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  1. AU="Ian B Wilkinson"
  2. AU="Sarpün, I.H."
  3. AU="Gums, Jeremiah J"
  4. AU="Petsalaki, Eleni"
  5. AU="Yu, Weichao"
  6. AU="Mertens, Anne Wiebke"
  7. AU="Roitershtein, Alexander"
  8. AU="Deppen, Stephen"
  9. AU="Goliath, Rene"
  10. AU="Emons, Günter"
  11. AU="Sarah S. Barnett"

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  1. Artikel ; Online: Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda

    Carmel M McEniery / Ian B Wilkinson / Ibrahimu Zamaladi / Sam Ruvuma / Teddy Kwaga / Daniel Atwine / Henry Mark Lugobe

    BMJ Open, Vol 13, Iss

    a cross-sectional study

    2023  Band 10

    Abstract: Objective Retinopathy is one of the complications occurring among women with hypertensive disorders of pregnancy. We sought to determine the prevalence and factors associated with retinopathy among women with hypertensive disorders of pregnancy in ... ...

    Abstract Objective Retinopathy is one of the complications occurring among women with hypertensive disorders of pregnancy. We sought to determine the prevalence and factors associated with retinopathy among women with hypertensive disorders of pregnancy in southwestern Uganda.Design This was a hospital-based cross-sectional study from November 2019 to March 2020.Setting Three selected hospitals in Mbarara city, south-western Uganda.Participants The study included all pregnant women with hypertensive disorders of pregnancy.Primary and secondary outcome measures The participants were screened for retinopathy using a fundus camera. Data on participant’s sociodemographics, obstetrics and medical factors were collected. The prevalence of retinopathy was determined and multivariable logistic regression was used to determine the independent factors associated with retinopathy.Results A total of 216 women with hypertensive disorders of pregnancy were enrolled in this study. The prevalence of retinopathy was 60.2% (130/216). The most common retinal lesions were grade 1 retinopathy (narrowing of arterioles) accounting for 86.9% (113/130), grade 3 (retinal haemorrhages) was present in 10% (13/130) of women and grade 4 (papilloedema) in 3% (4/130). In an adjusted analysis, severe hypertension was significantly associated with retinopathy (aOR=2.8; 95% CI: 1.36 to 5.68). Grandmultigravida women were also associated with retinopathy (aOR=2.4; 95% CI: 0.99 to 5.72) with a tendency towards significancy, p=0.051.Conclusions In our study, retinopathy was common among women with hypertensive disorders of pregnancy. Women presenting with severe hypertension were likely to have retinopathy. There is a need to integrate screening for retinopathy in the care cascade of women with hypertensive disorders of pregnancy.
    Schlagwörter Medicine ; R
    Thema/Rubrik (Code) 150 ; 610
    Sprache Englisch
    Erscheinungsdatum 2023-10-01T00:00:00Z
    Verlag BMJ Publishing Group
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: P163 REGIONAL DIFFERENCES IN GEOMETRICAL FEATURES AND LAYER-SPECIFIC RESIDUAL STRESSES IN THE BOVINE DESCENDING THORACIC AORTA

    Alessandro Giudici / Ian B. Wilkinson / Ashraf W. Khir

    Artery Research, Vol

    2018  Band 24

    Abstract: Background: The Opening Angle (OA) is widely used as an index of the residual stresses and strains present in the arterial wall not subjected to internal pressure. The aim of this work was to quantify regional variation of the layer-specific OA in the ... ...

    Abstract Background: The Opening Angle (OA) is widely used as an index of the residual stresses and strains present in the arterial wall not subjected to internal pressure. The aim of this work was to quantify regional variation of the layer-specific OA in the bovine descending thoracic aorta. Methods: Descending thoracic aortae from 7 cows were segmented into 3–4 mm wide rings. Geometrical features (mean internal/external radius Rin and Rout, wall thickness h) were measured. A radial cut was made on the anterior region of each ring, and then the rings were placed in a temperature-controlled water bath (37 °C) for 1.5 h to express the OA. The rings were separated into their three layers and the layer-specific OA was investigated. The separation of the intima from the media is a complex procedure due to its limited thickness. The isolated intima was therefore thicker than values reported in the literature. Results: Except for the most proximal region, h/Rin decreased towards the periphery (table 1). The medial and whole aortic wall OA increased moving towards the periphery, whilst the adventitia showed the opposite behaviour. The intimal OA was significantly higher and relatively constant (figure 1). Conclusions: The present set of experiments indicates that the compressive residual stresses are concentrated mainly in the internal part of the intima-media layer independently from the considered axial region. The other layers exhibit comparable OAs to the whole arterial wall.
    Schlagwörter Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Sprache Englisch
    Erscheinungsdatum 2018-12-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Association between hypertensive disorders of pregnancy and later risk of cardiovascular outcomes

