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Sample records for function duringl-name-induced hypertension

  1. Neurocognitive Function in Children with Primary Hypertension

    Science.gov (United States)

    Lande, Marc B.; Batisky, Donald L.; Kupferman, Juan C.; Samuels, Joshua; Hooper, Stephen R.; Falkner, Bonita; Waldstein, Shari R.; Szilagyi, Peter G.; Wang, Hongyue; Staskiewicz, Jennifer; Adams, Heather R.

    2016-01-01

    Objective To compare neurocognitive test performance of children with primary hypertension to that of normotensive controls. Study design Seventy-five children (10-18 years of age) with newly diagnosed, untreated hypertension and 75 frequency matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed. Parents completed rating scales of executive function and the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ-SRBD). Results Hypertension and control groups did not differ significantly in age, sex, maternal education, income, race, ethnicity, obesity, anxiety, depression, cholesterol, glucose, insulin, and C-reactive protein. Subjects with hypertension had higher PSQ-SRBD scores (p = 0.04) and triglycerides (p = 0.037). Multivariate analyses showed that hypertension was independently associated with worse performance on the Rey Auditory Verbal Learning Test (List A Trial 1, p = 0.034; List A Total, p = 0.009; Short delay recall, p = 0.013), CogState Groton Maze Learning Test delayed recall (p = 0.002), Grooved Pegboard dominant hand (p = 0.045), and Wechsler Abbreviated Scales of Intelligence Vocabulary (p = 0.016). Results indicated a significant interaction between disordered sleep (PSQ-SRBD score) and hypertension on ratings of executive function (p = 0.04), such that hypertension heightened the association between increased disordered sleep and worse executive function. Conclusions Youth with primary hypertension demonstrated significantly lower performance on neurocognitive testing compared with normotensive controls, in particular, on measures of memory, attention, and executive functions. PMID:27692987

  2. Impact of Hypertension on Cognitive Function

    Science.gov (United States)

    Iadecola, Costantino; Yaffe, Kristine; Biller, José; Bratzke, Lisa C.; Faraci, Frank M.; Gorelick, Philip B.; Gulati, Martha; Kamel, Hooman; Knopman, David S.; Launer, Lenore J.; Saczynski, Jane S.; Seshadri, Sudha; Zeki Al Hazzouri, Adina

    2017-01-01

    Background Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions. Methods Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data. Results Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive. Conclusions After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health. PMID:27977393

  3. Effects of calcium antagonists on hypertension and diastolic function ...

    African Journals Online (AJOL)

    Calcium antagonists are known to decrease blood pressure acutely and chronically in hypertensive patients with hypertensive heart disease, and also to improve their systolic function. However, disorders of diastolic function may occur early in hypertensive heart disease. The improvement of diastolic function by nifedipine ...

  4. Sexual function in hypertensive patients receiving treatment

    Directory of Open Access Journals (Sweden)

    Thorsten Reffelmann

    2006-12-01

    Full Text Available Thorsten Reffelmann, Robert A KlonerUniversity of Southern California, The Heart Institute, Good Samaritan Hospital, Division of Cardiovascular Medicine, Keck School of Medicine, Los Angeles, CA, USAAbstract: In many forms of erectile dysfunction (ED, cardiovascular risk factors, in particular arterial hypertension, seem to be extremely common. While causes for ED are related to a broad spectrum of diseases, a generalized vascular process seems to be the underlying mechanism in many patients, which in a large portion of clinical cases involves endothelial dysfunction, ie, inadequate vasodilation in response to endothelium-dependent stimuli, both in the systemic vasculature and the penile arteries. Due to this close association of cardiovascular disease and ED, patients with ED should be evaluated as to whether they may suffer from cardiovascular risk factors including hypertension, cardiovascular disease or silent myocardial ischemia. On the other hand, cardiovascular patients, seeking treatment of ED, must be evaluated in order to decide whether treatment of ED or sexual activity can be recommended without significantly increased cardiac risk. The guideline from the first and second Princeton Consensus Conference may be applied in this context. While consequent treatment of cardiovascular risk factors should be accomplished in these patients, many antihypertensive drugs may worsen sexual function as a drug specific side-effect. Importantly, effective treatment for arterial hypertension should not be discontinued as hypertension itself may contribute to altered sexual functioning; to the contrary, alternative antihypertensive regimes should be administered with individually tailored drug regimes with minimal side-effects on sexual function. When phosphodiesterase-5 inhibitors, such as sildenafil, tadalafil and vardenafil, are prescribed to hypertensive patients on antihypertensive drugs, these combinations of antihypertensive drugs and

  5. Cognitive function in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne Maria; Fagerlund, Birgitte; Forchhammer, Hysse Birgitte

    2014-01-01

    -up. At the time of testing, none of the patients took medication potentially affecting cognitive function. Controls were 31 healthy age-matched and sex-matched volunteers from the local community. OUTCOME MEASURES: Executive function, working memory, visuospatial memory, processing speed, attention and reaction......OBJECTIVE: To explore the extent and nature of cognitive deficits in patients with idiopathic intracranial hypertension (IIH) at the time of diagnosis and after 3 months of treatment. DESIGN: Prospective case-control study. SETTING: Neurological department, ophthalmological department...... time assessed by a comprehensive neuropsychological test battery consisting of validated computerised (Cambridge neuropsychological test automated battery) and paper-and-pencil tests. RESULTS: Patients with IIH performed significantly worse than controls in four of six cognitive domains (p≤0...

  6. Vascular function in health, hypertension, and diabetes

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Gliemann, Lasse; Hellsten, Ylva

    2015-01-01

    muscle, which can affect muscle function. Central aspects in the vascular impairments are alterations in the formation of prostacyclin, the bioavailability of NO and an increased formation of vasoconstrictors and reactive oxygen species (ROS). Regular physical activity effectively improves vascular......, the increase in muscle blood flow required for oxygen supply during exercise is achieved through a substantial increase in vasodilators locally formed in the active muscle tissue that overcome the vasoconstrictor signals. Most of the vasodilator signals are mediated via endothelial cells, which lead...... to the formation of vasodilators such as nitric oxide (NO) and prostacyclin. In essential hypertension and type II diabetes, the endothelial function and regulation of vascular tone is impaired with consequent increases in peripheral vascular resistance and inadequate regulation of oxygen supply to the skeletal...

  7. The Effect of Hypertension on Neurocognitive Functioning and ...

    African Journals Online (AJOL)

    Log in or Register to get access to full text downloads. ... The objectives of this study were to investigate the effect of hypertension on neurocognitive functioning and quality of life. Design: The study was ... Conclusion: Quality of life seems to be more affected than neurocognitive functioning in the hypertensives in this study.

  8. Endothelial function in children with white-coat hypertension.

    Science.gov (United States)

    Jurko, Alexander; Jurko, Tomas; Minarik, Milan; Mestanik, Michal; Mestanikova, Andrea; Micieta, Vladimir; Visnovcova, Zuzana; Tonhajzerova, Ingrid

    2018-01-29

    Several studies have demonstrated endothelial dysfunction in patients with essential hypertension. However, the presence of endothelial dysfunction in children with white-coat hypertension has not been studied. We evaluated the endothelial function in children with white-coat hypertension and essential hypertension using a novel method based on the assessment of flow-mediated dilation (FMD). Study involved 106 children: 30 white-coat hypertensives (age 16.3 ± 1.3 years, mean ± SD), 30 essential hypertensives (age 16.4 ± 1.3 years), and 46 healthy controls (age 16.2 ± 1.4 years). Ultrasound scans of the right brachial artery were performed using Prosound F75 Aloka system during protocol: baseline (1 min), forearm ischemia (5 min), and post-occlusion phase (3 min). FMD (%) was expressed as a change of the arterial diameter from baseline to maximum post-occlusion value and the values coat hypertension compared to control group (p coat hypertensives compared to controls (p coat hypertension could help to elucidate the mechanisms of the increased cardiovascular risk that could be similar as found in essential hypertension; therefore, white-coat hypertension should not be considered a benign phenomenon.

  9. The effect of hypertension on neurocognitive functioning and quality ...

    African Journals Online (AJOL)

    Objectives: Hypertension has been reported as one of the most important etiologic factors in cardiovascular disease. The objectives of this study were to investigate the effect of hypertension on neurocognitive functioning and quality of life. Design: The study was cross sectional, and clinic based. The sample comprised of 50 ...

  10. 35. the effect of hypertension on neurocognitive functioning and ...

    African Journals Online (AJOL)

    Esem

    understood yet, however knowledge in this area of study. 9 is on the ..... Science and Technology, Norway), Prof. R. Heaton ... Carey. 12. Grosssman, L.R., and Zalewski, C. Hypertension and. Cognitive Functioning, (abstract) Journal of Clinical.

  11. Hypertension

    Science.gov (United States)

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Obstructive sleep apnea is a potentially serious sleep ...

  12. Effects of calcium antagonists on hypertension and diastolic function

    African Journals Online (AJOL)

    1989-08-05

    Aug 5, 1989 ... and improve myocardial function. Digitalis compounds such as digoxin are not appropriate therapy for diastolic dysfunction and should be avoided. REFERENCES. I. Fouad FM, Slominski JM, Tarazi RC. Left ventricular diastolic function in hypertension: relation to left ventricular mass and systolic function.

  13. Correlation between hypertension and cognitive function in elderly

    Science.gov (United States)

    Fitri, F. I.; Rambe, A. S.

    2018-03-01

    Hypertension and cognitive impairment are common disorders among elderly adults, and their prevalences tend to rise as the population ages. This study aimed to determine the correlation between hypertension and cognitive function in elderly. It was a cross-sectional study involving 62 elderly subjects. All subjects underwent physical and neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function. This study included 62 subjects consisted of 26 males (41.9%) and 36 females (58.1%). There were 24 subjects (38.2%) with hypertension and 38 (61.3%) normal elderly subjects. The mean age was 65.71±4.49 years old. There were no significant differences in demographic characteristics, total MoCA-INA scores, and scores based on cognitive domains between two groups, except for visuospatial and executive function (p=0.026). There was a significant correlation between hypertension and visuospatial and executive function (r=0.301, p=0.017). Hypertension is correlated with cognitive impairment mainly on visuospatial and executive function in elderly.

  14. Endothelial function in postmenopausal women with nighttime systolic hypertension.

    Science.gov (United States)

    Routledge, Faye S; Hinderliter, Alan L; McFetridge-Durdle, Judith; Blumenthal, James A; Paine, Nicola J; Sherwood, Andrew

    2015-08-01

    Hypertension becomes more prevalent in women during their postmenopausal years. Nighttime systolic blood pressure (SBP) is especially predictive of adverse cardiac events, and the relationship between rising nighttime SBP and cardiovascular risk increases more rapidly in women compared with men. The reasons for the prognostic significance of nighttime SBP are not completely known but may involve vascular endothelial dysfunction. The purposes of this study were to examine the relationship between nighttime SBP and endothelial function, as assessed by brachial artery flow-mediated dilation (FMD), and to determine whether postmenopausal women with nighttime hypertension (SBP ≥120 mm Hg) evidenced greater endothelial dysfunction compared with women with normal nighttime SBP. One hundred postmenopausal women (mean [SD] age, 65.8 [7.5] y; mean [SD] body mass index, 28.3 [4.7] kg/m; hypertension, 47%; coronary artery disease, 51%; mean [SD] clinic SBP, 137 [17] mm Hg; mean [SD] clinic diastolic blood pressure, 67 [11] mm Hg; nighttime hypertension, 34 women) underwent 24-hour ambulatory blood pressure monitoring, actigraphy, and brachial artery FMD assessment. Multivariate regression models showed that higher nighttime SBP and larger baseline artery diameter were inversely related to FMD. Nighttime SBP and baseline artery diameter accounted for 23% of the variance in FMD. After adjustment for baseline artery diameter, women with nighttime hypertension had lower mean (SD) FMD than women with normal nighttime SBP (2.95% [0.65%] vs 5.52% [0.46%], P = 0.002). Nighttime hypertension is associated with reduced endothelial function in postmenopausal women. Research examining the therapeutic benefits of nighttime hypertension treatment on endothelial function and future cardiovascular risk in postmenopausal women is warranted.

