Pub Date : 2021-01-01DOI: 10.2174/1573402117666210406111927
Liliana E Favaloro, Roxana D Ratto, Carla Musso
The relationship between diabetes and risk of heart failure has been described in previous trials, releasing the importance of the hyperglycemic state that, added to other risk factors, favors the development of coronary heart disease. The mechanism by which, in the absence of hypertension, obesity and/or dyslipidemia, diabetic patients develop cardiomyopathy has been less studied. Recently, the Sodium Glucose Co-transporter type 2 inhibitors (SGLT2 inhibitors) used for the treatment of heart failure patients with or without diabetes has been a breakthrough in the field of medicine. This review describes the established pathophysiology of diabetic cardiomyopathy and SGLT2 inhibitors, their mechanisms of action, and benefits in this group of patients.
{"title":"Heart Failure and Diabetes: Perspective of a Dangerous Association.","authors":"Liliana E Favaloro, Roxana D Ratto, Carla Musso","doi":"10.2174/1573402117666210406111927","DOIUrl":"https://doi.org/10.2174/1573402117666210406111927","url":null,"abstract":"<p><p>The relationship between diabetes and risk of heart failure has been described in previous trials, releasing the importance of the hyperglycemic state that, added to other risk factors, favors the development of coronary heart disease. The mechanism by which, in the absence of hypertension, obesity and/or dyslipidemia, diabetic patients develop cardiomyopathy has been less studied. Recently, the Sodium Glucose Co-transporter type 2 inhibitors (SGLT2 inhibitors) used for the treatment of heart failure patients with or without diabetes has been a breakthrough in the field of medicine. This review describes the established pathophysiology of diabetic cardiomyopathy and SGLT2 inhibitors, their mechanisms of action, and benefits in this group of patients.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25564755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402116999201210194817
Ramiro A Sanchez, Maria J Sanchez, Agustin J Ramirez
Introduction: Silent coronary heart disease is frequently undetected in type 2 diabetes mellitus (DM2) and pre-diabetes determined by glucose intolerance (GI). Pulse wave velocity (PWV) and albumin-creatinine ratio (ACR) have been considered markers of cardiovascular mortality, coronary heart disease and chronic renal failure.
Aim: To evaluate the incidence of coronary artery disease (CAD) and the relationship between urinary albumin-creatinine ratio, glomerular filtration rate (GFR) and PWV in type 2 DM with silent CAD.
Methods: We analyzed 92 individuals (44 male), 49 (60±7y) type 2 DM non-insulin dependents and 43 prediabetics (43±4y), with Grade I-II hypertension and no symptoms of CAD. All type 2 DM patients were under antidiabetic treatment with A1C hemoglobin between 5.5 and 6.5%. Every patient underwent a myocardial perfusion SPECT scan. In those subjects with ischemic patterns, coronary angiography was performed. In addition, PWV, glomerular filtration rate, and ACR were evaluated.
Statistics: mean±SEM, and ANOVA among groups.
Results: 48.59% of DM2 and 25.58% of GI patients had silent coronary artery had silent coronary artery disease and higher ACR, PWV and reduced GFR. Higher ACR and PWV and reduced GFR. DM2 and GI showed a negative relationship between GFR and ACR. Moreover, this relation was also observed in different levels of GFR (>60 ml/min and <60ml.min (p<0.05) in patients with CAD, suggesting a cardio-renal interaction in DM2.
Conclusion: Higher PWV, lower GFR and ACR predict the incidence of CAD in DM2. Dysglycemic individuals also represent a group of higher risk for coronary artery disease with similar predictors as in DM2. Diabetic and prediabetics still develop renal microalbuminuria. Thus, PWV seems to represent a reliable marker of renal impairment and coronary artery disease.