    Clare Oliver-Williams / David Stevens / Rupert A. Payne / Ian B. Wilkinson / Gordon C. S. Smith / Angela Wood

    BMC Medicine, Vol 20, Iss 1, Pp 1-

    2022  Band 11

    Abstract: Abstract Background Hypertensive disorders of pregnancy are common pregnancy complications that are associated with greater cardiovascular disease risk for mothers. However, risk of cardiovascular disease subtypes associated with gestational hypertension ...

    Abstract Abstract Background Hypertensive disorders of pregnancy are common pregnancy complications that are associated with greater cardiovascular disease risk for mothers. However, risk of cardiovascular disease subtypes associated with gestational hypertension or pre-eclampsia is unclear. The present study aims to compare the risk of cardiovascular disease outcomes for women with and without a history of gestational hypertension and pre-eclampsia using national hospital admissions data. Methods This was a retrospective cohort study of national medical records from all National Health Service hospitals in England. Women who had one or more singleton live births in England between 1997 and 2015 were included in the analysis. Risk of total cardiovascular disease and 19 pre-specified cardiovascular disease subtypes, including stroke, coronary heart disease, cardiomyopathy and peripheral arterial disease, was calculated separately for women with a history of gestational hypertension and pre-eclampsia compared to normotensive pregnancies. Results Amongst 2,359,386 first live births, there were 85,277 and 74,542 hospital admissions with a diagnosis of gestational hypertension and pre-eclampsia, respectively. During 18 years (16,309,386 person-years) of follow-up, the number and incidence of total CVD for normotensive women, women with prior gestational hypertension and women with prior pre-eclampsia were n = 8668, 57.1 (95% CI: 55.9–58.3) per 100,000 person-years; n = 521, 85.8 (78.6–93.5) per 100,000 person-years; and n = 518, 99.3 (90.9–108.2) per 100,000 person-years, respectively. Adjusted HRs (aHR) for total CVD were aHR (95% CI) = 1.45 (1.33–1.59) for women with prior gestational hypertension and aHR = 1.62 (1.48–1.78) for women with prior pre-eclampsia. Gestational hypertension was strongly associated with dilated cardiomyopathy, aHR = 2.85 (1.67–4.86), and unstable angina, aHR = 1.92 (1.33–2.77). Pre-eclampsia was strongly associated with hypertrophic cardiomyopathy, aHR = 3.27 (1.49–7.19), and acute myocardial ...
    Schlagwörter Gestational hypertension ; Pre-eclampsia ; Cardiovascular disease ; Women ; Pregnancy ; Medicine ; R
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2022-01-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  4. Artikel ; Online: P.04 A Transfer-Function-Free Technique for the Non-Invasive Estimation of Central Arterial Pressure

    Alessandro Giudici / Ioana Cretu / Madalina Negoita / Ian B Wilkinson / Ashraf W Khir

    Artery Research, Vol 26, Iss Supplement

    2020  Band 1

    Abstract: Background: Central aortic pressure (CAP) is important for the determination of the cardiovascular risk. Transfer function (TF)-based techniques allow for estimating CAP non-invasively from pressure waveforms acquired distally in the circulation. However, ...