  15. Gastrointestinal motor function in patients with portal hypertension

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

    2000-01-01

    BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments...... of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit...... the test meal between patients and controls. CONCLUSIONS: These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected....

  16. Racial differences in hypertension knowledge: effects of differential item functioning.

    Science.gov (United States)

    Ayotte, Brian J; Trivedi, Ranak; Bosworth, Hayden B

    2009-01-01

    Health-related knowledge is an important component in the self-management of chronic illnesses. The objective of this study was to more accurately assess racial differences in hypertension knowledge by using a latent variable modeling approach that controlled for sociodemographic factors and accounted for measurement issues in the assessment of hypertension knowledge. Cross-sectional data from 1,177 participants (45% African American; 35% female) were analyzed using a multiple indicator multiple causes (MIMIC) modeling approach. Available sociodemographic data included race, education, sex, financial status, and age. All participants completed six items on a hypertension knowledge questionnaire. Overall, the final model suggested that females, Whites, and patients with at least a high school diploma had higher latent knowledge scores than males, African Americans, and patients with less than a high school diploma, respectively. The model also detected differential item functioning (DIF) based on race for two of the items. Specifically, the error rate for African Americans was lower than would be expected given the lower level of latent knowledge on the items, on the questions related to: (a) the association between high blood pressure and kidney disease, and (b) the increased risk African Americans have for developing hypertension. Not accounting for DIF resulted in the difference between Whites and African Americans to be underestimated. These results are discussed in the context of the need for careful measurement of health-related constructs, and how measurement-related issues can result in an inaccurate estimation of racial differences in hypertension knowledge.

  17. Sequential and functional renal scintiscanning in diabetic and hypertensive patients

    International Nuclear Information System (INIS)

    Wagner, M.

    1978-01-01

    47 diabetics (94 kidneys), 30 diabetics with concurrent hypertension (60 kidneys), and 23 hypertensives (46 kidneys) were examined by renal serial functional scintiscanning with 131 I-ortho-iodo-hippuric acid. For evaluation, camera nephrographs of the whole kidney, renal hemispheres, and renal cortex were used according to the technique of 'regions of interest', and the parameters of secretory value, maximum secretion, and elimination half-life were determined on this basis. With regard to the extent of hypertension, there are significant differences between all three groups for the elimination half-life; as far as the secretory value was concerned, there was a difference between the group with high hypertension and the two other groups. Significant differences in secretory value and elimination half-life were also observed in hypertensives with and without changes in the fundus of the eye. There was no noticeable difference between the three parameters in groups with and without albuminuria. (orig./AJ) 891 AJ/orig.- 892 MKO [de

  18. Gastrointestinal motor function in patients with portal hypertension

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

    2000-01-01

    BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments...... of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit...... rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS: No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients...

  19. hypertension

    Directory of Open Access Journals (Sweden)

    Emine Hatipoglu

    2013-05-01

    Full Text Available Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.

  20. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  1. Hypertension

    OpenAIRE

    Farrugia, Emanuel

    2004-01-01

    Hypertension is a rapidly moving clinical field with frequent developments in new pharmacologic agents and management strategies. Perhaps more importantly, there have been substantial improvements in our understanding of how best to use the drugs available to us. In this article, I will review some of the more important advances in our understanding of hypertension over the past two years, specifically by reviewing six important trials, one survey and two sets of guidelines, all published bet...

  2. Brain perfusion and cognitive function changes in hypertensive patients

    International Nuclear Information System (INIS)

    Efimova, I.Y.; Efimova, N.Y.; Triss, S.V.; Lishmanov, Y.B.

    2008-01-01

    The aim of our study was to estimate brain perfusion and cognitive function (CF) in patients with arterial hypertension (AH) before and after hypotensive therapy. The study included 15 patients (mean age, 53.0±5.7 years) with previously untreated or ineffectively treated essential hypertension of the second degree. All patients underwent brain single photon emission computed tomography (SPECT) scanning with 99m Tc-hexamethylpropylene amine oxime ( 99m Tc-HMPAO) and comprehensive neuropsychological testing before and after 24 weeks of hypotensive therapy (angiotensin-converting enzyme [ACE] inhibitor or diuretics). The brain perfusion was significantly lower (15-22%) in all regions of AH patients. These patients showed a 25% decrease in attention and psychomotor speed as well as a 14% decrease in mentation. Six months of hypotensive therapy led to an increase in brain perfusion by an average of 7-11% in all brain regions. After treatment these patients demonstrated an average 11-18% improvements in attention and psychomotor speed, as well as an average 10% improvement in abstract mentation. Marked signs of brain hypoperfusion and impaired CF: decrease in attention, slowing psychomotor speed and mentation was found in hypertensive patients even without focal neurological symptomatology. Twenty-four weeks of hypotensive treatment with ACE inhibitors or diuretics had a positive effect on cerebral perfusion and led to CF improvement. (author)

  3. Coherence and Coupling Functions Reveal Microvascular Impairment in Treated Hypertension

    Directory of Open Access Journals (Sweden)

    Valentina Ticcinelli

    2017-10-01

    Full Text Available The complex interactions that give rise to heart rate variability (HRV involve coupled physiological oscillators operating over a wide range of different frequencies and length-scales. Based on the premise that interactions are key to the functioning of complex systems, the time-dependent deterministic coupling parameters underlying cardiac, respiratory and vascular regulation have been investigated at both the central and microvascular levels. Hypertension was considered as an example of a globally altered state of the complex dynamics of the cardiovascular system. Its effects were established through analysis of simultaneous recordings of the electrocardiogram (ECG, respiratory effort, and microvascular blood flow [by laser Doppler flowmetry (LDF]. The signals were analyzed by methods developed to capture time-dependent dynamics, including the wavelet transform, wavelet-based phase coherence, non-linear mode decomposition, and dynamical Bayesian inference, all of which can encompass the inherent frequency and coupling variability of living systems. Phases of oscillatory modes corresponding to the cardiac (around 1.0 Hz, respiratory (around 0.25 Hz, and vascular myogenic activities (around 0.1 Hz were extracted and combined into two coupled networks describing the central and peripheral systems, respectively. The corresponding spectral powers and coupling functions were computed. The same measurements and analyses were performed for three groups of subjects: healthy young (Y group, 24.4 ± 3.4 y, healthy aged (A group, 71.1 ± 6.6 y, and aged treated hypertensive patients (ATH group, 70.3 ± 6.7 y. It was established that the degree of coherence between low-frequency oscillations near 0.1 Hz in blood flow and in HRV time series differs markedly between the groups, declining with age and nearly disappearing in treated hypertension. Comparing the two healthy groups it was found that the couplings to the cardiac rhythm from both respiration and

  4. The effect of melatonin on vascular function in NO-deficient hypertensive rats

    Czech Academy of Sciences Publication Activity Database

    Paulis, L.; Pecháňová, O.; Zicha, Josef; Gardlik, R.; Celec, P.; Kuneš, Jaroslav

    2008-01-01

    Roč. 26, Suppl.1 (2008), S382-S382 ISSN 0263-6352. [Scientific Meeting International Society of Hypertension /22./ , Scientific Meeting European Society of Hypertension /18./. 14.06.2008-19.06.2008, Berlin] Institutional research plan: CEZ:AV0Z50110509 Keywords : cpo1 * melatonin * NO-deficient hypertension * vascular function Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  5. Renal functional reserve and renal hemodynamics in hypertensive patients.

    Science.gov (United States)

    Gaipov, Abduzhappar; Solak, Yalcin; Zhampeissov, Nurlan; Dzholdasbekova, Aliya; Popova, Nadezhda; Molnar, Miklos Z; Tuganbekova, Saltanat; Iskandirova, Elmira

    2016-10-01

    The renal functional reserve (RFR) is the ability of the kidneys to increase renal plasma flow and glomerular filtration rate (GFR) in response to protein intake. It is a measure of functional and anatomic integrity of nephrons. It is not known what relation between RFR and kidney Doppler parameters. We aimed to study the relation between the RFR and renal hemodynamic parameters in hypertensive patients with and without nephropathy who had normal kidney function. Twenty-four hypertensive subjects with nephropathy (HTN-n, n = 10) and hypertension without nephropathy (HTN, n = 14) were included in the study. Control group included 11 healthy subjects. Baseline GFR (GFR1) and GFR after intake of egg protein 1 mg/kg of body weight were determined (GFR2). RFR was calculated by the following formula: (GFR2-GFR1)/GFR1 × 100%. Doppler ultrasonography was performed. Arterial blood pressure (BP), body mass index (BMI), and estimated GFR were also recorded. HTN and HTN-n groups had impaired levels of RFR compared with controls (p < 0.05), significantly decreased value of flow velocity parameters (Vmax, Vmin), and increased RRI compared with controls. There was significant negative correlation of RFR with blood pressure levels (sBP, r = -0.435, p = 0.009; dBP, r = -0.504, p = 0.002), RRI (r = -0.456, p = 0.008), micro albuminuria (MAU, r = -0.366, p = 0.031) and positive correlation with Vmax and Vmin (r = 0.556, p = 0.001 and r = 0.643, respectively, p < 0.001). Linear regression showed that RRI and MAU were independent predictors of decreased RFR. RFR is lower in hypertensive patients despite near-normal level of kidney function and is related to particular level of BP. RRI and MAU were independent predictors of decreased RFR.

  6. Serum Bicarbonate Concentration and Cognitive Function in Hypertensive Adults.

    Science.gov (United States)

    Dobre, Mirela; Gaussoin, Sarah A; Bates, Jeffrey T; Chonchol, Michel B; Cohen, Debbie L; Hostetter, Thomas H; Raphael, Kalani L; Taylor, Addison A; Lerner, Alan J; Wright, Jackson T; Rahman, Mahboob

    2018-04-06

    Cognitive function worsens as kidney function declines, but mechanisms contributing to this association are not completely understood. Metabolic acidosis, a common complication of CKD, leads to neural networks overexcitation and is involved in cerebral autoregulation. We aimed to evaluate the association between serum bicarbonate concentration as a measure of metabolic acidosis, and cognitive function in hypertensive adults with and without CKD. Five cognitive summary scores were measured (global cognitive function, executive function, memory, attention/concentration, and language) in 2853 participants in the Systolic BP Intervention Trial (SPRINT). Multivariable linear regression models adjusted for demographics, comorbidities, systolic BP, medications, eGFR and albuminuria evaluated the cross-sectional association between bicarbonate and cognition at SPRINT baseline. In a subset ( n =681) who underwent brain magnetic resonance imaging, the models were adjusted for white matter hyperintensity volume, vascular reactivity, and cerebral blood flow. The mean age (SD) was 68 (8.5) years. Global cognitive and executive functions were positively associated with serum bicarbonate (estimate [SEM]: 0.014 [0.006]; P =0.01, and 0.018 [0.006]; P =0.003, respectively). Each 1 mEq/L lower bicarbonate level had a similar association with global cognitive and executive function as being 4.3 and 5.4 months older, respectively. The association with global cognition persisted after magnetic resonance imaging findings adjustment (estimate [SEM]: 0.03 [0.01]; P =0.01). There was no association between serum bicarbonate level and memory, attention/concentration, and language. In a large cohort of hypertensive adults, higher serum bicarbonate levels were independently associated with better global cognitive and executive performance. (ClinicalTrials.gov: NCT01206062). Copyright © 2018 by the American Society of Nephrology.

