L. M. Brewster

Anton de Kom University · Public Health

Background: Female-specific risk factors for cardiovascular disease are understudied. We assessed whether women with uterine fibroids have a greater hypertension risk, independent of the shared risk factors for both conditions. Methods: Blood pressure was measured in women scheduled for fibroid surgery compared to women scheduled for nonfibroid...

Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood p...

We hypothesized that human variation in the activity of the ATP regenerating enzyme creatine kinase (CK) activity affects hypertension and cardiovascular disease risk. CK is tightly bound close to ATP-utilizing enzymes including Ca2+-ATPase, myosin ATPase, and Na+/K+-ATPase, where it rapidly regenerates ATP from ADP, H+, and phosphocreatine. Thus,...

Extracellular purine nucleotides and nucleosides including ADP and ATP regulate a wide array of physiological processes including platelet aggregation, vasomotor responses and inflammation through specific purinergic receptors. In the recent years, a strong association has been reported between circulating cytoplasmic-type creatine kinase and adver...

Background The ADP-scavenging enzyme creatine kinase (CK) is reported to reduce ADP-dependent platelet activation. Therefore, we studied whether highly elevated CK after ST-elevation myocardial infarction (STEMI) is associated with bleeding. Methods Data of the Thrombolysis in Myocardial Infarction Study Group phase II trial on the efficacy of ang...

We systematically reviewed randomized controlled trials (RCTs) that consider the effect of initial dual antihypertensive combination treatment on blood pressure (BP), morbidity, or mortality in hypertensive African ancestry adults, using the methodology of the Cochrane Collaboration. Main outcomes were difference in means (continuous data) and risk...

Background The adenosine triphosphate (ATP) regenerating enzyme creatine kinase (CK) is intimately involved in blood pressure generation. Consequently, the creatine transporter and CK inhibitor beta-guanidinopropionic acid (GPA) successfully reduced blood pressure in 16-week-old spontaneously hypertensive rats (SHR), but GPA may cause growth retard...

Background Initial antihypertensive combination therapy is considered the standard of care in most patients with hypertension. However, while monotherapy with calcium channel blockers (CAB) or Diuretics is known to have greater blood pressure lowering efficacy than other drugs in African ancestry (AA) patients, it is unclear which initial combinati...

Background Syncope is a common presentation to emergency departments. Cardiovascular risk differs markedly among ancestry groups, but data on syncope are scarce. Fundamental understanding of the determinants of syncope in the population might aid in the risk stratification of syncope in acute settings. Purpose To assess lifetime prevalence of sync...

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30...

BACKGROUND African ancestry patients are considered separately in hypertension guidelines because of more severe hypertension that is presumably harder to control. However, despite the perceived benefit in reducing health disparities, racial profiling in medicine is increasingly criticized for its potential of bias and stereotyping. Therefore, we s...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

Background It was recently reported that highly elevated plasma activity of the ADP-scavenging enzyme creatine kinase (CK), to >10 times the upper reference limit (URL), is independently associated with fatal or non-fatal bleeding during treatment for ST-segment elevation myocardial infarction (OR 2.6[95% CI, 1.8 to 2.7]/log CK increase). Evidence...

Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled ana...

Background The ADP-scavenging enzyme creatine kinase (CK) is reported to reduce ADP-dependent platelet activation. Therefore, we studied whether highly elevated CK after myocardial infarction (MI) is associated with bleeding. Method Data of the Thrombolysis In Myocardial Infarction Study Group phase II trial on the efficacy of angioplasty followin...

Increasing evidence indicates that the enzyme creatine kinase (CK) is intimately involved in microvascular contractility. The mitochondrial isoenzyme catalyses phosphocreatine synthesis from ATP, while cytoplasmic CK, predominantly the BB isoenzyme in vascular tissue, is tightly bound near myosin ATPase, where it favours ATP production from phospho...

Abstract The ATP-regenerating enzyme CK (creatine kinase) is strongly associated with blood pressure, which lowers upon experimental CK inhibition. The enzyme is thought to affect cardiovascular hemodynamics through enhanced systemic vascular resistance, stroke volume, and cardiac contractility, but data on these parameters are lacking. We hereby r...