    Abstract Background: Central aortic pressure (CAP) is important for the determination of the cardiovascular risk. Transfer function (TF)-based techniques allow for estimating CAP non-invasively from pressure waveforms acquired distally in the circulation. However, TF-based CAP might preserve the high frequencies of the distal waveform [1]. Therefore, we propose a new method where CAP is estimated from local direct non-invasive measurements of diameter (D) and blood velocity (U) waveforms. Methods: Aortic root D and U were measured using an ultrasound scanner (GE, Vivid E95) in 10 healthy volunteers (46 ± 15 years, 5 men), and used to determine local wave speed (PWV) using the lnDU-loop method [2]. Brachial systolic (Ps) and diastolic blood pressure (Pd), as well as central Ps, were also estimated using a sphygmomanometer (Uscom, BPPLUS-R7). CAP was determined as: , where, and blood density = 1060 kg/m3. Results: Mean brachial Ps and Pd were 124.1 ± 9.5 and 77.9 ± 5.4 mmHg, respectively. Mean PWV was 3.07 ± 0.71 m/s, leading to = 1.00 ± 0.46. The average calculated Ps was only –0.4% lower than TF-Ps (116.4 ± 11.2 vs. 116.9 ± 8.9, mmHg). Estimated calculated aortic and measured brachial mean pressure were almost identical with a difference of 0.01% (97.8 ± 6.9 vs. 97.8 ± 6.5, mmHg). Discussion: This proof-of-concept study shows that the CAP waveform can be estimated non-invasively from measurements of brachial Pd, and aortic D and U obtained using equipment available in almost every cardiovascular clinic. Further studies are warranted to establish the full utility of the new technique. FigureA: typical example of aortic D converted into CAP. B: Bland-Altman comparison between calculated and TF Ps.
    Schlagwörter Non-invasive pressure estimation ; Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Sprache Englisch
    Erscheinungsdatum 2020-12-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  5. Artikel ; Online: Correction to

    Carmel M. McEniery / Marie Fisk / Karen Miles / Fotini Kaloyirou / Annette Hubsch / Jane Smith / Ian B. Wilkinson / Joseph Cheriyan

    Trials, Vol 21, Iss 1, Pp 1-

    ChemoPROphyLaxIs with hydroxychloroquine For covId-19 infeCtious disease (PROLIFIC) to prevent covid-19 infection in frontline healthcare workers: A structured summary of a study protocol for a randomised controlled trial

    2020  Band 1

    Abstract: An amendment to this paper has been published and can be accessed via the original article. ...

    Abstract An amendment to this paper has been published and can be accessed via the original article.
    Schlagwörter Medicine (General) ; R5-920 ; covid19
    Sprache Englisch
    Erscheinungsdatum 2020-07-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  6. Artikel ; Online: Inverting the patient involvement paradigm

    Laura B. Mader / Tess Harris / Sabine Kläger / Ian B. Wilkinson / Thomas F. Hiemstra

    Research Involvement and Engagement, Vol 4, Iss 1, Pp 1-

    defining patient led research

    2018  Band 7

    Abstract: Plain English Summary Patients usually understand their disease and lifestyle needs better than many medical professionals. They also have important ideas about what research would be most beneficial to their lives, especially on how to manage symptoms ... ...

    Abstract Plain English Summary Patients usually understand their disease and lifestyle needs better than many medical professionals. They also have important ideas about what research would be most beneficial to their lives, especially on how to manage symptoms in a way that improves daily quality of life. In the UK, the National Institute for Health Research has recognised the value of patient insight, and now requires researchers with public funding to involve patients and the public throughout the research process. There are many opportunities for involvement, but these generally focus on improving study design to ensure the trial is acceptable to participants. Some programmes work towards setting research priorities as important to patients, public members, and medical experts, but due to the complexity and cost involved in running clinical trials, the majority of research originates with the pharmaceutical industry or academic institutions. There is a clear mismatch between research ideas that patients prioritise (quality of life), and those actually investigated (drug development). The Patient Led Research Hub (PLRH) is a new initiative hosted by the Cambridge Clinical Trials Unit. The PLRH supports research ideas as proposed by patient organisations, providing resources and expertise in research design and delivery. The PLRH aims to co-produce any technically feasible project, regardless of disease or symptom focus. The proposing patient group maintains ownership of the project with an active role in study management. This method of research has proven to produce credible research studies that are of direct relevance to patients. Abstract Patient and Public Involvement has become an indispensable and expected component of healthcare research in the United Kingdom, largely driven by the National Institute of Health Research and other research funders. Opportunities for patients to become involved in research abound, and many organisations now have dedicated ‘public involvement’ teams. However, its value is often ...
    Schlagwörter Co-production ; Patient ; Public ; Involvement ; PPI ; Research ; Medicine ; R ; Medicine (General) ; R5-920
    Thema/Rubrik (Code) 300
    Sprache Englisch
    Erscheinungsdatum 2018-07-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  7. Artikel ; Online: Inflammation and large arteries

    Kaisa M. Mäki-Petäjä / Ian B. Wilkinson

    Artery Research, Vol 6, Iss

    Potential mechanisms for inflammation-induced arterial stiffness

    2012  Band 2

    Abstract: Systemic inflammatory conditions are associated with an increased risk of cardiovascular disease (CVD). How exactly inflammation leads to this is not fully understood, but it has been suggested that arterial stiffening, could provide potential mechanisms ...