  7. Exercise training modulates functional sympatholysis and alpha-adrenergic vasoconstrictor responsiveness in hypertensive and normotensive individuals

    DEFF Research Database (Denmark)

    Mortensen, Stefan Peter; Nyberg, Michael Permin; Gliemann Hybholt, Lasse

    2014-01-01

    were measured before and after 8 weeks of aerobic training (3-4 times/week) in 8 hypertensive (47 ± 2 years) and 8 normotensive untrained individuals (46 ± 1 years) during arterial tyramine infusion, arterial ATP infusion and/or one-legged knee extensions. Before training, exercise hypaeremia and leg......Essential hypertension is linked to an increased sympathetic vasoconstrictor activity and reduced tissue perfusion. We investigated the role of exercise training on functional sympatholysis and postjunctional α-adrenergic responsiveness in individuals with essential hypertension. Leg haemodynamics...... vascular conductance (LVC) were lower in the hypertensive individuals (P Training lowered blood pressure in the hypertensive individuals (P

  8. Right ventricular systolic function in hypertensive heart failure

    Directory of Open Access Journals (Sweden)

    Oketona OA

    2017-09-01

    Full Text Available OA Oketona,1 MO Balogun,2 AO Akintomide,2 OE Ajayi,2 RA Adebayo,2 TO Mene-Afejuku,3 OT Oketona,1 OJ Bamikole2 1Fort Nelson General Hospital, Fort Nelson, BC, Canada; 2Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ife, Osun State, Nigeria; 3Department of Medicine, Metropolitan Hospital Center, New York, NY, USA Background: Heart failure (HF is a major cause of cardiovascular admissions and hypertensive heart failure (HHF is the most common cause of HF admissions in sub-Saharan Africa, Nigeria inclusive. Right ventricular (RV dysfunction is being increasingly recognized in HF and found to be an independent predictor of adverse outcomes in HF. This study aimed to determine the prevalence of RV systolic dysfunction in HHF by several echocardiographic parameters.Methodology: One hundred subjects with HHF were recruited consecutively into the study along with 50 age and sex-matched controls. All study participants gave written informed consent, and had a full physical examination, blood investigations, 12-lead electrocardiogram, and transthoracic echocardiography. RV systolic function was assessed in all subjects using different methods based on the American Society of Echocardiography guidelines for echocardiographic assessment of the right heart in adults. This included tricuspid annular plane systolic excursion (TAPSE, RV myocardial performance index (MPI, and RV systolic excursion velocity by tissue Doppler (S′.Results: RV systolic dysfunction was found in 53% of subjects with HHF by TAPSE, 56% by RV MPI, and 48% by tissue Doppler systolic excursion S′. RV systolic dysfunction increased with reducing left ventricular ejection fraction (LVEF in subjects with HHF.Conclusion: A high proportion of subjects with HHF were found to have RV systolic functional abnormalities using TAPSE, RV MPI, and RV S′. Prevalence of RV systolic dysfunction increased with reducing LVEF. Keywords: right ventricle

  9. Gastrointestinal motor function in patients with portal hypertension

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

    2000-01-01

    rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS: No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients...... and controls. After 24 h, however, the geometric center of the liquid marker had a more caudal localization in the colon of the patient group than in the controls (P = 0.04); that is, the patients had a faster colonic transit. No difference was found in the frequency of antral contractions 45 min after...... the test meal between patients and controls. CONCLUSIONS: These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected....

  10. Left ventricular functional, structural and energetic effects of normal aging: Comparison with hypertension.

    Directory of Open Access Journals (Sweden)

    Jehill D Parikh

    Full Text Available Both aging and hypertension are significant risk factors for heart failure in the elderly. The purpose of this study was to determine how aging, with and without hypertension, affects left ventricular function.Cross-sectional study of magnetic resonance imaging and 31P spectroscopy-based measurements of left ventricular structure, global function, strains, pulse wave velocity, high energy phosphate metabolism in 48 normal subjects and 40 treated hypertensive patients (though no other cardiovascular disease or diabetes stratified into 3 age deciles from 50-79 years.Normal aging was associated with significant increases in systolic blood pressure, vascular stiffness, torsion, and impaired diastolic function (all P<0.05. Age-matched hypertension exacerbated the effects of aging on systolic pressure, and diastolic function. Hypertension alone, and not aging, was associated with increased left ventricular mass index, reduced energetic reserve, reduced longitudinal shortening and increased endocardial circumferential shortening (all P<0.05. Multiple linear regression analysis showed that these unique hypertensive features were significantly related to systolic blood pressure (P<0.05.1 Hypertension adds to the age-related changes in systolic blood pressure and diastolic function; 2 hypertension is uniquely associated with changes in several aspects of left ventricular structure, function, systolic strains, and energetics; and 3 these uniquely hypertensive-associated parameters are related to the level of systolic blood pressure and so are potentially modifiable.

  11. Functioning adrenal myelolipoma: A rare cause of hypertension

    Directory of Open Access Journals (Sweden)

    Nagendar Jakka

    2013-01-01

    Full Text Available Co-occurrence of adrenal incidentaloma with hypertension calls for evaluation of endocrine causes including pheochromocytoma, Cushing′s disease, and primary aldosteronism. We are reporting 40-years-old man who presented with hypertension and adrenal mass. He had elevated metanephrines, histology of resected adrenal mass revealed adrenal myelolipoma, and immuno-histochemistry was positive for chromogranin A. Both his blood pressure and urinary metanephrines returned to normal after surgery. The association of hypertension and adrenal myelolipoma may not be entirely coincidental, as it may be associated with secreting catecholamine. Literature on such an uncommon association is reviewed briefly as well.

  12. THE ROLE OF ENDOTHELIUM FUNCTIONAL STATUS IN PULMONARY HYPERTENSION DEVELOPMENT AMONG CHILDREN

    Directory of Open Access Journals (Sweden)

    S.N. Ivanov

    2008-01-01

    Full Text Available The background paper approaches the problems of functional status of endothelium, significance of vasоactive substances as markers of endothelial dysfunction and reason of its development, role of endothelial dysfunction in the pathogenesis of primary and secondary pulmonary hypertension.Key words: pulmonary hypertension, endothelial dysfunction, vasoactive substances.

  13. Effects of benazepril on functional activity of endothelial progenitor cells from hypertension patients.

    Science.gov (United States)

    Li, Yongdong; Alatan, Gaole; Ge, Zhiping; Liu, Dan

    2014-01-01

    The effect of angiotensin-converting enzyme inhibitors on hypertension patients regarding endothelial progenitor cell (EPC) functions is poorly understood. The aim of this study was to investigate the effects of benazepril on the proliferation, adhesion and migration capacity of EPCs and its possible mechanism. The functions of EPCs from hypertension patients were obviously reduced compared with control group, and this could be improved by benazepril in a dose-dependent manner, whereas this improvement were obviously blocked when AMD3100 were used together. Therefore, benazepril could obviously improve functions of EPCs from hypertension patients, and the potential mechanism may be related to SDF-1/CXCR4 axis.

  14. Regulation of Hypertension for Secondary Prevention of Stroke: The Possible 'Bridging Function' of Acupuncture.

    Science.gov (United States)

    Zheng, Haizhen; Han, Yuhui; Du, Yuzheng; Shi, Xuemin; Huang, Huiyuan; Yu, Xiaoyang; Tan, Xiaochan; Hu, Chunxiao; Wang, Yue; Zhou, Shiyuan

    2018-01-01

    Worldwide, stroke is the leading cause of mortality and disability, with hypertension being an independent risk factor for a secondary stroke. Acupuncture for the treatment of hypertension gains more attention in alternative and complementary medicine, but the results are inconsistent. Few studies regarding the secondary prevention of stroke by managing hypertension with acupuncture have been carried out as there are some problems regarding the antihypertensive drug status in the secondary prevention of stroke. Still, the potential of acupuncture in regulating the blood pressure for secondary stroke prevention deserves our focus. This review is based on papers recorded in the PubMed, Embase, and Web of Science databases, from their inception until March 28, 2017, and retrieved with the following search terms: hypertension and acupuncture, limited in spontaneously hypertensive rats (SHRs), stress-induced (or cold-induced) hypertensive or pre-hypertensive models. We find that, in these hypertensive animals, acupuncture could mainly influence factors related to the nervous system, oxidative stress, the endocrine system, cardiovascular function, and hemorheology, which are closely associated with the stroke outcome. This trend may give us a hint that acupuncture might well participate in the secondary prevention of stroke through these pathways when used in the management of hypertension. © 2018 S. Karger GmbH, Freiburg.

  15. Structural and functional cardiac adaptations to 6 months of football training in untrained hypertensive men

    DEFF Research Database (Denmark)

    Andersen, L. J.; Randers, M. B.; Hansen, P. R.

    2014-01-01

    We investigated the effects of 3 and 6 months of regular football training on cardiac structure and function in hypertensive men. Thirty-one untrained males with mild-to-moderate hypertension were randomized 2:1 to a football training group (n = 20) and a control group receiving traditional...... training improves LV diastolic function in untrained men with mild-to-moderate arterial hypertension. Furthermore, it may improve longitudinal systolic function of both ventricles. The results suggest that football training has favorable effects on cardiac function in hypertensive men....... function improved with respect to tricuspid annular plane systolic excursion (21.8 ± 3.2 to 24.5 ± 3.7 mm). Arterial blood pressure decreased in both groups, but significantly more in the football training group. No significant changes were observed in the control group. In conclusion, short-term football...

  16. Hypertensive disease and renal hypertensions: renal structural and functional studies by using dynamic computed tomography

    International Nuclear Information System (INIS)

    Arabidze, G.G.; Pogrebnaya, G.N.; Todua, F.I.; Sokolova, R.I.; Kozdoba, O.A.

