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ABSTRACT: AIM: A number of studies have examined if WCHT is associated with increased cardiovascular risk but with definitions of WCHT that were not sufficiently robust, and results have been inconsistent. This review aims to standardise the evidence by only including studies which used a definition of WCHT consistent with international guidelines. METHOD: Published studies were reviewed for data on vascular dysfunction, target organ damage, risk of future sustained hypertension and cardiovascular events. FINDINGS: WCHT has a population prevalence of approximately 15% and is associated with non-smoking and slightly elevated clinic blood pressure. Compared to normotensives, subjects with WCHT are at increased cardiovascular risk due to a higher prevalence of glucose dysregulation, increased left ventricular mass index and increased risk of future diabetes and hypertension. CONCLUSION: Management of a subject with WCHT should focus on cardiovascular risk factors, particularly glucose intolerance, not blood pressure alone. This article is protected by copyright. All rights reserved.
Clinical and Experimental Pharmacology and Physiology 05/2013; · 1.85 Impact Factor
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The Medical journal of Australia 08/2012; 197(3):143-4. · 2.81 Impact Factor
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Geoffrey A Head, Barry P McGrath,
Anastasia S Mihailidou,
Mark R Nelson,
Markus P Schlaich,
Michael Stowasser,
Arduino A Mangoni,
Diane Cowley,
Mark A Brown,
Lee-Anne Ruta,
Alison Wilson
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ABSTRACT: Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines.
A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring.
ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost-benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments.
Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk.
Journal of hypertension 12/2011; 30(2):253-66. · 4.02 Impact Factor
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ABSTRACT: Isolated clinic hypertension (ICHT) may be an indicator of both future hypertension and diabetes. This study examines the 2-h plasma glucose level post load (2hPG), and measures of arterial stiffness, autonomic function and circulating biomarkers in ICHT, normotension and hypertension.
Participants aged 39-75 years, who were untreated for hypertension, nonsmokers and not known diabetic (n=105) were categorized as normotension, ICHT and hypertension, based on clinic and mean daytime ambulatory blood pressures. Participants had measurements of autonomic function, aorto-femoral pulse wave velocity (PWVc), as well as blood sampling for lipids and potential circulating biomarkers [high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), asymmetric dimethylarginine (ADMA), and von Willebrand factor (vWF)], followed by a glucose tolerance test.
A total of 8.3% normotension, 37.9% ICHT and 15% hypertension patients had impaired glucose tolerance. Mean 2hPG adjusted for age and waist circumference was 5.7 mmol/l [interquartile range (IQR) 5.2-6.4] for normotension, 7.4 mmol/l (IQR 6.5-8.3) for ICHT (P=0.002 vs. normotension) and 6.2 mmol/l (IQR 5.6-6.9) for hypertension group. Other measures of insulin resistance were similar in the three groups. Mental stress testing induced a greater blood pressure response in the ICHT group (P=0.01 vs. normotension); other autonomic function measures were similar in the three groups. Mean PWVc, adjusted for age and blood pressure, was similar in ICHT and normotension but increased in the hypertension group. Circulating biomarker levels were not different in the three groups.
Assessment of total cardiovascular risk in patients with ICHT should include measurement of postprandial glucose.
Journal of hypertension 12/2010; 29(4):749-57. · 4.02 Impact Factor
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Hypertension 07/2010; 56(1):e11; author reply e12. · 6.21 Impact Factor
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ABSTRACT: End-stage kidney disease registry data have reported increased mortality in patients with diabetes as compared with those without. Here we examine whether diabetes is independently associated with an increased risk of major cardiovascular events and death in patients with advanced chronic kidney disease (CKD).
Data from 315 participants with CKD in the Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) were assessed. Primary end-points were fatal or non-fatal cardiovascular events, including myocardial infarction, stroke, unstable angina, coronary revascularisation and peripheral vascular events assessed both jointly and separately using Cox-proportional hazard models.
