Pub Date : 2022-05-08DOI: 10.1080/10641963.2022.2071920
O. Wu, J. Leng, Xingyu Zhang, Wei Liu, F. Yang, Hu Zhang, Jia Li, Guo Zhong Zhang, Xi Lu
ABSTRACT Objective To explore the role of leptin in the onset and development of obesity-associated hypertension. Subjects and Methods A case-control study that had finished recruiting 153 subjects divided as four characteristic groups. Leptin serum levels were tested by ELISA in these subjects among these four characteristic Chinese adult physical examination groups. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), diastolic blood pressure (DB), and other clinical laboratory data were collected. Analyzation of correlations between the research index and differences between groups was done by SPSS. Results Serum leptin levels statistically significantly positively correlated with BMI and WC, and negatively with the HDLC (high-density lipoprotein cholesterol), even after adjustment for age and gender. There was no significant difference in the serum leptin levels between the normal healthy group (NH group) and the newly diagnosed untreated just-hypertension group (JH group). And the same is between the newly diagnosed untreated obesity-hypertension group (OH group) and the newly diagnosed untreated just-obesity group (JO group). Multiple linear regression analysis indicated BMI and gender as significant independent correlates of serum leptin. Conclusions These results show leptin may not be essential but play an additive effect in the development of obesity-associated hypertension. Leptin may only play an additive effect role in the intricate interwoven network of regulators contributing to the development of hypertension in obese patients.
{"title":"Controversial culprit of leptin in obesity hypertension: clues from a case-control study with Chinese newly diagnosed adult early-onset obesity hypertensives","authors":"O. Wu, J. Leng, Xingyu Zhang, Wei Liu, F. Yang, Hu Zhang, Jia Li, Guo Zhong Zhang, Xi Lu","doi":"10.1080/10641963.2022.2071920","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071920","url":null,"abstract":"ABSTRACT Objective To explore the role of leptin in the onset and development of obesity-associated hypertension. Subjects and Methods A case-control study that had finished recruiting 153 subjects divided as four characteristic groups. Leptin serum levels were tested by ELISA in these subjects among these four characteristic Chinese adult physical examination groups. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), diastolic blood pressure (DB), and other clinical laboratory data were collected. Analyzation of correlations between the research index and differences between groups was done by SPSS. Results Serum leptin levels statistically significantly positively correlated with BMI and WC, and negatively with the HDLC (high-density lipoprotein cholesterol), even after adjustment for age and gender. There was no significant difference in the serum leptin levels between the normal healthy group (NH group) and the newly diagnosed untreated just-hypertension group (JH group). And the same is between the newly diagnosed untreated obesity-hypertension group (OH group) and the newly diagnosed untreated just-obesity group (JO group). Multiple linear regression analysis indicated BMI and gender as significant independent correlates of serum leptin. Conclusions These results show leptin may not be essential but play an additive effect in the development of obesity-associated hypertension. Leptin may only play an additive effect role in the intricate interwoven network of regulators contributing to the development of hypertension in obese patients.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77220138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ABSTRACT Aim To explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease (DKD) in patients with type 2 diabetes. Design A retrospective study. Methods This study included 3050 patients with type 2 diabetes whose metabolic parameters were regularly checked. Intrapersonal means and standard deviations (SDs) of all recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) measurements were calculated. Subjects were divided into four groups: Q1 (SBP-Mean < 130, SBP-SD < 11.06); Q2 (SBP-Mean < 130, SBP-SD ≥ 11.06); Q3 (SBP-Mean ≥ 130, SBP-SD < 11.06); Q4 (SBP-Mean ≥ 130, SBP-SD ≥ 11.06). Similarly, based on whether the PP-Mean was higher or lower than 80 mmHg (average PP-Mean) and the PP-SD was higher or lower than 6.48 mmHg (average PP-SD), the involved patients were redivided into Q1’~ Q4’ groups. Results Adjusted for age, sex and diabetes duration, results revealed that the SBP-Mean, SBP-SD, PP-Mean and PP-SD were risk factors for DKD. Meanwhile, patients in the Q4 group had the highest DKD prevalence (HR = 1.976, p < .001), while Q1 group had the lowest. In addition, patients in the Q3 group (HR = 1.614, P < .001) had a higher risk of DKD than those in the Q2 group (HR = 1.408, P < .001). After re-stratification by PP-Mean and PP-SD, patients in the Q4’ group had the highest risk of DKD (HR = 1.370, p < .001), while those in the Q1’ group had the lowest risk. Patients in the Q3’ group (HR = 1.266, p < .001) had a higher risk of DKD than those in the Q2’ group (HR = 1.212, p < .001).
