Publications by authors named "Donald J DiPette"

57 Publications

Mapping stages, barriers and facilitators to the implementation of HEARTS in the Americas initiative in 12 countries: A qualitative study.

J Clin Hypertens (Greenwich) 2021 04 18;23(4):755-765. Epub 2021 Mar 18.

Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.

The World Health Organization (WHO) Global Hearts Initiative offers technical packages to reduce the burden of cardiovascular diseases through population-wide and targeted health services interventions. The Pan American Health Organization (PAHO) has led implementation of the HEARTS in the Americas Initiative since 2016. The authors mapped the developmental stages, barriers, and facilitators to implementation among the 371 primary health care centers in the participating 12 countries. The authors used the qualitative method of document review to examine cumulative country reports, technical meeting notes, and reports to regional stakeholders. Common implementation barriers include segmentation of health systems, overcoming health care professionals' scope of practice legal restrictions, and lack of health information systems limiting operational evaluation and quality improvement mechanisms. Main implementation facilitators include political support from ministries of health and leading scientific societies, PAHO's role as a regional catalyst to implementation, stakeholder endorsement demonstrated by incorporating HEARTS into official documents, and having a health system oriented to primary health care. Key lessons include the need for political commitment and cultivating on-the-ground leadership to initiate a shift in hypertension care delivery, accompanied by specific progress in the development of standardized treatment protocols and a set of high-quality medicines. By systematizing an implementation strategy to ease integration of interventions into delivery processes, the program strengthened technical leadership and ensured sustainability. These study findings will aid the regional approach by providing a staged planning model that incorporates lessons learned. A systematic approach to implementation will enhance equity, efficiency, scale-up, and sustainability, and ultimately improve population hypertension control.
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http://dx.doi.org/10.1111/jch.14157DOI Listing
April 2021

Sex-based differences in hypertension: Understanding the trends.

J Clin Hypertens (Greenwich) 2021 06 19;23(6):1129-1132. Epub 2021 Feb 19.

Department of Internal Medicine, University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA.

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http://dx.doi.org/10.1111/jch.14230DOI Listing
June 2021

A Novel Alginate-Based Delivery System for the Prevention and Treatment of Pressure-Overload Induced Heart Failure.

Front Pharmacol 2020 2;11:602952. Epub 2021 Feb 2.

Department of Cell Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC, United States.

α-CGRP (alpha-calcitonin gene related peptide) is a cardioprotective neuropeptide. Our recent study demonstrated that the administration of native α-CGRP, using osmotic mini-pumps, protected against transverse aortic constriction (TAC) pressure-induced heart failure in mice. However, the short half-life of peptides and the non-applicability of osmotic pumps in humans limits the use of α-CGRP as a therapeutic agent for heart failure (HF). Here, we sought to comprehensively study a novel α-CGRP delivery system using alginate microcapsules to determine its bioavailability and to test for cardioprotective effects in HF mice. Native α-CGRP filled alginate microcapsules (200 µm diameter) were prepared using an electrospray method. The prepared alginate-α-CGRP microcapsules were incubated with rat cardiac H9c2 cells, mouse cardiac HL-1 cells, and human umbilical vein endothelial cells (HUVECs), and the cytotoxicity of the alginate-α-CGRP microcapsules was measured by a trypan-blue cell viability assay and a calcium dye fluorescent based assay. The efficacy of the alginate-α-CGRP microcapsules was tested in a TAC-pressure overload mouse model of heart failure. Male C57BL6 mice were divided into four groups: sham, sham-alginate-α-CGRP, TAC-only, and TAC-alginate-α-CGRP, and the TAC procedure was performed in the TAC-only and TAC-alginate-α-CGRP groups of mice to induce pressure-overload heart failure. After 2 or 15 days post-TAC, alginate-α-CGRP microcapsules (containing an α-CGRP dose of 6 mg/kg/mouse) were administered subcutaneously on alternate days, for 28 days, and echocardiography was performed weekly. After 28 days of peptide delivery, the mice were sacrificed and their hearts were collected for histological and biochemical analyses. Our cell culture assays showed that alginate-α-CGRP microcapsules did not affect the viability of the cell lines tested. The alginate-α-CGRP microcapsules released their peptides for an extended period of time. Our echocardiography, biochemical, and histology data from HF mice demonstrated that the administration of alginate-α-CGRP microcapsules significantly improved all cardiac parameters examined in TAC-mice. When compared to sham mice, TAC significantly decreased cardiac functions (as determined by fraction shortening and ejection fraction) and markedly increased heart and lung weight, left ventricle (LV) cardiac cell size, cardiac apoptosis, and oxidative stress. In contrast, the administration of alginate-α-CGRP microcapsules significantly attenuated the increased heart and lung weight, LV cardiac cell size, apoptosis, and oxidative stress in TAC mice. Our results demonstrate that the encapsulation of α-CGRP in an alginate polymer is an effective strategy to improve peptide bioavailability in plasma and increase the duration of the therapeutic effect of the peptide throughout the treatment period. Furthermore, alginate mediates α-CGRP delivery, either prior to the onset or after the initiation of the symptom progression of pressure-overload, improves cardiac function, and protects hearts against pressure-induced HF.
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http://dx.doi.org/10.3389/fphar.2020.602952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884831PMC
February 2021