Twenty-three per cent reported diabetes. Median follow up was 3.6 years. In those with diabetes, an increased risk for major cardiovascular events was observed, crude hazard ratio (HR) 2.87 (95% confidence interval (CI) 2.11-3.90). After adjustment for age, gender, smoking, systolic blood pressure, body mass index, past ischaemic heart disease and use of preventive therapies, diabetes was associated with an HR of 1.83 (1.28-2.61) for major cardiovascular events. The risk for peripheral vascular events was also increased, adjusted HR 6.31 (2.61-15.25). For all-cause death, major coronary and stroke events, the risk in those with diabetes was not significantly increased (all-cause death, adjusted HR 1.31 (95% CI 0.80-2.14); major coronary events, adjusted HR 1.26 (95% CI 0.64-2.49); and major stroke events, adjusted HR 1.28 (95% CI 0.55-2.99)).
Diabetes significantly increases the risk of major cardiovascular events, especially peripheral vascular events in patients with advanced CKD. Trials of multifactorial management of cardiovascular risk factors are required to determine if outcomes for this population may be improved.
Internal Medicine Journal 03/2010; 41(12):825-32. · 1.54 Impact Factor
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Geoffrey A Head,
Anastasia S Mihailidou,
Karen A Duggan,
Lawrence J Beilin,
Narelle Berry,
Mark A Brown,
Alex J Bune,
Diane Cowley,
John P Chalmers,
Peter R C Howe,
Jonathan Hodgson,
John Ludbrook,
Arduino A Mangoni, Barry P McGrath,
Mark R Nelson,
James E Sharman,
Michael Stowasser
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ABSTRACT: Twenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalents to clinic blood pressure thresholds for diagnosis and treatment of hypertension.
We collated 24 hour ambulatory blood pressure data, recorded with validated devices, from 11 centres across six Australian states (n=8575). We used least product regression to assess the relation between these measurements and clinic blood pressure measured by trained staff and in a smaller cohort by doctors (n=1693).
Mean age of participants was 56 years (SD 15) with mean body mass index 28.9 (5.5) and mean clinic systolic/diastolic blood pressure 142/82 mm Hg (19/12); 4626 (54%) were women. Average clinic measurements by trained staff were 6/3 mm Hg higher than daytime ambulatory blood pressure and 10/5 mm Hg higher than 24 hour blood pressure, but 9/7 mm Hg lower than clinic values measured by doctors. Daytime ambulatory equivalents derived from trained staff clinic measurements were 4/3 mm Hg less than the 140/90 mm Hg clinic threshold (lower limit of grade 1 hypertension), 2/2 mm Hg less than the 130/80 mm Hg threshold (target upper limit for patients with associated conditions), and 1/1 mm Hg less than the 125/75 mm Hg threshold. Equivalents were 1/2 mm Hg lower for women and 3/1 mm Hg lower in older people compared with the combined group.
Our study provides daytime ambulatory blood pressure thresholds that are slightly lower than equivalent clinic values. Clinic blood pressure measurements taken by doctors were considerably higher than those taken by trained staff and therefore gave inappropriate estimates of ambulatory thresholds. These results provide a framework for the diagnosis and management of hypertension using ambulatory blood pressure values.
BMJ (Clinical research ed.). 01/2010; 340:c1104.
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ABSTRACT: To assess the interaction between insulin resistance and endothelial function and the optimal treatment strategy addressing cardiovascular risk in polycystic ovary syndrome.
Randomized controlled trial.
Controlled clinical study.
Overweight age- and body mass index-matched women with polycystic ovary syndrome.
Six months metformin (1 g two times per day, n = 36) or oral contraceptive pill (OCP) (35 microg ethinyl E(2)-2 mg cytoproterone acetate, n = 30).
Fasting and oral glucose tolerance test glucose and insulin levels, endothelial function (flow-mediated dilation, asymmetric dimethylarginine, plasminogen activator inhibitor-1, von Willebrand factor), inflammatory markers (high-sensitivity C-reactive protein), lipids, and hyperandrogenism.
