Virginia Commonwealth University School of Medicine researchers have discovered that changes in the gene expression of a key enzyme may contribute to high blood pressure and increase susceptibility to forming blood clots in pregnant women with preeclampsia.

These findings could provide clues to the best treatment approaches for high blood pressure and the formation of blood clots that can block blood flow to a pregnant woman's internal organs and lead to organ failure.

Researchers have been working to determine the root cause of preeclampsia on the molecular level and have now identified that epigenetic mechanisms may be at play. Epigenetics refers to changes in gene expression that are mediated through mechanisms other than changes in the DNA sequence.

In a study published online this week in Hypertension, a journal of the American Heart Association, the VCU team reported that thromboxane synthase -- an important inflammatory enzyme -- is increased in the blood vessels of expectant mothers with preeclampsia. The thromboxane synthase gene codes for this enzyme, which is involved in several processes including cardiovascular disease and stroke. This enzyme results in the synthesis of thromboxane, which increases blood pressure and causes blood clots.

"The present work is unique because it opens up a new concept as to the cause and subsequent consequences of preeclampsia relating to epigenetics," said corresponding author Scott W. Walsh, Ph.D., professor in the VCU Department of Obstetrics and Gynecology. "It is the first study to show that epigenetic alterations in the blood vessels of the mother are related to preeclampsia."

According to Walsh, one of the main epigenetic mechanisms is methylation of the DNA, which controls the expression of genes. The increase of this enzyme in the blood vessels is related to reduced DNA methylation and the infiltration of neutrophils into the blood vessels. Neutrophils are white blood cells that normally help fight infection.

In the future, Walsh said some potential treatments for preeclampsia may include inhibition of thromboxane synthase, blockade of thromboxane receptors or dietary supplementation with folate. He said that folate supplementation could increase methylation donors to protect against adverse changes in DNA methylation that affect expression of the thromboxane synthase enzyme.

This study builds on previously published work by the VCU team that appeared in the November 2011 issue of Hypertension and in the January 2011 issue of the American Journal of Pathology and demonstrated a significant role for neutrophils as causative agents of high blood pressure in preeclampsia.

This work was supported by grants from the National Heart, Lung and Blood Institute and the National Center on Minority Health and Health Disparities.

Taking antidepressants during pregnancy raises the risk of high blood pressure in expectant mothers, a new study shows.

Antidepressants are one of the most commonly used medications in pregnancy, and hypertension can cause problems for both mother and child. About one in five women suffer from depression during pregnancy, and up to 14 percent of those women end up using an antidepressant medication to treat it.

Though the drugs are commonly prescribed to pregnant women, there has not been much research on the effect they can have on a mother's health.

The new study, published in The British Journal of Clinical Pharmacology, looked at more than 13,000 pregnant women, 1,200 of whom had pregnancy-induced hypertension with no history of the condition before they became pregnant. The researchers found that women taking antidepressants of any kind had a 53 percent greater risk of high blood pressure. Those who were taking Paxil, which belongs to the most commonly prescribed class of antidepressants, known as selective serotonin reuptake inhibitors, saw their risk rise even higher, by 81 percent.

Though those numbers sound high, it's important to note that the absolute risk from taking these drugs remained low. Antidepressants raised a woman's absolute risk of hypertension from 2 percent to 3.2 percent, and Paxil raised it from 2 percent to 3.6 percent.

Still, the findings show that women taking antidepressants while pregnant should be aware of the risk, and weigh that against the benefits, said Dr. Anick Berard, the lead author of the study and director of the research unit on medications and pregnancy at Ste. Justine's Hospital in Montreal.

"It's a very tricky situation for physicians and women themselves," she said. "But if there's more benefit, then I would suggest take the medication, monitor the pregnancy and make sure that everything goes accordingly."

But experts disagree on whether the findings are meaningful.

FRIDAY, March 25 (HealthDay News) -- Laughter and music not only lift the mood, they might also drop blood pressure among middle-aged adults, a new study suggests.

Japanese researchers divided 79 adults, aged 40 to 74, into three groups, studying the effects of one-hour music sessions every two weeks on one group, laughter sessions on another group, and no intervention for the remaining participants (the control group).