Self-measurement of blood pressure in the workplace: An expansion of out-of-office blood pressure measurements to unmask masked hypertension.

J Clin Hypertens (Greenwich) 2021 02 7;23(2):215-217. Epub 2021 Jan 7.

Department of Internal Medicine, University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA.

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http://dx.doi.org/10.1111/jch.14167DOI Listing
February 2021

Implementation of a Vertically Integrated Trainee Program (VITP): Progress and Lessons Learned.

South Med J 2020 12;113(12):629-632

From the University of South Carolina School of Medicine, Columbia.

Mentorship is vital in the effective progression of a physician's educational training. This journey often begins during a physician's undergraduate career prior to advancing on to medical school, residency, and fellowship training. These levels of training distinguish different tiers of mastery, and collaboration among these tiers is integral in order to facilitate a meaningful transition into an independent physician.
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http://dx.doi.org/10.14423/SMJ.0000000000001181DOI Listing
December 2020

Approaches to the Management of Hypertension in Resource-Limited Settings: Strategies to Overcome the Hypertension Crisis in the Post-COVID Era.

Integr Blood Press Control 2020 28;13:125-133. Epub 2020 Sep 28.

Department of Internal Medicine, University of South Carolina School of Medicine, University of South Carolina, Columbia, SC, USA.

The COVID-19 pandemic has changed most aspects of everyday life in both the non-medical and medical settings. In the medical world, the pandemic has altered how healthcare is delivered and has necessitated an aggressive and new coordinated public health approach to limit its spread and reduce its disease burden and socioeconomic impact. This pandemic has resulted in a staggering morbidity and mortality and massive economic and physical hardships. Meanwhile, non-communicable diseases such as hypertension, diabetes mellitus, and cardiovascular disease in general continue to cause significant disease burden globally in the background. Though presently receiving less attention in the public eye than the COVID-19 pandemic, the hypertension crisis cannot be separated from the minds of healthcare providers, policymakers and the general public, as it continues to wreak havoc, particularly in vulnerable populations in resource limited settings. On this background, many of the strategies being employed to combat the COVID-19 pandemic can be used to re-energize and galvanize the fight against hypertension and hopefully bring the public health crisis associated with uncontrolled hypertension to an end.
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http://dx.doi.org/10.2147/IBPC.S261031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532072PMC
September 2020

Standardized treatment to improve hypertension control in primary health care: The HEARTS in the Americas Initiative.

J Clin Hypertens (Greenwich) 2020 12 12;22(12):2285-2295. Epub 2020 Oct 12.

Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.

Hypertension is the leading risk factor for cardiovascular disease (CVD) worldwide. Despite the availability of effective antihypertensive medications, the control of hypertension at a global level is dismal, and consequently, the CVD burden continues to increase. In response, countries in Latin America and the Caribbean are implementing the HEARTS in the Americas, a community-based program that focuses on increasing hypertension control and CVD secondary prevention through risk factor mitigation. One key pillar is the implementation of a standardized hypertension treatment protocol supported by a small, high-quality formulary. This manuscript describes the methodology used by the HEARTS in the Americas program to implement a population-based standardized hypertension treatment protocol. It is rooted in a seamless transition from existing treatment practices to best practice using pharmacologic protocols built around a core set of ideal antihypertensive medications. In alignment with recent major hypertension guidelines, the HEARTS in the Americas protocols call for the rapid control of blood pressure, through the use of two antihypertensive medications, preferably in the form of a single pill, fixed-dose combination, in the initial treatment of hypertension. To date, the HEARTS in the Americas program has seen the improvement in antihypertensive medication formularies and the establishment of pharmacologic treatment protocols tailored to individual participating countries. This has translated to significant increases in hypertension control rates post-program implementation in these jurisdictions. Thus, the HEARTS in the Americas program could serve as a model, for not only the Americas Region but globally, and ultimately decrease the burden of CVD.
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http://dx.doi.org/10.1111/jch.14072DOI Listing
December 2020

Apparent resistant hypertension in sub-Saharan Africa: Frequency and associated factors.

J Clin Hypertens (Greenwich) 2020 09 6;22(9):1603-1605. Epub 2020 Aug 6.

Department of Internal Medicine, University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA.

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http://dx.doi.org/10.1111/jch.13970DOI Listing
September 2020

Implementation of a community-based hypertension control program in Matanzas, Cuba.

J Clin Hypertens (Greenwich) 2020 02 22;22(2):142-149. Epub 2020 Jan 22.

Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.

Increased blood pressure is a leading risk factor for death worldwide, and improving the control of hypertension is a major health goal to reduce non-communicable disease. Thus, in 2016, as part of a regional effort between the Pan American Health Organization and Cuban Ministry of Public Health to reduce cardiovascular risk and disease, a community demonstration project was implemented to enhance hypertension control. The intervention project was in a population of 25 868 people served by the Carlos Verdugo Martínez Polyclinic in Matanzas, Cuba. The project implemented interventions currently recommended in the World Health Organization HEARTS modules, including a standardized clinical training program with certification for blood pressure measurement, routine screening for hypertension in clinics and in the community, a simple directive pharmacologic treatment algorithm, and a registry with performance reporting and feedback. Qualitative and quantitative program monitoring and evaluation was established. In a 2010 national survey, the prevalence of hypertension and the rate of hypertension control were estimated to be 31% and 36%, respectively. Following less than one year of the full implementation of the program, the prevalence of hypertension, proportion of the hypertensive population registered as having hypertension, proportion of those drug-treated who were controlled, and estimated population rate of control were 30%, 90%, 68%, and 58%, respectively. Based on these positive results, the program has been expanded to include another demonstration program initiated in a second region. In addition, preliminary efforts to disseminate and scale-up aspects of the program to the full Cuban population have started.
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http://dx.doi.org/10.1111/jch.13814DOI Listing
February 2020

Determining central blood pressure: Role in the prediction of the decline of renal function.

J Clin Hypertens (Greenwich) 2020 02 15;22(2):243-244. Epub 2020 Jan 15.

Department of Internal Medicine, University of South Carolina and University of South Carolina School of Medicine, Columbia, South Carolina.

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http://dx.doi.org/10.1111/jch.13789DOI Listing
February 2020

Alpha-calcitonin gene-related peptide prevents pressure-overload induced heart failure: role of apoptosis and oxidative stress.

Physiol Rep 2019 11;7(21):e14269

Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina.

