Hypertension is a public health concern that needs immediate attention upon diagnosis. The demand for natural alternatives is on the rise; Hibiscus sabdariffa and Olea europaea are traditionally used for hypertension management in Egypt. In this study, we aimed to investigate the antihypertensive efficacy and safety of two doses of an herbal product of Hibiscus sabdariffa calyxes and Olea europaea leaves (NW Roselle) in Egyptian patients with grade 1 essential hypertension. We equally randomized 134 patients to receive captopril 25 mg, low‐dose NW Roselle, or high‐dose NW Roselle BID for 8 weeks. No significant decrease was found in systolic blood pressure or diastolic blood pressure when we compared low‐dose NW Roselle and high‐dose NW Roselle to captopril (p > .05). In all groups, mean reduction in BP at 8 weeks was significant; 16.4/9.9 mmHg (p < .0001), 15.4/9.6 mmHg (p < .0001), and 14.9/9.4 mmHg (p < .0001) with captopril, low‐dose NW Roselle, and high‐dose NW Roselle respectively. In addition, low‐dose NW Roselle induced a significant reduction in the mean level of triglycerides (17.56 mg/dL; p = .038). In conclusion, NW Roselle had comparable antihypertensive efficacy and safety to captopril in Egyptian patients with grade 1 essential hypertension.

Background: Peripheral arterial disease (PAD) is a common macrovascular complication in diabetic patients related to atherosclerosis. Early diagnosis of PAD by ankle brachial index (ABI) is highly critical as this disease results in significant morbidity and mortality. Objectives: To screen for PAD in asymptomatic diabetic patients by using ABI, determining its prevalence and associated risk factors. Patients and Methods: This is a cross-sectional study conducted on 309 diabetic asymptomatic patients in Internal Medicine Department, Menoufia University Hospitals in the period between December 2018 and December 2020. Full history and biochemical profiles were obtained and ABI indices were measured to evaluate for PAD. Results: The prevalence of PAD in this study was 36.2%. Advancing age, sedentary life, long duration of diabetes, smoking, poor glycemic control and dyslipidemia were identified as risk factors for PAD (p value <0.001) while, hypertension and body mass index were not significant among studied patients (p value 0.594 and 0.733 respectively). Conclusion: PAD has a high prevalence in asymptomatic diabetic individuals. It is associated with multiple risk factors such as smoking, dyslipidemia, advancing age, atherosclerosis and prolonged uncontrolled hyperglycemia. Diabetic patients should be routinely examined by ABI to improve the outcome.

Background: Pentraxin 3 (PTX3), a member of a superfamily of conserved proteins called pentraxins. PTX3 and Creactive protein (CRP) are members of this family and play an important role in the innate immune system. PTX3 is classified as a long pentraxin, while CRP is a short pentraxin. PTX3 is reported to be a vascular inflammatory marker providing prognostic information of vasculopathy, such as diabetic nephropathy (DN). The purpose of this study is to evaluate the association between serum PTX3 concentrations and the development and/or progression of DN. A total number of 66 patients with type 2 diabetes mellitus (T2DM) and 22 healthy subjects were enrolled in this study. Patients with T2DM were divided, according to the levels of urinary albumin/creatinine ratio (UACR), into three groups: normoalbuminuric, microalbuminuric, and macroalbuminuric groups. Serum PTX3 and high-sensitivity C-reactive protein (hs-CRP) concentrations were determined using ELISA kits. Results: Serum PTX3 and hs-CRP concentrations were significantly higher in patients with T2DM compared with the controls. Furthermore, serum PTX3 concentrations were significantly higher in macroalbuminuric patients than in microalbuminuric patients (P < 0.001) and also were significantly higher in microalbuminuric patients than in normoalbuminuric patients (P < 0.001). However, there were no significant differences between controls and T2DM patients with normoalbuminuria regarding serum PTX3 concentrations (P > 0.05). Moreover, like PTX3, hs-CRP concentrations were higher in microalbuminuric patients than in normoalbuminuric patients (P < 0.05), and also, there were no significant differences between controls and T2DM patients with normoalbuminuria regarding hs-CRP concentrations (P > 0.05). But, unlike PTX3, there were no significant differences between macroalbuminuric and microalbuminuric patients regarding hs-CRP concentrations (P > 0.05). Conclusions: Serum PTX3 is positively associated with DN development and progression, and may be a more accurate predictor of DN development than hs-CRP as it can discriminate between macroalbuminuric and microalbuminuric DN patients, while hs-CRP cannot.

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