Biomedical subjects

Aletta E Schutte

Publications and source records attributed to Aletta E Schutte.

10 recordsLinked to original sources

PubMed2026

Wearable wrist-watch type cuff oscillometric blood pressure monitors: consensus statement by the European Society of Hypertension Working Group on blood pressure monitoring.

Wearable wristwatch-type cuff oscillometric blood pressure (BP) monitors represent a new category of BP devices and are the first wearable monitors to use established cuff-oscillometric BP measurement technology. This consensus statement by the European Society of Hypertension Working Group on BP Monitoring reviews the published evidence on their design, accuracy, validation, clinical application, and remaining research questions. Of 281 articles identified through a systematic PubMed search, 26 were relevant. Several devices are currently available; however, only two have published validation studies performed according to established standards (Omron HeartGuide and Huawei Watch D/D2). Static validation studies generally showed acceptable accuracy, whereas data on 24-h ambulatory use, in special populations, and clinical applications remain limited. Potential advantages include self-initiated measurement at home, at work, and in other settings and conditions; more convenient and repeatable 24-h ambulatory monitoring; more convenient and accurate assessment of asleep BP; capture of stress-related and other BP-related episodes. However, proper wrist position, user adherence, ambulatory performance, and clinical applications require further investigation. More research is needed to establish the accuracy and clinical utility of these novel devices and their role in improving the diagnosis and management of hypertension.

Humans↗

PubMed2026

Home blood pressure telemonitoring reveals race-specific patterns of target organ damage.

BACKGROUND: Racial differences in cardiac and renal target organ damage (TOD) may persist at comparable blood pressure levels. This study compared TOD in high-risk, non-African-American Black and White patients in relation to the home blood pressure (HBP). METHODS: UPRIGHT-HTM (NCT04299529) is an ongoing international trial comparing risk stratification strategies in asymptomatic patients, aged 55-75  years, with ≥5 risk factors. Patients engage in HBP telemonitoring (OMRON HEM 9210-T). After 34.7 months (median), 287 Black and 154 White patients underwent echocardiography. At baseline, their chronic kidney disease (CKD) grade was assessed by cross-classification of the race-free estimated glomerular filtration rate and albuminuria (2024 KDIGO guideline). HBP was stratified by the 2024 ESC thresholds. Linear and logistic regression models, including a race-by-HBP interaction term, were applied to assess associations with the home systolic HBP. RESULTS: The number of HBP readings was 252 215. Median systolic/diastolic HBP was 127/77 mmHg with 142 patients (32.2%) having home hypertension. Fewer Black patients received statins or combination therapy for hypertension or diabetes. Among nonhypertensive White compared to Black patients, left atrial dimensions, mitral annular s', and stroke volume had a steeper slope in relation to systolic HBP. All patients had concentric left ventricular remodeling, but only 4 Black and 13 White patients had an ejection fraction < 50%. CKD grade was worse in Black than White patients without association with HBP. CONCLUSIONS: TOD primarily affects the kidney in Black and the heart in White patients. Intensifying pharmacological treatment in sub-Saharan Africa, including antihypertensives, lipid-lowering agents, antidiabetic medications, and aspirin, should create an opportunity for improved overall cardiovascular and metabolic prevention.

Aged↗

PubMed2006

Ethnic differences in C-peptide secretion but not in non-esterified fatty acid metabolism in pre-menopausal women with and without abdominal obesity.

The present study aimed to reveal racial differences in the metabolic pattern of C-peptide and non-esterified fatty acids (NEFA), and in their associations with cardiovascular measures in healthy urban African (102) and Caucasian women (115) from South Africa. An oral glucose tolerance test was performed with measurements before and at 30, 60, 90 and 120min. Various cardiovascular parameters and blood lipids were assessed. Statistical analyses were done in a sub-sample of pre-menopausal women. Fasting C-peptide and hepatic insulin extraction were significantly higher in lean African women compared to their Caucasian counterparts, with no racial differences between women with abdominal obesity. Postchallenge C-peptide response and hepatic insulin extraction were significantly higher in Caucasians with abdominal obesity. There were no racial differences in insulin sensitivity and resistance. Despite different associations of C-peptide and NEFA with cardiovascular measures between the ethnicities both showed significant positive correlations with triglycerides. Increased fasting C-peptide levels and unfavorable associations of C-peptide and NEFA with triglycerides and cardiovascular measures implicate a higher cardiovascular risk in lean African women only. This may be of importance for the development of hypertension in this population group.

Abdominal Fat↗

PubMed2006

Modulation of baroreflex sensitivity by walnuts versus cashew nuts in subjects with metabolic syndrome.