{"title":"Renal Function, Albumin-Creatinine Ratio and Pulse Wave Velocity Predict Silent Coronary Artery Disease and Renal Outcome in Type 2 Diabetic and Prediabetic Subjects.","authors":"Ramiro A Sanchez, Maria J Sanchez, Agustin J Ramirez","doi":"10.2174/1573402116999201210194817","DOIUrl":"https://doi.org/10.2174/1573402116999201210194817","url":null,"abstract":"<p><strong>Introduction: </strong>Silent coronary heart disease is frequently undetected in type 2 diabetes mellitus (DM2) and pre-diabetes determined by glucose intolerance (GI). Pulse wave velocity (PWV) and albumin-creatinine ratio (ACR) have been considered markers of cardiovascular mortality, coronary heart disease and chronic renal failure.</p><p><strong>Aim: </strong>To evaluate the incidence of coronary artery disease (CAD) and the relationship between urinary albumin-creatinine ratio, glomerular filtration rate (GFR) and PWV in type 2 DM with silent CAD.</p><p><strong>Methods: </strong>We analyzed 92 individuals (44 male), 49 (60±7y) type 2 DM non-insulin dependents and 43 prediabetics (43±4y), with Grade I-II hypertension and no symptoms of CAD. All type 2 DM patients were under antidiabetic treatment with A1C hemoglobin between 5.5 and 6.5%. Every patient underwent a myocardial perfusion SPECT scan. In those subjects with ischemic patterns, coronary angiography was performed. In addition, PWV, glomerular filtration rate, and ACR were evaluated.</p><p><strong>Statistics: </strong>mean±SEM, and ANOVA among groups.</p><p><strong>Results: </strong>48.59% of DM2 and 25.58% of GI patients had silent coronary artery had silent coronary artery disease and higher ACR, PWV and reduced GFR. Higher ACR and PWV and reduced GFR. DM2 and GI showed a negative relationship between GFR and ACR. Moreover, this relation was also observed in different levels of GFR (>60 ml/min and <60ml.min (p<0.05) in patients with CAD, suggesting a cardio-renal interaction in DM2.</p><p><strong>Conclusion: </strong>Higher PWV, lower GFR and ACR predict the incidence of CAD in DM2. Dysglycemic individuals also represent a group of higher risk for coronary artery disease with similar predictors as in DM2. Diabetic and prediabetics still develop renal microalbuminuria. Thus, PWV seems to represent a reliable marker of renal impairment and coronary artery disease.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38702603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402117666210121100936
Satish G Patil, Sneha Arakeri, Vitthal Khode
Background: Increased arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. It is unknown whether low BMI has any detrimental effect on the arterial wall during young age.
Objectives: The present study was aimed to determine if low BMI can increase arterial stiffness in young, healthy individuals.
Methods: A cross-sectional study was conducted on young, healthy subjects (n=100) with low BMI <18.5 (n=50) and normal BMI: 18.5-24.9 (n=50) with ages ranging between 15-23 years. BMI, heart rate, blood pressure, and arterial stiffness indices such as regional pulse wave velocity (PWV) between brachial-ankle (baPWV), carotid-femoral (cfPWV), heart-ankle (haPWV), heartbrachial (hbPWV) were measured.
Results: A significantly increased pulse pressure (p=0.014), baPWV (1059.2 ± 140.26 cm/s vs 994.66 ± 129.23 cm/s; p=0.019) and cfPWV (641.03 ± 113.83 cm/s vs 583.96 ± 120.48 cm/s; p=0.017) was found in individuals with low BMI than normal BMI group. There was a significant negative correlation between BMI and central arterial PWV. Further multiple regression analysis showed that BMI was robustly associated with cf-PWV (p=0.004) and baPWV (p=0.016) even after multiple adjustments with potential confounders using several models.
Conclusion: These findings show a significant increased aortic stiffness and pulse pressure in low BMI subjects compared to those with normal BMI. Low BMI was inversely and independently associated with central arterial or aortic stiffness. These findings suggest that low BMI may be a risk factor for aortic stiffness in young, healthy individuals.
