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Abstract-Adiponectin is one of the key molecules in the metabolic syndrome, and its concentration is decreased in obesity, type-2 diabetes, and coronary artery disease. Genetic investigation has revealed that 2 polymorphisms (I164T and G276T) are related to adiponectin concentration and diabetes. To examine whether adiponectin affects hypertension genetically or biologically, we performed a case-control study. A total of 446 diagnosed cases of hypertension (HT) in men and 312 normotensive (NT) men were enrolled in this study. Plasma adiponectin concentration was measured using an enzyme-linked immunosorbent assay system. Single nucleotide polymorphisms were determined by TaqMan polymerase chain reaction method. After adjustment for confounding factors, adiponectin concentration was significantly lower in HT (HT: 5.2Ϯ0.2 g/mL; NT: 6.1Ϯ0.2 g/mL; PϽ0.001). Furthermore, multiple regression analysis indicated that hypoadiponectinemia was an independent risk factor for hypertension (PϽ0.001). Blood pressure was inversely associated with adiponectin concentration in normotensives regardless of insulin resistance. In subjects carrying the TC genotype of the I164T polymorphism, adiponectin concentration was significantly lower (TC: 2.6Ϯ0.9 g/mL; TT: 5.5Ϯ0.1 g/mL; PϽ0.01), and most of them had hypertension. In contrast, the G276T polymorphism was not associated with adiponectin concentration or hypertension. In conclusion, hypoadiponectinemia is a marker for predisposition to hypertension in men.

Disease-associated SNPs at the 9p21 locus predominantly affect the expression of ANRIL. Overall, our results suggest that several CVD-associated SNPs in the 9p21 locus affect the expression of ANRIL, which, in turn modulate cell growth, possibly via CDKN2A/B regulation.

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Japan 11 Health Promotion Administration, Ministry of Health and Welfare, Taiwan Abstract: The coronavirus disease 2019 (COVID-19) pandemic has casted a huge impact on global public health and economy. In this challenging situation, older people are vulnerable to the infection and the secondary effects of the pandemic and need special attentions. To evaluate the impacts of COVID-19 on older people, it is important to balance the successful pandemic control and active management of secondary consequences. These considerations are especially salient in the Asian context, with its diversity among countries in terms of sociocultural heritage, healthcare setup and availability of resources. Thus, the Asian Working Group for Sarcopenia summarized the considerations of Asian countries focusing on responses and difficulties in each country, impacts of health inequity related to COVID-19 pandemic and proposed recommendations for older people which are germane to the Asian context. More innovative services should be developed to address the increasing demands for new approaches to deliver health care in the difficult times and to establish resilient health care systems for older people.

Abstract-The potential effects of angiotensin II receptor blockers (ARBs) on adipose tissue biology and body weight are of considerable interest, because these agents are frequently used to treat hypertension in patients who are prone to visceral obesity, the metabolic syndrome, and diabetes. In rats fed a high-fat, high-carbohydrate diet, we compared the effects of 2 ARBs, telmisartan and valsartan, on body weight, food intake, energy expenditure, fat accumulation, fat cell size, and hepatic triglyceride levels. Telmisartan, but not valsartan, promoted increases in caloric expenditure and protected against dietary-induced weight gain. In the telmisartan-treated rats, absolute food intake, but not food intake adjusted for body weight, was lower than in valsartan-treated rats or controls. Telmisartan reduced the accumulation of visceral fat and decreased adipocyte size to a much greater extent than valsartan and was also associated with a significant reduction in hepatic triglyceride levels. Moreover, telmisartan, but not valsartan, increased the expression of both nuclear-encoded and mitochondrial-encoded genes in skeletal muscle known to play important roles in mitochondrial energy metabolism. Thus, in addition to a class effect of ARBs in modulating adipocyte size, these findings raise the possibility that certain molecules, like telmisartan, may have a particularly strong impact on fat cell volume and fat accumulation, as well as distinctive effects on energy metabolism, that may help protect against dietary-induced visceral obesity and weight gain. Key Words: liver Ⅲ hypertension, obesity Ⅲ receptors, angiotensin II I n patients with the metabolic syndrome, diabetes, or both, increased visceral fat is believed to play an important role in the pathogenesis of insulin resistance and dyslipidemia. 1 Although surgical removal of subcutaneous abdominal fat may have little or no effect on glucose or lipid metabolism, 2 surgical removal of intra-abdominal visceral fat can improve insulin sensitivity. 3 Moreover, pharmacological treatments that redistribute fat from visceral to subcutaneous depots can also improve insulin resistance and dyslipidemia. For example, thiazolidinedione ligands of the peroxisome proliferatoractivated receptor ␥ (PPAR␥) are thought to improve carbohydrate and lipid metabolism at least in part by promoting the differentiation of small adipocytes that buffer against inappropriate deposition of fat in muscle and visceral tissues and that are more metabolically efficient than large, hypertrophied adipocytes. 4 -6 Given that abdominal obesity and the metabolic syndrome are very common in patients with hypertension, the availability of antihypertensive agents that retard the accumulation of visceral fat, promote the formation of small, metabolically active adipocytes, and attenuate weight gain could be of considerable clinical value.Recently, we and others have discovered that telmisartan, an angiotensin II receptor blocker (ARB) approved for the treatment of hypertension, is also a partial ago...

