibre and a potassium-rich diet containing 0.5-1.0 kg of guava daily (group A) and 73 patients to their usual diet (group B), while salt, fat, cholesterol, caffeine and alcohol intake were similar in both groups. Mean age, mean body weight and male sex, were similar, and so were risk factors, mean BPs, mean serum sodium, potassium, calcium, magnesium, triglycerides, cholesterol and HDL-cholesterol in both groups. Dietary adherence to guava intake was checked by a questionnaire. After four weeks of follow-up on an increased consumption of dietary potassium and low sodium/potassium ratio, group A patients were associated with 7.5/8.5 mmHg net decrease in mean systolic and diastolic pressures compared with group B. Increased intake of soluble dietary fibre (47.8 +/- 11.5 vs. 9.5 +/- 0.85 g/day) was associated with a significant decrease in serum total cholesterol (7.9%), triglycerides (7.0%) and an insignificant increase in HDL-cholesterol (4.6%) with a mild increase in the ratio of total cholesterol/HDL-cholesterol in group A patients compared with group B. It is possible that an increased consumption of guava fruit can cause a substantial reduction in BPs and blood lipids with a lack of decrease in HDL-cholesterol due to its higher potassium and soluble fibre content, respectively.

Can guava fruit intake decrease blood pressure and blood lipids

Epidemiological study of hypertension and its determinants in an urban population of North India

Epidemiological study of hypertension and its determinants in an urban population of North India.

Prognostic value of neuron specific enolase and IL-10 in ischemic stroke and its correlation with degree of neurological deficit

To determine the association of socio-economic status (SES) and prevalence of hypertension and its risk factors in a rural population, a cross sectional survey was conducted in two randomly selected villages in the Moradabad district in North India. There were 1935 residents aged over 25 (984 men and 951 women) who were randomly selected and categorised into social classes 1-4 depending upon SES based on occupation, housing conditions, land holding, total per capita income, ownership of consumer durables and education. The prevalence of hypertension diagnosed by JNCV criteria (>140/90 mm Hg) was significantly higher among social class 1 and 2 and showed positive relation with SES in both sexes. Among social class 1 and 2 subjects, there was a higher prevalence of overweight and obesity and sedentary lifestyle. Logistic regression analysis with adjustment of age showed that SES had a positive relation with hypertension (odds ratio: men 1.09, 95% Cl 1.05-1.14; women 1.08, 95% Cl 1.05-1.13), body mass index (odds ratio: men 1.12, 1.08-1.18; women 1.11, 1.06-1.16) and sedentary lifestyle (odds ratio: men 1.45, 1.32-1.58; women 1.38, 1.26-1.49). Only weak but significant associations were observed with smoking, alcohol and salt intake. The association of hypertension with social class was reduced after adjustment of body mass index, sedentary lifestyle, smoking and salt intake (odds ratio: men 0.96, 0.81-1.14; women 0.73, 0.54-1.04). There was an increase in the prevalence of hypertension and age-specific blood pressure (BP) with increasing age in both sexes. The overall prevalence of hypertension by WHO criteria (>160/95) was 4.6% and by JNC V criteria 20.8%, and the rates were comparable in both sexes. Social class 1 and 2 subjects in rural North India have a higher prevalence of hypertension and its risk factors of overweight and sedentary lifestyle.

Prevalence and determinants of hypertension in the Indian social class and heart survey.

In diabetic patients, persistence of hyperglycemia has been reported as a cause of increased production of oxy- gen free radicals. Hyperglycemia could induce oxidative stress and become the main factor for predisposing the complica- tions in diabetes. The study is being aimed to find out the status of lipid peroxidation product i.e. malondialdehyde (MDA) and antioxidant enzymes (AOEs) such as glutathione peroxidase (GPx), glutathione reductase (GR), catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH) which might be helpful in risk assessment of various complications of diabetes mellitus. The study included 300 subjects (50-70yrs) out of which 150 patients were non insulin dependent diabetes mellitus (NIDDM) with micro vascular complications and 150 age matched healthy controls. The status of fasting blood sugar (FBS), reduced glutathione (GSH), GPx, GR, CAT, SOD and MDA were determined. Our results showed significant increase (p< 0.001) in FBS, CAT and MDA while GSH, GPx, GR and SOD were found decreased significantly (p< 0.001). The data suggest that alteration in antioxidant status and MDA may help to predict the risk of various micro vascular complications of diabetes mellitus.

/pdf/status-of-antioxidant-enzymes-and-lipid-peroxidation-in-type-43nehygf86.pdf

Neelima Singh

Papers

Can guava fruit intake decrease blood pressure and blood lipids

Epidemiological study of hypertension and its determinants in an urban population of North India.

Prognostic value of neuron specific enolase and IL-10 in ischemic stroke and its correlation with degree of neurological deficit

Prevalence and determinants of hypertension in the Indian social class and heart survey.

Status of Antioxidant Enzymes and Lipid Peroxidation in Type 2 Diabetes Mellitus with Micro Vascular Complications