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Find video protocols related to scientific articles indexed in Pubmed.
Updated national and international hypertension guidelines: a review of current recommendations.
Drugs
PUBLISHED: 10-16-2014
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Despite the availability of effective pharmacological treatments to aid the control of blood pressure, the global rate of uncontrolled blood pressure remains high. As such, further measures are required to improve blood pressure control. Recently, several national and international guidelines for the management of hypertension have been published. These aim to provide easily accessible information for healthcare professionals and patients to aid the diagnosis and treatment of hypertension. In this review, we have compared new and current guidelines from the American and International Societies of Hypertension; the American Heart Association, American College of Cardiology and the US Center for Disease Control and Prevention; the panel appointed to the Eighth Joint National Committee; the European Societies of Hypertension and Cardiology; the French Society of Hypertension; the Canadian Hypertension Education Program; the National Institute for Health and Clinical Excellence (UK); the Taiwan Society of Cardiology and the Chinese Hypertension League. We have identified consensus opinion regarding best practises for the management of hypertension and have highlighted any discrepancies between the recommendations. In general there is good agreement between the guidelines, however, in some areas, such as target blood pressure ranges for the elderly, further trials are required to provide sufficient high-quality evidence to form the basis of recommendations.
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Follow-up of blood-pressure lowering and glucose control in type 2 diabetes.
N. Engl. J. Med.
PUBLISHED: 09-19-2014
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In the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) factorial trial, the combination of perindopril and indapamide reduced mortality among patients with type 2 diabetes, but intensive glucose control, targeting a glycated hemoglobin level of less than 6.5%, did not. We now report results of the 6-year post-trial follow-up.
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Association of variants in KCNK17 gene with ischemic stroke and cerebral hemorrhage in a Chinese population.
J Stroke Cerebrovasc Dis
PUBLISHED: 08-29-2014
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KCNK17 (potassium channel, subfamily K, member17) has a role in the pathogenesis of stroke. We reported previously that rs10947803 single-nucleotide polymorphism (SNP) in KCNK17 is associated with cerebral hemorrhage in a Chinese population. The aim of the present study was to examine other SNPs in the KCNK17 gene that are associated with cerebral hemorrhage and other subtypes of stroke in the Chinese population.
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Association of CVD candidate gene polymorphisms with ischemic stroke and cerebral hemorrhage in Chinese individuals.
PLoS ONE
PUBLISHED: 08-21-2014
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Contribution of cardiovascular disease related genetic risk factors for stroke are not clearly defined. We performed a genetic association study to assess the association of 56 previously characterized gene variants in 34 candidate genes from cardiovascular disease related biological pathways with ischemic stroke and cerebral hemorrhage in a Chinese population.
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Blood pressure and LDL-cholesterol targets for prevention of recurrent strokes and cognitive decline in the hypertensive patient: design of the European Society of Hypertension-Chinese Hypertension League Stroke in Hypertension Optimal Treatment randomized trial.
J. Hypertens.
PUBLISHED: 07-01-2014
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The SBP values to be achieved by antihypertensive therapy in order to maximize reduction of cardiovascular outcomes are unknown; neither is it clear whether in patients with a previous cardiovascular event, the optimal values are lower than in the low-to-moderate risk hypertensive patients, or a more cautious blood pressure (BP) reduction should be obtained. Because of the uncertainty whether 'the lower the better' or the 'J-curve' hypothesis is correct, the European Society of Hypertension and the Chinese Hypertension League have promoted a randomized trial comparing antihypertensive treatment strategies aiming at three different SBP targets in hypertensive patients with a recent stroke or transient ischaemic attack. As the optimal level of low-density lipoprotein cholesterol (LDL-C) level is also unknown in these patients, LDL-C-lowering has been included in the design.
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Blood pressure and low-density lipoprotein-cholesterol lowering for prevention of strokes and cognitive decline: a review of available trial evidence.
J. Hypertens.
PUBLISHED: 07-01-2014
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It is well established by a large number of randomized controlled trials that lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) by drugs are powerful means to reduce stroke incidence, but the optimal BP and LDL-C levels to be achieved are largely uncertain. Concerning BP targets, two hypotheses are being confronted: first, the lower the BP, the better the treatment outcome, and second, the hypothesis that too low BP values are accompanied by a lower benefit and even higher risk. It is also unknown whether BP lowering and LDL-C lowering have additive beneficial effects for the primary and secondary prevention of stroke, and whether these treatments can prevent cognitive decline after stroke.
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Patterns of alcohol consumption and myocardial infarction risk: observations from 52 countries in the INTERHEART case-control study.
Circulation
PUBLISHED: 06-13-2014
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Although moderate alcohol use is associated with protection against myocardial infarction (MI), it is not known whether this effect is generalizable to populations worldwide. It is also uncertain whether differences in the pattern of alcohol use (and in particular heavy episodic consumption) between different regions negate any beneficial effect.
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[An analysis of risk factors for stroke in atrial fibrillation and hypertension patients].
Zhonghua Nei Ke Za Zhi
PUBLISHED: 05-27-2014
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To explore the independent risk factors for the 1 year stroke event in Chinese patients with atrial fibrillation (AF) and hypertension (HT).
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Degree of blood pressure reduction and recurrent stroke: the PROGRESS trial.
J. Neurol. Neurosurg. Psychiatr.
PUBLISHED: 05-14-2014
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There is ongoing controversy regarding a 'J-curve' phenomenon such that low and high blood pressure (BP) levels are associated with increased risks of recurrent stroke. We aimed to determine whether large treatment-related BP reductions are associated with increased risks of recurrent stroke.
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Association between Glutathione S-Transferase T1, M1, and P1 Genotypes and the Risk of Colorectal Cancer.