    Abstract Systemic inflammatory conditions are associated with an increased risk of cardiovascular disease (CVD). How exactly inflammation leads to this is not fully understood, but it has been suggested that arterial stiffening, could provide potential mechanisms to explain it. Chronic, systemic inflammatory conditions, as well as acute-models of inflammation are associated with arterial stiffening. Moreover, aortic stiffness can be reversed with successful immunomodulatory therapy. Although it seems evident that inflammation is involved in the process of aortic stiffening, the precise mechanism responsible for this remains unclear. There are number of possible mechanisms by which inflammation could lead to arterial stiffening. (1) Inflammation is associated with endothelial dysfunction and this can regulate arterial stiffness via changes in smooth muscle tone. (2) Inflammation leads to increased synthesis of matrix metalloproteinases, which can degrade elastin, resulting in stiffening. (3) Several mediators of inflammation may directly stimulate vascular calcification, whereas endogenous inhibitors of vascular calcification are downregulated during inflammation, both of which can lead to stiffening. (4) During inflammation arterial glycosaminoglycan (GAG) synthesis is upregulated. In animal models, an overproduction of certain GAGs in the aorta results in stiffening of the arterial wall by thinning of elastic lamellae. (5) Finally, direct vascular inflammation could lead to arterial stiffening by changing the composition of extracellular matrix. This review aims to discuss potential mechanisms by which inflammation could lead to aortic stiffening.
    Schlagwörter Aortic stiffness ; Inflammation ; Rheumatoid arthritis ; Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2012-04-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  8. Artikel ; Online: P116 CARDIAC OUTPUT IS INCREASED IN YOUNG PEOPLE WITH ELEVATED BP

    Chiara Nardin / Kaisa Maki-Petaja / Yasmin Yasmin / Barry McDonnell / John R. Cockcroft / Ian B. Wilkinson / Carmel M. McEniery

    Artery Research, Vol

    2018  Band 24

    Abstract: Background: The relationship between Blood Pressure (BP) and cardiovascular risk is continuous. Here, we examined haemodynamic characteristics across a range of BP categories, to determine kihaemodynamic mechanisms associated with early elevations of BP ... ...

    Abstract Background: The relationship between Blood Pressure (BP) and cardiovascular risk is continuous. Here, we examined haemodynamic characteristics across a range of BP categories, to determine kihaemodynamic mechanisms associated with early elevations of BP and whether these differ by gender. Methods: 2618 apparently healthy subjects aged 18–40 years were grouped according to gender and BP category, following the recent reclassification of BP as part of AHA/ACC 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire, together with detailed metabolic and haemodynamic assessments. Results: Hypertension (HT), stage 1 was the most common BP phenotype in males (29%), whereas normal BP was the most common BP phenotype in females (68%). In both males and females, cardiac output (CO) was significantly increased in subjects with elevated BP and HT versus normotensives (P < 0.001 for all). Stroke volume (SV) was increased in hypertensive males compared with those with elevated or normal BP. In contrast, peripheral vascular resistance (PVR) and pulse wave velocity (PWV) were significantly increased in hypertensive females (P < 0.001 for all) compared with the other BP categories. Conclusion: In young adults, increased CO is evident at the elevated BP stage and this could represent an initiating mechanism involved in the onset of HT. SV, PVR and PWV might play different roles in females and males in the development of later sustained HT. Elevated CO may be an important risk stratifier for future HT in young people.
    Schlagwörter Specialties of internal medicine ; RC581-951 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
    Thema/Rubrik (Code) 590
    Sprache Englisch
    Erscheinungsdatum 2018-12-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  9. Artikel ; Online: Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes

    Giulia Masini / Jasmine Tay / Carmel M McEniery / Ian B Wilkinson / Herbert Valensise / Grazia M Tiralongo / Daniele Farsetti / Wilfried Gyselaers / Sharona Vonck / Christoph C. Lees

    Journal of Clinical Medicine, Vol 9, Iss 2891, p

    2020  Band 2891

    Abstract: We investigate the relationship between maternal cardiovascular (CV) function and fetal Doppler changes in healthy pregnancies and those with pre-eclampsia (PE), small for gestational age (SGA) or fetal growth restriction (FGR). This was a three-centre ... ...