Blood pressure readings taken immediately after the sessions were 6 mm Hg lower in the music group and 7 mm Hg lower among the laughter participants compared to measurements taken just prior to the sessions, the study authors said.

Improvements in blood pressure were still seen three months later, according to the results.

No change in blood pressure was recorded among participants who received neither intervention.

"The [participants'] cortisol level, a stress marker, decreased just after the intervention sessions," said lead author Eri Eguchi, a public health researcher at Osaka University's Graduate School of Medicine in Japan. "We think this is one of the explanations for the physiological processes."

The results of Eguchi's study were scheduled for presentation Friday at an American Heart Association conference in Atlanta. The study does not show a direct cause and effect, merely an association. Also, experts say that research presented at meetings is considered preliminary because it has not been subject to the rigorous scrutiny required for publication in a medical journal.

For three months, music therapists guided 32 participants in listening to, singing and stretching with music. They were also encouraged to listen to music at home.

Laughter sessions were led by trained laughter yogis, with 30 participants performing laughter yoga -- a combination of breathing exercises and laughter stimulated through playful eye contact -- and listening to Rakugo, Japanese sit-down comedy.

"We think yoga breathing may play some role for lowering blood pressure," Eguchi said, noting that his team will examine the link in upcoming research.

"Also, people with intervention may be more motivated to modify their health behaviors," Eguchi added. "The data showed that the amount of exercise increased in the intervention group, but not in non-intervention group."

High blood pressure, or hypertension, is linked to serious health problems.

Cardiology experts offered mixed reviews of the study's findings.

Dr. Franz Messerli, director of the hypertension program at St. Luke's-Roosevelt Hospital Center in New York City, said he was skeptical of the results because the researchers knew all along which participants were in the intervention and control groups.

"The mechanisms involved [in lowering blood pressure] are not entirely clear," Messerli said. "Exercise does the same thing, and just sitting down will lower blood pressure, too."

Messerli said Eguchi could have "objectivated" the results by measuring participants' blood pressure over 24-hour periods before and after intervention sessions.

But Dr. John Ciccone, a preventive cardiologist at Saint Barnabas Medical Center in West Orange, N.J., contended that the study highlights "interesting physiology" about the role stress plays in blood pressure.

In Ciccone's practice, holistic nurses offer music therapy for stress management, a growing field that can incorporate techniques such as reflexology, acupressure and others, he said.

"I think there has been interesting data that shows that relaxation techniques, regardless of the technique, can possibly affect borderline elevated blood pressure," Ciccone said.

"They're not outside the mainstream anymore," he added. "I think a lot of what was considered alternative is no longer alternative."

Eating Plenty of Anthocyanin-Rich Blueberries and Strawberries Lowers High Blood Pressure Risk, Study Finds

Eating just 1 cup of strawberries or blueberries each week can reduce your risk of developing high blood pressure, a major risk factor for heart disease and stroke. The new findings appear in the February issue of the American Journal of Clinical Nutrition.

The new study included 87,242 women who took part in the Nurses’ Health Study II, 46,672 women from the Nurses’ Health Study I, and 23,043 men from the Health Professionals Follow-up study. During the 14-year follow-up period, 29,018 women and 5,629 men developed high blood pressure.

Men and women with the highest amount of anthocyanin from blueberries and strawberries had an 8% reduction in their risk for developing high blood pressure, compared to study participants who ate the least amount of these anthocyanin-rich berries, the study showed.

Anthocyanin is a powerful antioxidant that gives blueberries and strawberries their vibrant color. It may also help open blood vessels, which allows for smoother blood flow and a lower risk for high blood pressure.

Berries and Blood Pressure

The risk reduction from eating blueberries and strawberries was most pronounced in study participants who were 60 or younger. The researchers speculate that the reason for this may be that “the cumulative damage over many decades exceeds the capacity for flavonoids to beneficially affect [blood vessel] function and blood pressure in older individuals.”

Additionally, the berry connection was not simply due to healthier people tending to eat better. The findings held even after researchers controlled for other factors linked to high blood pressure risk, including family history, body mass index, physical activity, and multiple other dietary factors.

The new study did have its share of limitations. For example, researchers did not measure food intake or blood pressure levels directly. Instead, blood pressure and dietary composition was self-reported by study participants.