背景:动脉僵硬度升高是心血管疾病发病率和死亡率的独立预测因子。目前尚不清楚低BMI是否对年轻时的动脉壁有任何有害影响。目的:本研究旨在确定低BMI是否会增加年轻健康个体的动脉硬化。方法:对100名BMI较低的年轻健康受试者进行横断面研究。结果:患者脉压(p=0.014)、baPWV(1059.2±140.26 cm/s vs 994.66±129.23 cm/s)显著升高;p=0.019)和cfPWV(641.03±113.83 cm/s vs 583.96±120.48 cm/s;p=0.017)。BMI与中央动脉PWV呈显著负相关。进一步的多元回归分析显示,BMI与cf-PWV (p=0.004)和baPWV (p=0.016)存在显著相关,即使在多个模型中对潜在混杂因素进行了多次调整后也是如此。结论:这些发现表明,与BMI正常的受试者相比,低BMI受试者的主动脉僵硬度和脉压明显增加。低BMI与中央动脉或主动脉僵硬度呈负相关且独立相关。这些发现表明,低BMI可能是年轻健康个体主动脉僵硬的一个危险因素。
{"title":"Association of Low BMI with Aortic Stiffness in Young Healthy Individuals","authors":"Satish G Patil, Sneha Arakeri, Vitthal Khode","doi":"10.2174/1573402117666210121100936","DOIUrl":"https://doi.org/10.2174/1573402117666210121100936","url":null,"abstract":"<p><strong>Background: </strong>Increased arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. It is unknown whether low BMI has any detrimental effect on the arterial wall during young age.</p><p><strong>Objectives: </strong>The present study was aimed to determine if low BMI can increase arterial stiffness in young, healthy individuals.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on young, healthy subjects (n=100) with low BMI <18.5 (n=50) and normal BMI: 18.5-24.9 (n=50) with ages ranging between 15-23 years. BMI, heart rate, blood pressure, and arterial stiffness indices such as regional pulse wave velocity (PWV) between brachial-ankle (baPWV), carotid-femoral (cfPWV), heart-ankle (haPWV), heartbrachial (hbPWV) were measured.</p><p><strong>Results: </strong>A significantly increased pulse pressure (p=0.014), baPWV (1059.2 ± 140.26 cm/s vs 994.66 ± 129.23 cm/s; p=0.019) and cfPWV (641.03 ± 113.83 cm/s vs 583.96 ± 120.48 cm/s; p=0.017) was found in individuals with low BMI than normal BMI group. There was a significant negative correlation between BMI and central arterial PWV. Further multiple regression analysis showed that BMI was robustly associated with cf-PWV (p=0.004) and baPWV (p=0.016) even after multiple adjustments with potential confounders using several models.</p><p><strong>Conclusion: </strong>These findings show a significant increased aortic stiffness and pulse pressure in low BMI subjects compared to those with normal BMI. Low BMI was inversely and independently associated with central arterial or aortic stiffness. These findings suggest that low BMI may be a risk factor for aortic stiffness in young, healthy individuals.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38842823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402117666210121102405
Airton C Martins, Alessanda A D Santos, Ana C B A Lopes, Anatoly V Skalny, Michael Aschner, Alexey A Tinkov, Monica M B Paoliello
Hypertension is an important public health concern that affects millions globally, leading to a large number of morbidities and fatalities. The etiology of hypertension is complex and multifactorial, and it involves environmental factors, including heavy metals. Cadmium and mercury are toxic elements commonly found in the environment, contributing to hypertension. We aimed to assess the role of cadmium and mercury-induced endothelial dysfunction in the development of hypertension. A narrative review was carried out through database searches. In this review, we discussed the critical roles of cadmium and mercury in the etiology of hypertension and provided new insights into potential mechanisms of their effect, focusing primarily on endothelial dysfunction. Although the mechanisms by which cadmium and mercury induce hypertension have yet to be completely elucidated, evidence for both implicates impaired nitric oxide signaling in their hypertensive etiology.