【摘要】目的探讨2型糖尿病患者不同血压变量的长期变异性与糖尿病肾病(DKD)的关系。设计回顾性研究。方法定期检查3050例2型糖尿病患者的代谢指标。计算所有记录的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和脉压(PP)的个人平均值和标准差(SDs)。受试者分为四组:Q1组(SBP-Mean < 130, SBP-SD < 11.06);Q2 (SBP-Mean < 130, SBP-SD≥11.06);Q3 (SBP-Mean≥130,SBP-SD < 11.06);Q4 (SBP-Mean≥130,SBP-SD≥11.06)。同样，根据PP-Mean高于或低于80 mmHg(平均PP-Mean)， PP-SD高于或低于6.48 mmHg(平均PP-SD)，将患者重新分为Q1’~ Q4’组。结果经年龄、性别和糖尿病病程调整后，结果显示SBP-Mean、SBP-SD、PP-Mean和PP-SD是DKD的危险因素。同时，Q4组患者DKD患病率最高(HR = 1.976, p < 0.001)， Q1组最低。此外，Q3组患者发生DKD的风险(HR = 1.614, P < 0.001)高于Q2组(HR = 1.408, P < 0.001)。经PP-Mean和PP-SD重新分层后，Q4’组患者DKD风险最高(HR = 1.370, p < 0.001)， Q1’组患者DKD风险最低。Q3组(HR = 1.266, p < 0.001)患者发生DKD的风险高于Q2组(HR = 1.212, p < 0.001)。
{"title":"Effects of different blood pressures and their long-term variability on the development of diabetic kidney disease in patients with type 2 diabetes mellitus","authors":"Weiyan Zhu, Lichen Xu, Xue Chen, Yau-Jiunn Lee, Zongjun Zhang, Qingqing Lou","doi":"10.1080/10641963.2022.2071917","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071917","url":null,"abstract":"ABSTRACT Aim To explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease (DKD) in patients with type 2 diabetes. Design A retrospective study. Methods This study included 3050 patients with type 2 diabetes whose metabolic parameters were regularly checked. Intrapersonal means and standard deviations (SDs) of all recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) measurements were calculated. Subjects were divided into four groups: Q1 (SBP-Mean < 130, SBP-SD < 11.06); Q2 (SBP-Mean < 130, SBP-SD ≥ 11.06); Q3 (SBP-Mean ≥ 130, SBP-SD < 11.06); Q4 (SBP-Mean ≥ 130, SBP-SD ≥ 11.06). Similarly, based on whether the PP-Mean was higher or lower than 80 mmHg (average PP-Mean) and the PP-SD was higher or lower than 6.48 mmHg (average PP-SD), the involved patients were redivided into Q1’~ Q4’ groups. Results Adjusted for age, sex and diabetes duration, results revealed that the SBP-Mean, SBP-SD, PP-Mean and PP-SD were risk factors for DKD. Meanwhile, patients in the Q4 group had the highest DKD prevalence (HR = 1.976, p < .001), while Q1 group had the lowest. In addition, patients in the Q3 group (HR = 1.614, P < .001) had a higher risk of DKD than those in the Q2 group (HR = 1.408, P < .001). After re-stratification by PP-Mean and PP-SD, patients in the Q4’ group had the highest risk of DKD (HR = 1.370, p < .001), while those in the Q1’ group had the lowest risk. Patients in the Q3’ group (HR = 1.266, p < .001) had a higher risk of DKD than those in the Q2’ group (HR = 1.212, p < .001).","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79372093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-08DOI: 10.1080/10641963.2022.2071916
C. Oblitas, Ana Torres-Do-Rego, A. García, Víctor Mato-Jimeno, Leyre Alonso Gonzalo, Sara Luis-García, A. Enríquez-Gómez, Mercedes Baltasar-López, Elena Bello-Martínez
ABSTRACT Objective The role of hypertension in COVID-19 has not been clearly elucidated yet. The aim of this study was to evaluate the incidence and severity of COVID-19 in a hypertensive population and assess whether there is a link between blood pressure control and SARS-CoV-2 infection outcomes. Methods This was a single-center retrospective observational study that evaluated the incidence and severity of COVID-19 in a chronic hypertensive population (n=1,637) from a specialized consultation of Hypertension and Cardiovascular Risk of Internal Medicine in a tertiary hospital in Madrid (Spain). Results A total of 147 COVID-19 patients (9%) were found, with a median age of 59 (±14) years, where 77 (52.4%) patients were male. Forty patients required hospitalization (27.2%), 15 patients had severe COVID-19 (10.2%), and 6 patients died (4.1%). Among the causes of hypertension, 104 (70.7%) patients had essential hypertension and 22 (15%) patients presented primary hyperaldosteronism; and 66 (44.9%) patients presented RH. Severe COVID-19 was associated with age over 65 years (crude OR 4.43 [95% CI 1.3–14.2; p = .012]) and diabetes mellitus (crude OR 4.15 [95% CI 1.3–12.9; p = .014]). Conclusion This study showed a lower rate of incidence, hospitalization, and severity of COVID-19 in the hypertensive population.