J. Korean Med. Sci.
PUBLISHED: 04-24-2014
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Glutathione S-transferases (GSTs) are enzymes which play an important role in the neutralization of toxic compounds and eradication of electrophilic carcinogens. Genetic polymorphisms within the genes encoding for GSTs may therefore cause variations in their enzyme activity, which may in turn influence the interindividual susceptibility to cancers. In this study, we aimed to investigate the association between genetic polymorphisms of GSTT1, GSTM1, and GSTP1 and the risk of colorectal cancer (CRC) in 264 cases and 317 controls in a Chinese population. Genotyping was performed by using multiplex PCR (for GSTT1 and GSTM1) and PCR-RFLP (for GSTP1) methods. The association between the polymorphic genotypes and CRC risk was evaluated by deriving odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression analysis. Our results showed that individuals with GSTT1 and GSTM1 null genotypes exhibited a higher risk of CRC (GSTT1, OR,1.66; 95% CI, 1.20-2.31, P=0.003; GSTM1, OR,1.57; 95% CI,1.13-2.18, P=0.007), while no association was observed for GSTP1 (P heterozygous=0.790 or P variant=0.261). Furthermore, individuals who simultaneously carried the null genotypes for both GSTT1 and GSTM1 showed a stronger risk association (OR, 1.95; 95% CI, 1.33-2.85; P<0.001). In conclusion, the GSTT1 and GSTM1 polymorphisms, but not GSTP1, may modulate the CRC risk among Chinese.
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Influence of Tea Consumption on Acute Myocardial Infarction in China Population: The INTERHEART China Study.
Angiology
PUBLISHED: 04-24-2014
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We assessed the association between tea consumption and acute myocardial infarction (AMI) using INTERHEART China data. Cases (n = 2909) and controls (n = 2947) were randomly selected and frequency matched by age and sex. Participants who drank tea ?4 cups/d had a significantly higher risk of AMI than tea nondrinkers; odds ratio (OR) was 1.29 (95% confidence interval [CI]: 1.03-1.61) compared with tea nondrinkers. A similar trend was found in green tea drinkers; OR was 1.52 (95% CI: 1.13-2.05) in the participants who drank 3 cups/d and 1.73 (95% CI: 1.35-2.22) in the participants who drank ?4 cups/d compared with tea nondrinkers. We also found that green tea consumption had a greater effect on females; OR was 2.80 (95% CI: 1.43-5.50) in females. In conclusion, we found that the risk of AMI increases as tea consumption increases. Further studies are needed to confirm this association.
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Prevalence, awareness, treatment, and control of hypertension in china: results from a national survey.
Am. J. Hypertens.
PUBLISHED: 04-03-2014
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Hypertension is one of the major risk factor for cardiovascular disease worldwide. The objective of this study was to investigate the prevalence, awareness, treatment, and control of hypertension in China.
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Aliskiren alone or with other antihypertensives in the elderly with borderline and stage 1 hypertension: the APOLLO trial.
Eur. Heart J.
PUBLISHED: 03-09-2014
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We studied the unclear question whether blood pressure (BP) lowering reduces cardiovascular disease (CVD) in elderly individuals with systolic BP <160 mm Hg.
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Efficacy and safety of valsartan/amlodipine single-pill combination in 11,422 Chinese patients with hypertension: an observational study.
Adv Ther
PUBLISHED: 02-25-2014
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Single-pill combination (SPC) therapy of two drugs is recommended by international guidelines, including the Chinese guidelines (2010), for the treatment of hypertension in high-risk patients who require marked blood pressure (BP) reductions. Real-world data on the efficacy and safety of valsartan/amlodipine (Val/Aml) SPC are scarce. The present study is the first observational study in China to evaluate the efficacy (primary endpoint) and safety of Val/Aml (80/5 mg) SPC in Chinese patients with hypertension whose BP was not adequately controlled by monotherapy in a real-world setting.
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Sleep duration, snoring habits and risk of acute myocardial infarction in China population: results of the INTERHEART study.
BMC Public Health
PUBLISHED: 01-28-2014
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Less sleep time and snoring have been associated with cardiovascular disease (CVD) risk in Western populations; however, few studies have evaluated the different aspects of sleep duration and snoring frequency in relation to CVD, and this association has not been examined in China. The present study aimed to address the relation between sleep duration, snoring frequency and risk of acute myocardial infarction (AMI) in China population.
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Predicting Hyperhomocysteinemia by Methylenetetrahydrofolate Reductase C677T Polymorphism in Chinese Patients With Hypertension.
Clin. Appl. Thromb. Hemost.
PUBLISHED: 01-25-2014
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Objective: To evaluate the performance of methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism in predicting hyperhomocysteinemia (HHcy) in Chinese patients with hypertension. Methods: We measured plasma total homocysteine tHcy level and C677T genotype in 1058 Chinese patients with hypertension from 4 previous studies. We used 10, 15, and 20 ?mol/L as cutoff values for the definition of mild, modest, and severe HHcy, respectively. Logistic models for HHcy were built from the study sample using the C677T genotype as well as age and gender as predictors. The receiver-operating characteristics of the models were evaluated. Results: Our major findings are that (1) C677T TT genotype is consistently associated with a higher tHcy across the 4 studies, with an increase in size ranging from 38% to 68% in the 4 studies and 51% overall. The C677T polymorphism independently explained about 14% of the total variance of the normalized tHcy. (2) The TT genotype is associated with a large increase in odds ratio (OR) for HHcy. Overall, the multivariate-adjusted ORs for the TT genotype are 3.9 (95% confidence interval [CI]: 2.4-6.4), 6.5 (95% CI: 4.0-10.6), and 17.9 (95% CI: 8.4-38.1) for mild, modest, and severe HHcy, respectively. (3) Overall, the predicting performance increased with HHcy severity, with sensitivity improving from 31.0% for mild HHcy to 70.3% for severe HHcy, and with specificity slightly decreasing from 85.4% to 80.3%. Inclusion of gender and age as predictors significantly improves the sensitivity, especially for predicting mild HHcy. Conclusion: With an excellent sensitivity and a modest specificity, C677T could be a useful screening marker for severe HHcy.