The OCP increased levels of glucose and insulin on oral glucose tolerance test, high-sensitivity C-reactive protein, triglycerides, and sex-hormone binding globulin and decreased levels of low-density lipoprotein cholesterol and T. Metformin decreased levels of fasting insulin, oral glucose tolerance test insulin, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein. Flow-mediated dilation increased only with metformin (+2.2% +/- 4.8%), whereas asymmetric dimethylarginine decreased equivalently for OCP and metformin (-0.3 +/- 0.1 vs. -0.1 +/- 0.1 mmol/L). Greater decreases in plasminogen activator inhibitor-1 occurred for the OCP than for metformin (-1.8 +/- 1.6 vs. -0.7 +/- 1.7 U/mL).
In polycystic ovary syndrome, metformin improves insulin resistance, inflammatory markers, and endothelial function. The OCP worsens insulin resistance and glucose homeostasis, inflammatory markers, and triglycerides and has neutral or positive endothelial effects. The effect of the OCP on cardiovascular risk in polycystic ovary syndrome is unclear.
Fertility and sterility 12/2008; 93(1):184-91. · 3.97 Impact Factor
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ABSTRACT: To evaluate the feasibility, reliability and acceptability of the mini clinical evaluation exercise (mini-CEX) for performance assessment among international medical graduates (IMGs).
Observational study of 209 patient encounters involving 28 IMGs and 35 examiners at three metropolitan teaching hospitals in New South Wales, Victoria and Queensland, September-December 2006.
The reliability of the mini-CEX was estimated using generalisability (G) analysis, and its acceptability was evaluated by a written survey of the examiners and IMGs.
The G coefficient for eight encounters was 0.88, suggesting that the reliability of the mini-CEX was 0.90 for 10 encounters. Almost half of the IMGs (7/16) and most examiners (14/18) were satisfied with the mini-CEX as a learning tool. Most of the IMGs and examiners enjoyed the immediate feedback, which is a strong component of the tool.
The mini-CEX is a reliable tool for performance assessment of IMGs, and is acceptable to and well received by both learners and supervisors.
The Medical journal of Australia 09/2008; 189(3):159-61. · 2.81 Impact Factor
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ABSTRACT: The contribution of obesity to the occurrence of cardiovascular events may not be wholly related to its influence on traditional risk factors. Coagulation and fibrinolysis may also influence cardiovascular risk, but the relationship of adiposity with these processes is unclear. The aim of the present study was to investigate the relationships of BMI (body mass index), waist circumference, hip circumference and WHR (waist-to-hip ratio) with VIIc (factor VII activity), plasma markers of thrombin generation [F1+2 (prothrombin fragment 1+2)], fibrin formation [SF (soluble fibrin)] and fibrin turnover (D-dimer), and PAI-1 (plasminogen activator inhibitor-1; a marker of fibrinolytic inhibitory capacity). The study cohort was 80 healthy postmenopausal women who were not diabetic, current smokers or taking hormone therapy and who had a fasting sample of blood collected. VIIc, F1+2, SF and PAI-1 were all positively correlated with BMI, waist circumference and WHR, whereas D-dimer was positively correlated with waist circumference and WHR, but not BMI. WHR was the strongest correlate of all the markers except for PAI-1, which was most closely related to BMI. Hip circumference became a negative correlate of F1+2 and D-dimer after adjusting for waist circumference. The relationships of WHR with F1+2 and SF, but not with VIIc and D-dimer, were independent of traditional risk factors. The positive association between waist circumference and markers of thrombin generation, fibrin production and fibrin turnover suggests that abdominal adiposity may contribute to atherothrombosis by activating intravascular coagulation. In contrast, a larger hip circumference appears to have a protective affect against coagulation activation.
Clinical Science 12/2007; 113(9):383-91. · 4.61 Impact Factor
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ABSTRACT: Indices of arterial structure and stiffness are proposed as surrogate markers of cardiovascular disease in patients with chronic kidney disease (CKD), but no study examined multiple markers in the same population.
Prospective observational study.
315 subjects with stages 4 to 5 CKD, aged 24 to 79 years (mean age, 56.6 +/- 13.6 [SD] years), enrolled in the Atherosclerosis and Folic Acid Supplementation Trial.
