Engineering Commons^™

Homocysteine Reduction For Stroke Prevention: Regarding The Recent Aha/Asa 2021 Prevention Of Stroke In Patients With Stroke And Transient Ischemic Attack, Craig Brown, Jianhua Wang, Hong Jiang, Merrill F. Elias

Maine-Syracuse Longitudinal Papers

Reduction of secondary ischemic stroke risk following an initial stroke is an important goal. The 2021 Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack assembles opportunities for up to 80% secondary stroke reduction. Homocysteine reduction was not included in the recommendations. The reduction of homocysteine with low doses of folic acid has been shown to reduce ischemic stroke and all stroke. This has been obscured by studies using high doses of folic acid and cyanocobalamin in patients with renal failure and Methylenetetrahydrofolate reductase (MTHFR) polymorphisms. The confounding impacts of high dose folic acid and cyanocobalamin toxicity in …

Medical Foods For Lowering Homocysteine In Hypertensive Patients, Merrill F. Elias, Craig J. Brown

Maine-Syracuse Longitudinal Papers

In a recent commentary, Elias and Brown review the history of skepticism about the value of homocysteine for preventing hypertension and stroke. They argue that this skepticism is not supported by recent literature. This paper was stimulated by a recent comprehensive review of the literature on this topic by Smith and Refsum. Prior to these papers, a commentary and review by Skeete and DiPette provided evidence for the value of homocysteine-lowering in the treatment of hypertension. Elias and Brown supported this conclusion. Both papers emphasized that more work is needed to clarify the beneficial effects of lowering homocysteine.

Elias and …

New Evidence For Homocysteine Lowering For Management Of Treatment-Resistant Hypertension, Merrill F. Elias, Craig J. Brown

Maine-Syracuse Longitudinal Papers

Treatment-resistant hypertension is a topic of great importance and the subject of editorial comments in the American Journal of Hypertension. Homocysteine is an intermediate compound in the vitamin regulated One Carbon Methylation pathway which affects glutathione, methionine, and nitric oxide metabolism. Elevated homocysteine, triggered by genetic mutations or insufficient body stores of active vitamins B6, B12, folate, riboflavin, indicates oxidative stress and is associated with impaired nitric oxide synthesis causing small vessel vasoconstriction in the central nervous system. High homocysteine (defined later) is also a risk factor for hypertension.

Higher Yogurt Intake Is Associated With Lower Blood Pressure In Hypertensive Individuals: Cross-Sectional Findings From The Maine–Syracuse Longitudinal Study, Alexandra T. Wade, Benjamin A. Guenther, Fayeza S. Ahmed, Merrill F. Elias

Maine-Syracuse Longitudinal Papers

Associations between fermented dairy products and blood pressure are unclear. The current study therefore examined the association between yogurt and blood pressure in hypertensive and non-hypertensive individuals. Cross-sectional analyses were undertaken on 915 community-dwelling adults from the Maine-Syracuse Longitudinal Study. Habitual yogurt consumption was measured using a food frequency questionnaire. The primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure. Secondary outcomes included BMI (kg m^-2), total cholesterol (mg dL^-1), glucose (mg dL^-1), HDL (mg dL^-1), LDL (mg dL^-1), triglycerides (mg …

Reclaiming The Importance Of Homocysteine As A Marker Of Cardiovascular And Neurologic Disease, Merrill F. Elias

Maine-Syracuse Longitudinal Papers

The Smith and Refsum review of ‘Homocysteine’ – from biomarker to disease prevention in this issue of the Journal of Internal Medicine [1 – is much more than an updated review of the literature. It provides a history of the progression of studies on homocysteine in relation to cardiovascular disease and neurological disorders from its earliest days to the present time. It is a scholarly examination of the mounting evidence of the importance of homocysteine as a biomarker for cardiovascular and neurologic disease and the utility of B vitamins and folate as a treatment.

The Perils Of Automated Wrist-Cuff Devices And Dental Chairs In Opportunistic Blood Pressure Screening, Merrill F. Elias, Amanda L. Goodell, Adam Davey

Maine-Syracuse Longitudinal Papers

In our opinion, the automated arm-cuff method should be used where the goal is OBPS and the patient should be properly seated at a table with BP measurement conducted following the recommendations of the American Heart Association.

Human Errors In Automated Office Blood Pressure Measurement, Merrill F. Elias, Amanda L. Goodell

Maine-Syracuse Longitudinal Papers

In this review of the literature and commentary, we examine the literature on automated blood pressure (BP) measurements in the office and clinic. Our purpose is to revisit issues as to the pros and cons of automated BP measurement published in Hypertension in June 2020 and to identify areas needing additional research. Despite initial reservations about automated BP, it is here to stay. A number of experts suggest that human error will be reduced when we move from the more complex skills required by aneroid sphygmomanometer measurement to the fewer skills and steps required by automated BP measurement. Our review …

Leisure Activity For Dementia Prevention. More Work To Be Done., Victor W. Henderson, Merrill F. Elias

Maine-Syracuse Longitudinal Papers

Dementia prevention is a worldwide priority because of the aging population, devastating consequences for patients and families, and the drain on societal resources. In the absence of disease-modifying therapies, there is interest in lifestyle factors that might prevent or delay the onset of dementia. Chief among these is leisure activity, conceptualized as pursuits undertaken for relaxation or pleasure after completion of essential chores and occupational responsibilities. Leisure activity invokes the cornerstones of cognitive reserve: mental activity, physical activity, and social engagement.