目的高血压在COVID-19中的作用尚未明确。本研究的目的是评估高血压人群中COVID-19的发病率和严重程度，并评估血压控制与SARS-CoV-2感染结局之间是否存在联系。方法采用单中心回顾性观察性研究，评估来自西班牙马德里某三级医院高血压和心血管风险内科专科会诊的慢性高血压人群(n= 1637)中COVID-19的发病率和严重程度。结果共发现COVID-19患者147例(9%)，中位年龄59(±14)岁，其中男性77例(52.4%)。住院40例(27.2%)，重症15例(10.2%)，死亡6例(4.1%)。高血压病因中，原发性高血压104例(70.7%)，原发性高醛固酮增多症22例(15%);RH 66例(44.9%)。严重的COVID-19与65岁以上的年龄相关(粗比值比4.43 [95% CI 1.3-14.2;p = 0.012])和糖尿病(粗比值比4.15 [95% CI 1.3-12.9;P = .014])。结论高血压人群中COVID-19的发病率、住院率和严重程度较低。
{"title":"A retrospective analysis of incidence and severity of COVID-19 among hypertensive patients: the other side","authors":"C. Oblitas, Ana Torres-Do-Rego, A. García, Víctor Mato-Jimeno, Leyre Alonso Gonzalo, Sara Luis-García, A. Enríquez-Gómez, Mercedes Baltasar-López, Elena Bello-Martínez","doi":"10.1080/10641963.2022.2071916","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071916","url":null,"abstract":"ABSTRACT Objective The role of hypertension in COVID-19 has not been clearly elucidated yet. The aim of this study was to evaluate the incidence and severity of COVID-19 in a hypertensive population and assess whether there is a link between blood pressure control and SARS-CoV-2 infection outcomes. Methods This was a single-center retrospective observational study that evaluated the incidence and severity of COVID-19 in a chronic hypertensive population (n=1,637) from a specialized consultation of Hypertension and Cardiovascular Risk of Internal Medicine in a tertiary hospital in Madrid (Spain). Results A total of 147 COVID-19 patients (9%) were found, with a median age of 59 (±14) years, where 77 (52.4%) patients were male. Forty patients required hospitalization (27.2%), 15 patients had severe COVID-19 (10.2%), and 6 patients died (4.1%). Among the causes of hypertension, 104 (70.7%) patients had essential hypertension and 22 (15%) patients presented primary hyperaldosteronism; and 66 (44.9%) patients presented RH. Severe COVID-19 was associated with age over 65 years (crude OR 4.43 [95% CI 1.3–14.2; p = .012]) and diabetes mellitus (crude OR 4.15 [95% CI 1.3–12.9; p = .014]). Conclusion This study showed a lower rate of incidence, hospitalization, and severity of COVID-19 in the hypertensive population.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75549284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-05DOI: 10.1080/10641963.2022.2071923
Gülsüm Özkan, S. Ulusoy, Y. Erdem, B. Altun, R. Yılmaz, N. Ata, Mustafa Mahir Ülgü, M. Çağlayan, O. Çelik, Ş. Birinci
ABSTRACT Aim The effect of hypertension (HT) and antihypertensive therapies such as renin-angiotensin-aldosterone system (RAAS) blockers on the disease course in COVID-19 patients is controversial. The purpose of this study was to evaluate the effect of HT and antihypertensive therapies on the course of COVID-19 disease. Method The age, sex, comorbid diseases, and antihypertensive therapies of 132,790 patients with positive COVID-19 real-time transcriptase polymerase chain reaction (RT-PCR) tests in the Turkish Health Ministry National COVID-19 database between 11 March and 31 May 2020, were examined and analyzed. Results Forty-one percent of the 132,790 patients in this study (median age: 40, 47.3% female) were hospitalized for treatment, and 4.5% were followed-up in the intensive care unit (ICU). The most frequent comorbid disease, at 19.5%, was HT (n = 25,863). Mortality was determined in 4.9% of HT patients and 1.9% of non-HT patients (p < .001). HT, age, and male gender emerged as independent predictors of hospitalization and admission to the ICU, while HT was not a predictor of mortality. In addition, no adverse effect of any antihypertensive treatment, including RAAS inhibitors, on mortality was detected. Conclusion Based on Turkish national data, HT is common in COVID-19 patients, but does not appear to be an independent predictor of mortality, and no adverse effect of RAAS inhibitors on COVID-19-related mortality was observed.