{"title":"Endothelial Dysfunction Induced by Cadmium and Mercury and its Relationship to Hypertension.","authors":"Airton C Martins, Alessanda A D Santos, Ana C B A Lopes, Anatoly V Skalny, Michael Aschner, Alexey A Tinkov, Monica M B Paoliello","doi":"10.2174/1573402117666210121102405","DOIUrl":"https://doi.org/10.2174/1573402117666210121102405","url":null,"abstract":"<p><p>Hypertension is an important public health concern that affects millions globally, leading to a large number of morbidities and fatalities. The etiology of hypertension is complex and multifactorial, and it involves environmental factors, including heavy metals. Cadmium and mercury are toxic elements commonly found in the environment, contributing to hypertension. We aimed to assess the role of cadmium and mercury-induced endothelial dysfunction in the development of hypertension. A narrative review was carried out through database searches. In this review, we discussed the critical roles of cadmium and mercury in the etiology of hypertension and provided new insights into potential mechanisms of their effect, focusing primarily on endothelial dysfunction. Although the mechanisms by which cadmium and mercury induce hypertension have yet to be completely elucidated, evidence for both implicates impaired nitric oxide signaling in their hypertensive etiology.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38842825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402116666200510011356
Alejandro F do Prado, Cahy M Bannwart, Victoria M T Shinkai, Ildercílio M de Souza Lima, César A Meschiari
Matrix metalloproteinases (MMPs) are enzymes that present a metallic element in their structure. These enzymes are ubiquitously distributed and function as extracellular matrix (ECM) remodelers. MMPs play a broad role in cardiovascular biology regulating processes such as cell adhesion and function, cellular communication and differentiation, integration of mechanical force and force transmission, tissue remodeling, modulation of damaged-tissue structural integrity, cellular survival or apoptosis and regulation of inflammation-related cytokines and growth factors. MMPs inhibition and downregulation are correlated with minimization of cardiac damage, i.e., Chinese herbal medicine has shown to stabilize abdominal aorta aneurysm due to its antiinflammatory, antioxidant and MMP-2 and 9 inhibitory properties. Thus phyto-derived products rise as promising sources for novel therapies focusing on MMPs inhibition and downregulation to treat or prevent cardiovascular disorders.
{"title":"Phyto-derived Products as Matrix Metalloproteinases Inhibitors in Cardiovascular Diseases.","authors":"Alejandro F do Prado, Cahy M Bannwart, Victoria M T Shinkai, Ildercílio M de Souza Lima, César A Meschiari","doi":"10.2174/1573402116666200510011356","DOIUrl":"https://doi.org/10.2174/1573402116666200510011356","url":null,"abstract":"<p><p>Matrix metalloproteinases (MMPs) are enzymes that present a metallic element in their structure. These enzymes are ubiquitously distributed and function as extracellular matrix (ECM) remodelers. MMPs play a broad role in cardiovascular biology regulating processes such as cell adhesion and function, cellular communication and differentiation, integration of mechanical force and force transmission, tissue remodeling, modulation of damaged-tissue structural integrity, cellular survival or apoptosis and regulation of inflammation-related cytokines and growth factors. MMPs inhibition and downregulation are correlated with minimization of cardiac damage, i.e., Chinese herbal medicine has shown to stabilize abdominal aorta aneurysm due to its antiinflammatory, antioxidant and MMP-2 and 9 inhibitory properties. Thus phyto-derived products rise as promising sources for novel therapies focusing on MMPs inhibition and downregulation to treat or prevent cardiovascular disorders.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37915904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402116999201209203250
Katerina Baou, Vasiliki Katsi, Thomas Makris, Dimitris Tousoulis
Approximately half a century has passed since the discovery of beta-blockers. Then, their prime therapeutic purpose was to treat angina and cardiac arrhythmias; nowadays, beta-blockers' usage and effectiveness are extended to treat other cardiovascular diseases, such as hypertension, congestive heart failure, and coronary artery disease. Safety concerns were raised about beta- blockers and their use for chronic obstructive pulmonary disease (COPD) patients with concurrent cardiovascular disease. After thorough research of the literature, this review summarizes the evidence proving that beta-blockers not only might be well tolerated in COPD patients, but they might also have a beneficial effect in this group of patients.