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The International Society of Hypertension and World Hypertension League call on governments, nongovernmental organizations and the food industry to work to reduce dietary sodium.
J. Hypertens.
PUBLISHED: 01-17-2014
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The International Society of Hypertension and the World Hypertension League have developed a policy statement calling for reducing dietary salt. The policy supports the WHO and the United Nations recommendations, which are based on a comprehensive and up-to-date review of relevant research. The policy statement calls for broad societal action to reduce dietary salt, thus reducing blood pressure and preventing hypertension and its related burden of cardiovascular disease. The hypertension organizations and experts need to become more engaged in the efforts to prevent hypertension and to advocate strongly to have dietary salt reduction policies implemented. The statement is being circulated to national hypertension organizations and to international nongovernmental health organizations for consideration of endorsement. Member organizations of the International Society of Hypertension and the World Hypertension League are urged to support this effort.
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Association of functional FEN1 genetic variants and haplotypes and breast cancer risk.
Gene
PUBLISHED: 01-08-2014
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As a tumor suppressor, FEN1 plays an essential role in preventing tumorigenesis. Two functional germline variants (-69G>A and 4150G>T) in the FEN1 gene have been associated with DNA damage levels in coke-oven workers and multiple cancer risk in general populations. However, it is still unknown how these genetic variants are involved in breast cancer susceptibility.
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Genetic variants associated with myocardial infarction and the risk factors in Chinese population.
PLoS ONE
PUBLISHED: 01-01-2014
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Recent genome-wide association (GWA) studies in Caucasians identified multiple single nucleotide polymorphisms (SNPs) associated with coronary artery disease (CAD). The associations of those SNPs with myocardial infarction (MI) have not been replicated in Asian populations. Among those previously identified SNPs, we selected nine (rs10953541, rs1122608, rs12190287, rs12413409, rs1412444, rs1746048, rs3798220, rs4977574, rs579459, in or near genes 7q22, LDLR, TCF21, CYP17A1, LIPA, CXCL12, LPA, CDKN2A, ABO, respectively) because of the relatively high minor allele frequencies in Chinese individuals and tested the associations of the SNPs with MI and MI related risk factors in Chinese population.
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Linear equations method for modal decomposition using intensity information.
J Opt Soc Am A Opt Image Sci Vis
PUBLISHED: 12-11-2013
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The linear equations method is proposed to calculate the complete modal content of the partially coherent laser beam using only the intensity information. This method could give not only the incoherent expansion coefficients of the modal decomposition but also the cross-correlation expansion coefficients using the intensity profiles in several planes of finite distance along the propagation direction. A simulation is also presented to verify the validity of this theory. In our algorithm, the minimum and maximum mode orders should be known a priori, so we provide an estimation method for the two parameters.
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Newly diagnosed and previously known diabetes mellitus and short-term outcomes in patients with acute myocardial infarction.
Coron. Artery Dis.
PUBLISHED: 11-12-2013
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The prognostic value of diabetes mellitus (DM) on the long-term outcomes of patients after myocardial infarction has been well established. The correlation between DM, including newly diagnosed DM, and short-term outcomes needs to be validated.
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Hypertension control in community health centers across china: analysis of antihypertensive drug treatment patterns.
Am. J. Hypertens.
PUBLISHED: 10-09-2013
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Blood pressure (BP) control in China is generally poor. It is assumed that an important cause of this unsatisfactory situation is the present standard of care provided by primary care physicians.
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Hemoglobin A1c and short-term outcomes in patients with acute myocardial infarction undergoing primary angioplasty: an observational multicenter study.
Coron. Artery Dis.
PUBLISHED: 05-23-2013
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Several studies to date have examined whether admission levels of hemoglobin A1c (HbA1c) correlate with short-term and long-term outcomes in patients with acute myocardial infarction treated with primary percutaneous coronary intervention (PCI). However, the results have been ambiguous. We speculated that admission levels of HbA1c correlate with short-term outcomes of patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI.
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Prediabetes and Short-Term Outcomes in Nondiabetic Patients after Acute ST-Elevation Myocardial Infarction.
Cardiology
PUBLISHED: 05-02-2013
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Objectives: A prediabetic state is defined as the time period before the development of symptomatic diabetes. Limited evidence is available for evaluating the correlation between prediabetes and short-term outcomes in nondiabetic patients with ST-elevation of myocardial infarction (STEMI). Methods: 4,787 nondiabetic patients with a diagnosis of STEMI based on typical onset of chest pain within 12 h were enrolled. Patients were followed up for 7 and 30 days after hospital admission. According to the 2013 Standards of Medical Care in Diabetes, the study population was stratified into three groups: normal, prediabetic and newly diagnosed diabetic patients. The primary outcomes of our study were all-cause mortality and major adverse cardiac events (MACE) on days 7 day and 30. Results: The proportions of patients with prediabetes and newly diagnosed diabetes were 31.1 and 19.2%, respectively. Rates of 7- and 30-day mortality and MACE were similar among the different HbA1c groups. Multivariable Cox regression analysis showed that compared with normal glucose metabolism, prediabetes (hazard ratio, HR, 1.003; 95% CI, 0.865-1.165) and newly diagnosed diabetes (HR, 0.887; 95% CI, 0.739-1.064) were not correlated with 30-day MACE. However, admission glucose was an independent predictor of short-term MACE (HR, 1.031; 95% CI, 1.017-1.046). Conclusions: In nondiabetic patients after STEMI, the incidence of latent diabetes mellitus was increased. Newly diagnosed diabetes and prediabetes were not correlated with short-term outcome in nondiabetic patients with STEMI, yet admission glucose level was an independent predictor of short-term MACE. To reduce the incidence of short-term MACE after STEMI, more attention should be paid to the control of increased glucose levels and intrinsic stress states. © 2013 S. Karger AG, Basel.