Alpha-calcitonin gene-related peptide (α-CGRP) is a 37-amino acid neuropeptide that plays an important protective role in modulating cardiovascular diseases. Deletion of the α-CGRP gene increases the vulnerability of the heart to pressure-induced heart failure and the administration of a modified α-CGRP agonist decreases this vulnerability. Systemic administration of α-CGRP decreases blood pressure in normotensive and hypertensive animals and humans. Here we examined the protective effect of long-term administration of native α-CGRP against pressure-overload heart failure and the likely mechanism(s) of its action. Transverse aortic constriction (TAC) was performed to induce pressure-overload heart failure in mice. We found that TAC significantly decreased left ventricular (LV) fractional shortening, ejection fraction, and α-CGRP content, and increased hypertrophy, dilation, and fibrosis compared to sham mice. Administration of α-CGRP-filled mini-osmotic pumps (4 mg/kg bwt/day) in TAC mice preserved cardiac function and LV α-CGRP levels, and reduced LV hypertrophy, dilation, and fibrosis to levels comparable to sham mice. Additionally, TAC pressure-overload significantly increased LV apoptosis and oxidative stress compared to the sham mice but these increases were prevented by α-CGRP administration. α-CGRP administration in TAC animals decreased LV AMPK phosphorylation levels and the expression of sirt1, both of which are regulatory markers of oxidative stress and energy metabolism. These results demonstrate that native α-CGRP is protective against pressure-overload induced heart failure. The mechanism of this cardio-protection is likely through the prevention of apoptosis and oxidative stress, possibly mediated by sirt1 and AMPK. Thus, α-CGRP is a potential therapeutic agent in preventing the progression to heart failure, and the cardio-protective action of α-CGRP is likely the result of a direct cellular effect; however, a partial vasodilatory blood pressure-dependent mechanism of α-CGRP cannot be excluded.
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http://dx.doi.org/10.14814/phy2.14269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854098PMC
November 2019

Could uric acid reduction by specific xanthine oxidase inhibition improve vascular function and reduce cardiovascular risk?

J Clin Hypertens (Greenwich) 2019 11 26;21(11):1721-1723. Epub 2019 Sep 26.

University of South Carolina School of Medicine, University of South Carolina, Columbia, South Carolina.

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http://dx.doi.org/10.1111/jch.13693DOI Listing
November 2019

Editorial commentary: Two years post the ACC/AHA 2017 hypertension guidelines: Where are we now?

Trends Cardiovasc Med 2020 04 6;30(3):165-167. Epub 2019 Aug 6.

University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA. Electronic address:

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http://dx.doi.org/10.1016/j.tcm.2019.07.010DOI Listing
April 2020

Protective Role of α-Calcitonin Gene-Related Peptide in Cardiovascular Diseases.

Front Physiol 2019 2;10:821. Epub 2019 Jul 2.

Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC, United States.

α-Calcitonin gene-related peptide (α-CGRP) is a regulatory neuropeptide of 37 amino acids. It is widely distributed in the central and peripheral nervous system, predominantly in cell bodies of the dorsal root ganglion (DRG). It is the most potent vasodilator known to date and has inotropic and chronotropic effects. Using pharmacological and genetic approaches, our laboratory and other research groups established the protective role of α-CGRP in various cardiovascular diseases such as heart failure, experimental hypertension, myocardial infarction, and myocardial ischemia/reperfusion injury (I/R injury). α-CGRP acts as a depressor to attenuate the rise in blood pressure in three different models of experimental hypertension: (1) DOC-salt, (2) subtotal nephrectomy-salt, and (3) L-NAME-induced hypertension during pregnancy. Subcutaneous administration of α-CGRP lowers the blood pressure in hypertensive and normotensive humans and rodents. Recent studies also demonstrated that an α-CGRP analog, acylated α-CGRP, with extended half-life (~7 h) reduces blood pressure in Ang-II-induced hypertensive mouse, and protects against abdominal aortic constriction (AAC)-induced heart failure. Together, these studies suggest that α-CGRP, native or a modified form, may be a potential therapeutic agent to treat patients suffering from cardiac diseases.
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http://dx.doi.org/10.3389/fphys.2019.00821DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614340PMC
July 2019

"Real-world data analysis" in disease management such as hypertension: Has the time come?