{"title":"Beta Blockers and Chronic Obstructive Pulmonary Disease (COPD): Sum of Evidence.","authors":"Katerina Baou, Vasiliki Katsi, Thomas Makris, Dimitris Tousoulis","doi":"10.2174/1573402116999201209203250","DOIUrl":"https://doi.org/10.2174/1573402116999201209203250","url":null,"abstract":"<p><p>Approximately half a century has passed since the discovery of beta-blockers. Then, their prime therapeutic purpose was to treat angina and cardiac arrhythmias; nowadays, beta-blockers' usage and effectiveness are extended to treat other cardiovascular diseases, such as hypertension, congestive heart failure, and coronary artery disease. Safety concerns were raised about beta- blockers and their use for chronic obstructive pulmonary disease (COPD) patients with concurrent cardiovascular disease. After thorough research of the literature, this review summarizes the evidence proving that beta-blockers not only might be well tolerated in COPD patients, but they might also have a beneficial effect in this group of patients.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38697522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402117666210111102508
Joseph A Adeyemi, Victor O Ukwenya, Olatunbosun K Arowolo, Christian C Olise
Increased applications of pesticides, mainly in agriculture and public health, have resulted in increased chances of human exposure to pesticides. Chronic exposure to pesticides has been implicated in several human diseases, including cardiovascular diseases. Cardiovascular diseases are broadly used for various heart pathological conditions, including a defect in blood vessels, and they include myocardial infarction, atherosclerosis, stroke, cardiomyopathy, coronary heart disease, etc. In this review, the association between human exposure to pesticides and the development of cardiovascular diseases was discussed using epidemiological and laboratory data. The toxicokinetics of pesticides in humans was reviewed, as well as the risk factors for cardiovascular diseases. The important role of oxidative stress principally the induction of reactive oxygen species as the signaling molecules for various signaling pathways involved in pesticides-induced cardiovascular disease, was discussed.
{"title":"Pesticides-induced Cardiovascular Dysfunctions: Prevalence and Associated Mechanisms.","authors":"Joseph A Adeyemi, Victor O Ukwenya, Olatunbosun K Arowolo, Christian C Olise","doi":"10.2174/1573402117666210111102508","DOIUrl":"https://doi.org/10.2174/1573402117666210111102508","url":null,"abstract":"<p><p>Increased applications of pesticides, mainly in agriculture and public health, have resulted in increased chances of human exposure to pesticides. Chronic exposure to pesticides has been implicated in several human diseases, including cardiovascular diseases. Cardiovascular diseases are broadly used for various heart pathological conditions, including a defect in blood vessels, and they include myocardial infarction, atherosclerosis, stroke, cardiomyopathy, coronary heart disease, etc. In this review, the association between human exposure to pesticides and the development of cardiovascular diseases was discussed using epidemiological and laboratory data. The toxicokinetics of pesticides in humans was reviewed, as well as the risk factors for cardiovascular diseases. The important role of oxidative stress principally the induction of reactive oxygen species as the signaling molecules for various signaling pathways involved in pesticides-induced cardiovascular disease, was discussed.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38741673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: There are limited data on the management of hypertension (HT) in Algeria. The aim of this study was to assess, in current medical practice, the use and benefits of ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of HT.
Methods: A prospective, observational, multicenter study was performed in 2017. Patients aged ≥ 18 years with suspected or treated HT were included. A 24-hour ABPM was performed at baseline in all patients. Therapeutic decision was taken by the physician according to ABPM results and patients were then followed up to 6 weeks.
Results: The analysis included 1027 patients (mean age, 51.0 years; women, 61.6%) with treated HT (37.3%) or suspected HT (62.7%). Major cardiovascular risk factors were diabetes (15.7%) and lipid disorders (7.2%). ABPM was pathological in 55.1% of patients on antihypertensive treatment and in 60.8% of patients with suspected HT. A therapeutic adjustment or a treatment switch was performed after pathological ABPM in 37.4% of patients already on antihypertensive treatment and an antihypertensive therapy was initiated in 54.9% of patients with initially suspected HT.
Conclusion: This study is the first evaluation of the usefulness of ABPM for the management of HT in Algeria. Our results emphasize that ABPM is a highly valuable method for avoiding the whitecoat effect and for detecting patients who are insufficiently treated with antihypertensive drugs.