Adherence To A Mediterranean Diet Associated With Lower Blood Pressure In A Us Sample: Findings From The Maine- Syracuse Longitudinal Study, Fayeza S. Ahmed, Alexandra T. Wade, Benjamin A. Guenther, Karen J. Murphy, Merrill F. Elias

Maine-Syracuse Longitudinal Papers

Hypertension is a key modifiable risk factor for cardiovascular disease. The Mediterranean diet (MedDiet) may be associated with improvements in blood pressure. However, few studies have examined the association between MedDiet adherence and blood pressure in non-Mediterranean populations, and findings are mixed. We analyzed cross-sectional data (Wave 6) for 851 participants of the Maine-Syracuse Longitudinal Study. MedDiet adherence was calculated using food frequency questionnaire data and a literature-based MedDiet adherence score. Dependent variables included systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP). Separate linear robust regression analyses revealed significant associations between MedDiet …

Adherence To A Mediterranean Diet Is Associated With Cognitive Function In An Older Non- Mediterranean Sample: Findings From The Maine- Syracuse Longitudinal Study, Alexandra T. Wade, Merril F. Elias, Karen J. Murphy

Maine-Syracuse Longitudinal Papers

Background: Adherence to a Mediterranean diet is associated with higher cognitive function and reduced risk of dementia in Mediterranean populations. However, few studies have investigated the association between Mediterranean diet adherence and cognition in populations outside of the Mediterranean basin. Furthermore, it is currently unknown whether the association between Mediterranean diet adherence and cognitive function differs between middle-aged and older individuals. Methods: Cross-sectional (n = 894) and longitudinal (n = 530) multivariable analyses were undertaken using data from community-dwelling adults from the Maine-Syracuse Longitudinal Study (MSLS). Mediterranean diet adherence was measured by applying a literature-based Mediterranean diet score to food …

Setting The Record Straight For Two Heroes In Hypertension: John J. Hay And Paul Dudley White, Merrill Elias, Amanda L. Goodell

Maine-Syracuse Longitudinal Papers

Papers dealing with the history of the study of hypertension provide an invaluable window to our past. They identify our misconceptions, mistakes, and advances and describe the evolution of new knowledge. New knowledge develops in the context of contemporary scientific knowledge and zeitgeist. Zeitgeist is the German word for the defining mood or spirit of a particular era as expressed in the ideas and beliefs of the time.

The limitations of a scientist's knowledge and perspective at any given point in time must be considered in historical context. Therefore, we must tread carefully when criticizing a scientist's thinking and ideas …

Design Of The Maine-Syracuse Longitudinal Study, Merrill F. Elias

Maine-Syracuse Longitudinal Papers

The Maine-Syracuse Longitudinal Study (MSLS) uses a design that was very popular in life-span aging research in 1960 and for many years after. Starting with baseline the original cohort is followed over many years. Outcome measures are obtained at distinct time intervals, but new cohorts of individuals join the study at each specific period.

Systolic Orthostatic Hypotension Is Related To Lowered Cognitive Function: Findings From The Maine-Syracuse Longitudinal Study, Rachael V. Torres, Merrill Elias, Georgina E. Crichton, Gregory A. Dore, Adam Davey

Maine-Syracuse Longitudinal Papers

The aim of the present study was to examine the relationship between orthostatic changes in blood pressure (BP) and cognition, with consideration given to cardiovascular risk factors and lifestyle variables. The cross-sectional analysis included 961 community-dwelling participants of the Maine-Syracuse Longitudinal Study, for whom BP clinic measures (five sitting, five recumbent, and five standing) were obtained. Eighteen percent of participants had orthostatic hypotension (fall in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg upon standing) and 6% had orthostatic hypertension (rise in systolic BP ≥20 mm Hg). Orthostatic hypotension and hypertension defined using traditional criteria were unrelated …

High Rates Of Uncontrolled Blood Pressure: Pulse Wave Velocity And Future Opportunities, Merrill Elias, Kevin Sullivan, Gregory A. Dore, Michael A. Robbins

Maine-Syracuse Longitudinal Papers

The recent commentary on high rates of uncontrolled blood pressure (BP) and opportunities for health care providers in this Journal prompted an examination of treated but uncontrolled BP in relation to pulse wave velocity (PWV) in the Maine Syracuse Longitudinal Study (MSLS). Cohen and Townsend noted that a Center for Disease Control analysis2 of National Health and Nutrition Examination Survey (NHANES) data (2003–2010) indicated that the presence of uncontrolled hypertension (≥140 mm Hg systolic and ≥90 mm Hg diastolic) in US adults was 53.5%. They further noted that approximately 45% of these individuals with uncontrolled hypertension were aware of their …

Anxiety And Depression In Young And Middle Aged Hypertensive And Normotensive Subjects, W. Gibson Wood, Merrill F. Elias, Norman R. Schultz, Clyde A. Pentz

Maine-Syracuse Longitudinal Papers

This study examined the effects of essential hypertension on measures of anxiety and depression for two age groups of hypertensive (free from hypertension-related pathology and/or cardiovascular disease) and normotensive subjects. Hypertensive subjects had significantly higher State Anxiety scores and Zung Depression scores than did normotensive subjects. These differences between the blood pressure groups were due largely to the scores of the younger hypertensive subjects. The results of the present study are consistent with previous results from our laboratory that have found that younger hypertensives differed (relative to controls) from middle aged hypertensives on measures, such as, symptoms reported on the …