J Clin Hypertens (Greenwich) 2019 05 13;21(5):635-637. Epub 2019 Apr 13.

Department of Internal Medicine, University of South Carolina and University of South Carolina School of Medicine, Columbia, South Carolina.

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http://dx.doi.org/10.1111/jch.13533DOI Listing
May 2019

Development of a Vertically Integrated Trainee Program: Linking Future and Young Physicians.

South Med J 2019 03;112(3):137-141

From the University of South Carolina, Columbia, the University of Alabama Medical Center, Birmingham, and the Columbia Medical Society, Columbia, South Carolina.

Supplemental digital content is available in the text.
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http://dx.doi.org/10.14423/SMJ.0000000000000952DOI Listing
March 2019

Differences in the response to periarterial nerve stimulation or exogenous noradrenaline infusion in the mesenteric vascular bed with the intestinal tract harvested from commonly used rat models of hypertension.

Clin Exp Pharmacol Physiol 2019 05 25;46(5):427-434. Epub 2019 Feb 25.

First Department of Pharmacology, Graduate School of Clinical Pharmacy, Kyushu University of Health and Welfare, Nobeoka, Japan.

Many hypertensive animal models have been developed and used to elucidate the pathophysiology of hypertension and to develop antihypertensive drugs. Among them, the spontaneous hypertensive rat (SHR), deoxycorticosterone acetate (DOCA)-treated and high salt intake rat (DOCA-salt), and high sodium-fed Dahl salt-sensitive rat (HS) models are commonly used. Multiple studies have been conducted, however, elevation in blood pressure in these models due to the reactivity of adrenergic vasoconstriction has not been well characterized in a centralized experiment. In this study, the pressor responses to periarterial nerve stimulation (PNS) or exogenous noradrenaline (NA) infusion were measured in the isolated mesenteric vascular bed with the intestinal tract to investigate the reactivity of mesenteric adrenergic vasoconstriction. The systemic arterial blood pressure of the hypertensive rat models was uniformly elevated compared with their respective controls. However, the changes in perfusion pressure in the mesenteric vascular bed in response to PNS and exogenous NA infusion were quite different depending on the model. The pressor responses to PNS in SHRs and Dahl S HS rats were significantly higher, and those in DOCA-salt rats were significantly lower than those in the controls. The pressor responses to exogenous NA infusion in SHRs were significantly higher, and those in Dahl S HS rats were significantly lower than those in their respective controls. No difference was observed in the pressor responses to the exogenous NA between the DOCA-salt and sham groups. These results demonstrate that the reactivity of adrenergic vasoconstriction is different for each type of experimental hypertensive model rat.
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http://dx.doi.org/10.1111/1440-1681.13068DOI Listing
May 2019

Fixed-dose combination pharmacologic therapy to improve hypertension control worldwide: Clinical perspective and policy implications.

J Clin Hypertens (Greenwich) 2019 01 27;21(1):4-15. Epub 2018 Nov 27.

Department of Non-Communicable Diseases and Mental Health, The Pan-American Health Organization, Washington, District of Columbia.

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http://dx.doi.org/10.1111/jch.13426DOI Listing
January 2019

The American College of Cardiology/American Heart Association 2017 hypertension guideline: Implications for incorporation in Latin America, the Caribbean, and other resource-limited settings.

J Clin Hypertens (Greenwich) 2018 09 10;20(9):1342-1349. Epub 2018 Jul 10.

The University of South Carolina, University of South Carolina School of Medicine, Columbia, SC, USA.