BACKGROUND: Impaired baroreflex sensitivity (BRS) is associated with cardiovascular diseases and the metabolic syndrome. Because lipid abnormalities have been associated with impaired BRS, this study aimed to determine whether diets known to improve the lipid profile, namely a diet high in polyunsaturated fatty acids (walnuts) or monounsaturated fatty acids (cashew nuts), would improve BRS in subjects with metabolic syndrome (MS). METHODS: A controlled feeding trial with a randomized, controlled, parallel study design was undertaken, which involved 62 subjects with MS. Subjects were stratified according to gender and age and were randomized into three groups receiving a control diet, or a diet high (20% energy) in walnuts or unsalted cashew nuts for 8 weeks while maintaining body weight. The BRS, C-reactive protein (CRP), and MS components were measured before and after the intervention. RESULTS: After the intervention, BRS in the walnut-fed study group decreased (P = .038) and that in the cashew-fed study group increased (P = .036), but the BRS in the control group did not change (P = .56). The percent change of the walnut versus cashew group differed (P = .019). Body mass index, waist circumference, blood pressure, high-density lipoprotein cholesterol, and triacylglycerol did not change. The fasting glucose concentrations of the cashew group increased (P = .03). CONCLUSIONS: The significant improvements in BRS obtained by a diet rich in cashew nuts underline the beneficial cardiovascular effects of nuts. However, the opposite result was obtained with a diet rich in walnuts. These significant changes observed might indicate that BRS is particularly sensitive and influenced by changes in diet without changes in obesity.

Adult↗

PubMed2005

Could statistical adjustments for age mask the insulin-blood pressure relationship?

Even though conclusive findings regarding the relationship between insulin and blood pressure (BP) have been made, several papers still report on finding weak or non-existing relationships in various population groups. These relationships are often weak, depend on the characteristics of the study population and are usually strongly confounded by obesity and age. Subsequently many investigators adjust via statistical methods for age and measures of obesity (such as body mass index). In the present study four different datasets were used (Australian Aboriginal people (N=675), Torres Strait Islanders (N=369), African women (N=94) and Caucasian women (N=112)) and showed very weak correlations in all groups after statistical adjustments for age and obesity (ranging from r=-0.04 to 0.13). All subjects were then divided into different age groups (15-29 years; 30-40 years; >40 years) and partial correlations were performed within each age group whilst adjusting only for obesity. Results still showed correlations (ranging from r=-0.29 to 0.27) with a similar trend with increasing age. More positive correlations were shown for the youngest groups, and more negative correlations for the oldest groups, with the middle-group (30-40 years) showing the weakest correlations-seeming to be in a transitional phase from a positive to negative correlation. It is therefore suggested that when the relationship between fasting insulin and BP is assessed, age stratification be used and not statistical adjustments.

Adolescent↗

PubMed2004

Cardiovascular effects of oral Supplementation of vitamin C, E and folic acid in young healthy males.

Numerous observational studies showed associations of antioxidants (vitamins C and E) and folate intake with a reduced risk of cardiovascular disease, but randomized controlled clinical trials have generally not supported this hypothesis. The objective of this study was to investigate the effects of a daily dosage of 1000 mg vitamin C, 800 mg vitamin E, and 10 mg folate on markers of vascular function in 31 young healthy male adults. Cardiovascular values after a 12-week vitamin (14 subjects) or placebo (17 subjects) intervention were compared to baseline values. Cardiovascular parameters (blood pressure, stroke volume, heart rate, cardiac output, vascular resistance, arterial compliance) were measured continuously after an overnight fast under controlled circumstances with a Finometer device. Our main finding was a significant decrease (p = 0.03) in systolic blood pressure in the experimental group. No statistically significant changes were observed within other cardiovascular variables of the experimental group, but possible beneficial decreases in diastolic blood pressure and increases in arterial compliance after 12 weeks of vitamin supplementation were indicated. In conclusion, beneficial effects of antioxidants and folate were observed probably because the supplementation was used by young healthy subjects under carefully controlled conditions.

Adolescent↗

PubMed2004

Differences in resting cardiovascular parameters in 10- to 15-year-old children of different ethnicity: the contribution of physiological and psychological factors.

BACKGROUND: The health status of children in the North West Province of South Africa was examined using the Transition and Health during Urbanization in South Africa in Children study. This is an epidemiological, cross-sectional study for which 1,244 children between 10 and 15 years of age were recruited from 44 schools. PURPOSE: Our objective was to investigate whether differences exist between resting cardiovascular parameters of Black, White, colored, and Indian children and evaluate the contribution of physiological and psychological factors. METHODS: Blood pressure was monitored with the Finapres apparatus. By means of the Fast Modelflo software program, the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure, heart rate, cardiac output (CO), total peripheral resistance (TPR), and "Windkessel" compliance (Cw) of the arterial system were obtained. The psychological data were obtained by validated questionnaires. RESULTS: After correction for body mass index, the SBP of the White children was significantly higher (p < .05) than the SBP of the other ethnic groups. The DBP showed no significant differences. The TPR measurements of the Black and colored children were significantly higher (p < .05) than the TPR of the White children, and the Cw measurements of the Black and colored children were significantly lower than the Cw of the White children. Significant correlations (p < .05) were found between the SV, CO, TPR, Cw, and the total score on violence in the Black and colored children. CONCLUSIONS: There are differences in the resting cardiovascular parameters in the different ethnic groups studied. The higher levels of violence to which the Black and colored children are exposed could alter vascular sensitivity to sympathetic stimulation. This may contribute via the higher -adrenergic sensitivity to the pathogenesis of hypertension in their later lives.

