Effect of Ramadan fasting on arterial stiffness parameters among Egyptian hypertensive patients with and without chronic kidney disease

Eldeeb, Ahmed; Mahmoud, Mostafa; Ibrahim, Ahmed B; Yousef, Eman; Sabry, Alaa

doi:10.4103/1319-2442.289444

Cited by 17 publications

(12 citation statements)

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“…There is scarce evidence regarding arterial stiffness and fasting, particularly in the Ramadan model of TRF. A previous study has demonstrated that Ramadan fasting improves AIx, central systolic, and diastolic blood pressures, but not PWV in hypertensive patients without CKD 27 . Another study showed no significant change in arterial stiffness parameters (including PWV and PWA indices) among 100 healthy overweight and obese men 28…”

Section: Discussionmentioning

confidence: 94%

“…A previous study has demonstrated that Ramadan fasting improves AIx, central systolic, and diastolic blood pressures, but not PWV in hypertensive patients without CKD. 27 Another study showed no significant change in arterial stiffness parameters (including PWV and PWA indices) among 100 healthy overweight and obese men. 28 One previous study assessing central pulse pressure after a fasting period in young, overweight, and obese men reported no significant change.…”

Section: Discussionmentioning

confidence: 98%

“…Previous studies showed that Ramadan fasting has a beneficial effect on cardiovascular risk factors in moderate and high‐risk populations 24 and no adverse effect on ambulatory blood pressure monitoring in treated hypertensive volunteers 25,26 . There is not conclusive evidence regarding the association between Ramadan model of TRF and arterial stiffness indices 27,28 …”

Section: Introductionmentioning

confidence: 98%

“…25,26 There is not conclusive evidence regarding the association between Ramadan model of TRF and arterial stiffness indices. 27,28 This study aimed to evaluate the association of the Ramadan waist cut-off values (Table 1). 5,30 Exclusion criteria were patients with a history of cardiac arrhythmias, carotid or aortic valve stenosis, peripheral artery disease, and hypotension.…”

Section: Introductionmentioning

confidence: 99%

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Association of time‐restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome

Alinezhad-Namaghi

Eslami

Nematy

et al. 2023

Health Science Reports

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Background Time‐restricted feeding (TRF) is a kind of intermittent fasting defined as eating and drinking only during a certain number of hours in a day. It has been suggested that intermittent fasting may improve cardiovascular risk factors. This study evaluated the association of TRF and arterial stiffness, using pulse wave velocity (PWV), pulse wave analysis, and arterial age in metabolic syndrome participants. Methods A cohort study was carried out among metabolic syndrome adults who were followed over the Ramadan fasting period (used as a model of TRF since food was only allowed for about 8 h/day). The subjects were divided into Ramadan fasting and Ramadan nonfasting groups. The aortic PWV and central aortic pressure waveform were measured. Central systolic pressure, central pulse pressure, and indices of arterial compliance, such as augmentation pressure and augmentation index (AIx), were determined from waveform analysis. Results Ninety‐five adults (31.57% female, age: 45.46 ± 9.10 years) with metabolic syndrome (based on the International Diabetes Federation definition) participated in this study. Ramadan fasting and Ramadan nonfasting groups were including 80 and 15 individuals respectively. A significant reduction was seen in PWV (0.29 m/s), central systolic pressure (4.03 mmHg), central pulse pressure (2.43 mmHg), central augmentation pressure (1.88 mmHg), and central AIx (2.47) in the Ramadan fasting group (p = 0.014, p < 0.001, p = 0.001, p = 0.003, and p = 0.036 respectively). There were no significant changes in these indices among the Ramadan nonfasting group. Conclusions This study suggested that TRF reduces arterial age and improves arterial stiffness among people with metabolic syndrome. This might be considered a beneficial nutrition strategy for extending healthspan (and perhaps longevity).