    1989-01-01

    Dynamic computed tomography was conducted by the original methods; the findings were analyzed by taking into account time-density curves which made it possible to gain an insight into the status of blood flow and filtration in each individual kidney. Computed tomography and dynamic computed tomography revealed that hypertensive disease was characterized by normal volume and thickness of the renal cortical layer and symmetric time-density curves, whereas a hypertensive type of chronic glomerulonephritis featured lower renal cartical layer thickness, reduced renal volume, symmetrically decrease amplitudes of the first and second peaks of the time-density curve, chronic pyelonephritis showed asymmetric time-density diagrams due to the lower density areas in the afflicted kidney

  17. Gene Polymorphism and Left Ventricular Geometry and Function in Hypertensive Subjects

    Directory of Open Access Journals (Sweden)

    Rosario Scaglione

    2010-01-01

    Full Text Available The distribution of the T29C TGFβ1 gene polymorphism was analyzed in 198 hypertensives with left ventricular hypertrophy (LVH and in 235 hypertensives without LVH. Circulating TGFβ1 levels, procollagen type III levels, microalbuminuria, and left ventricular geometry and function were evaluated in all the hypertensives with LVH subgrouped according to T29C TGFβ1 gene polymorphism. Circulating TGFβ1 was evaluated by ELISA technique, procollagen type III by a specific radioimmunoassay, microalbuminuria by radioimmunoassay, and left ventricular geometry and function by echocardiography. All groups were comparable for gender, age, and sex. Regarding T29C TGFβ1 gene polymorphism, prevalence of TC or CC genotypes was significantly (P<.05 higher in hypertensives with LVH than hypertensives without LVH TC and CC LVH hypertensives were characterized by a higher prevalence of subjects with microalbuminuria (P<.05 TC and CC versus TT, by increased levels of TGFβ1, procollagen type III, urinary albumin excretion, LVM, LVM/h2.7, and lower values of left ventricular ejection fraction (P<.05 TC and CC versus TT. Our data suggest that T29C TGFβ1 gene polymorphism was associated with clinical characteristics adequate to recognize a subset of LVH hypertensives with a higher severity of hypertension.

  18. Kidney Function Decline and Apparent Treatment-Resistant Hypertension in the Elderly.

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    Jean Kaboré

    Full Text Available Cross-sectional studies show a strong association between chronic kidney disease and apparent treatment-resistant hypertension, but the longitudinal association of the rate of kidney function decline with the risk of resistant hypertension is unknown.The population-based Three-City included 8,695 participants older than 65 years, 4265 of them treated for hypertension. We estimated the odds ratios (OR of new-onset apparent treatment-resistant hypertension, defined as blood pressure ≥ 140/90 mmHg despite use of 3 antihypertensive drug classes or ≥ 4 classes regardless of blood pressure, associated with the mean estimated glomerular filtration rate (eGFR level and its rate of decline over 4 years, compared with both controlled hypertension and uncontrolled nonresistant hypertension with ≤ 2 drugs. GFR was estimated with three different equations.Baseline prevalence of apparent treatment-resistant hypertension and of controlled and uncontrolled nonresistant hypertension, were 6.5%, 62.3% and 31.2%, respectively. During follow-up, 162 participants developed apparent treatment-resistant hypertension. Mean eGFR decline with the MDRD equation was 1.5±2.9 mL/min/1.73 m² per year: 27.7% of the participants had an eGFR ≥3 and 10.1% ≥ 5 mL/min/1.73 m² per year. After adjusting for age, sex, obesity, diabetes, and cardiovascular history, the ORs for new-onset apparent treatment-resistant hypertension associated with a mean eGFR level, per 15 mL/min/1.73 m² drop, were 1.23 [95% confidence interval 0.91-1.64] compared to controlled hypertension and 1.10 [0.83-1.45] compared to uncontrolled nonresistant hypertension; ORs associated with a decline rate ≥ 3 mL/min/1.73 m² per year were 1.89 [1.09-3.29] and 1.99 [1.19-3.35], respectively. Similar results were obtained when we estimated GFR with the CKDEPI and the BIS1 equations. ORs tended to be higher for an eGFR decline rate ≥ 5 mL/min/1.73 m² per year.The speed of kidney function decline is

  19. Decreased Cognitive/CNS Function in Young Adults at Risk for Hypertension: Effects of Sleep Deprivation

    Directory of Open Access Journals (Sweden)

    James A. McCubbin

    2012-01-01

    Full Text Available Hypertension has been linked to impaired cognitive/CNS function, and some of these changes may precede development of frank essential hypertension. The stress and fatigue of sleep deprivation may exacerbate these cognitive changes in young adults at risk. We hypothesize that individuals at risk for hypertension will show significant declines in cognitive function during a night of sleep deprivation. Fifty-one young adults were recruited for 28-hour total sleep deprivation studies. Hypertension risk was assessed by mildly elevated resting blood pressure and by family history of hypertension. A series of cognitive memory tasks was given at four test sessions across the sleep deprivation period. Although initially comparable in cognitive performance, persons at risk showed larger declines across the night for several indices of working memory, including code substitution, category, and order recall. These results suggest that cognitive/CNS changes may parallel or precede blood pressure dysregulation in the early stages of hypertension development. The role of CNS changes in the etiology of essential hypertension is discussed.

  20. Neurocognitive Function in Children with Primary Hypertension after Initiation of Antihypertensive Therapy.

    Science.gov (United States)

    Lande, Marc B; Batisky, Donald L; Kupferman, Juan C; Samuels, Joshua; Hooper, Stephen R; Falkner, Bonita; Waldstein, Shari R; Szilagyi, Peter G; Wang, Hongyue; Staskiewicz, Jennifer; Adams, Heather R

    2018-04-01

    To determine the change in neurocognitive test performance in children with primary hypertension after initiation of antihypertensive therapy. Subjects with hypertension and normotensive control subjects had neurocognitive testing at baseline and again after 1 year, during which time the subjects with hypertension received antihypertensive therapy. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed, and parents completed rating scales of executive function. Fifty-five subjects with hypertension and 66 normotensive control subjects underwent both baseline and 1-year assessments. Overall, the blood pressure (BP) of subjects with hypertension improved (24-hour systolic BP load: mean baseline vs 1 year, 58% vs 38%, P < .001). Primary multivariable analyses showed that the hypertension group improved in scores of subtests of the Rey Auditory Verbal Learning Test, Grooved Pegboard, and Delis-Kaplan Executive Function System Tower Test (P < .05). However, the control group also improved in the same measures with similar effects sizes. Secondary analyses by effectiveness of antihypertensive therapy showed that subjects with persistent ambulatory hypertension at 1 year (n = 17) did not improve in subtests of Rey Auditory Verbal Learning Test and had limited improvement in Grooved Pegboard. Overall, children with hypertension did not improve in neurocognitive test performance after 1 year of antihypertensive therapy, beyond that also seen in normotensive controls, suggesting improvements with age or practice effects because of repeated neurocognitive testing. However, the degree to which antihypertensive therapy improves BP may affect its impact upon neurocognitive function. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Evaluation of renal first pass blood flow with a functional image technique in hypertensive patients

    International Nuclear Information System (INIS)

    Ishibashi, Masatoshi; Morita, Seiichiro; Umezaki, Noriyoshi; Ohtake, Hisashi

    1988-01-01

    The renal circulation of patients with essential hypertension and renovascular hypertension was evaluated using 99m Tc-DTPA. The first renal peak count (the first C max ; FC max ), time phase distribution (the first T max ; FT max ), and blood velocity (the FC max /FT max ) were calculated by digital imaging. This yields a visual image of the renal circulation. We consider that the increase in the renal first pass blood flow in patients with essential hypertension is best observed pixel by pixel. The FC max and FC max /FT max images before and after treatment by percutaneous transluminal renal angioplasty in patients with renovascular hypertension clearly show its therapeutic effect. The FI technique, therefore, has the advantage that it can be performed at the same time as the conventional routine examinations of renal function. This makes it very useful clinically. (orig.)

  2. A STUDY OF ELECTROCARDIOGRAPHY AND KIDNEY FUNCTION TEST IN NEWLYDIAGNOSED HYPERTENSIVE PATIENTS IN COASTAL ANDHRA PRADESH

    Directory of Open Access Journals (Sweden)

    Ramswaroop

    2017-11-01

    Full Text Available BACKGROUND As per the fact sheet published by World Health Organisation, South East Asia, nearly one billion people have high blood pressure and are one of the most common causes of premature death worldwide. About one third of the adult population in the South East Asia region is having hypertension. In our country, the number of people with hypertension are undiagnosed and untreated, so early detection and treatment of hypertension will decrease the complication of hypertension and premature death due to it. MATERIALS AND METHODS This is a prospective study conducted in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram, from May 2015 to August 2017. This study was started with an aim to know that electrocardiographic abnormalities and kidney function at the time of diagnosis of hypertension in a patient in coastal Andhra Pradesh. RESULTS We have found ECG changes in both the stages of hypertensive group patients. In stage-1 hypertensive group patients, out of 80 patients, 6 patients having sinus tachycardia, 2 having sinus bradycardia, 4 patients having left bundle-branch block and 6 having right bundle-branch block. ST elevation was found in 1 patient and ST depression was found in 8 patients. AV block was present in 2 patients. Right ventricular hypertrophy was present in 1 patient and left ventricular hypertrophy was present in 4 patients. T-wave inversion was found in 4 patients. In stage-2 hypertensive patients, sinus tachycardia in 6 patients and bradycardia in 1 patient, LBBB was found in 8 patients. ST depression was found in 6 patients and ST elevation was found in 2 patients out of 40 patients. AV block was present in 3 patients. Left ventricular hypertrophy patients 16 out of 40, but right ventricular hypertrophy was only 1. T-wave inversion was found in 6 patients. CONCLUSION In our study, we have found that stage-2 hypertensive patients have higher BMI, serum urea and creatinine than stage-1

  3. An evaluation of the effect of atorvastatin on memory and psychomotor functions in hypertensive patients

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    S Prajapati

    2011-01-01

    Full Text Available Background : The effect of statins on memory and psychomotor function has been controversial and needs further evaluation. Aims : To evaluate the effect of atorvastatin on memory and psychomotor functions in hypertensive patients treated with enalapril or amlodipine. Settings and Design : Prospective, comparative, non-randomized, before-after, open-label clinical study conducted at a tertiary care hospital in Western India. Materials and Methods : Memory was evaluated with PGI (Post Graduate Institute, Chandigarh Memory Scale, while psychomotor functions were evaluated with Digit Letter Substitution test, Six Letter Cancellation test, and Finger Tapping test at baseline, 1 week, 1 month, and 3 months of starting atorvastatin in 74 hypertensive patients who were prescribed either enalapril or amlodipine with or without atorvastatin 10 mg/day. Scores obtained in patients receiving enalapril or amlodipine were compared with those receiving these drugs along with atorvastatin. Memory and psychomotor functions of 12 healthy volunteers were also evaluated and compared with those of the patients at respective time periods. Statistical Analysis : Student′s t test, Wilcoxon Signed Rank test, and Mann Whitney U test were used to compare the pre- and post-treatment scores of memory and psychomotor functions in various groups. Statistical significance was considered at P<0.05. Results : A statistically significant improvement in scores of memory and psychomotor functions was observed in both healthy volunteers (P=0.009 and P=0.016 and hypertensive patients (P=0.008 and P=0.031 throughout the study period. Memory and psychomotor function in hypertensive patients remained significantly inferior to those of healthy volunteers (P=0.01 and P=0.018. There was no significant difference in the scores of memory and psychomotor functions between patients receiving atorvastatin and those not receiving this drug. Conclusion : Atorvastatin, at 10 mg/day dose, does not

  4. Echocardiographic assessment of fetal left ventricular function in hypertensive disorder of pregnancy

    International Nuclear Information System (INIS)

    Liu Xiaozhen; Liu Shaozhong

    2011-01-01

    Objective: To investigate fetal left ventricular function in hypertensive disorder of pregnancy (HDP). Methods: Fetuses of hypertensive (84) and normotensive (147) mothers were enrolled in this study. The fetal left ventricular ejection fractions, E/A ratios of mitral valves, left atrial shortening fractions and Tei indexes of the two groups were measured on fetal echocardiography. Results: The left ventricular ejection fractions (P=0.040), E/A ratios of the mitral valves (P=0.042) and the left atrial shortening fractions (P=0.036) in fetuses of HDP were significantly smaller than those of the normal group whereas the Tei indexes (P=0.030) were significantly larger than those of the normal group. Conclusion: The hypertensive disorder of pregnancy may cause decreased systolic, diastolic and global function of the fetal left ventricle. (authors)

  5. Impaired skin capillary recruitment in essential hypertension is caused by both functional and structural capillary rarefaction

    NARCIS (Netherlands)

    Serne, EH; Gans, ROB; ter Maaten, JC; Tangelder, GJ; Donker, AJM; Stehouwer, CDA

    Capillary rarefaction occurs in many tissues in patients with essential hypertension and may contribute to an increased vascular resistance and impaired muscle metabolism. Rarefaction may be caused by a structural (anatomic) absence of capillaries, functional nonperfusion, or both. The aim of this

  6. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    DEFF Research Database (Denmark)

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...... [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients....