Carotid arterial intima-medial thickness (IMT; n = 315) and indices of arterial stiffness (n = 207), including aortofemoral pulse wave velocity (PWV[a-f]), systemic arterial compliance (SAC), and carotid-derived augmentation index.
The primary outcome was a composite of all fatal and nonfatal cardiovascular events.
During follow-up (median, 3.6 years), 95 cardiovascular events occurred. On Cox proportional-hazard modeling, mean maximum IMT, PWV(a-f), and SAC were predictive of the composite clinical end point of all cardiovascular events, but carotid-derived augmentation index was not (hazard ratio [HR] for every 0.01-mm increase in IMT, 1.09; P = 0.001; 95% confidence interval [CI], 1.03 to 1.14; HR for every 1-m/s increase in PWV(a-f), 1.18; P < 0.001; 95% CI, 1.12 to 1.25; HR for every 0.01-U/mm Hg decrease in SAC, 0.98; P = 0.01; 95% CI, 0.97 to 0.99). After adjustment for age, sex, blood pressure, diabetes, past cardiovascular disease, cholesterol level, and smoking, PWV(a-f) remained a significant independent predictor of cardiovascular events (adjusted HR, 1.12; P = 0.001; 95% CI, 1.05 to 1.20), but IMT and SAC did not.
Study power to analyze differences between predialysis and dialysis stages of CKD.
PWV(a-f) is the only arterial index independently associated with cardiovascular outcome in patients with CKD.
American Journal of Kidney Diseases 11/2007; 50(4):622-30. · 5.43 Impact Factor
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Clinical and Experimental Pharmacology and Physiology 08/2007; 34(7):645-6. · 1.85 Impact Factor
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ABSTRACT: SUMMARY1. Hormone replacement therapy (HRT) with oestrogen or oestrogen plus progestin may have different effects on arterial structure and function. To examine this question, carotid artery intima-medial thickness (IMT) and indices of systemic and carotid arterial compliance were measured in groups of older men, postmenopausal women not on HRT (non-HRT) and those women on long-term HRT with oestrogen alone (HRT-E) or oestrogen plus progestin (HRT-EP).2. Sixty men, 90 postmenopausal women taking HRT and 91 not taking HRT participated in the study. The groups were similar for age, body mass index, numbers of smokers, physical activity, alcohol intake and blood pressure.3. Plasma total cholesterol was reduced and high-density lipo-protein-cholesterol was increased in the HRT group compared with the non-HRT group; low-density lipoprotein-cholesterol, triglyceride and lipoprotein (a) values were similar in these two groups. Results for HRT-E and HRT-EP subgroups were similar.4. Carotid IMT was significantly reduced in the HRT group compared with men and non-HRT groups. Results for HRT-E and HRT-EP subgroups were similar.5. Mean systemic arterial compliance (SAC) was significantly greater in men than in women and was related to age; SAC was higher in both HRT-E and HRT-EP groups compared with the non-HRT group. Indices of carotid stiffness were similar in men and in non-HRT groups. The HRT-EP group showed increased carotid stiffness compared with the HRT-E group.6. There is an apparent protective effect of long-term oestrogen therapy on carotid IMT and age-related changes in arterial stiffness. Progestin does not alter the IMT effects but may adversely influence arterial stiffness.
Clinical and Experimental Pharmacology and Physiology 06/2007; 24(6):457 - 459. · 1.85 Impact Factor
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The Medical journal of Australia 05/2007; 186(7 Suppl):S5. · 2.81 Impact Factor
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ABSTRACT: The Confederation of Postgraduate Medical Education Councils launched the Australian Curriculum Framework for Junior Doctors in October 2006. The curriculum framework: balances the major areas of clinical management, communication and professionalism, and highlights the importance of an integrated approach to prevocational learning and teaching; supports practice-based, opportunistic and continuous learning, and specifies performance and supervision requirements for junior doctors; and has been published in both Internet and printable versions, to make the document accessible and easily usable by junior doctors and supervisors. The implementation of the curriculum framework will be overseen by a steering group that includes representatives from key stakeholder groups, including junior doctors and medical students.