Excess salt intake is an important environmental risk for the predisposition to essential hypertension. Previous physiological studies have shown that salt sensitivity is associated with insulin resistance, enhancement of sympathetic nerve activity and decrease of blood pressure decline at night. We have been examining the genetic importance of candidate gene polymorphisms of salt-sensitive hypertension using several populations. The angiotensinogen gene (AGT ) is Key Words: genetics, non-dipper, insulin resistance, essential hypertension, lacunar infarctionFrom the Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan. The present study was supported by a Grant-in-Aid from the Japanese Ministry of Health, Labor, and Welfare, Grants-in-Aid for Scientific Research (12557063, 13770349, 13204050, 13670709) herit an aggregate of genes related to hypertension and/or who are exposed to exogenous factors that predispose them to hypertension. Whereas young adults with a familial predisposition to hypertension and those without such a predisposition both show a pressor response to high sodium intake, only the former show a depressor response to a high potassium intake (2). Garay et al. found a defect in the furosemidesensitive Na-K cotransfer mechanism in red cells of patients

Background-Recently, ultrasonic tissue characterization of the composition of plaques has been performed in a quantitative fashion on the basis of integrated backscatter (IBS) analysis, but most of those studies have used high-frequency ultrasound to obtain microscopic images. Methods and Results-We performed B-mode measurement and IBS signal analysis with acoustic densitometry with a 7.5-MHz linear-array transducer in freshly excised human aortas (nϭ58) (normal, atheromatous, and fibrous tissue) obtained at autopsy. Atheromatous and fibrous tissue had a similar intima-media thickness (IMT), but the IBS value in atheromatous specimens was lower than that in fibrous specimens. We further applied this method to human carotid ultrasonography. The subjects were young (80 regions), middle aged with 1 or no coronary risk factors (low risk) (120 regions), middle aged with Ն2 coronary risk factors (high risk) (240 regions), or elderly (80 regions) or were patients with myocardial infarction (MI) with multivessel disease (90 regions). The IMT was similar in middle-aged, elderly, and MI subjects. In contrast, the IBS value was significantly higher in elderly subjects and lower in high-risk middle-aged and MI subjects compared with that in low-risk middle-aged subjects. The percent of regions diagnosed as atheromatous (IBS less than mean minus 2-SD value of IBS in young subjects) was 11% in low-risk middle-aged subjects, 29% in high-risk middle-aged subjects, and 63% in the MI group. Conclusions-In conjunction with conventional B-mode imaging, IBS analysis with carotid ultrasonography appeared to provide prognostic information to identify a high-risk group with systemic atherosclerosis, which could lead to coronary heart disease in individuals with early-stage disease. (Circulation. 2000;102:766-770.)