Still, “these findings warrant further investigation, including intervention studies designed to test optimal doses of anthocyanin-rich foods for the prevention of hypertension and to underpin guidelines for the prevention and treatment of hypertension,” the study authors conclude. They also note that the current results “reinforce the importance of dietary intervention strategies for blood pressure reduction before middle age.”

A new study finds that race, gender and where you live strongly affect your risk for high blood pressure, which is a major risk factor for heart disease and stroke.

Deaths from heart disease and stroke in the United States decreased 65 percent overall between 1968 and 2006, but rates of cardiovascular death are still higher in the southeastern United States, in blacks compared to whites, and in men compared to women.

Study author Dr. Deborah A. Levine and colleagues suspected high blood pressure may play a role in these differences. They examined data from 3,436 people in Birmingham, Ala., Chicago, Minneapolis and Oakland, Calif., who took part in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

The participants were aged 18 to 30 when they enrolled in the study and none of them had high blood pressure. After 20 years of follow-up, high blood pressure had been diagnosed in:

• 37.6 percent of black women, 34.5 percent of black men, 21.4 percent of white men and 12.3 percent of white women.

• 33.6 percent of Birmingham residents, 27.4 percent in Oakland, Calif., 23.4 percent in Chicago and 19 percent in Minneapolis.

After they adjusted for a number of risk factors, the researchers concluded that living in Birmingham significantly increased the risk of developing high blood pressure.

"In addition, independently of where they live, blacks -- especially black women -- are at markedly higher risk of hypertension even after we took into account factors that are known to affect blood pressure, such as physical activity and obesity," Levine, an assistant professor of internal medicine at the University of Michigan Medical School, said in an American Heart Association news release.

Further research is needed to learn more about how race, gender and geography affect high blood pressure risk, she added.

The study appears in the Dec. 6 online issue of the journal Hypertension

Children who have hypertension are much more likely to have learning disabilities than children with normal blood pressure, according to a new University of Rochester Medical Center (URMC) study published this week in the journal, Pediatrics. In fact, when variables such as socio-economic levels are evened out, children with hypertension were four times more likely to have cognitive problems.

"This study also found that children with hypertension are more likely to have ADHD (attention deficit hyperactivity disorder)," said Heather R. Adams, Ph.D., an assistant professor of Neurology and Pediatrics at URMC, and an author of the study. "Although retrospective, this work adds to the growing evidence of an association between hypertension and cognitive function. With 4 percent of children now estimated to have hypertension, the need to understand this potential connection is incredibly important."

Among the study's 201 patients, all of whom had been referred to a pediatric hypertension clinic at URMC's Golisano Children's Hospital, 101 actually had hypertension, or sustained high blood pressure, determined by 24-hour ambulatory monitoring or monitoring by a school nurse or at home. Overall, 18 percent of the children had learning disabilities, well above the general population's rate of 5 percent. But the percentage among those without hypertension was closer to 9 percent, and among those with hypertension, the rate jumped to 28 percent. All of the children were between 10- and 18-years-old, and the children's learning disability and ADHD diagnoses were reported by parents.

This study is part of a series of hypertension studies by Golisano Children's Hospital researchers, led by Principal Investigator Marc Lande, M.D., a pediatric nephrologist, but it was the first that included children with ADHD. Previous studies excluded them because ADHD medications can increase blood pressure. Researchers included them this time because, although it is possible that some of the children's hypertension was caused by medications, it is also possible that the higher rate of ADHD among children with hypertension is a reflection of neurocognitive problems caused by hypertension. Twenty percent of the children with hypertension had ADHD whereas only 7 percent of those without hypertension had ADHD among the study participants. And even when ADHD was factored out of the analyses, there was still a higher rate of learning disabilities in the hypertensive, compared to the non-hypertensive group of children.

"With each study, we're getting closer to understanding the relationship between hypertension and cognitive function in children," Lande said. "And this study underscores the need for us to continue to tease out the potential risk children with hypertension have for learning difficulties at a time when learning is so important. It may be too early to definitively link hypertension and learning disabilities, but it isn't too early for us, as clinicians, to ensure our pediatric patients with hypertension are getting properly screened for cognitive issues."