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Functional polymorphisms in FAS and FASL contribute to risk of squamous cell carcinoma of the larynx and hypopharynx in a Chinese population.
Gene
PUBLISHED: 04-01-2013
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Accumulating evidences indicate that the functional FAS-1377G>A, -670A>G and FASL-844T>C polymorphisms affect the risk of several kinds of cancers. However, their roles in the development of larynx and hypopharynx squamous cell carcinoma (SCC) were still unknown in the Chinese. In the current study, we examined whether these functional genetic variants were associated with the risk of larynx and hypopharynx squamous SCC in a Han Chinese population. The FAS and FASL polymorphisms were genotyped in 300 patients with laryngeal and hypopharyngeal SCC and 300 control subjects by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Logistic regression analysis revealed that subjects carrying the FASL-844CT or TT genotype had a significantly decreased risk of developing laryngeal and hypopharyngeal SCC [odds ratio (OR)=0.69; 95% confidence interval (CI)=0.51-0.93; P=0.016; or, OR=0.41; 95% CI=0.20-0.86; P=0.009] compared with those carrying the CC genotype. Joint gene-smoking and gene-drinking effects were also observed, with the OR of CC genotype for smokers or drinkers were 5.15 (95%CI=3.24-8.97) or 12.52 (95%CI=7.31-22.47), respectively. Therefore, the FASL-844T>C polymorphism is associated with genetic susceptibility of developing laryngeal and hypopharyngeal SCC in a Han Chinese population.
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Common genetic variants of the human uromodulin gene regulate transcription and predict plasma uric acid levels.
Kidney Int.
PUBLISHED: 01-23-2013
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Uromodulin (UMOD) genetic variants cause familial juvenile hyperuricemic nephropathy, characterized by hyperuricemia with decreased renal excretion of UMOD and uric acid, suggesting a role for UMOD in the regulation of plasma uric acid. To determine this, we screened common variants across the UMOD locus in one community-based Chinese population of 1000 individuals and the other population from 642 American twins and siblings of European and Hispanic ancestry. Transcriptional activity of promoter variants was estimated in luciferase reporter plasmids transfected into HEK-293 cells and mIMCD3 cells. In the primary Chinese population, we found that carriers of the GCC haplotype had higher plasma uric acid, and three promoter variants were associated with plasma uric acid. UMOD promoter variants displayed reciprocal effects on urine uric acid excretion and plasma uric acid concentration, suggesting a primary effect on renal tubular handling of urate. These UMOD genetic marker-on-trait associations for uric acid were replicated in the independent American cohort. Site-directed mutagenesis at trait-associated UMOD promoter variants altered promoter activity in transfected luciferase reporter plasmids. Thus, UMOD promoter variants seem to initiate a cascade of transcriptional and biochemical changes influencing UMOD secretion, leading to altered plasma uric acid levels.
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The rs10947803 SNP of KCNK17 is associated with cerebral hemorrhage but not ischemic stroke in a Chinese population.
Neurosci. Lett.
PUBLISHED: 01-16-2013
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KCNK17 (potassium channel, subfamily K, member17) was first discovered to associate with the pathogenesis of ischemic stroke in the first genome-wide association study. The rs10947803 SNP in KCNK17 is significantly associated with ischemic stroke in Caucasian populations. The aim of the present study was to investigate the association with strokes in the Chinese population. A total of 1364 stroke patients and 1293 controls were examined using a case-control methodology. The rs10947803 SNP in KCNK17 was genotyped by a TaqMan real-time PCR assay. The rs10947803 SNP (A allele) of KCNK17 was significantly associated with cerebral hemorrhage (for AA+AC versus CC, unadjusted odds ratio [OR]=1.70; 95% confidence interval [CI], 1.08-2.69; P=0.020). After adjustment for age and sex, the association remained significant for AA+AC versus CC, OR=1.65; 95% CI, 1.04-2.62; P=0.033. In addition, the rs10947803 SNP in KCNK17 was not associated with ischemic stroke (for AA+AC versus CC, unadjusted OR=0.92; 95% CI, 0.81-1.05; P=0.212, after age- and sex-adjustment, OR=0.87; 95% CI, 0.72-1.05; P=0.143). The rs10947803 SNP (A allele) in KCNK17 increases the risk of cerebral hemorrhage but not ischemic stroke in the Chinese population.
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Physical Activity Levels, Sport Activities, and Risk of Acute Myocardial Infarction: Results of the INTERHEART Study in China.
Angiology
PUBLISHED: 01-16-2013
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Physical activity (PA) during leisure time has been inversely associated with cardiovascular disease risk in the Western populations. We evaluated PA at work and leisure time in relation to acute myocardial infarction (AMI) in Chinese population. We conducted a hospital-based case-control study. The cases had first AMI (n = 2909). The controls (n = 2947) were matched to the cases in age and sex. The odds ratios (ORs) of leisure-time PA for strenuous exercise compared to mainly sedentary was 0.74 (95% confidence interval [CI]: 0.61-0.90) and for moderate exercise it was 0.96 (95% CI: 0.85-1.08). Multivariate adjustment did not substantially alter the association. The ORs of work-related PA for heavy PA compared to mainly sedentary was 1.44 (95% CI: 1.06-1.94), for climbing and lifting was 1.00 (95% CI: 0.77-.30), and for walking was 0.90 (95%CI: 0.75-1.07). Leisure-time PA was protective for AMI risk compared to sedentary lifestyles in a population in China.