{"title":"Ambulatory Blood Pressure Monitoring in the Diagnosis and Management of Arterial Hypertension in Current Medical Practice in Algeria.","authors":"Naima Hammoudi-Bendib, Leila Manamani, Souhila Ouabdesselam, Dalila S Ouamer, Sofiane Ghemri, Laurene Courouve, Amine Cherif, Lamine Mahi, Salim Benkhedda","doi":"10.2174/1573402116666200324144223","DOIUrl":"https://doi.org/10.2174/1573402116666200324144223","url":null,"abstract":"<p><strong>Objective: </strong>There are limited data on the management of hypertension (HT) in Algeria. The aim of this study was to assess, in current medical practice, the use and benefits of ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of HT.</p><p><strong>Methods: </strong>A prospective, observational, multicenter study was performed in 2017. Patients aged ≥ 18 years with suspected or treated HT were included. A 24-hour ABPM was performed at baseline in all patients. Therapeutic decision was taken by the physician according to ABPM results and patients were then followed up to 6 weeks.</p><p><strong>Results: </strong>The analysis included 1027 patients (mean age, 51.0 years; women, 61.6%) with treated HT (37.3%) or suspected HT (62.7%). Major cardiovascular risk factors were diabetes (15.7%) and lipid disorders (7.2%). ABPM was pathological in 55.1% of patients on antihypertensive treatment and in 60.8% of patients with suspected HT. A therapeutic adjustment or a treatment switch was performed after pathological ABPM in 37.4% of patients already on antihypertensive treatment and an antihypertensive therapy was initiated in 54.9% of patients with initially suspected HT.</p><p><strong>Conclusion: </strong>This study is the first evaluation of the usefulness of ABPM for the management of HT in Algeria. Our results emphasize that ABPM is a highly valuable method for avoiding the whitecoat effect and for detecting patients who are insufficiently treated with antihypertensive drugs.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37768194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402116666200817113125
Godela M Brosnahan, Zhiying You, Wei Wang, Berenice Y Gitomer, Michel Chonchol
Background: Epidemiological studies have suggested that elevated serum uric acid may contribute to the progression of chronic kidney disease. However, no large prospective study has examined whether hyperuricemia is an independent risk factor for the progression of autosomal dominant polycystic kidney disease (ADPKD).
Methods: We measured uric acid in stored serum samples from the 2-year study visit of 671 participants from the HALT PKD multicenter trials. Participants were categorized according to uric acid tertiles. For Study A (participants aged 15-49 years with preserved kidney function, n=350), we used linear mixed effects models to examine the association between uric acid and repeated measures of height-adjusted total kidney volume (htTKV), the primary outcome for Study A. For Study B (participants aged 18-64 with decreased kidney function, n=321), we used Cox proportional hazards models to assess the hazard for the combined endpoint of 50% loss in estimated glomerular filtration rate (eGFR), end-stage kidney disease (ESKD), or death, the primary outcome for Study B. To assess the association of uric acid with the slope of eGFR decline (secondary outcome of HALT A and B), we used linear mixed effects models for the combined population of Study A and B.
Results: In the unadjusted model, the annual change in htTKV was 2.7% higher in the highest uric acid tertile compared to the lowest (p<0.001), but this difference became insignificant after adjustment for gender. Men had faster TKV growth than women (p<0.001). There was no difference in eGFR decline between the 3 uric acid tertiles. Hazard ratios for the clinical endpoint were 2.9 (95% confidence interval, 1.9-4.4) and 1.8 (1.1-2.8) respectively in the high and medium uric acid groups in unadjusted and partially adjusted models (p<0.001), but the significance was lost after adjustment for baseline eGFR. Results were similar when uric acid was examined as a continuous variable.
Conclusion: Elevated serum uric acid is not an independent risk factor for disease progression in ADPKD.