    Abstract We investigate the relationship between maternal cardiovascular (CV) function and fetal Doppler changes in healthy pregnancies and those with pre-eclampsia (PE), small for gestational age (SGA) or fetal growth restriction (FGR). This was a three-centre prospective study, where CV assessment was performed using inert gas rebreathing, continuous Doppler or impedance cardiography. Maternal cardiac output (CO) and peripheral vascular resistance (PVR) were analysed in relation to the uterine artery, umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices (PI, expressed as z -scores by gestational week) using polynomial regression analyses, and in relation to the presence of absent/reversed end diastolic (ARED) flow in the UA. We included 81 healthy controls, 47 women with PE, 65 with SGA/FGR and 40 with PE + SGA/FGR. Maternal CO was inversely related to fetal UA PI and positively related to MCA PI; the opposite was observed for PVR, which was also positively associated with increased uterine artery impedance. CO was lower ( z -score 97, p = 0.02) and PVR higher ( z -score 2.88, p = 0.02) with UA ARED flow. We report that maternal CV dysfunction is associated with fetal vascular changes, namely raised impedance in the fetal-placental circulation and low impedance in the fetal cerebral vessels. These findings are most evident with critical UA Doppler changes and represent a potential mechanism for therapeutic intervention.
    Schlagwörter cardiovascular function ; cardiac output ; Doppler ; fetal growth restriction ; pre-eclampsia ; Medicine ; R
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2020-09-01T00:00:00Z
    Verlag MDPI AG
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  10. Artikel ; Online: Effect of kidney donation on bone mineral metabolism.

    Thomas F Hiemstra / Jane C Smith / Kenneth Lim / Dihua Xu / Shreya Kulkarni / J Andrew Bradley / Kaido Paapstel / Inez Schoenmakers / John R Bradley / Laurie Tomlinson / Carmel M McEniery / Ian B Wilkinson

    PLoS ONE, Vol 15, Iss 7, p e

    2020  Band 0235082

    Abstract: Kidney donation results in reductions in kidney function and lasting perturbations in phosphate homeostasis, which may lead to adverse cardiovascular sequelae. However, the acute effects of kidney donation on bone mineral parameters including regulators ... ...

    Abstract Kidney donation results in reductions in kidney function and lasting perturbations in phosphate homeostasis, which may lead to adverse cardiovascular sequelae. However, the acute effects of kidney donation on bone mineral parameters including regulators of calcium and phosphate metabolism are unknown. We conducted a prospective observational controlled study to determine the acute effects of kidney donation on mineral metabolism and skeletal health. Biochemical endpoints were determined before and after donation on days 1, 2 and 3, 6 weeks and 12 months in donors and at baseline, 6 weeks and 12 months in controls. Baseline characteristic of donors (n = 34) and controls (n = 34) were similar: age (53±10 vs 50±14 years, p = 0.33), BMI (26.3±2.89 vs 25.9±3.65, p = 0.59), systolic BP (128±13 vs 130±6 mmHg, p = 0.59), diastolic BP (80±9 vs 81±9 mmHg, p = 0.68) and baseline GFR (84.4±20.2 vs 83.6±25.2 ml/min/1.73m2, p = 0.89). eGFR reduced from 84.4±20.2 to 52.3±17.5 ml/min/1.73m2 (p<0.001) by day 1 with incomplete recovery by 12 months (67.7±22.6; p = 0.002). Phosphate increased by day 1 (1.1(0.9-1.2) to 1.3(1.1-1.4) mmol/L, p <0.001) but declined to 0.8(0.8-1.0) mmol/L (p<0.001) before normalizing by 6 weeks. Calcium declined on day 1 (p = 0.003) but recovered at 6 weeks or 12 months. PTH and FGF-23 remained unchanged, but α-Klotho reduced by day 1 (p = 0.001) and remained low at 6 weeks (p = 0.02) and 1 year (p = 0.04). In this study, we conclude that kidney donation results in acute disturbances in mineral metabolism characterised by a reduced phosphate and circulating α-Klotho concentration without acute changes in the phosphaturic hormones FGF23 and PTH.
    Schlagwörter Medicine ; R ; Science ; Q
    Sprache Englisch
    Erscheinungsdatum 2020-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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