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A systematic comparison of the properties of clinically used angiotensin II type 1 receptor antagonists.
Pharmacol. Rev.
PUBLISHED: 01-01-2013
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Angiotensin II type 1 receptor antagonists (ARBs) have become an important drug class in the treatment of hypertension and heart failure and the protection from diabetic nephropathy. Eight ARBs are clinically available [azilsartan, candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan]. Azilsartan (in some countries), candesartan, and olmesartan are orally administered as prodrugs, whereas the blocking action of some is mediated through active metabolites. On the basis of their chemical structures, ARBs use different binding pockets in the receptor, which are associated with differences in dissociation times and, in most cases, apparently insurmountable antagonism. The physicochemical differences between ARBs also manifest in different tissue penetration, including passage through the blood-brain barrier. Differences in binding mode and tissue penetration are also associated with differences in pharmacokinetic profile, particularly duration of action. Although generally highly specific for angiotensin II type 1 receptors, some ARBs, particularly telmisartan, are partial agonists at peroxisome proliferator-activated receptor-?. All of these properties are comprehensively reviewed in this article. Although there is general consensus that a continuous receptor blockade over a 24-hour period is desirable, the clinical relevance of other pharmacological differences between individual ARBs remains to be assessed.
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The association between plasma uric acid and renal function decline in a Chinese population-based cohort.
Nephrol. Dial. Transplant.
PUBLISHED: 10-24-2011
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Uric acid may be associated with kidney damage through multiple pathways. Previous cohort studies revealed inconsistent results, and research among the non-hypertensive and non-diabetic population are extremely limited.
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Does glycemic control offer similar benefits among patients with diabetes in different regions of the world? Results from the ADVANCE trial.
Diabetes Care
PUBLISHED: 10-04-2011
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Participants in ADVANCE were drawn from many countries. We examined whether the effects of intensive glycemic control on major outcomes in ADVANCE differ between participants from Asia, established market economies (EMEs), and eastern Europe.
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Blood pressure targets recommended by guidelines and incidence of cardiovascular and renal events in the Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET).
Circulation
PUBLISHED: 09-26-2011
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Hypertension treatment guidelines recommend that blood pressure (BP) be lowered to <140/90 mm Hg, but that a reduction to <130/80 mm Hg be adopted in patients at high cardiovascular (CV) risk. We investigated the CV and renal benefits associated with these BP targets in the high-CV-risk population of the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET).
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Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey.
Lancet
PUBLISHED: 08-26-2011
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Although most cardiovascular disease occurs in low-income and middle-income countries, little is known about the use of effective secondary prevention medications in these communities. We aimed to assess use of proven effective secondary preventive drugs (antiplatelet drugs, ? blockers, angiotensin-converting-enzyme [ACE] inhibitors or angiotensin-receptor blockers [ARBs], and statins) in individuals with a history of coronary heart disease or stroke.
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Is a systolic blood pressure target <140 mmHg indicated in all hypertensives? Subgroup analyses of findings from the randomized FEVER trial.
Eur. Heart J.
PUBLISHED: 02-22-2011
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Major guidelines recommend lowering systolic blood pressure (SBP) to <140 mmHg in all hypertensives, but evidence is missing whether this is beneficial in (i) uncomplicated hypertensives, (ii) grade 1 hypertensives, and (iii) elderly hypertensives. Providing this missing evidence is important to justify efforts and costs of aggressive therapy in all hypertensives.
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Mortality and renal function decline among a community-based Chinese population with normal or mildly impaired renal function.
Nephrol. Dial. Transplant.
PUBLISHED: 02-01-2011
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Longitudinal studies of the mortality and renal outcomes among the population with an estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m(2) and among the elderly are limited, especially in developing countries.
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The effect of chromosome 9p21 variants on cardiovascular disease may be modified by dietary intake: evidence from a case/control and a prospective study.
PLoS Med.
PUBLISHED: 01-11-2011
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One of the most robust genetic associations for cardiovascular disease (CVD) is the Chromosome 9p21 region. However, the interaction of this locus with environmental factors has not been extensively explored. We investigated the association of 9p21 with myocardial infarction (MI) in individuals of different ethnicities, and tested for an interaction with environmental factors.
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World Health Organization definition of myocardial infarction: 2008-09 revision.
Int J Epidemiol
PUBLISHED: 10-05-2010
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WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s.
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Effects of individual risk factors on the residual risk of cardiovascular events in a population of treated Chinese patients with hypertension: data from the Felodipine Event Reduction (FEVER) study.
J. Hypertens.
PUBLISHED: 07-14-2010
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The added cardiovascular risk conferred by risk factors or diseases accompanying hypertension has been investigated in Caucasian patients, and much less is known in Chinese patients. Furthermore, the residual risk persisting in hypertensive patients, despite blood pressure (BP) reduction, due to accompanying conditions has never been explored in Chinese, and whether they differ from Caucasians under this respect is unknown.
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The common rs9939609 variant of the fat mass and obesity-associated gene is associated with obesity risk in children and adolescents of Beijing, China.
BMC Med. Genet.
PUBLISHED: 07-05-2010
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Previous genome-wide association studies for type 2 diabetes susceptibility genes have confirmed that a common variant, rs9939609, in the fat mass and obesity associated (FTO) gene region is associated with body mass index (BMI) in European children and adults. A significant association of the same risk allele has been described in Asian adult populations, but the results are conflicting. In addition, no replication studies have been conducted in children and adolescents of Asian ancestry.