{"title":"The effect of hypertension and antihypertensive therapies on the course of COVID-19 infection: Turkish national health system data","authors":"Gülsüm Özkan, S. Ulusoy, Y. Erdem, B. Altun, R. Yılmaz, N. Ata, Mustafa Mahir Ülgü, M. Çağlayan, O. Çelik, Ş. Birinci","doi":"10.1080/10641963.2022.2071923","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071923","url":null,"abstract":"ABSTRACT Aim The effect of hypertension (HT) and antihypertensive therapies such as renin-angiotensin-aldosterone system (RAAS) blockers on the disease course in COVID-19 patients is controversial. The purpose of this study was to evaluate the effect of HT and antihypertensive therapies on the course of COVID-19 disease. Method The age, sex, comorbid diseases, and antihypertensive therapies of 132,790 patients with positive COVID-19 real-time transcriptase polymerase chain reaction (RT-PCR) tests in the Turkish Health Ministry National COVID-19 database between 11 March and 31 May 2020, were examined and analyzed. Results Forty-one percent of the 132,790 patients in this study (median age: 40, 47.3% female) were hospitalized for treatment, and 4.5% were followed-up in the intensive care unit (ICU). The most frequent comorbid disease, at 19.5%, was HT (n = 25,863). Mortality was determined in 4.9% of HT patients and 1.9% of non-HT patients (p < .001). HT, age, and male gender emerged as independent predictors of hospitalization and admission to the ICU, while HT was not a predictor of mortality. In addition, no adverse effect of any antihypertensive treatment, including RAAS inhibitors, on mortality was detected. Conclusion Based on Turkish national data, HT is common in COVID-19 patients, but does not appear to be an independent predictor of mortality, and no adverse effect of RAAS inhibitors on COVID-19-related mortality was observed.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77722230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1080/10641963.2022.2071919
B. Ye, Xiaofei Peng, D. Su, Dongli Liu, Yanyun Huang, Yuqin Huang, Y. Pang
ABSTRACT Introduction Proliferation and apoptosis of pulmonary artery smooth muscle cells (PASMCs) play an important role in the occurrence and development of pulmonary arterial hypertension (PAH). The purpose of this study was to investigate the effects of survivin inhibitor YM155 on the proliferation and apoptosis of PASMCs in rats with PAH induced by high pulmonary blood flow. Methods Thirty male Sprague-Dawley (SD) rats were randomly divided into control, model, and YM155 intervention groups. A rat model of PAH induced by high pulmonary blood flow was established, and it was confirmed by assessments of right-ventricular pressure (RVP) and right ventricular hypertrophy index (RVHI). Immunohistochemical staining and western blot analysis were used to detect the expression of survivin, and the proliferation and apoptosis of PASMCs. Lastly, the effects of in vivo treatment of YM155 were tested. Results The increased expression of survivin mRNA and protein were observed in the model group, accompanied by pulmonary arteriolar wall thickening, lumen stenosis, and perivascular inflammatory cell infiltration. Elevated expression of survivin and pulmonary vascular remodeling were significantly mitigated after YM155 treatment. Specifically, the YM155 intervention group had a significantly lower PASMC proliferation rate and a higher PASMC apoptotic rate. Conclusion YM155 suppressed PASMC proliferation and promoted PASMC apoptosis by inhibiting survivin expression and thereby reducing pulmonary vascular remodeling in high pulmonary blood flow-induced PAH in vivo.
{"title":"Effects of YM155 on the proliferation and apoptosis of pulmonary artery smooth muscle cells in a rat model of high pulmonary blood flow-induced pulmonary arterial hypertension","authors":"B. Ye, Xiaofei Peng, D. Su, Dongli Liu, Yanyun Huang, Yuqin Huang, Y. Pang","doi":"10.1080/10641963.2022.2071919","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071919","url":null,"abstract":"ABSTRACT Introduction Proliferation and apoptosis of pulmonary artery smooth muscle cells (PASMCs) play an important role in the occurrence and development of pulmonary arterial hypertension (PAH). The purpose of this study was to investigate the effects of survivin inhibitor YM155 on the proliferation and apoptosis of PASMCs in rats with PAH induced by high pulmonary blood flow. Methods Thirty male Sprague-Dawley (SD) rats were randomly divided into control, model, and YM155 intervention groups. A rat model of PAH induced by high pulmonary blood flow was established, and it was confirmed by assessments of right-ventricular pressure (RVP) and right ventricular hypertrophy index (RVHI). Immunohistochemical staining and western blot analysis were used to detect the expression of survivin, and the proliferation and apoptosis of PASMCs. Lastly, the effects of in vivo treatment of YM155 were tested. Results The increased expression of survivin mRNA and protein were observed in the model group, accompanied by pulmonary arteriolar wall thickening, lumen stenosis, and perivascular inflammatory cell infiltration. Elevated expression of survivin and pulmonary vascular remodeling were significantly mitigated after YM155 treatment. Specifically, the YM155 intervention group had a significantly lower PASMC proliferation rate and a higher PASMC apoptotic rate. Conclusion YM155 suppressed PASMC proliferation and promoted PASMC apoptosis by inhibiting survivin expression and thereby reducing pulmonary vascular remodeling in high pulmonary blood flow-induced PAH in vivo.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80439083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-03DOI: 10.1080/10641963.2022.2071921
R. Aydogan Baykara, Pinar Diydem Yilmaz, M. H. Göktepe, C. Kadıyoran, Mustafa Ogul, A. Kucuk, Medine Cumhur Cüre, Erkan Cüre
ABSTRACT Objectives The incidence of cardiovascular disease is increased in patients with Behcet’s disease (BD). Proprotein convertase subtilisin/kexin type 9 (PCSK9) causes the acceleration of atherosclerosis. We aimed to investigate whether there is a relationship between PCSK9 with carotid artery intima-media thickness (cIMT), a marker of subclinical atherosclerosis, and BD disease activity. Methods Fifty-eight patients with BD and 58 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. The disease activity of the patients was estimated. Individuals’ cIMT values were measured, and PCSK9 levels were studied. Results Patients with BD’ cIMT (0.51 ± 0.1 vs 0.41 ± 0.1 mm, p < .001) and PCSK9 (623.2 ± 101.7 ± 10.1 vs 528.3 ± 242.7 ng/ml, p = .007), values were significantly higher than the control group. In stepwise regression analysis, there was an independent relationship between cIMT with PCSK9 (β = 0.179, p < .050). There was no independent relationship between disease activities with PCSK9. Based on the ROC curve analysis, the PCSK9 optimal cutoff value for cIMT was 595.1 ng/ml, sensitivity 66.7%, specificity 64.7% (AUC = 0.672; 95% CI: 0.530–0.815, p = .040). Conclusion There is a strong independent association between subclinical atherosclerosis and PCSK9 in patients with BD. There may be no independent association between PCSK9 and disease activity.