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Association of time‐restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome

Alinezhad-Namaghi

Eslami

Nematy

et al. 2023

Health Science Reports

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“…To avoid the risk of worsening kidney function, HCPs should reevaluate BP, kidney function, and hypertensive medications with a diuretic component, such as aldosterone antagonists or thiazide-like diuretics, during a regular visit before Ramadan fasting. Also, home BP monitoring will help to track the patient’s BP response to antihypertensive therapy during Ramadan fasting [ 120 ].…”

Section: Methodsmentioning

confidence: 99%

Risk Stratification in People with Diabetes for Fasting During Ramadan: Consensus from Arabic Association for the Study of Diabetes and Metabolism

Shaltout,

Abdelwahab,

El Meligi

et al. 2024

CDR

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Background: Current international guidelines recommend a pre-Ramadan risk assessment for people with diabetes (PwDM) who plan on fasting during the Holy month. However, a comprehensive risk assessment-based recommendation for the management of PwDM intending to fast is still controversial. Therefore, the Arabic Association for the Study of Diabetes and Metabolism (AASD) developed this consensus to provide further insights into risk stratification in PwDM intending to fast during Ramadan. Methods: The present consensus was based on the three-step modified Delphi method. The modified Delphi method is based on a series of voting rounds and in-between meetings of the expert panel to reach agreements on the statements that did not reach the consensus level during voting. The panel group comprised professors and consultants in endocrinology (both adult and pediatric). Other members included experts in the fields of cardiovascular medicine, nephrology, ophthalmology, and vascular surgery, affiliated with academic institutions in Egypt. Result: In PwDM who intend to fast during Ramadan, risk stratification is crucial to optimize patient outcomes and prevent serious complications. The present consensus provides risk assessment of those living with diabetes according to several factors, including the type of diabetes, presence, and severity of complications, number of fasting hours, and other socioeconomic factors. According to their risk factors, patients were classified into four categories (very high, high, moderate, and low risk). Conclusion: Future research is warranted due to the controversial literature regarding the impact of fasting on certain comorbidities.

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Effects of fasting on patients with chronic kidney disease during Ramadan and practical guidance for healthcare professionals

Malik

Bhanji

Abuleiss

et al. 2021

Clinical Kidney Journal

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There are an estimated 1.8 billion Muslims worldwide, with the majority of them choosing to fast during the month of Ramadan. Fasting, which requires abstinence from food and drink from dawn to sunset can be up to 20 hours duration during the summer months in temperate regions. Fasting can especially be challenging in patients on haemodialysis and peritoneal dialysis, moreover, there is concern that those with Chronic Kidney Disease can experience electrolyte imbalance and worsening of renal function. In this paper, current literature is reviewed and a decision-making management tool has been developed to assist clinicians in discussing the risks of fasting in patients with CKD, with consideration also given to circumstances such as the COVID-19 pandemic. Our review highlights that patients with CKD wishing to fast should undergo a thorough risk assessment ideally within a month before Ramadan, they may require medication changes and a plan for regular monitoring of renal function and electrolytes in order to fast safely. Recommendations have been based on risk tiers (very high risk, high risk and low/moderate risk) established by the International Diabetes Federation and the Diabetes and Ramadan International Alliance. Patients in the ‘Very high risk’ and ‘High Risk’ categories should be encouraged to explore alternative options to fasting, those in the low/moderate category may be able to fast safely with guidance from their clinician. Prior to the commencement of Ramadan, all patients must receive up-to-date education on sick day rules, instructions on when to terminate their fast or abstain from fasting.

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Effect of Ramadan fasting on arterial stiffness parameters among Egyptian hypertensive patients with and without chronic kidney disease

Cited by 17 publications

References 0 publications

Association of time‐restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome

Association of time‐restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome

Risk Stratification in People with Diabetes for Fasting During Ramadan: Consensus from Arabic Association for the Study of Diabetes and Metabolism

Effects of fasting on patients with chronic kidney disease during Ramadan and practical guidance for healthcare professionals

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