  7. The Dietary Approaches to Stop Hypertension Diet, Cognitive Function, and Cognitive Decline in American Older Women

    NARCIS (Netherlands)

    Berendsen, A.M.; Kang, Jae H.; Rest, van de O.; Feskens, E.J.M.; Groot, de C.P.G.M.; Grodstein, F.

    2017-01-01

    ObjectivesTo examine the association between long-term adherence to the Dietary Approaches to Stop Hypertension (DASH) diet with cognitive function and decline in older American women.DesignProspective cohort study.SettingThe Nurses' Health Study, a cohort of registered nurses residing in 11 US

  8. Hyperuricemia in Destabilization of Endothelial Function in Adolescents with Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    N.M. Korenev

    2013-08-01

    Full Text Available The objective of this work was to study the correlation of uric acid level in blood serum and parameters of endothelial function and non-specific inflammation in adolescents with arterial hypertension considering their body weight. In the most of patients with arterial hypertension endothelial dysfunction was detected; endothelium-dependent vasodilation was more altered in the patients with obesity and especially in those with hyperuricemia. An increase in C-reactive protein serum level was mainly associated with obesity; a decrease in systolic-diastolic ratio — with hyperuricemia.

  9. Left Ventricular Diastolic Function in Essential Hypertensive Patients: Influence of Age and Left Ventricular Geometry

    Directory of Open Access Journals (Sweden)

    Rosa Eduardo Cantoni

    2002-01-01

    Full Text Available PURPOSE - To evaluate diastolic dysfunction (DD in essential hypertension and the influence of age and cardiac geometry on this parameter. METHODS - Four hundred sixty essential hypertensive patients (HT underwent Doppler echocardiography to obtain E/A wave ratio (E/A, atrial deceleration time (ADT, and isovolumetric relaxation time (IRT. All patients were grouped according to cardiac geometric patterns (NG - normal geometry; CR - concentric remodeling; CH- concentric hypertrophy; EH - eccentric hypertrophy and to age (60 years. One hundred six normotensives (NT persons were also evaluated. RESULTS - A worsening of diastolic function in the HT compared with the NT, including HT with NG (E/A: NT - 1.38±0.03 vs HT - 1.27±0.02, p<0.01, was observed. A higher prevalence of DD occurred parallel to age and cardiac geometry also in the prehypertrophic groups (CR. Multiple regression analysis identified age as the most important predictor of DD (r²=0.30, p<0.01. CONCLUSION - DD was prevalent in this hypertensive population, being highly affected by age and less by heart structural parameters. DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.

  10. Renal Oxidative Stress Induced by Long-Term Hyperuricemia Alters Mitochondrial Function and Maintains Systemic Hypertension

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    Magdalena Cristóbal-García

    2015-01-01

    Full Text Available We addressed if oxidative stress in the renal cortex plays a role in the induction of hypertension and mitochondrial alterations in hyperuricemia. A second objective was to evaluate whether the long-term treatment with the antioxidant Tempol prevents renal oxidative stress, mitochondrial alterations, and systemic hypertension in this model. Long-term (11-12 weeks and short-term (3 weeks effects of oxonic acid induced hyperuricemia were studied in rats (OA, 750 mg/kg BW, OA+Allopurinol (AP, 150 mg/L drinking water, OA+Tempol (T, 15 mg/kg BW, or vehicle. Systolic blood pressure, renal blood flow, and vascular resistance were measured. Tubular damage (urine N-acetyl-β-D-glucosaminidase and oxidative stress markers (lipid and protein oxidation along with ATP levels were determined in kidney tissue. Oxygen consumption, aconitase activity, and uric acid were evaluated in isolated mitochondria from renal cortex. Short-term hyperuricemia resulted in hypertension without demonstrable renal oxidative stress or mitochondrial dysfunction. Long-term hyperuricemia induced hypertension, renal vasoconstriction, tubular damage, renal cortex oxidative stress, and mitochondrial dysfunction and decreased ATP levels. Treatments with Tempol and allopurinol prevented these alterations. Renal oxidative stress induced by hyperuricemia promoted mitochondrial functional disturbances and decreased ATP content, which represent an additional pathogenic mechanism induced by chronic hyperuricemia. Hyperuricemia-related hypertension occurs before these changes are evident.

  11. EFFECT OF HIGH INTENSITY INTERVAL TRAINING ON ENDOTHELIAL FUNCTION IN POSTMENOPAUSAL HYPERTENSIVE PATIENTS RANDOMIZED CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    Mona Mohamed Taha

    2016-02-01

    Full Text Available Background: Postmenopausal hypertension is the most common risk factor of cardiovascular morbidity and mortality. As the exercises training conveys benefits of the setting of secondary prevention of hypertension. High intensity interval training (HIIT emerged as a new form of physical training and presents as therapeutic alternative to patients and health care professionals. This study aimed to investigate the effect of high intensity interval training on endothelial function in postmenopausal hypertension. Methods: Forty six mildly hypertensive postmenopausal women, their ages ranged from (45-55 years old, were randomly allocated to two groups: HIIT group (group-I; n=23 performed a high intensity interval training 3 times a week for 10 weeks at an intensity of (80-85% HR max for 40 minutes and control group (group-II; n=23 remains sedentary during this period. Serum nitric oxide (NO, vascular endothelial growth factor levels (VEGF and blood pressures were measured before and after intervention. Results: A significant reduction in both systolic and diastolic blood pressure values by 9.5% and 7 % respectively, was seen after high intensity interval training which was accompanied by increase in NO and VEGF levels by 43.3% and 15.2 % respectively, while no significant change observed in the control group. Conclusion: High intensity interval training had obvious benefits in improving plasma No, VEGF concentrations and controlling hypertension in postmenopausal women.

  12. Left ventricular structure and diastolic function in subjects with two hypertensive parents

    DEFF Research Database (Denmark)

    Andersen, U B; Steensgaard-Hansen, F; Rokkedal, J

    2001-01-01

    hypertension and 26 matched controls with normotensive parents. Families with non-insulin-dependent diabetes or morbid obesity were excluded. (i) Echocardiography; (ii) plasma concentrations of renin, angiotensin-II, aldosterone, epinephrine and norepinephrine; (iii) euglycaemic, hyperinsulinemic clamp study......PURPOSE: To examine the influence of (i) strong predisposition to essential hypertension and (ii) insulin sensitivity and plasma levels of cardiomyotrophic hormones on echocardiographic parameters of left ventricular structure and function. METHODS: 26 normotensive subjects (age 18-35) with bi-parental....... RESULTS (means +/- SD): Hypertension-prone subjects vs controls had (i) higher resting systolic (117.0 +/- 14.0 vs 107.1 +/- 11.9 mmHg), and 24-h diastolic blood pressure (77.9 +/- 7.1 vs 72.9 +/- 7.2 mmHg), (ii) higher relative wall thickness (RWT) (0.39 +/- 0.09 vs 0.34 +/- 0.06). They had similar left...

  13. Left atrial appendage function in prediction of paroxysmal atrial fibrilation in patients with untreated hypertension.

    Science.gov (United States)

    Tenekecioglu, Erhan; Agca, Fahriye Vatansever; Karaagac, Kemal; Ozluk, Ozlem Arican; Peker, Tezcan; Kuzeytemiz, Mustafa; Senturk, Muhammed; Yılmaz, Mustafa

    2014-01-01

    Abstract The onset of AF results in a significant increase in mortality rates and morbidity in hypertensive patients and this rhythm disorder exposes patients to a significantly increased risk of cerebral or peripheral embolisms. Tissue Doppler imaging was found to be useful in early detection of myocardial dysfunction in several diseases. It was shown that tissue Doppler analysis of the walls of the left atrial appendage (LAA) can give accurate information about the function of the LAA in hypertensive patients. In this study, we aimed to investigate and identify the specific predictive parameters for the onset of AF in patients with hypertension with tissue Doppler imaging of LAA. We studied age and sex matched 57 untreated hypertensive patients with paroxysmal atrial fibrillation (PAF) and 27 untreated hypertensive subjects without PAF. With transthoracic echocardiography, diastolic mitral A-velocity and LA maximal volume index which reflects reservoir function of left atrium was measured, with transesophageal echocardiography, LAA emptying velocity (LAA-PW D2) and tissue Doppler contracting velocity of LAA (LAA-TDI-D2) were measured. LA maximal volume index of the groups (22.28 ± 3.59 mL/m(2) in Group 1 versus 20.37 ± 3.97 mL/m(2) in Group 2, p = 0.07) and diastolic mitral A-velocity [0.93 (0.59-1.84) m/s in patients with PAF versus 0.90 (0.62-1.76) m/s in patients without PAF, p = 0.26] was not significantly different between study groups, during TEE, LAA-PW D2 (0.31 ± 0.04 m/s in Group 1 versus 0.33 ± 0.03 m/s in Group 2, p = 0.034) and LAA-TDI-D2 (0.18 ± 0.04 m/s in Group 1 versus 0.21 ± 0.05 m/s in Group 2, p = 0.014) were significantly decreased in Group 1. In this study, we found that in hypertensive PAF patients despite normal global LA functions, LAA contracting function was deteriorated. Tissue Doppler analysis of LAA is clinically usefull approach to detect the risk of developing PAF in

  14. Diagnosis of pulmonary hypertension and pulmonary heart at Berylliosis and plutonium pneumosclerosis (Clinical-functional investigation)

    International Nuclear Information System (INIS)

    Metlyaeva, N. A.