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The effect of treatment based on a diuretic (indapamide) +/- ACE inhibitor (perindopril) on fractures in the Hypertension in the Very Elderly Trial (HYVET).
Age Ageing
PUBLISHED: 06-23-2010
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fractures may have serious implications in an elderly individual, and fracture prevention may include a careful choice of medications.
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Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study.
Lancet
PUBLISHED: 06-17-2010
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The contribution of various risk factors to the burden of stroke worldwide is unknown, particularly in countries of low and middle income. We aimed to establish the association of known and emerging risk factors with stroke and its primary subtypes, assess the contribution of these risk factors to the burden of stroke, and explore the differences between risk factors for stroke and myocardial infarction.
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Efficacy and safety of routine blood pressure lowering in older patients with diabetes: results from the ADVANCE trial.
J. Hypertens.
PUBLISHED: 05-21-2010
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The efficacy and safety of blood pressure lowering in elderly patients have not been sufficiently investigated in patients with diabetes. Using data from the Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation study, we assessed the efficacy and safety of routine blood pressure lowering to prevent major clinical outcomes in elderly patients with type 2 diabetes.
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Magnetic Properties of Ni-doped ZnO Nanocombs by CVD Approach.
Nanoscale Res Lett
PUBLISHED: 04-15-2010
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The search for above room temperature ferromagnetism in dilute magnetic semiconductors has been intense in recent year. Arrays of perpendicular ferromagnetic nanowire/rods have recently attracted considerable interest for their potential use in many areas of advanced nanotechnology. We report a simple low-temperature chemical vapor deposition (CVD) to create self-assembled comb-like Ni-/undoped ZnO nanostructure arrays. The phases, compositions, and physical properties of the studied samples were analyzed by different techniques, including high-resolution X-ray diffraction/photoelectron spectroscopy/transmission electron microscopy, photoluminescence, and MPMS. In particular, the Ni-doped ZnO nanocombs (NCs) with ferromagnetic and superparamagnetic properties have been observed whereas undoped ZnO NCs disappear. The corresponding ferromagnetic source mechanism is discussed, in which defects such as O vacancies would play an important role.
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Level of kidney function correlates with cognitive decline.
Am. J. Nephrol.
PUBLISHED: 03-28-2010
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Early stage chronic kidney disease has been related to cognitive decline recently, while the association between them has never been explored in a Chinese population.
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In a subgroup of high-risk Asians, telmisartan was non-inferior to ramipril and better tolerated in the prevention of cardiovascular events.
PLoS ONE
PUBLISHED: 03-18-2010
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Results of the recently published ONTARGET study (The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial) showed that telmisartan (80 mg/day) was non-inferior to ramipril (10 mg/day) in reducing cardiovascular events. Clinicians in Asia doubt tolerability of these doses for their patients. We therefore analyzed data from this study and a parallel study TRANSCEND (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease). Our objectives were to compare Asians and non-Asians with respect to the following: 1) Effectiveness of telmisartan vs. ramipril in reducing cardiovascular events;2) Proportions who reached the full dose of telmisartan, ramipril or placebo; and3) Proportions of overall discontinuations, and discontinuations due to adverse effects.
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Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtoler
Circulation
PUBLISHED: 03-15-2010
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Although erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive of future events in individuals with cardiovascular disease. We evaluated whether ED is predictive of mortality and cardiovascular outcomes, and because inhibition of the renin-angiotensin system in high-risk patients reduces cardiovascular events, we also tested the effects on ED of randomized treatments with telmisartan, ramipril, and the combination of the 2 drugs (ONTARGET), as well as with telmisartan or placebo in patients who were intolerant of angiotensin-converting enzyme inhibitors (TRANSCEND).
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Differential clinical outcomes associated with hypoglycemia and hyperglycemia in acute myocardial infarction.
Circulation
PUBLISHED: 11-30-2009
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In patients with acute myocardial infarction (AMI), hyperglycemia predicts death, but the prognostic significance of hypoglycemia is controversial.
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Blood pressure reduction for the secondary prevention of stroke: a Chinese trial and a systematic review of the literature.
Hypertens. Res.
PUBLISHED: 10-02-2009
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We assessed, in a double-blind, placebo-controlled trial, whether lowering blood pressure (BP) prevents the recurrence of stroke in Chinese patients with cerebrovascular disease. Patients were randomized into two groups: 2825 patients received a placebo and 2840 patients received 2.5 mg of indapamide daily. The primary and secondary outcomes were the recurrence of fatal or nonfatal stroke and major fatal and nonfatal cardiovascular events, respectively. The average systolic/diastolic BP at randomization was 153.8/92.8 mm Hg. At median follow-up (2 years), BP was, on an average, 6.8/3.3 mm Hg lower in patients on active treatment. In total, 143 patients on indapamide and 219 patients on placebo had recurrent strokes (hazard ratio for indapamide, 0.69; 95% confidence interval (CI): 0.54-0.89; P<0.001). In addition, 199 patients on indapamide and 258 patients on placebo had a cardiovascular event (hazard ratio, 0.75; 95% CI: 0.89-0.62; P=0.002). We performed a systematic review of literature that included our new results. Across 10 trials, the odds ratio for the prevention of stroke recurrence by BP lowering was 0.78 (95% CI: 0.68-0.90; P=0.0007). The pooled odds ratio was 0.63 (95% CI: 0.54-0.73; P<0.0001) for trials involving diuretics as a component of therapy and 0.93 (95% CI: 0.87-1.01; P=0.086) for trials in which treatment included renin system inhibitors (P<0.0001 for heterogeneity). The weighted correlation between the odds for stroke recurrence and the reduction in systolic BP was -0.57 (P=0.067). In conclusion, BP lowering by indapamide treatment reduced the recurrence of stroke and the incidence of cardiovascular events in Chinese patients with cerebrovascular disease. Whether prevention of stroke recurrence depends on drug class, degree of BP lowering or both requires further investigation.