{"title":"Serum Uric Acid and Progression of Autosomal Dominant Polycystic Kidney Disease: Results from the HALT PKD Trials.","authors":"Godela M Brosnahan, Zhiying You, Wei Wang, Berenice Y Gitomer, Michel Chonchol","doi":"10.2174/1573402116666200817113125","DOIUrl":"https://doi.org/10.2174/1573402116666200817113125","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies have suggested that elevated serum uric acid may contribute to the progression of chronic kidney disease. However, no large prospective study has examined whether hyperuricemia is an independent risk factor for the progression of autosomal dominant polycystic kidney disease (ADPKD).</p><p><strong>Methods: </strong>We measured uric acid in stored serum samples from the 2-year study visit of 671 participants from the HALT PKD multicenter trials. Participants were categorized according to uric acid tertiles. For Study A (participants aged 15-49 years with preserved kidney function, n=350), we used linear mixed effects models to examine the association between uric acid and repeated measures of height-adjusted total kidney volume (htTKV), the primary outcome for Study A. For Study B (participants aged 18-64 with decreased kidney function, n=321), we used Cox proportional hazards models to assess the hazard for the combined endpoint of 50% loss in estimated glomerular filtration rate (eGFR), end-stage kidney disease (ESKD), or death, the primary outcome for Study B. To assess the association of uric acid with the slope of eGFR decline (secondary outcome of HALT A and B), we used linear mixed effects models for the combined population of Study A and B.</p><p><strong>Results: </strong>In the unadjusted model, the annual change in htTKV was 2.7% higher in the highest uric acid tertile compared to the lowest (p<0.001), but this difference became insignificant after adjustment for gender. Men had faster TKV growth than women (p<0.001). There was no difference in eGFR decline between the 3 uric acid tertiles. Hazard ratios for the clinical endpoint were 2.9 (95% confidence interval, 1.9-4.4) and 1.8 (1.1-2.8) respectively in the high and medium uric acid groups in unadjusted and partially adjusted models (p<0.001), but the significance was lost after adjustment for baseline eGFR. Results were similar when uric acid was examined as a continuous variable.</p><p><strong>Conclusion: </strong>Elevated serum uric acid is not an independent risk factor for disease progression in ADPKD.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887140/pdf/nihms-1629002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38275292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.2174/1573402116999200819162306
Vladimir A Kashkin, Alexei Y Egorov, Evgeniy M Krupitsky, Alexei Y Bagrov
Background and objective: Previously, it was demonstrated that marinobufagenin (MBG) is implicated in the development of ethanol withdrawal in rats. It has been shown that ethanol withdrawal is associated with a pressor response in the alcoholics. We hypothesized that elevated levels of sodium pump ligand, MBG, would underline the increase in systolic blood pressure during alcohol withdrawal in humans.
Methods: The cohort included 9 patients with the diagnosis "alcohol dependence syndrome" (F10.(1-3) according to ICD-10). The blood samples for measurement of MBG concentration were collected from the subjects on the first day of withdrawal and after 7 days treatment of the abstinence. Arterial blood pressure was measured via plethysmography at the same time points.
Results: The beginning of the alcoholic abstinence was associated with the rise of arterial blood pressure with enhanced levels of plasma MBG. At day 7 following withdrawal, the systolic blood pressure and MBG levels were decreased to normal values.
Conclusion: The development of alcohol withdrawal is accompanied by an increase in arterial blood pressure, which is associated with increased plasma MBG concentration.
{"title":"Endogenous Bufadienolide, Blood Pressure and Alcohol Withdrawal.","authors":"Vladimir A Kashkin, Alexei Y Egorov, Evgeniy M Krupitsky, Alexei Y Bagrov","doi":"10.2174/1573402116999200819162306","DOIUrl":"https://doi.org/10.2174/1573402116999200819162306","url":null,"abstract":"<p><strong>Background and objective: </strong>Previously, it was demonstrated that marinobufagenin (MBG) is implicated in the development of ethanol withdrawal in rats. It has been shown that ethanol withdrawal is associated with a pressor response in the alcoholics. We hypothesized that elevated levels of sodium pump ligand, MBG, would underline the increase in systolic blood pressure during alcohol withdrawal in humans.</p><p><strong>Methods: </strong>The cohort included 9 patients with the diagnosis \"alcohol dependence syndrome\" (F10.(1-3) according to ICD-10). The blood samples for measurement of MBG concentration were collected from the subjects on the first day of withdrawal and after 7 days treatment of the abstinence. Arterial blood pressure was measured via plethysmography at the same time points.</p><p><strong>Results: </strong>The beginning of the alcoholic abstinence was associated with the rise of arterial blood pressure with enhanced levels of plasma MBG. At day 7 following withdrawal, the systolic blood pressure and MBG levels were decreased to normal values.</p><p><strong>Conclusion: </strong>The development of alcohol withdrawal is accompanied by an increase in arterial blood pressure, which is associated with increased plasma MBG concentration.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38282627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}