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world³ and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein...

Background It was recently reported that highly elevated plasma activity of the ADP-scavenging enzyme creatine kinase (CK), to >10 times the upper reference limit (URL), is independently associated with fatal or non-fatal bleeding during treatment for ST-segment elevation myocardial infarction (OR 2.6 [95% CI, 1.8 to 2.7]/log CK increase). Evidence...

Aortic pulse wave velocity has emerged as an important predictor of cardiovascular events, but data on ethnic differences in pulse wave velocity remain scarce. We explored differences in pulse wave velocity between people of Asian and African ancestry. Data were used from the cross-sectional Healthy Life in Suriname (HELISUR) study. Pulse wave velo...

Aortic pulse wave velocity has emerged as an important predictor of cardiovascular events, but data on ethnic differences in pulse wave velocity remain scarce. We explored differences in pulse wave velocity between people of Asian and African ancestry. Data were used from the cross-sectional Healthy Life in Suriname (HELISUR) study. Pulse wave velo...

We studied hypertension prevalence, awareness, treatment, and control among persons living in a middle-income country compared with those of similar ethnicity living in a high-income country. Data from the cross-sectional HELISUR and HELIUS studies were used among 1000 Surinamese and 6971 Surinamese migrants living in The Netherlands (18–70 years),...

Background: Highly elevated plasma activity of the ADP scavenging enzyme creatine kinase (CK) might reduce ADP and ADP-dependent platelet activation. Therefore, we studied, whether high CK after myocardial infarction (MI) is associated with bleeding. Method: Data of the Thrombolysis In Myocardial Infarction Study Group phase II trial on the efficac...

Please view the paper at: https://doi.org/10.1007/s11739-019-02106-3 or https://rdcu.be/bBlUX

Rising rural body-mass index is the main driver of the global obesity epidemic in adults NCD Risk Factor Collaboration (NCD-RisC) Nature 569, pages260–264 (2019) Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view th...

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height...

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3–6. Here we use 2,009 population-based studies, with measurements of height and...

The pathophysiology of hypertension in African ancestry patients is characterized by low circulating renin. However, low renin does not cause or explain the greater occurrence of hypertension, nor the enhanced vascular contractility and sodium retention observed in this population subgroup. This comment summarizes other factors than renin that are...

Background: Hypertension is a main risk factor for premature death. Although blood pressure is a complex trait, we have shown that the activity of the ATP-generating enzyme creatine kinase (CK) is a significant predictor of blood pressure and of failure of antihypertensive drug therapy in the general population. In this report, we systematically re...

Aims Population data indicate that one in 25 persons of African ancestry has heart failure, a condition with relatively high mortality of around 50% in 5 years. Combined hydralazine and isosorbide dinitrate added to conventional therapy in African ancestry patients with heart failure and reduced ejection fraction improves quality of life and reduce...

From experiments by the Nazis in Germany, to the infamous American Tuskegee study, controversies surround racialized medical science and clinical practice. However, although 'race' is a social construct, disease patterns may cluster in groups with a common ethno-cultural ancestry. In this journal, Buckle and Achterbergh et al. discuss the use of ra...

Background Access to quality hypertension care is often poor in sub-Saharan Africa. Some community pharmacies offer hypertension monitoring services, with and without involvement of medical doctors. To directly connect pharmacy staff and cardiologists a care model including a mobile application (mHealth) for remote patient monitoring was implemente...

Objectives Cardiovascular risk factor burden was recently reported to be high in the Caribbean country Suriname. However, historical data for comparison were lacking. We report here rediscovered and hitherto unpublished aggregated data of what was apparently the first population study on measured blood pressure, diabetes, and cardiovascular health...

The high cardiovascular risk burden in low- and middle-income countries is expected to lead to an explosive increase in chronic kidney disease (CKD). However, population data on CKD from these countries are scarce. Therefore, we assessed kidney health in Suriname. In the Healthy Life in Suriname (HeliSur) study, a random sample of the adult populat...