The Medical journal of Australia 05/2007; 186(7 Suppl):S14-9. · 2.81 Impact Factor
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ABSTRACT: When prevocational medical trainees become registrars, they have increasing responsibilities for ensuring safe, effective, and timely delivery of health care, while simultaneously performing a number of managerial and leadership roles. Registrars do not currently receive training for their roles as front-line managers, despite this being an identified need by trainees and the health care workers with whom they interact. The national program for the Professional Development of Registrars is a soundly based, well developed and successful generic program that could be applied in a wide variety of postgraduate arenas.
The Medical journal of Australia 05/2007; 186(7 Suppl):S22-4. · 2.81 Impact Factor
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ABSTRACT: We aimed to determine the impact of medical therapy for symptom management on insulin resistance, metabolic profiles, and surrogate markers of cardiovascular disease in polycystic ovary syndrome (PCOS), an insulin-resistant pre-diabetes condition.
One hundred overweight women (BMI >27 kg/m2), average age 31 years, who were nonsmokers, were not pregnant, did not have diabetes, and were off relevant medications for 3 months completed this 6-month open-label controlled trial. Randomization was to a control group (higher-dose oral contraceptive [OCP] 35 microg ethinyl estradiol [EE]/2 mg cyproterone acetate, metformin [1 g b.d.] or low-dose OCP [20 microg EE/100 microg levonorgestrel + aldactone 50 mg b.d.]). Primary outcome measures were insulin resistance (area under curve on oral glucose tolerance test) and surrogate markers of cardiovascular disease including arterial stiffness (pulse wave velocity [PWV]) and endothelial function.
All treatments similarly and significantly improved symptoms including hirsutism and menstrual cycle length. Insulin resistance was improved by metformin and worsened by the high-dose OCP. Arterial stiffness worsened in the higher-dose OCP group (PWV 7.46 vs. 8.03 m/s, P < 0.05), related primarily to the increased insulin resistance.
In overweight women with PCOS, metformin and low- and high-dose OCP preparations have similar efficacy but differential effects on insulin resistance and arterial function. These findings suggest that a low-dose OCP preparation may be preferable if contraception is needed and that metformin should be considered for symptomatic management, particularly in women with additional metabolic and cardiovascular risk factors.
Diabetes care 03/2007; 30(3):471-8. · 8.09 Impact Factor
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ABSTRACT: To investigate if noradrenaline (NA) and 5-hydroxyptamine (5-HT) drugs induce responses of isolated control and varicose veins are altered by removal of the endothelium. SUBJECTS #ENTITYSTARTX00026;
Specimens of the great saphenous vein (GSV) were obtained from 12 subjects with primary varicose veins and 12 subjects from donor vessels at cardiac surgery. A total of 10 normal healthy volunteers were selected for comparison. The diameter changes of GSV during the resting phase, at the end of 5 minutes occlusion, and then every 30 seconds post deflation for five minutes were measured using B-mode ultrasound. Post-surgery the vein sample was collected in a tube of Krebs-Henseleit solution.
The repeated measure ANOVA test for the diameter, percent, and difference changes of GSV diameter from maximum diameter at different time intervals showed significance difference within and between all groups. NA and 5-HT produced concentration-dependent contractions of control and varicose saphenous vein segments. There was no significant difference in the potency of NA and for 5-HT, but the maximum response, normalized for tissue weight, was less in varicose vein segments. Removal of the endothelium had no effect on the potency of NA or 5-HT but significantly (p<0.05) reduced the maximum response to NA and 5-HT in varicose vein segments but not to 5-HT in control veins.
The venous endothelial damage may cause vascular smooth muscle contractions dysfunction that favours dilatation and secondary valvular insufficiency.
The Open Cardiovascular Medicine Journal 01/2007; 1:15-21.
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ABSTRACT: To examine the effects of dietary soy/isoflavones on 24 hr blood pressure profiles and arterial function [systemic arterial compliance (SAC), pulse wave velocity (PWV) and brachial arterial flow mediated vasodilation (FMD)] compared to non legume-based plant protein without isoflavones, in hypertensive subjects.