Adolescent↗

PubMed2003

Sensitivity of the Finometer device in detecting acute and medium-term changes in cardiovascular function.

BACKGROUND: The Finometer (FMS, Finapres Measurement Systems, Arnhem, Netherlands), which is the improved successor of the Finapres (TNO Biomedical Instrumentation, Amsterdam, Netherlands), measures finger arterial blood pressure non-invasively and computes other cardiovascular parameters from the computed aortic-flow waveform. The usability of the Finometer would depend on whether it is sensitive enough to detect small cardiovascular changes. The aim was therefore to determine the sensitivity of the Finometer regarding acute and longer-term cardiovascular changes. DESIGN AND METHODS: The sensitivity of the Finometer regarding the acute effect of 200 mg caffeine was determined with a double-blind, placebo-controlled crossover study which included 38 young male subjects. Finometer recordings were performed during four occasions at fasting level and after 30 min of ingestion. To evaluate the sensitivity of the Finometer in recording longer-term effects of a daily dosage of 1000 mg vitamin C, 800 mg vitamin E and 10 mg folic acid, 14 young males took placebo and 17 took the vitamins for 12 weeks in a double-blind study. Two recordings were performed at baseline and two after 12 weeks. RESULTS: After caffeine ingestion significantly (P<0.05) higher systolic, diastolic and mean blood pressure values than resting values were obtained. The arterial compliance was significantly lower after caffeine ingestion, whereas heart rate, peripheral resistance, stroke volume and cardiac output did not change significantly. No differences were shown after intake of placebo. Concerning the effects of vitamin intake, the vitamin group indicated a significant decrease in systolic blood pressure (P=0.03) whereas the placebo group indicated no significant differences after 12 weeks. CONCLUSIONS: The results suggest that the improved Finometer might be a sensitive instrument in the recording of relative small acute and longer-term changes in cardiovascular function, but more studies are necessary before final conclusions can be drawn.

Adolescent↗

PubMedDate not supplied

Early cardiovascular changes in 10- to 15-year-old stunted children: the Transition and Health during Urbanization in South Africa in Children study.

OBJECTIVE: Early changes in vascular function could be associated with stunting, which may contribute to the development of cardiovascular diseases in later life. In this study we tested the hypothesis that stunting may be related to changes in cardiovascular function in African children ages 10 to 15 y. METHODS: In the Transition and Health during Urbanization in South Africa in Children study, the health status of children in the North-West Province of South Africa was studied. It was an epidemiologic, cross-sectional study in which 583 black non-stunted and 192 stunted children (stature below the fifth percentile for age) of both sexes ages 10 to 15 y were recruited from 44 schools. Blood pressure was monitored with the Finapres (finger-arterial pressure) apparatus and by means of the Fast Modelflo software program; measurements for systolic and diastolic blood pressure, mean arterial pressure, pulse pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, and arterial compliance were obtained. Dietary intake data were collected with a 24-h dietary recall questionnaire. Nutrient coding was the same for all recalls and macro- and micronutrients were calculated. Anthropometric measurements were done according to standard methods. RESULTS: There were no significant differences in systolic blood pressure and diastolic blood pressure between stunted and non-stunted children after correction for body mass index and heart rate. Stroke volume, arterial compliance, and cardiac output were significantly lower and total peripheral resistance was significantly higher in stunted children than in non-stunted children. No significant differences in dietary intake could be detected, although dietary intakes were slightly lower in the stunted children. CONCLUSIONS: We found that compliance, a marker of vascular function, is significantly lower in stunted children. Stunting was related to early changes in cardiovascular function in African children ages 10 to 15 y.

Adolescent↗

PubMedDate not supplied

Differences in cardiovascular function of rural and urban African males: the THUSA study.

INTRODUCTION: South Africa's black population has been in a process of transition from rural monocultural environments to industrialised urban environments since the early 1990s. This transition has led to an increased susceptibility to cardiovascular diseases such as hypertension, which in this group commonly leads to stroke. Besides the already observed increases in blood pressure, there is still uncertainty as to how the factors associated with urbanisation influence the cardiovascular system as a whole. AIM: To obtain a more complete cardiovascular profile and its association with the lipid profile and subcutaneous fat distribution of the African in transition. METHODS: A cross-sectional epidemiological study was performed which included 433 men from the North-West Province. The Finapres apparatus and Modelflow software program were used to obtain a more elaborate cardiovascular profile. The lipid profile and subcutaneous fat were also determined. RESULTS: An increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed in the urban group. The heart rate (HR) did not differ while the stroke volume (SV) and cardiac output (CO) was lower in the urban group. Arterial compliance (Cw) also showed a decrease in the urban group along with an increased total peripheral resistance (TPR), compared with the rural group. The lipid profile and BMI did not differ between the two groups. CONCLUSIONS: The factors associated with urbanization elevate blood pressure via a peripheral mechanism. This peripheral mechanism may be due to endothelial damage associated with low-density lipoprotein cholesterol (LDL-C) and a truncal subcutaneous fat distribution.

Adipose Tissue↗