【摘要】目的白塞氏病(BD)患者心血管疾病的发生率增高。蛋白转化酶枯草素/键合蛋白9型(PCSK9)导致动脉粥样硬化加速。我们的目的是研究PCSK9与颈动脉内膜-中膜厚度(cIMT)(亚临床动脉粥样硬化的标志)和BD疾病活动性之间是否存在关系。方法将58例BD患者和58例年龄、性别、体重指数(BMI)匹配的健康对照者纳入研究。估计患者的疾病活动性。测量个体的cIMT值，研究PCSK9水平。结果BD组患者cIMT(0.51±0.1 vs 0.41±0.1 mm, p < 0.001)、PCSK9(623.2±101.7±10.1 vs 528.3±242.7 ng/ml, p = 0.007)值均显著高于对照组。逐步回归分析显示，cIMT与PCSK9呈独立相关(β = 0.179, p < 0.050)。疾病活动与PCSK9之间没有独立的关系。ROC曲线分析显示，PCSK9检测cIMT的最佳临界值为595.1 ng/ml，灵敏度66.7%，特异性64.7% (AUC = 0.672;95% CI: 0.530-0.815, p = 0.040)。结论BD患者亚临床动脉粥样硬化与PCSK9有较强的独立相关性，PCSK9与疾病活动度可能无独立相关性。
{"title":"Proprotein convertase subtilisin/kexin type 9 is associated with atherosclerosis in patients with Behcet’s disease","authors":"R. Aydogan Baykara, Pinar Diydem Yilmaz, M. H. Göktepe, C. Kadıyoran, Mustafa Ogul, A. Kucuk, Medine Cumhur Cüre, Erkan Cüre","doi":"10.1080/10641963.2022.2071921","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071921","url":null,"abstract":"ABSTRACT Objectives The incidence of cardiovascular disease is increased in patients with Behcet’s disease (BD). Proprotein convertase subtilisin/kexin type 9 (PCSK9) causes the acceleration of atherosclerosis. We aimed to investigate whether there is a relationship between PCSK9 with carotid artery intima-media thickness (cIMT), a marker of subclinical atherosclerosis, and BD disease activity. Methods Fifty-eight patients with BD and 58 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. The disease activity of the patients was estimated. Individuals’ cIMT values were measured, and PCSK9 levels were studied. Results Patients with BD’ cIMT (0.51 ± 0.1 vs 0.41 ± 0.1 mm, p < .001) and PCSK9 (623.2 ± 101.7 ± 10.1 vs 528.3 ± 242.7 ng/ml, p = .007), values were significantly higher than the control group. In stepwise regression analysis, there was an independent relationship between cIMT with PCSK9 (β = 0.179, p < .050). There was no independent relationship between disease activities with PCSK9. Based on the ROC curve analysis, the PCSK9 optimal cutoff value for cIMT was 595.1 ng/ml, sensitivity 66.7%, specificity 64.7% (AUC = 0.672; 95% CI: 0.530–0.815, p = .040). Conclusion There is a strong independent association between subclinical atherosclerosis and PCSK9 in patients with BD. There may be no independent association between PCSK9 and disease activity.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84314477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-03DOI: 10.1080/10641963.2022.2071922
G. Zeren, İ. Avcı, M. Sungur, B. Şimşek, Aylin Sungur, F. Can, M. F. Yılmaz, Ufuk Gürkan, S. Kalkan, A. Karagöz, I. Tanboğa, C. Karabay
ABSTRACT Studies reported conflicting results on the effect of renin-angiotensin-aldosterone system (RAAS) blocker use on acute kidney injury (AKI) in patients undergoing elective coronary angiography but association in elderly patients with ST-elevation myocardial infarction (STEMI) is not known. Also, there are limited data on the effect of inflammatory markers on AKI. We aimed to investigate the effects of RAAS blocker pretreatment and inflammatory markers on AKI in this population. A total of 471 patients were compared according to presence of RAAS blocker pretreatment at admission. Conventional and inverse probability weighed conditional logistic regression were used to determine independent predictors of AKI. Mean age of the study group was 75.4 ± 7.1 years and 29.1% of the patients were female. AKI was observed in 17.2% of the study population. Weighted conditional multivariable logistic regression analysis revealed that AKI was associated with baseline creatinine levels and C-reactive protein/albumin ratio (CAR) (OR 2.08, 95% CI = 1.13–3.82, p = .02 and OR 1.19, 95% CI = 1.01–1.41, p = .04, respectively). No significant association was found between RAAS blocker pretreatment and AKI. CAR and elevated baseline creatinine levels were independent predictors of AKI in this patient group.