In a 6 month double-blind, placebo controlled, cross-over trial, 41 hypertensive subjects (26 men, 15 postmenopausal women), 30-75 years, received soy cereal (40 g soy protein, 118 mg isoflavones) and gluten placebo cereal, each for 3 months.
Thirty-eight subjects completed protocol with results expressed as mean or mean change (+/-SEM) with each intervention. Soy increased urinary isoflavones (daidzein: 8-fold; genistein: 8-fold; equol: 9-fold; ODMA: 18-fold) with no change during gluten placebo. There was no difference in the change in individual 24 hr ambulatory BP parameters (SBP: 2 +/- 2 vs -1 +/- 1 mmHg, p = 0.21; DBP: 1 +/- 1 vs -1 +/- 1 mmHg, p = 0.06) central BP (cSBP: -4 +/- 2 vs 0 +/- 2 mmHg, p = 0.2) or the change in arterial function (FMD: 0.3 +/- 0.5 vs -0.2 +/- 0.5%, p = NS; SAC: 0.02 +/- 0.02 vs -0.02 +/- 0.02 U/mmHg, p = NS; PWV central: -0.2 +/- 0.2 vs 0.0 +/- 0.2 m/sec, p = NS; PWV peripheral: 0.01 +/- 0.3 vs -0.4 +/- 0.4 m/sec, p = NS) noted between interventions. Analysis of the area under curve of 24 hr BP outputs demonstrated that soy protein compared to gluten protein resulted in higher 24 hr systolic BP by 2.3 mmHg (p = 0.003), a higher daytime systolic BP by 3.4 mmHg (p = 0.0002) and a higher daytime diastolic BP by 1.4 mmHg (p = 0.008). Overall 24 hr diastolic BP, night systolic BP and night diastolic BP were not significantly different between groups. Furthermore, soy protein compared to gluten protein resulted in higher 24 hr heart rates by 3.5 bpm (p < 0.0001).
In hypertensive subjects, compared to gluten placebo, soy dietary supplementation containing isoflavones had no effect on arterial function, on average 24 hr ambulatory blood pressure parameters or central blood pressure in men and women with hypertension. Area under the curve of 24 hr profiles demonstrated that daytime BP was higher after soy compared to gluten.
Journal of the American College of Nutrition 01/2007; 25(6):533-40. · 2.29 Impact Factor
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ABSTRACT: To determine the effects of dietary soy containing phytoestrogens on blood pressure and lipids in healthy volunteers.
Two hundred thirteen healthy volunteers (108 men and 105 post-menopausal women, 50 - 76 years old) received either soy protein isolate (40 g soy protein, 118 mg isoflavones) or cassin placebo for 3 months in this randomized, double-blind trial.
There were 34 withdrawals (16%) and 179 people (96 men and 83 women) completed the study protocol. After 3 months treatment, urinary phytoestrogens was significantly increased and blood pressure was significant reduced in soy protein group than that in cassin placebo group [mean change in systolic (-7.5 +/- 1.2) mm Hg vs. (-3.6 +/- 1.1) mm Hg, P < 0.05; diastolic: -4.3 +/- 0.8) mm Hg vs (-1.9 +/- 0.7) mm Hg, P < 0.05; mean aortic blood pressure: (-5.5 +/- 1.0) mm Hg vs (-0.9 +/- 1.0) mm Hg, P < 0.008]. Low- to high-density lipoprotein ratio [(-0.33 +/- 0.10) mmol/L vs (0.04 +/- 0.10) mmol/L, P < 0.05] and triglycerides [(-0.20 +/- 0.05) mmol/L vs (-0.01 +/- 0.05) mmol/L, P < 0.05] were significantly reduced and Lp(a) lipoprotein significantly increased [42 (17 - 67) mg/L vs 4 (22 - 31) mg/L, P < 0.05] in soy protein group compared to cassin placebo group. Total, low-density lipoprotein, and high-density lipoprotein cholesterols all improved in both groups and were similar between the groups. No side-effect was observed in both groups and no effect on the hypothalamic-pituitary-gonadal axis was noted in study subjects.
In normotensive men and post-menopausal women, phytoestrogens intake improved blood pressure and lipids status.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 08/2006; 34(8):726-9.