    2004-01-01

    The subject of the research was 54 workers with Beryllium and Plutonium incorporation from 33 to 60 old, all of them had 41- Berylliosis and 13- Plutonium pneumosclerosis. Patient were investigated with ECG, pulmonary, kinetocordiography, echocardiography. Hypertension in the pulmonary artery developed due to a combination of anatomical and functional disturbances and also with increasing of a stroke and minutely volumes at a definite stage of the disease with Beryllium and Plutonium pneumosclerosis. Two type of hypertension were discovered with pulmonary reography in the Beryllium and the Plutonium pneumosclerosis patients: hyper volume and hypertension type. Hyper volume type of pulmonary circulation (31.7% and 53.8%) consist ed of a high amplitude systolic wave. It was revealed in patients at the early stage of disease, when the pulmonary vessels stretching and right ventricle function kept still at a good condition. Hypertensive type of pulmonary circulation (68.3% and 46.2%) had a low amplitude systolic wave. The low amplitude systolic wave caused by increasing resistance of the pulmonary vessels, decreasing in the flow of blood in arterial system and the injection fraction and a low circulatory volume. (Author) 17 refs

  15. Assessment of function of the cardiovascular system in arterial hypertension using radionuclide methods of investigation

    International Nuclear Information System (INIS)

    Oganesyan, N.M.; Babayan, A.S.; Mikaehlyan, R.S.; Mnatsakyan, Eh.L.

    1986-01-01

    Proceeding from a study of the nature of changes in hemodynamics during development of hypertensive disease (HD) at its different stages it was shown that hemodynamic changes in 42.1% of the patients with Stage 1-2A HD were of hypertensive type, in the patients with Stage 2B-3 HD normal and hypokinetic types of the blood circulation prevailed. After bicycle ergometry exercise the reactivity of the cardiovascular system was revealed more completely. The most complete information on function of the cardiovascular system and myocardial contractility can be obtained with the help of radioangiocardiography and radionuclide ventriculography. However in the absence of a gamma-chamber radiocardiography can provide necessary information on function of the cardiovascular system in case it is used in one and the same patient over time using bicycle ergometry testing

  16. Speckle tracking analysis: a new tool for left atrial function analysis in systemic hypertension: an overview.

    Science.gov (United States)

    Cameli, Matteo; Ciccone, Marco M; Maiello, Maria; Modesti, Pietro A; Muiesan, Maria L; Scicchitano, Pietro; Novo, Salvatore; Palmiero, Pasquale; Saba, Pier S; Pedrinelli, Roberto

    2016-05-01

    Speckle tracking echocardiography (STE) is an imaging technique applied to the analysis of left atrial function. STE provides a non-Doppler, angle-independent and objective quantification of left atrial myocardial deformation. Data regarding feasibility, accuracy and clinical applications of left atrial strain are rapidly gathering. This review describes the fundamental concepts of left atrial STE, illustrates its pathophysiological background and discusses its emerging role in systemic arterial hypertension.

  17. Environmental Exposure to Cadmium: Health Risk Assessment and its Associations with Hypertension and Impaired Kidney Function

    Science.gov (United States)

    Wu, Haiyun; Liao, Qilin; Chillrud, Steven N.; Yang, Qiang; Huang, Lei; Bi, Jun; Yan, Beizhan

    2016-07-01

    Cadmium (Cd) is a toxic metal. This study was aimed to estimate the potential health risks in a Cd-polluted district in China, and examine the relationship between urinary cadmium(UCd) and hypertension and impaired kidney function at low exposure levels (UCd: GM 1.3 μg/g creatinine). Blood pressure measurement, questionnaires, and collection of urinary samples were conducted from 217 residents. Environmental samples, food, and cigarette samples were collected and detected to estimate the risks posed by Cd and the contribution of inhalation, ingestion, and dermal contact pathways to these risks. A logistic regression model was used in examining associations between exposure and hypertension and impaired kidney function. Results show that this population is at high risk. For non-smokers, incremental lifetime cancer risk (ILCR) and hazard quotient (HQ) are 1.74E-04 and 2.96, and for smokers, they are 1.07E-03 and 52.5, respectively. Among all exposure pathways, smoking and foods cause the major increases in ILCR and HQ. UCd is significantly associated with hypertension (odds ratio (OR) = 1.468 95% confidence interval (CI): 1.104, 1.953; P = 0.008) and impaired kidney function (OR = 1.902, 95% CI: 1.054, 3.432; P = 0.033). The results demonstrate that Cd can potentially lead to adverse health effects.

  18. Functional classification of pulmonary hypertension in children: Report from the PVRI pediatric taskforce, Panama 2011.

    Science.gov (United States)

    Lammers, Astrid E; Adatia, Ian; Cerro, Maria Jesus Del; Diaz, Gabriel; Freudenthal, Alexandra Heath; Freudenthal, Franz; Harikrishnan, S; Ivy, Dunbar; Lopes, Antonio A; Raj, J Usha; Sandoval, Julio; Stenmark, Kurt; Haworth, Sheila G

    2011-08-02

    The members of the Pediatric Task Force of the Pulmonary Vascular Research Institute (PVRI) were aware of the need to develop a functional classification of pulmonary hypertension in children. The proposed classification follows the same pattern and uses the same criteria as the Dana Point pulmonary hypertension specific classification for adults. Modifications were necessary for children, since age, physical growth and maturation influences the way in which the functional effects of a disease are expressed. It is essential to encapsulate a child's clinical status, to make it possible to review progress with time as he/she grows up, as consistently and as objectively as possible. Particularly in younger children we sought to include objective indicators such as thriving, need for supplemental feeds and the record of school or nursery attendance. This helps monitor the clinical course of events and response to treatment over the years. It also facilitates the development of treatment algorithms for children. We present a consensus paper on a functional classification system for children with pulmonary hypertension, discussed at the Annual Meeting of the PVRI in Panama City, February 2011.

  19. Relationship of carotid arterial functional and structural changes to left atrial volume in untreated hypertension.

    Science.gov (United States)

    Jaroch, Joanna; Rzyczkowska, Barbara; Bociąga, Zbigniew; Vriz, Olga; Driussi, Caterina; Loboz-Rudnicka, Maria; Dudek, Krzysztof; Łoboz-Grudzień, Krystyna

    2016-04-01

    The contribution of arterial functional and structural changes to left ventricular (LV) diastolic dysfunction has been the area of recent research. There are some studies on the relationship between arterial stiffness (a.s.) and left atrial (LA) remodelling as a marker of diastolic burden. Little is known about the association of arterial structural changes and LA remodelling in hypertension (H). The aim of this study was to examine the relationship between carotid a.s. and intima-media thickness (IMT) and LA volume in subjects with H. The study included 245 previously untreated hypertensives (166 women and 79 men, mean age 53.7 ± 11.8 years). Each patient was subjected to echocardiography with measurement of LA volume, evaluation of left ventricular hypertrophy (LVH) and LV systolic/diastolic function indices, integrated assessment of carotid IMT and echo-tracking of a.s. and wave reflection parameters. Univariate regression analysis revealed significant correlations between indexed LA volume and selected clinical characteristics, echocardiographic indices of LVH and LV diastolic/systolic function and a.s./wave reflection parameters. The following parameters were identified as independent determinants of indexed LA volume on multivariate regression analysis: diastolic blood pressure (beta = -0.229, P arterial stiffness but not intima-media thickness and LA volume in patients with untreated hypertension.

  20. Community Noise Exposure and its Effect on Blood Pressure and Renal Function in Patients with Hypertension and Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Dzhambov Angel M.

    2017-09-01

    Full Text Available Background: Road traffic noise (RTN is a risk factor for cardiovascular disease (CVD and hypertension; however, few studies have looked into its association with blood pressure (BP and renal function in patients with prior CVD.

  1. [Clinical, functional and biochemical characteristics of arterial hypertension in military men under chronic stress].

    Science.gov (United States)

    Shpagina, L A; Ermakova, M A; Volkova, E A; Iakovleva, S A

    2008-01-01

    Peculiarities of military occupational activities are repeated stress and high degree of psychoemotional strain. The article deals with results of momentary study covering a select from military men cohort, with thyroid tests, renal functional tests, diurnal monitoring of blood pressure and psychologic state assessment. Course of arterial hypertension in military men subjected to chronic stress presents prevailing systolic-diastolic and diastolic variants with excessive decrease of blood pressure at night, with high values of albuminuria. Psychologic state of the military men examined, whe were subjects to chronic stress, was mostly mixed reactivity type with general overstrain and somatization of inner conflict (psychosomatic variant of dysadaptation). The authors demonstrated close correlation between intrinsic emotional strain degree with arterial hypertension type according to "hyper-dipper" variant and free T3 level.

  2. Cognitive Function and Emotional Status of Middle-aged Chinese Hypertensive Patients Without Detectable White Matter Brain Lesions or Lacunar Infarctions

    National Research Council Canada - National Science Library

    Rogers, Heather L

    2006-01-01

    .... Executive functions, speed of processing, memory and attention are especially impacted. Hypertension may affect cognitive function because of pathological physiological changes in the brain (e.g...

  3. COGNITIVE FUNCTIONS IN PATIENTS WITH ARTERIAL HYPERTENSION DEPENDING ON THE STATE OF HEMOSTASIS AND RENAL FUNCTION

    Directory of Open Access Journals (Sweden)

    Oleh Shmanko

    2015-09-01

      Summary. In 58 patients with arterial hypertension cognitive functions were examined depending on the state of hemostasis and renal function. The evaluation was conducted using short scale assessment of mental status (MMSE, Montreal scale (MOCA for studying attention and concentration, executive functions, memory, language performance, constructive visual performance, abstract thinking, mental calculation, spatial and temporal orientation. The sustainability of attentional focus and speed of sensorimotor reactions were investigated using the tables of Schulte. The quality of life of patients was assessed for physical and mental components employing a questionnaire SF-12. It was found that such indicators of hemostasis system as international normalized ratio, prothrombin index, level of fibrinogen are diagnostic predictors of the risk of cognitive impairment development in patients with arterial hypertension, considering the results of neuropsychological assessment and evaluation of quality of life. No significant dependence was found between the glomerular filtration rate and the development of cognitive impairment in patients with arterial hypertension.   Keywords: arterial hypertension, cognitive impairment, international normalized ratio, prothrombin index, fibrinogen, glomerular filtration rate.       Резюме У 58 пацієнтів з артеріальною гіпертензією досліджено когнітивні функції в залежності від стану згортальної системи крові та функції нирок.  Оцінку когнітивного статусу проводили за допомогою короткої шкали оцінки психічного статусу (MMSE, Монреальської шкали (MOCA для вивчення уваги та концентрації, виконавчих функцій, пам’яті, мови, конструкти

  4. Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine

    Directory of Open Access Journals (Sweden)

    Cesar Romaro Pozzobon

    2014-07-01

    Full Text Available Background: Antihypertensive drugs are used to control blood pressure (BP and reduce macro- and microvascular complications in hypertensive patients with diabetes. Objectives: The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan. Methods: Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day or losartan (100 mg/day. Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascular parameters using applanation tonometry, pulse wave velocity (PWV, and flow-mediated dilation (FMD of the brachial artery. Results: A total of 42 patients were evaluated (21 in each group, with a predominance of women (71% in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years, with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic and 84 ± 8 mmHg (diastolic; losartan group: 153 ± 19 mmHg (systolic and 90 ± 9 mmHg (diastolic]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025 and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045 were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups. Conclusions: Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

  5. EFFECT OF METOPROLOL ON COGNITIVE FUNCTION IN HYPERTENSIVE PATIENTS OF YOUNG TO MIDDLE AGE

    Directory of Open Access Journals (Sweden)

    S. A. Smakotina

    2008-01-01

    Full Text Available Aim. To evaluate the effect of metoprolol tartrate on blood pressure (BP and cognitive function in young to middle aged patients with essential hypertension (HT.Material and methods. 40 men (age of 49,0±1,9 y.o. with HT of I-II stage not taking antihypertensive medication regularly were enrolled into the study. All patients were given metoprolol tartrate (start dose 50-100 mg/d. Variables of 24-h BP monitoring and clinic BP, left ventricular mass index (measured by echocardiography and characteristics of cognitive function (memory, attention, thinking and neurodynamic were assessed at the start, after 1 and 6 months of therapy.Results. Good and satisfactory antihypertensive effect was achieved in 75% of hypertensive patients with metoprolol (186,6±13,4mg/d monotherapy. Metoprolol significantly decreased maximum day-time systolic and diastolic BP, maximum night-time diastolic BP, mean day-time systolic and night-time diastolic BP, time-index, load-index and variability-index for night-time diastolic BP, day-time and night-time pulse BP. Left ventricular mass index reduced significantly (p<0,0001. After 6 months of therapy significant improvement of memory, attention, thinking and neurodynamic was observedConclusion. Metoprolol had beneficial effect on cognitive function in hypertensive patients, which demonstrate its cerebroprotective properties in addition to antihypertensive action. Metoprolol can reduce the risk of dementia in young to middle aged patients with HT.

