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Biomedical subjects

Jiguang Wang

Publications and source records attributed to Jiguang Wang.

9 recordsLinked to original sources

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↗

Mutation analysis of SCNN1B in a family with Liddle's syndrome.

Liddle's syndrome has been known as a disorder associated with abnormal sodium reabsorption in the distal tubule and transmitted as a rare autosomal dominant trait. It is caused by mutations in the SCNN1B or SCNN1C gene, which truncate the cytoplasmic carboxyl terminus of the beta and gamma subunit of the epithelial sodium channel (ENaC). Genetic analysis of ENaC in a Chinese family with Liddle's syndrome revealed P616H of SCNN1B coaggregated with the phenotype, while this variant was not detected in 100 unrelated subjects. No mutation at gamma ENaC could be detected in all members of the family. P616H is located in the conserved proline-rich PY motif of the betaENaC. The PY motif can interact with the WW domain in Nedd4 and affect the activity of ENaC. Structural bioinformatics analysis confirmed that the functional interaction between Nedd4 and ENaC reduces in Liddle-ENaC (P616H) when compared with wild-type ENaC. In summary, P616H may be an underlying mechanism for the signs and symptoms of this family.

Adult↗

Essential hypertension.

Hypertension is a frequent, chronic, age-related disorder, which often entails debilitating cardiovascular and renal complications. Blood pressure is usually noted in combination with other cardiovascular risk factors. Diagnosis of hypertension increasingly relies on automated techniques of blood pressure measurement. The pathophysiology of essential hypertension depends on the primary or secondary inability of the kidney to excrete sodium at a normal blood pressure. The central nervous system, endocrine factors, the large arteries, and the microcirculation also have roles in the disorder. Although monogenic forms of blood pressure dysregulation exist, hypertension mostly arises as a complex quantitative trait that is affected by varying combinations of genetic and environmental factors. Non-pharmacological strategies can reduce blood pressure. Antihypertensive drug treatment diminishes the complications of hypertension. The concept that a few major genes will provide the final clue to the pathogenesis of essential hypertension is an oversimplification that contradicts the heterogeneous nature of this disorder. Further integration of genetic, molecular, clinical, and epidemiological research could disclose subsets of patients in whom specific combinations of genetic and environmental factors raise blood pressure, and might lead to more individualised treatment.

Adolescent↗

Do ancillary properties of antihypertensive drugs explain the outcome results of recent trials?

BACKGROUND: In a quantitative overview of published trials, we investigated whether some pharmacological properties of antihypertensive drugs, besides reduction in blood pressure, explain cardiovascular outcomes in hypertensive or high-risk patients. METHODS: Across trials, using meta-regression, we correlated odds ratios with differences in systolic blood pressure between study groups. We then compared odds ratios of benefit observed in recent trials with those predicted by metaregression on the basis of the differences in systolic pressure between randomised groups. RESULTS: Significant differences in systolic pressure between randomised groups (experimental minus reference) were observed in the ALLHAT (-2/+1), CAPPP(-3/-1) and NORDIL (-3.1/+0.2) trials. Furthermore, the differences in achieved systolic and/or diastolic pressure between study groups were also significant in the hypertension trials which involved untreated control patients, as well as in MIDAS (-3.5/ approximately 0 mm Hg), HOPE (-3.3/-1.0 mm Hg), PART2 (-5/-4 mm Hg), and SCAT (4/-2 mm Hg) (1). The differences between the observed odds ratios and those predicted by the meta-regression between outcome and difference in systolic pressure did not reach statistical significance except for the NORDIL trial, in which the risk of stroke was lower on diltiazem than on the older drugs despite a 3.1 mm Hg higher systolic pressure on the calcium-channel blocker. CONCLUSIONS: The finding that in the reviewed trials blood pressure reduction largely accounted for outcome emphasizes the desirability of blood pressure control. The hypothesis that converting-enzyme inhibitors or alpha-blockers might influence cardiovascular prognosis over and beyond their antihypertensive effect remains unproved.

Antihypertensive Agents↗