Patients of sub-Saharan African or South Asian descent tend to have more hypertension and diabetes leading to early organ damage and premature cardiovascular mortality, compared to patients of white European descent. Abundant data indicate that greater salt sensitivity, blunted nocturnal dipping, and enhanced vasoconstriction in patients of African...

Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive pop...

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hype...

We analyzed a stratified random sample of the population of Amsterdam, the Netherlands, consisting of 1444 citizens (503 white European, 292 South Asian, 580 black, and 69 of other ethnicity) aged 34 to 60 years. We used linear regression analysis to investigate the association between blood pressure and normal serum creatine kinase after rest, as...

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hyp...

Creatine kinase (CK) rapidly regenerates ATP for Na⁺/K⁺-ATPase driven sodium retention throughout the kidney. Therefore, we assessed whether resting plasma CK is associated with sodium retention after a high sodium diet. Sixty healthy men (29 European and 31 African ancestry) with a mean age of 37.2 years (SE 1.2) were assigned to low sodium intake...

Patients of South Asian or African ethnicity have a greater burden of hypertension and diabetes, leading to early target organ damage and premature cardiovascular mortality. This could have important implications for cardiovascular risk management. In this chapter, we systematically review the evidence on the effect of antihypertensive drug treatme...

Reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans and other ethnicities. The burden of cardiovascular disease in African Americans and other people of African descent remains high and is a primary cause of disparities in life expectancy with whites. Explanations for these persistent dispa...

Accumulation of metabolites may mark or contribute to the development of type 2 diabetes mellitus (T2D), but there is a lack of data from ethnic groups at high risk. We examined sphingolipids, acylcarnitines and amino acids, and their association with T2D in a nested case-control study among 54 South Asian Surinamese, 54 African Surinamese and 44 D...

Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those...

BACKGROUND:Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends...

COMMENT Outcomes of Dabigatran and Warfarin for Atrial Fibrillation in Contemporary Practice: is Dabigatran of Benefit in African Ancestry Patients? Annals of Internal Medicine http://annals.org/aim/fullarticle/2662108/outcomes-dabigatran-warfarin-atrial-fibrillation-contemporary-practice-retrospective-cohort-study Lizzy M. Brewster MD PhD, Ger...

Zijn antihypertensiva 'kleurenblind'? Recent werd een nieuwe subgroepanalyse naar etniciteit van de 'Antihypertensive and lipid-lowering treatment to prevent heart attack trial' (ALLHAT) gepubliceerd. 1 Deze trial telde 42.448 participanten-waaronder 15.094 mensen van Afro-Amerikaanse af-komst-ouder dan 55 jaar met hypertensie en minimaal 1 addit...

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128•9 million children, adolescents, and adults NCD Risk Factor Collaboration (NCD-RisC)* Summary Background Underweight, overweight, and obesity in childhood and adolescence are associated w...

Abstract Aim: Increasing evidence indicates that the ATP-generating enzyme creatine kinase is involved in hypertension. Creatine kinase rapidly regenerates ATP from creatine phosphate and ADP. Recently, we showed that beta-guanidinopropionic acid (GPA), a kidney-synthesized creatine analogue and competitive inhibitor of creatine kinase, effectively...

Background & aims: Cardiovascular disease (CVD) is highly prevalent in Suriname, a middle-income country with predominantly people of African and Asian ancestry. We examined whether the more comprehensive body composition measures determined by bioelectrical impedance analysis (BIA) are superior to the more traditional BMI and waist measures in re...

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare tr...

Aim: Increasing evidence indicates that the ATP-generating enzyme creatine kinase (CK) is involved in hypertension. CK rapidly regenerates ATP from creatine phosphate and ADP. Recently, we showed that beta-guanidinopropionic acid (GPA), a kidney-synthesized creatine analogue and competitive CK inhibitor, reduced blood pressure in spontaneously hyp...

BACKGROUND Hypertension is the leading risk factor responsible for premature death worldwide, but its burden has shifted to low- and middle-income countries. Therefore, we studied hypertension and cardiovascular risk in the population of Suriname, a middle-income country with a predominantly urban population of African and Asian ancestry. METHODS A...