  6. Effects of a new nutraceutical combination on cognitive function in hypertensive patients.

    Science.gov (United States)

    Giugliano, Giuseppe; Salemme, Alessia; De Longis, Sara; Perrotta, Marialuisa; D'Angelosante, Valentina; Landolfi, Alessandro; Izzo, Raffaele; Trimarco, Valentina

    2018-01-01

    Chronic increased arterial blood pressure has been associated with executive dysfunction, slowing of attention and mental processing speed, and later with memory deficits. Due to the absence of a concrete therapeutic approach to this pathophysiological process, in the last decades there has been an increasing interest in the use of nutraceuticals, especially those with antioxidant properties, which own strong neuroprotective potential, that may help to improve cognitive function and to delay the onset of dementia. We evaluated the effects of the treatment with a new nutraceutical preparation containing different molecules with potent antioxidant properties (AkP05, IzzeK®) and placebo on a cohort of thirty-six hypertensive patients. At baseline, neuropsychological evaluation, arterial stiffness and biochemical parameters of the subjects were comparable. After 6 months of treatment, there was a significant reduction of the augmentation index in the AkP05-treated group. Moreover, the measurement of cognitive function, evaluated with MoCA test and Word Match Testing, showed a significant improvement in patients receiving the active treatment. In addition, the group treated with nutraceutical reached a better Stroop test score, while subjects that received placebo did not showed any improvement. Finally, a positive relationship between SBP variation and the psychometric assessment with the EQ-VAS scale was observed only in the active treatment group. In this study, we demonstrated that the therapy with a new nutraceutical preparation is able to significantly increase the scores of important neuropsychological tests in hypertensive patients already on satisfactory blood pressure control. Although future studies are needed to better characterize the molecular mechanisms involved, these results candidate the new nutraceutical combination as a possible therapeutic strategy to support the cerebrovascular functions and delay the onset of dementia in hypertensive patients.

  7. Characterisation of hypertensive patients with improved endothelial function after dark chocolate consumption.

    Science.gov (United States)

    d'El-Rei, Jenifer; Cunha, Ana Rosa; Burlá, Adriana; Burlá, Marcelo; Oigman, Wille; Neves, Mario Fritsch; Virdis, Agostino; Medeiros, Fernanda

    2013-01-01

    Recent findings indicate an inverse relationship between cardiovascular disease and consumption of flavonoids. We aimed to identify clinical and vascular parameters of treated hypertensive who present beneficial effects of dark chocolate for one-week period on vascular function. Twenty-one hypertensive subjects, aged 40-65 years, were included in a prospective study with measurement of blood pressure (BP), brachial flow-mediated dilatation (FMD), peripheral arterial tonometry, and central hemodynamic parameters. These tests were repeated after seven days of eating dark chocolate 75 g/day. Patients were divided according to the response in FMD: responders (n = 12) and nonresponders (n = 9). The responder group presented lower age (54 ± 7 versus 61 ± 6 years, P = 0.037), Framingham risk score (FRS) (2.5 ± 1.8 versus 8.1 ± 5.1%, P = 0.017), values of peripheral (55 ± 9 versus 63 ± 5 mmHg, P = 0.041), and central pulse pressure (PP) (44 ± 10 versus 54 ± 6 mmHg, P = 0.021). FMD response showed negative correlation with FRS (r = -0.60, P = 0.014), baseline FMD (r = -0.54, P = 0.011), baseline reactive hyperemia index (RHI; r = -0.56, P = 0.008), and central PP (r = -0.43, P = 0.05). However, after linear regression analysis, only FRS and baseline RHI were associated with FMD response. In conclusion, one-week dark chocolate intake significantly improved endothelial function and reduced BP in younger hypertensive with impaired endothelial function in spite of lower cardiovascular risk.

  8. Characterisation of Hypertensive Patients with Improved Endothelial Function after Dark Chocolate Consumption

    Directory of Open Access Journals (Sweden)

    Jenifer d'El-Rei

    2013-01-01

    Full Text Available Recent findings indicate an inverse relationship between cardiovascular disease and consumption of flavonoids. We aimed to identify clinical and vascular parameters of treated hypertensive who present beneficial effects of dark chocolate for one-week period on vascular function. Twenty-one hypertensive subjects, aged 40–65 years, were included in a prospective study with measurement of blood pressure (BP, brachial flow-mediated dilatation (FMD, peripheral arterial tonometry, and central hemodynamic parameters. These tests were repeated after seven days of eating dark chocolate 75 g/day. Patients were divided according to the response in FMD: responders (n=12 and nonresponders (n=9. The responder group presented lower age (54 ± 7 versus 61 ± 6 years, P=0.037, Framingham risk score (FRS (2.5 ± 1.8 versus 8.1 ± 5.1%, P=0.017, values of peripheral (55 ± 9 versus 63 ± 5 mmHg, P=0.041, and central pulse pressure (PP (44 ± 10 versus 54 ± 6 mmHg, P=0.021. FMD response showed negative correlation with FRS (r=−0.60, P=0.014, baseline FMD (r=−0.54, P=0.011, baseline reactive hyperemia index (RHI; r=−0.56, P=0.008, and central PP (r=−0.43, P=0.05. However, after linear regression analysis, only FRS and baseline RHI were associated with FMD response. In conclusion, one-week dark chocolate intake significantly improved endothelial function and reduced BP in younger hypertensive with impaired endothelial function in spite of lower cardiovascular risk.

  9. Characterisation of Hypertensive Patients with Improved Endothelial Function after Dark Chocolate Consumption

    Science.gov (United States)

    d'El-Rei, Jenifer; Cunha, Ana Rosa; Burlá, Adriana; Burlá, Marcelo; Oigman, Wille

    2013-01-01

    Recent findings indicate an inverse relationship between cardiovascular disease and consumption of flavonoids. We aimed to identify clinical and vascular parameters of treated hypertensive who present beneficial effects of dark chocolate for one-week period on vascular function. Twenty-one hypertensive subjects, aged 40–65 years, were included in a prospective study with measurement of blood pressure (BP), brachial flow-mediated dilatation (FMD), peripheral arterial tonometry, and central hemodynamic parameters. These tests were repeated after seven days of eating dark chocolate 75 g/day. Patients were divided according to the response in FMD: responders (n = 12) and nonresponders (n = 9). The responder group presented lower age (54 ± 7 versus 61 ± 6 years, P = 0.037), Framingham risk score (FRS) (2.5 ± 1.8 versus 8.1 ± 5.1%, P = 0.017), values of peripheral (55 ± 9 versus 63 ± 5 mmHg, P = 0.041), and central pulse pressure (PP) (44 ± 10 versus 54 ± 6 mmHg, P = 0.021). FMD response showed negative correlation with FRS (r = −0.60, P = 0.014), baseline FMD (r = −0.54, P = 0.011), baseline reactive hyperemia index (RHI; r = −0.56, P = 0.008), and central PP (r = −0.43, P = 0.05). However, after linear regression analysis, only FRS and baseline RHI were associated with FMD response. In conclusion, one-week dark chocolate intake significantly improved endothelial function and reduced BP in younger hypertensive with impaired endothelial function in spite of lower cardiovascular risk. PMID:23533716

  10. Postural Effect on Renal Function In Cases of Pregnancy-Induced Hypertension

    OpenAIRE

    丸山, 晋司; Maruyama, Shinji

    1989-01-01

    Postual effect on renal function was analysed on the cases of pregnancy-induced hypertension (PIH) (n=11) compared with cases of normotensive pregnancies (n=12) and non-pregnant women (n=9). In non-pregnant women, GFR, RBF and RPF showed no changes in relation to the changing posture (supine and left lateral). In normal pregnant women and cases of PIH, GFR, RBF and RPF significantly increased on changing their posture from supine to left lateral at third trimester. Especially, patients with P...

  11. The Soluble Epoxide Hydrolase Inhibitor AR9281 Decreases Blood Pressure, Ameliorates Renal Injury and Improves Vascular Function in Hypertension

    Directory of Open Access Journals (Sweden)

    Sean Shaw

    2009-12-01

    Full Text Available Soluble epoxide hydrolase inhibitors (sEHIs are demonstrating promise as potential pharmaceutical agents for the treatment of cardiovascular disease, diabetes, inflammation, and kidney disease. The present study determined the ability of a first-inclass sEHI, AR9281, to decrease blood pressure, improve vascular function, and decrease renal inflammation and injury in angiotensin hypertension. Rats were infused with angiotensin and AR9281 was given orally during the 14-day infusion period. Systolic blood pressure averaged 180 ± 5 mmHg in vehicle treated and AR9281 treatment significantly lowered blood pressure to 142 ± 7 mmHg in angiotensin hypertension. Histological analysis demonstrated decreased injury to the juxtamedullary glomeruli. Renal expression of inflammatory genes was increased in angiotensin hypertension and two weeks of AR9281 treatment decreased this index of renal inflammation. Vascular function in angiotensin hypertension was also improved by AR9281 treatment. Decreased afferent arteriolar and mesenteric resistance endothelial dependent dilator responses were ameliorated by AR9281 treatment of angiotensin hypertensive rats. These data demonstrate that the first-in-class sEHI, AR9281, lowers blood pressure, improves vascular function and reduces renal damage in angiotensin hypertension.

  12. Multicomponent Exercise Improves Physical Functioning but Not Cognition and Hemodynamic Parameters in Elderly Osteoarthritis Patients Regardless of Hypertension

    Directory of Open Access Journals (Sweden)

    Hélio José Coelho-Júnior

    2018-01-01

    Full Text Available The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP on physical function, cognition, and hemodynamic parameters of elderly normotensive (NTS and hypertensive (HTS osteoarthritis patients. A total of 99 elderly osteoarthritis patients (44 NTS and 55 HTS were recruited and submitted to functional, cognitive, and hemodynamic evaluations before and after six months of a MCEP. The program of exercise was performed twice a week at moderate intensity. The physical exercises aggregated functional and walking exercises. Results indicate that 6 months of MCEP were able to improve one-leg stand and mobility (walking speeds of osteoarthritis patients regardless of hypertension. On the other hand, cognitive and hemodynamic parameters were not altered after the MCEP. The findings of the present study demonstrate that 6 months of MCEP were able to improve the physical functioning (i.e., usual and maximal walking speed and balance of osteoarthritis patients regardless of hypertensive condition.