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Association of two CETP polymorphisms with HDL levels in the Chinese obese population.
Obesity (Silver Spring)
PUBLISHED: 05-14-2009
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The association of two cholesterol ester transfer protein (CETP) polymorphisms, D442G and TAQIB (B1-->B2), with high-density lipoprotein (HDL) levels in 932 Chinese obese individuals (BMI >or= 27) was investigated in comparison with normal controls (BMI
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Baseline characteristics of participants in the Hypertension in the Very Elderly Trial (HYVET).
Blood Press.
PUBLISHED: 04-09-2009
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The Hypertension in the Very Elderly Trial (HYVET) is a randomized double-blind trial of active antihypertensive treatment (indapamide 1.5 mg sustained release +/-2-4 mg perindopril) vs placebo in participants over the age of 80 years with a systolic blood pressure (SBP) of 160-199 mmHg during a placebo run-in period plus a diastolic blood pressure (DBP) of<110 mmHg. The trial has completed with 3845 subjects randomized and we report the baseline characteristics. The participants were a healthy group. The numbers smoking, drinking alcohol and having previous cardiovascular events were low, and their hypertensive status was not usually associated with the metabolic syndrome; 1.0% of the whole group had a total cholesterol over 8.0 mmol/l, 1.1% a blood sugar over 11.1 mmol/l (irrespective of anti-diabetic treatment) and 1.7% a serum urate over 460 micromol/l (women) and 0.6% over 520 micromol/l (men). A serum creatinine over 150 micromol/l excluded participants from the trial. The gender differences and age comparisons were as expected but the women had higher average total and high-density-lipoprotein-cholesterol blood concentrations. Those with prior cardiovascular disease had an excess of the known cardiovascular risk factors. The baseline characteristics provide a basis for further understanding of the HYVET results, which have been published recently.
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TAQIB and I405V polymorphisms of CETP are moderately associated with obesity risk in the Chinese adult population.
Acta Diabetol
PUBLISHED: 03-24-2009
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Associations between the TAQIB and I405V polymorphisms and obesity risk were studied for a single locus as well as in combination. A total of 934 obese subjects and 924 normal controls were included in the study. TAQIB was associated with high-density lipoprotein (HDL) levels (P < 0.001), while I405V was associated with levels of low-density lipoprotein (P = 0.03) and total cholesterol (P = 0.007). Less common alleles of TAQIB and I405V were associated with decreased obesity risk and further drops in odds ratio (OR) were observed in carriers with rare homozygous alleles on both loci (OR = 0.659, P = 0.02). The TAQIB B2 allele was associated with reductions in both hip circumference (P = 0.034) and triceps skinfold thickness (TST) (P = 0.045), although this effect was completely abolished after controlling for HDL levels. The 405V variant was associated with reductions in hip circumference (P = 0.031), body fat composition (P = 0.039) and TST (P = 0.036); these effects were weakened (P < 0.1) after controlling for HDL levels. In conclusion, less common alleles of TAQIB and I405V appear to be modestly associated with obesity risk in an adult Chinese population. Adjustments for HDL levels completely (TAQIB) or partially (I405V) abolished the observed association.
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Enhanced thermoelectric performance in barium and indium double-filled skutterudite bulk materials via orbital hybridization induced by indium filler.
J. Am. Chem. Soc.
PUBLISHED: 02-28-2009
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Maximizing the thermoelectric figure-of-merit (ZT) is a challenge owing to the conflicting combination of material properties. We explored simultaneously enhancing the power factor and reducing the thermal conductivity through filling In in Ba-filled skutterudite (Ba(0.3)Co(4)Sb(12)). Two large ZT values of 1.33 and 1.34 have been achieved for Ba(0.15)In(0.16)Co(4)Sb(11.83) and Ba(0.14)In(0.23)Co(4)Sb(11.84) at 850 K, respectively. The excellent thermoelectric transport properties for Ba(r)In(s)Co(4)Sb(12) are supposed to be due to the orbital hybridizations induced by In filler. It was found that the In filler made the [Sb(4)](4-) rings become bigger and squarer because of an electron transition from Sb to In brought out by the orbital hybridization between In and Sb and that the Ba filler caused the [Sb(4)](4-) rings to get smaller and squarer because of a reverse electron transition from Ba to Sb induced by a large difference in electronegativities between Ba and Sb. A model of how to form the rectangular [Sb(4)](4-) ring is presented, and the five chemical states of Sb in CoSb(3) are reasonably assigned to different chemical bonds in the model.
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Glucose levels compared with diabetes history in the risk assessment of patients with acute myocardial infarction.
Am. Heart J.
PUBLISHED: 02-20-2009
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Both a history of diabetes mellitus and elevated inhospital glucose levels predict death after acute myocardial infarction (AMI). However, only diabetes history (and not glucose levels) is routinely considered in AMI risk assessment.
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The functional variant rs1048990 in PSMA6 is associated with susceptibility to myocardial infarction in a Chinese population.