研究报告了肾素-血管紧张素-醛固酮系统(RAAS)阻滞剂对选择性冠状动脉造影患者急性肾损伤(AKI)的影响的相互矛盾的结果，但与老年st段抬高型心肌梗死(STEMI)患者的关联尚不清楚。此外，关于炎症标志物对AKI的影响的数据有限。我们的目的是研究RAAS阻断剂预处理和炎症标志物对该人群AKI的影响。471例患者根据入院时是否存在RAAS阻滞剂进行比较。采用常规和逆概率加权条件logistic回归确定AKI的独立预测因子。研究组平均年龄75.4±7.1岁，女性占29.1%。在17.2%的研究人群中观察到AKI。加权条件多变量logistic回归分析显示AKI与基线肌酐水平和c反应蛋白/白蛋白比(CAR)相关(OR分别为2.08,95% CI = 1.13-3.82, p = 0.02和OR为1.19,95% CI = 1.01-1.41, p = 0.04)。RAAS阻滞剂预处理与AKI之间无显著相关性。CAR和基线肌酐水平升高是该患者组AKI的独立预测因子。
{"title":"Effects of RAAS blocker use on AKI in elderly hypertensive STEMI patients with propensity score weighed method","authors":"G. Zeren, İ. Avcı, M. Sungur, B. Şimşek, Aylin Sungur, F. Can, M. F. Yılmaz, Ufuk Gürkan, S. Kalkan, A. Karagöz, I. Tanboğa, C. Karabay","doi":"10.1080/10641963.2022.2071922","DOIUrl":"https://doi.org/10.1080/10641963.2022.2071922","url":null,"abstract":"ABSTRACT Studies reported conflicting results on the effect of renin-angiotensin-aldosterone system (RAAS) blocker use on acute kidney injury (AKI) in patients undergoing elective coronary angiography but association in elderly patients with ST-elevation myocardial infarction (STEMI) is not known. Also, there are limited data on the effect of inflammatory markers on AKI. We aimed to investigate the effects of RAAS blocker pretreatment and inflammatory markers on AKI in this population. A total of 471 patients were compared according to presence of RAAS blocker pretreatment at admission. Conventional and inverse probability weighed conditional logistic regression were used to determine independent predictors of AKI. Mean age of the study group was 75.4 ± 7.1 years and 29.1% of the patients were female. AKI was observed in 17.2% of the study population. Weighted conditional multivariable logistic regression analysis revealed that AKI was associated with baseline creatinine levels and C-reactive protein/albumin ratio (CAR) (OR 2.08, 95% CI = 1.13–3.82, p = .02 and OR 1.19, 95% CI = 1.01–1.41, p = .04, respectively). No significant association was found between RAAS blocker pretreatment and AKI. CAR and elevated baseline creatinine levels were independent predictors of AKI in this patient group.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74278385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-23DOI: 10.1080/10641963.2022.2065290
Igor M Mariano, A. Amaral, Victor Hugo V Carrijo, J. G. Costa, M. D. L. Rodrigues, T. Cunha, G. Puga
ABSTRACT Aim To verify the influence of β-blockers or angiotensin receptor blockers on cardiovascular responses to exercise training in hypertensive post-menopausal women. Methods Postmenopausal women were allocated into: healthy control group (CON; n = 9); angiotensin receptor blockers users (ARB; n = 19); and β-adrenergic blockers users (BB; n = 19). Before and after 12 weeks of combined (aerobic and resistance) exercise training they were evaluated by: heart rate (HR) and its variability (HRV), blood pressure (BP) under stress (Cold pressor and Stroop color tests), and ambulatorial BP and its variability. Results In ambulatorial BP analysis only in ARB group awake systolic BP decreased (p = .011; ARB: From 122 ± 11 to 117 ± 9; BB: From 118 ± 7 to 114 ± 5; CON: From 121 ± 7 to 127 ± 11 mmHg). There were time effects in BP reactivity to stress, where BP reactivity after Stroop color and Cold pressor test decreased in all groups. In BP variability analysis, only BB group has significative decreased values in systolic SD24 (p = .007; ΔARB = −0.3 ± 2.0; ΔBB = −1.3 ± 2.0; ΔCON = 0.8 ± 1.7 mmHg) and SDdn (p = .006; ΔARB = −0.2 ± 1.6; ΔBB = −1.3 ± 2.0; ΔCON = 0.4 ± 2.1 mmHg). HRV analysis demonstrated that post-training, only in BB group LF/HF decreased (p = .001; ΔARB = 0.1 ± 0.8; ΔBB = −0.4 ± 1.5; ΔCON = 1.0 ± 1.7). Conclusion ARB present pronounced responses in awake ambulatorial systolic BP, while β-blockers users present greater responses in BP variability. Besides that, exercise can mitigate BP reactivity to stress with no differences between groups. Lastly, there were no major differences in HRV. Trial registry at “Clinicaltrials.gov” NCT03529838