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http://dx.doi.org/10.1111/jch.13343DOI Listing
September 2018

Monitoring and evaluation framework for hypertension programs. A collaboration between the Pan American Health Organization and World Hypertension League.

J Clin Hypertens (Greenwich) 2018 06 22;20(6):984-990. Epub 2018 May 22.

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

The Pan American Health Organization (PAHO)-World Hypertension League (WHL) Hypertension Monitoring and Evaluation Framework is summarized. Standardized indicators are provided for monitoring and evaluating national or subnational hypertension control programs. Five core indicators from the World Health Organization hearts initiative and a single PAHO-WHL core indicator are recommended to be used in all hypertension control programs. In addition, hypertension control programs are encouraged to select from 14 optional qualitative and 33 quantitative indicators to facilitate progress towards enhanced hypertension control. The intention is for hypertension programs to select quantitative indicators based on the current surveillance mechanisms that are available and what is feasible and to use the framework process indicators as a guide to program management. Programs may wish to increase or refine the number of indicators they use over time. With adaption the indicators can also be implemented at a community or clinic level. The standardized indicators are being pilot tested in Cuba, Colombia, Chile, and Barbados.
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http://dx.doi.org/10.1111/jch.13307DOI Listing
June 2018

Genetics of hypertension: Implications of single nucleotide polymorphism(s) in African populations and beyond.

J Clin Hypertens (Greenwich) 2018 03 9;20(3):496-498. Epub 2018 Mar 9.

University of South Carolina School of Medicine, University of South Carolina, Columbia, SC, USA.

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http://dx.doi.org/10.1111/jch.13249DOI Listing
March 2018

Relationship between homocysteine and hypertension: New data add to the debate.

J Clin Hypertens (Greenwich) 2017 11 24;19(11):1171-1172. Epub 2017 Sep 24.

School of Medicine, University of South Carolina, Columbia, SC, USA.

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http://dx.doi.org/10.1111/jch.13073DOI Listing
November 2017

Removing vessel constriction on the embryonic heart results in changes in valve gene expression, morphology, and hemodynamics.

Dev Dyn 2018 03 4;247(3):531-541. Epub 2017 Oct 4.

Department of Cell Biology and Anatomy, University of South Carolina School of Medicine, Columbia, South Carolina.

Background: The formation of healthy heart valves throughout embryonic development is dependent on both genetic and epigenetic factors. Hemodynamic stimuli are important epigenetic regulators of valvulogenesis, but the resultant molecular pathways that control valve development are poorly understood. Here we describe how the heart and valves recover from the removal of a partial constriction (banding) of the OFT/ventricle junction (OVJ) that temporarily alters blood flow velocity through the embryonic chicken heart (HH stage 16/17). Recovery is described in terms of 24- and 48-hr gene expression, morphology, and OVJ hemodynamics.

Results: Collectively, these studies show that after 24 hr of recovery, important epithelial-mesenchymal transformation (EMT) genes TGFßRIII and Cadherin 11 (CDH11) transcript levels normalize return to control levels, in contrast to Periostin and TGFß,3 which remain altered. In addition, after 48 hr of recovery, TGFß3 and CDH11 transcript levels remain normalized, whereas TGFßRIII and Periostin are down-regulated. Analyses of OFT cushion volumes in the hearts show significant changes, as does the ratio of cushion to cell volume at 24 hr post band removal (PBR). Morphologically, the hearts show visible alteration following band removal when compared to their control age-matched counterparts.

Conclusions: Although some aspects of the genetic/cellular profiles affected by altered hemodynamics seem to be reversed, not all gene expression and cardiac growth normalize following 48 hr of band removal. Developmental Dynamics 247:531-541, 2018. © 2017 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/dvdy.24588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814323PMC
March 2018

Controlling hypertension and reducing its associated morbidity and mortality in the Caribbean: implications of race and ethnicity.

J Clin Hypertens (Greenwich) 2017 Oct 28;19(10):1010-1014. Epub 2017 Jul 28.