Atherosclerosis
PUBLISHED: 01-22-2009
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A recent case-control study reported that a functional single nucleotide polymorphism (SNP) in the proteasome subunit alpha type 6 gene (PSMA6) (rs1048990, C/G) was associated with susceptibility to myocardial infarction (MI) in the Japanese population. Replication studies have been performed in European and other Japanese study samples, but the results were not conclusive. The purpose of the present study was to determine whether this locus confers significant susceptibility to MI in a Chinese population. We conducted a case-control association study on a cohort of 1884 MI patients and 2643 unrelated controls from the Chinese population. Genotyping of the rs1048990 SNP was performed by the Allele-specific Real Time PCR method. We found that rs1048990 was significantly associated with MI (adjusted for age and sex, odds ratio 1.22, p=0.000005, allele frequency model; odds ratio 1.44, p=0.0000025; recessive model; odds ratio 1.56, p=0.00000048, additive model). A meta-analysis yielded a combined OR for MI of 1.15 (95% CI: 1.11-1.21) with an allele frequency model, 1.37 (95% CI: 1.23-1.51) with a recessive model and 1.44 (95% CI: 1.29-1.60) with an additive model. There was no relationship between rs1048990 and age, sex or other conventional cardiovascular risk factors. Our results indicate that the PSMA6 variant rs1048990 is a risk factor of myocardial infarction in the Chinese population.
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A meta-analysis of candidate gene polymorphisms and ischemic stroke in 6 study populations: association of lymphotoxin-alpha in nonhypertensive patients.
Stroke
PUBLISHED: 01-08-2009
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Ischemic stroke is a multifactorial disease with a strong genetic component. Pathways, including lipid metabolism, systemic chronic inflammation, coagulation, blood pressure regulation, and cellular adhesion, have been implicated in stroke pathophysiology, and candidate gene polymorphisms in these pathways have been proposed as genetic risk factors.
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Higher cardiovascular risk and impaired benefit of antihypertensive treatment in hypertensive patients requiring additional drugs on top of randomized therapy: is adding drugs always beneficial?
J. Hypertens.
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In antihypertensive treatment trials, when randomized therapies do not reach target, additional drugs are administered. However, patients requiring (add-on) or not requiring add-on therapy (no-add-on) may be at different cardiovascular risk and differently susceptible to benefits of antihypertensive treatment.
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Are fixed-dose combination antihypertensives suitable as first-line therapy?
Curr Med Res Opin
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To contemplate how initial antihypertensive therapy with fixed-dose combinations (FDC) might be incorporated into clinical practice, based on a compilation of evidence comparing FDCs with monotherapy and loose-dose combinations in varying patient populations.
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Methylenetetrahydrofolate reductase C677T polymorphism is associated with estimated glomerular filtration rate in hypertensive Chinese males.
BMC Med. Genet.
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Plasma level of total homocysteine (tHcy) is negatively correlated with kidney function in general population. However, the causal mechanism of this correlation is poorly understood. The purpose of this study is to investigate the association of methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, which is a major genetic determinant of the plasma tHcy level, with estimated glomerular filtration rate (eGFR) in Chinese.
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Prevalence of hyperhomocysteinaemia and its major determinants in rural Chinese hypertensive patients aged 45-75 years.
Br. J. Nutr.
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We aimed to investigate the prevalence of hyperhomocysteinaemia (total plasma homocysteine (tHcy) ? 10 ?mol/l) and its major determinants in rural Chinese hypertensive patients. A cross-sectional investigation was carried out in Lianyungang of Jiangsu province, China. This analysis included 13 946 hypertensive adults. The prevalence of hyperhomocysteinaemia was 51.6 % (42.7 % in women and 65.6 % in men). The OR of hyperhomocysteinaemia were 1.52 (95 % CI 1.39, 1.67) and 2.32 (95 % CI 2.07, 2.61) for participants aged 55-65 and 65-75 v. 45-55 years; 1.27 (95 % CI 1.18, 1.37) for participants with a BMI ? 25 v. < 25 kg/m²; 1.14 (95 % CI 1.06, 1.23) for participants with v. without antihypertensive treatment; 1.09 (95 % CI 1.00, 1.18) for residents inland v. coastal; 0.89 (95 % CI 0.82, 0.97) and 0.83 (95 % CI 0.74, 0.92) for participants with moderate and high v. low physical activity levels; 1.54 (95 % CI 1.41, 1.68) and 2.47 (95 % CI 2.17, 2.81) for participants with a glomerular filtration rate 60-90 and < 60 v. ? 90 ml/min per 1.73 m²; and 1.20 (95 % CI 1.07, 1.35) and 3.81 (95 % CI 3.33, 4.36) for participants with CT and TT v. CC genotype at methylenetetrahydrofolate reductase 677C>T polymorphism, respectively. Furthermore, higher tHcy concentrations were observed in smokers of both sexes (men: geometric mean 12.1 (interquartile range (IQR) 9.2-14.5) v. 11.9 (IQR 9.-14.) ?mol/l, P= 0.005; women: geometric mean 10·3 (IQR 8.3-13.0) v. 9.6 (IQR 7.8-11.6) ?mol/l, P= 0.010), and only in males with hypertension grade 3 (v. grade 1 or controlled blood pressure) (geometric mean 12.1 (IQR 9.2-14.4) v. 11.7 (IQR 9.2-14.0), P= 0.016) and in male non-drinkers (yes v. no) (geometric mean 12.3 (IQR 9.4-14.8) v. 11.7 (IQR 9.1-13.9), P= 0.014). In conclusion, there was a high prevalence of hyperhomocysteinaemia in Chinese hypertensive adults, particularly in the inlanders, who may benefit greatly from tHcy-lowering strategies, such as folic acid supplementation and lifestyle change.
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The association between changes in urinary albumin-to-creatinine ratio and risk of abnormal ankle-brachial index in a community-based Chinese population.
J. Atheroscler. Thromb.
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To investigate the prospective association between changes in the urinary albumin-creatinine ratio (ACR) and abnormal ankle-brachial index (ABI) in a community-based Chinese population.
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