{"title":"Different cardiovascular responses to exercise training in hypertensive women receiving β-blockers or angiotensin receptor blockers: A pilot study","authors":"Igor M Mariano, A. Amaral, Victor Hugo V Carrijo, J. G. Costa, M. D. L. Rodrigues, T. Cunha, G. Puga","doi":"10.1080/10641963.2022.2065290","DOIUrl":"https://doi.org/10.1080/10641963.2022.2065290","url":null,"abstract":"ABSTRACT Aim To verify the influence of β-blockers or angiotensin receptor blockers on cardiovascular responses to exercise training in hypertensive post-menopausal women. Methods Postmenopausal women were allocated into: healthy control group (CON; n = 9); angiotensin receptor blockers users (ARB; n = 19); and β-adrenergic blockers users (BB; n = 19). Before and after 12 weeks of combined (aerobic and resistance) exercise training they were evaluated by: heart rate (HR) and its variability (HRV), blood pressure (BP) under stress (Cold pressor and Stroop color tests), and ambulatorial BP and its variability. Results In ambulatorial BP analysis only in ARB group awake systolic BP decreased (p = .011; ARB: From 122 ± 11 to 117 ± 9; BB: From 118 ± 7 to 114 ± 5; CON: From 121 ± 7 to 127 ± 11 mmHg). There were time effects in BP reactivity to stress, where BP reactivity after Stroop color and Cold pressor test decreased in all groups. In BP variability analysis, only BB group has significative decreased values in systolic SD24 (p = .007; ΔARB = −0.3 ± 2.0; ΔBB = −1.3 ± 2.0; ΔCON = 0.8 ± 1.7 mmHg) and SDdn (p = .006; ΔARB = −0.2 ± 1.6; ΔBB = −1.3 ± 2.0; ΔCON = 0.4 ± 2.1 mmHg). HRV analysis demonstrated that post-training, only in BB group LF/HF decreased (p = .001; ΔARB = 0.1 ± 0.8; ΔBB = −0.4 ± 1.5; ΔCON = 1.0 ± 1.7). Conclusion ARB present pronounced responses in awake ambulatorial systolic BP, while β-blockers users present greater responses in BP variability. Besides that, exercise can mitigate BP reactivity to stress with no differences between groups. Lastly, there were no major differences in HRV. Trial registry at “Clinicaltrials.gov” NCT03529838","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76375124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-20DOI: 10.1080/10641963.2022.2065286
Xoan Thi Le, Loan Thanh Thi Nguyen, Phuong Thi Tuyet Nguyen, Tai Van Nguyen, Hiep Van Nguyen, Hang Thi Nguyet Pham, Hong Nguyen Tran, Thang Dac Hoang, Dong Van Le, Kinzo Matsumoto
ABSTRACT Objectives This study aims to investigate the anti-hypertensive effects of aqueous extract of Callisia fragrans and their underlying mechanism using a two-kidney one-clip (2K1C) model of reno-vascular hypertension in rats. Methods The reno-vascular hypertensive rats were treated with C. fragrans leaf extract (100 and 500 mg/kg; p.o.) and a reference drug, captopril (20 mg/kg; p.o.), for 4 weeks. The blood pressure and heart rate were recorded using a tail-cuff. The heart weight, left ventricular wall thickness, and serum creatinine and urea levels were measured. A spectrophotometric assay was used to analyze the angiotensin-converting enzyme (ACE) inhibition activity of the extract and the reference drug. The total volume and the concentration of sodium, potassium, and chloride in urine samples were evaluated. Results C. fragrans extract significantly reduced both systolic and diastolic blood pressures in the reno-vascular hypertensive rats. No significant difference in the heart rate was observed between each animal group. C. fragrans extract reduced the 2K1C-induced increase in the heart and body weight ratio and the left ventricular wall thickness. Moreover, the extract also attenuated the increase in serum urea induced by the 2K1C treatment. C. fragrans extract inhibited ACE activity in vitro with an IC50 of 20.97 ± 3.94 µg/ml. The urine output and urinary electrolyte excretion significantly increased in C. fragrans extract-treated rats. Conclusions These findings demonstrated that C. fragrans extract can mitigate hypertension and alleviate ventricular hypertrophy and renal dysfunction in reno-vascular hypertensive rats, at least in part via ACE activity inhibition and diuretic property.