University of South Carolina, University of South Carolina School of Medicine, Columbia, SC, USA.

Cardiovascular diseases and stroke, especially hypertension, represent a significant global disease burden for both morbidity and mortality, with a disproportionately higher impact in vulnerable low- to middle-income countries. International initiatives such as the Centers for Disease and Prevention and the Pan American Health Organization Standardized Hypertension Treatment Project have been developed to address this burden on the Caribbean and Latin America populations. The disparity in disease burden observed in low- to middle-income countries is explained, in part, by differences in disease risks for different racial and ethnic groups with high blood pressure more prevalent and hypertension-related morbidity significantly higher in men and women of African heritage. In addition to the race and ethnic differences in indicators of socioeconomic status, access to care and health service delivery, the physiologic mechanism of high blood pressure including salt-sensitivity, may also play a significant role in the disparities in hypertension and hypertension-related outcomes. This article focuses on potential racial and ethnic differences in influences on the pathophysiology of hypertension in the Caribbean region of the world. The identification of such differences may be used in the development of population hypertension control strategies and treatment approach that address the excess disease burden in these populations. The consideration of strategies, such as salt reduction and hypertension awareness and treatment, are particularly relevant to the high-risk Caribbean region.
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http://dx.doi.org/10.1111/jch.13056DOI Listing
October 2017

Implementing standardized performance indicators to improve hypertension control at both the population and healthcare organization levels.

J Clin Hypertens (Greenwich) 2017 May 13;19(5):456-461. Epub 2017 Feb 13.

Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.

The ability to reliably evaluate the impact of interventions and changes in hypertension prevalence and control is critical if the burden of hypertension-related disease is to be reduced. Previously, a World Hypertension League Expert Committee made recommendations to standardize the reporting of population blood pressure surveys. We have added to those recommendations and also provide modified recommendations from a Pan American Health Organization expert meeting for "performance indicators" to be used to evaluate clinical practices. Core indicators for population surveys are recommended to include: (1) mean systolic blood pressure and (2) mean diastolic blood pressure, and the prevalences of: (3) hypertension, (4) awareness of hypertension, (5) drug-treated hypertension, and (6) drug-treated and controlled hypertension. Core indicators for clinical registries are recommended to include: (1) the prevalence of diagnosed hypertension and (2) the ratio of diagnosed hypertension to that expected by population surveys, and the prevalences of: (3) controlled hypertension, (4) lack of blood pressure measurement within a year in people diagnosed with hypertension, and (5) missed visits by people with hypertension. Definitions and additional indicators are provided. Widespread adoption of standardized population and clinical hypertension performance indicators could represent a major step forward in the effort to control hypertension.
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http://dx.doi.org/10.1111/jch.12980DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476944PMC
May 2017

Erratum to: Conformational changes and translocation of tissue-transglutaminase to the plasma membranes: role in cancer cell migration.

BMC Cancer 2016 Aug 8;16(1):609. Epub 2016 Aug 8.

Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, Columbia, SC, 29209, USA.

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http://dx.doi.org/10.1186/s12885-016-2567-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976466PMC
August 2016

Resistant Hypertension: Is There a Pathophysiologic Role for the Metalloproteinase System?

J Clin Hypertens (Greenwich) 2016 10 15;18(10):966-968. Epub 2016 Jul 15.

Department of Internal Medicine, University of South Carolina and University of South Carolina School of Medicine, Columbia, SC.

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http://dx.doi.org/10.1111/jch.12870DOI Listing
October 2016

Editorial Commentary: Resistant hypertension: Pathogenesis and current and future management.

Trends Cardiovasc Med 2016 11 8;26(8):707-708. Epub 2016 Jun 8.

Department of Internal Medicine, University of South Carolina School of Medicine, University of South Carolina, Columbia, SC. Electronic address:

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http://dx.doi.org/10.1016/j.tcm.2016.06.004DOI Listing
November 2016
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