Suchergebnisse

PUBLISHED ; Background Impaired blood pressure (BP) stabilisation after standing, defined using beat-to-beat mea- surements, has been shown to predict important health outcomes. We aimed to define the relationship between individual classes of antihypertensive agent and BP stabilisation among hypertensive older adults. Methods Cross-sectional analysis from The Irish Longitudinal Study on Ageing, a cohort study of Irish adults aged 50 years and over. Beat-to-beat BP was recorded in participants undergo- ing an active stand test. We defined grade 1 hypertension according to European Society of Cardiology criteria (systolic BP [SBP] 140-159mmHg ? diastolic BP [DBP] 90-99mmHg). Outcomes were: (i) initial orthostatic hypotension (IOH) (SBP drop 40mmHg ? DBP drop 20mmHg within 15 seconds [s] of standing accompanied by symptoms); (ii) sustained OH (SBP drop 20mmHg ? DBP drop 10mmHg from 60 to 110s inclusive); (iii) impaired BP stabilisation (SBP drop 20mmHg ? DBP drop 10mmHg at any 10s interval during the test). Outcomes were assessed using multivariable-adjusted logistic regression. Results A total of 536 hypertensive participants were receiving monotherapy with a renin-angioten- sin-aldosterone-system inhibitor (n = 317, 59.1%), beta-blocker (n = 89, 16.6%), calcium channel blocker (n = 89, 16.6%) or diuretic (n = 41, 7.6%). A further 783 untreated partici- pants met criteria for grade 1 hypertension. Beta-blockers were associated with increased odds of initial OH (OR 2.05, 95% CI 1.31 ? 3.21) and sustained OH (OR 3.36, 95% CI 1.87 ? 6.03) versus untreated grade 1 hypertension. ; MC was supported by a Health Research Board research training fellowship grant (HPF-2014- 540). Funding for TILDA was gratefully received from the Atlantic Philanthropies ( www. atlanticphilanthropies.org ), the Irish Government, and the Health Research Board ( www.hrb.ie ). TILDA was funded by the Department of Health and Atlantic Philanthropies, along with support from Irish Life in the form of a charitable gift. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Non-DNA targeted effects of ionizing radiation, which include genomic instability, and a variety of bystander effects including abscopal effects and bystander mediated adaptive response, have raised concerns about the magnitude of low-dose radiation risk. Genomic instability, bystander effects and adaptive responses are powered by fundamental, but not clearly understood systems that maintain tissue homeostasis. Despite excellent research in this field by various groups, there are still gaps in our understanding of the likely mechanisms associated with non-DNA targeted effects, particularly with respect to systemic (human health) consequences at low and intermediate doses of ionizing radiation. Other outstanding questions include links between the different non-targeted responses and the variations in response observed between individuals and cell lines, possibly a function of genetic background. Furthermore, it is still not known what the initial target and early interactions in cells are that give rise to non-targeted responses in neighbouring or descendant cells. This paper provides a commentary on the current state of the field as a result of the Non-targeted effects of ionizing radiation (NOTE) Integrated Project funded by the European Union. Here we critically examine the evidence for non-targeted effects, discuss apparently contradictory results and consider implications for low-dose radiation health effects.