{"title":"Anti-hypertensive effects of Callisia fragrans extract on Reno-vascular hypertensive rats","authors":"Xoan Thi Le, Loan Thanh Thi Nguyen, Phuong Thi Tuyet Nguyen, Tai Van Nguyen, Hiep Van Nguyen, Hang Thi Nguyet Pham, Hong Nguyen Tran, Thang Dac Hoang, Dong Van Le, Kinzo Matsumoto","doi":"10.1080/10641963.2022.2065286","DOIUrl":"https://doi.org/10.1080/10641963.2022.2065286","url":null,"abstract":"ABSTRACT Objectives This study aims to investigate the anti-hypertensive effects of aqueous extract of Callisia fragrans and their underlying mechanism using a two-kidney one-clip (2K1C) model of reno-vascular hypertension in rats. Methods The reno-vascular hypertensive rats were treated with C. fragrans leaf extract (100 and 500 mg/kg; p.o.) and a reference drug, captopril (20 mg/kg; p.o.), for 4 weeks. The blood pressure and heart rate were recorded using a tail-cuff. The heart weight, left ventricular wall thickness, and serum creatinine and urea levels were measured. A spectrophotometric assay was used to analyze the angiotensin-converting enzyme (ACE) inhibition activity of the extract and the reference drug. The total volume and the concentration of sodium, potassium, and chloride in urine samples were evaluated. Results C. fragrans extract significantly reduced both systolic and diastolic blood pressures in the reno-vascular hypertensive rats. No significant difference in the heart rate was observed between each animal group. C. fragrans extract reduced the 2K1C-induced increase in the heart and body weight ratio and the left ventricular wall thickness. Moreover, the extract also attenuated the increase in serum urea induced by the 2K1C treatment. C. fragrans extract inhibited ACE activity in vitro with an IC50 of 20.97 ± 3.94 µg/ml. The urine output and urinary electrolyte excretion significantly increased in C. fragrans extract-treated rats. Conclusions These findings demonstrated that C. fragrans extract can mitigate hypertension and alleviate ventricular hypertrophy and renal dysfunction in reno-vascular hypertensive rats, at least in part via ACE activity inhibition and diuretic property.","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78055624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-19DOI: 10.1080/10641963.2022.2065288
I. Roque Marçal, Vanessa Teixeira Do Amaral, Bianca Fernandes, Raphael Martins de Abreu, Cristian Alvarez, Guilherme Veiga Guimarães, V. Cornelissen, Emmanuel Gomes Ciolac
ABSTRACT Objectives This crossover study design aimed to assess hemodynamic, cardiac autonomic, and vascular responses to high-intensity interval (HIIE) vs moderate-intensity continuous exercise (MICE) in older individuals with hypertension. Methods Twenty (67 ± 7 y) older individuals with hypertension were randomly assigned to perform HIIE, MICE, or control (CON) sessions in the heated swimming pool (30–32°C). Blood pressure (BP), arterial stiffness, endothelial reactivity, and heart rate variability (HRV) were measured pre, post, and 45 min (recovery) after each intervention followed by 24-h ambulatory BP and HRV. Results One single aerobic exercise session was not effective to provoke post-exercise hypotension and vascular improvements. HIIE was superior to MICE and CON to increasing parasympathetic modulation at post and recovery. Exercise sessions showed to disturb the autonomic system at nighttime compared to CON. Conclusions These results may have important implications in water-based therapy and the elderly with hypertension
{"title":"Acute high-intensity interval exercise versus moderate-intensity continuous exercise in heated water-based on hemodynamic, cardiac autonomic, and vascular responses in older individuals with hypertension","authors":"I. Roque Marçal, Vanessa Teixeira Do Amaral, Bianca Fernandes, Raphael Martins de Abreu, Cristian Alvarez, Guilherme Veiga Guimarães, V. Cornelissen, Emmanuel Gomes Ciolac","doi":"10.1080/10641963.2022.2065288","DOIUrl":"https://doi.org/10.1080/10641963.2022.2065288","url":null,"abstract":"ABSTRACT Objectives This crossover study design aimed to assess hemodynamic, cardiac autonomic, and vascular responses to high-intensity interval (HIIE) vs moderate-intensity continuous exercise (MICE) in older individuals with hypertension. Methods Twenty (67 ± 7 y) older individuals with hypertension were randomly assigned to perform HIIE, MICE, or control (CON) sessions in the heated swimming pool (30–32°C). Blood pressure (BP), arterial stiffness, endothelial reactivity, and heart rate variability (HRV) were measured pre, post, and 45 min (recovery) after each intervention followed by 24-h ambulatory BP and HRV. Results One single aerobic exercise session was not effective to provoke post-exercise hypotension and vascular improvements. HIIE was superior to MICE and CON to increasing parasympathetic modulation at post and recovery. Exercise sessions showed to disturb the autonomic system at nighttime compared to CON. Conclusions These results may have important implications in water-based therapy and the elderly with hypertension","PeriodicalId":10333,"journal":{"name":"Clinical and Experimental Hypertension","volume":null,"pages":null},"PeriodicalIF":12.3,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89418254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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