  13. Characteristics of functional state of arteriolar and venular skin microvessels in patients with essential arterial hypertension.

    Science.gov (United States)

    Fedorovich, Andrey A; Rogoza, Anatoly N; Chikhladze, Novella M

    2014-05-01

    The aim of the study was to evaluate the vasomotor activity of skin precapillary arterioles, depending on the condition of blood outflow from the capillary bed in patients with essential arterial hypertension (AH). The study included 30 normotensive subjects (NT) and 63 patients with AH, who were tested with a laser Doppler flowmetry with wavelet analysis of blood flow oscillations on the right forearm and ambulatory blood pressure monitoring (ABPM) on the left shoulder. Antihypertensive therapy was stopped for all patients 14 days prior to the experiment or AH was diagnosed for the first time. The hypertensive patients were divided into 2 groups, depending on the amplitude of the respiratory blood flow oscillations in skin microvessels. The first group included 30 patients without blood outflow violations of the capillary bed (AHVN), the second group consisted of 33 patients with various intensity of functional disorders in venular sector of microvasculature (AHVS). If the value of the amplitude of blood flow oscillations can be related to the tone" definition, then AHVN patients have a significant increase in neurogenic component of vascular tone (phypertensive patients can have significant differences in the functional state of microvessels. The assessment of the initial skin microvasculatory regulatory mechanism status could potentially be useful for individual choice of antihypertensive therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. The effects of baroreflex activation therapy on blood pressure and sympathetic function in patients with refractory hypertension

    DEFF Research Database (Denmark)

    Gordin, Daniel; Fadl Elmula, Fadl Elmula M; Andersson, Bert

    2017-01-01

    ). Results: The primary end point is the reduction in 24-hour systolic ABPM by BAT at 8 months, as compared to pharmacotherapy. Secondary and tertiary endpoints are effects of BAT on home and office blood pressures, measures of indices of cardiac and vascular structure and function during follow......Objective: To explore the effects of baroreflex activation therapy (BAT) on hypertension in patients with treatment resistant or refractory hypertension. Methods: This investigator-initiated randomized, double-blind, 1:1 parallel-design clinical trial will include 100 patients with refractory...... hypertension from 6 tertiary referral hypertension centers in the Nordic countries. A Barostim Neo System will be implanted and after 1 month patients will be randomized to either BAT for 16 months or continuous pharmacotherapy (BAT off) for 8 months followed by BAT for 8 months. A second randomization...

  15. Evaluation of left ventricular function in obese children without hypertension by a tissue Doppler imaging study

    Directory of Open Access Journals (Sweden)

    Yazdan Ghandi

    2018-01-01

    Conclusions : Obesity in children without hypertension is associated with subclinical systolic and diastolic cardiac dysfunction. We propose the evaluation of blood pressure as well as myocardial performance using PWD and TDI in all obese children without hypertension, regularly.

  16. Effect of endovascular treatment on nitric oxide and renal function in Takayasu's arteritis with renovascular hypertension.

    Science.gov (United States)

    Parildar, Zuhal; Gulter, Ceyda; Parildar, Mustafa; Oran, Ismail; Erdener, Dilek; Memis, Ahmet

    2002-01-01

    Renal involvement in Takayasu's arteritis (TA) effects the disease outcome and endovascular treatment is an effective treatment of choice. We investigated nitric oxide (NO) levels and the effect of endovascular treatment in renovascular hypertensive TA patients. In five hypertensive patients with renal artery stenosis due to TA, serum creatinine, nitrite, nitrate; urinary microalbumin, nitrite, nitrate measurements and blood pressures were recorded at entry and after 24 h and 6 weeks of endovascular treatment. Serum NO levels were higher in patients than controls (p = 0.008). Serum and urine NO levels increased 24 h after the treatment and decreased after 6 weeks (p = 0.015; p = 0.01, respectively). After the treatment blood pressures decreased. Urinary microalbumin excretions increased after the intervention (p = 0.02) and returned to normal in patients 1 and 4, and decreased in the others. There were no significant differences in estimated glomerular filtration rate (EGFR), serum creatinine, urinary sodium and potassium levels. Increased NO secretion in these patients may contribute to improve the prognosis of renal function through its vasodilator and antiproliferative activities possibly by counterbalancing the excessive vasoconstrictor actions. Endovascular treatment causes a dilatation-induced shear stress that may be responsible for the increased NO release, which in turn leads to the rapid hypotensive response. Copyright 2002 S. Karger AG, Basel

  17. Beneficial Effects of Different Flavonoids on Vascular and Renal Function in L-NAME Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    M. Dolores Paredes

    2018-04-01

    Full Text Available Background: we have evaluated the antihypertensive effect of several flavonoid extracts in a rat model of arterial hypertension caused by chronic administration (6 weeks of the nitric oxide synthesis inhibitor, L-NAME. Methods: Sprague Dawley rats received L-NAME alone or L-NAME plus flavonoid-rich vegetal extracts (Lemon, Grapefruit + Bitter Orange, and Cocoa or purified flavonoids (Apigenin and Diosmin for 6 weeks. Results: L-NAME treatment resulted in a marked elevation of blood pressure, and treatment with Apigenin, Lemon Extract, and Grapefruit + Bitter Orange extracts significantly reduced the elevated blood pressure of these animals. Apigenin and some of these flavonoids also ameliorated nitric oxide-dependent and -independent aortic vasodilation and elevated nitrite urinary excretion. End-organ abnormalities such as cardiac infarcts, hyaline arteriopathy and fibrinoid necrosis in coronary arteries and aorta were improved by these treatments, reducing the end-organ vascular damage. Conclusions: the flavonoids included in this study, specially apigenin, may be used as functional food ingredients with potential therapeutic benefit in arterial hypertension.

  18. Topical carbonic anhydrase inhibitors and visual function in glaucoma and ocular hypertension.

    Science.gov (United States)

    Gugleta, Konstantin

    2010-06-01

    Dorzolamide and brinzolamide are topical carbonic anhydrase inhibitors (CAI) indicated for patients with glaucoma and ocular hypertension. An evidence-based review of clinical trials of dorzolamide and brinzolamide was undertaken to determine an effect of these medications on visual function (primarily visual field) in open-angle glaucoma and ocular hypertension. Using the keywords 'dorzolamide' and 'brinzolamide', all articles describing trials of these medications reporting on visual acuity, contrast sensitivity and visual field from September 1966 to July 2009 were found in MEDLINE and EMBASE databases. No information from other sources was included in this review. A relatively modest number of trials was identified, where impact of therapy on one or more of the visual function modes was reported. In the studies of less than 1 year duration (3 days to 1 year, 23 studies) in all but three studies treatment with topical CAIs did not influence visual function, in two studies with dorzolamide some improvement in the contrast sensitivity was observed and in one open-label retrospective no-control-group study with dorzolamide visual field indices improved significantly. A different picture was seen in long-term studies, which were designed and powered to detect changes in visual field. One large study (European Glaucoma Prevention Study) with dorzolamide versus placebo failed to detect significant protective effect of the drug on glaucoma occurrence in ocular hypertensives. Several interesting aspects of this study are discussed in detail. The other two long-term studies reported on the superiority of adding dorzolamide over timolol therapy alone, and the superiority of the combination of dorzolamide and timolol over brinzolamide and timolol in terms of improving ocular blood flow (retrobulbar Color Doppler Imaging--CDI parameters) as well as in terms of visual field preservation in glaucoma patients over 4 to 5 years. For the first time one study could demonstrate

  19. A Single Resistance Exercise Session Improves Aortic Endothelial Function in Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Thaís de Oliveira Faria

    Full Text Available Abstract Background: Physical exercise is an important tool for the improvement of endothelial function. Objective: To assess the effects of acute dynamic resistance exercise on the endothelial function of spontaneously hypertensive rats (SHR. Methods: Ten minutes after exercise, the aorta was removed to evaluate the expression of endothelial nitric oxide synthase (eNOS, phosphorylated endothelial nitric oxide synthase (p-eNOS1177 and inducible nitric oxide synthase (iNOS and to generate concentration-response curves to acetylcholine (ACh and to phenylephrine (PHE. The PHE protocol was also performed with damaged endothelium and before and after NG-nitro-L-arginine methyl ester (L-NAME and indomethacin administration. The maximal response (Emax and the sensitivity (EC50 to these drugs were evaluated. Results: ACh-induced relaxation increased in the aortic rings of exercised (Ex rats (Emax= -80 ± 4.6%, p < 0.05 when compared to those of controls (Ct (Emax = -50 ± 6.8%. The Emax to PHE was decreased following exercise conditions (95 ± 7.9%, p < 0.05 when compared to control conditions (120 ± 4.2%. This response was abolished after L-NAME administration or endothelial damage. In the presence of indomethacin, the aortic rings' reactivity to PHE was decreased in both groups (EC50= Ex -5.9 ± 0.14 vs. Ct -6.6 ± 0.33 log µM, p < 0.05 / Emax = Ex 9.5 ± 2.9 vs. Ct 17 ± 6.2%, p < 0.05. Exercise did not alter the expression of eNOS and iNOS, but increased the level of p-eNOS. Conclusion: A single resistance exercise session improves endothelial function in hypertensive rats. This response seems to be mediated by increased NO production through eNOS activation.

  20. Total Cerebral Small Vessel Disease MRI Score Is Associated With Cognitive Decline In Executive Function In Patients With Hypertension

    Directory of Open Access Journals (Sweden)

    Renske Uiterwijk

    2016-12-01

    Full Text Available Objectives: Hypertension is a major risk factor for white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD. Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a total SVD score was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of white matter hyperintensities, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0-4 in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p=0.017, executive functioning (p<0.001 and information processing speed (p=0.037, but not with memory (p=0.911. The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group and baseline cognitive performance.Conclusions: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

  1. Consumption of High-Polyphenol Dark Chocolate Improves Endothelial Function in Individuals with Stage 1 Hypertension and Excess Body Weight

    Directory of Open Access Journals (Sweden)

    Lívia de Paula Nogueira

    2012-01-01

    Full Text Available Background. Hypertension and excess body weight are important risk factors for endothelial dysfunction. Recent evidence suggests that high-polyphenol dark chocolate improves endothelial function and lowers blood pressure. This study aimed to evaluate the association of chocolate 70% cocoa intake with metabolic profile, oxidative stress, inflammation, blood pressure, and endothelial function in stage 1 hypertensives with excess body weight. Methods. Intervention clinical trial includes 22 stage 1 hypertensives without previous antihypertensive treatment, aged 18 to 60 years and presents a body mass index between 25.0 and 34.9 kg/m2. All participants were instructed to consume 50 g of chocolate 70% cocoa/day (2135 mg polyphenols for 4 weeks. Endothelial function was evaluated by peripheral artery tonometry using Endo-PAT 2000 (Itamar Medical. Results. Twenty participants (10 men completed the study. Comparison of pre-post intervention revealed that (1 there were no significant changes in anthropometric parameters, percentage body fat, glucose metabolism, lipid profile, biomarkers of inflammation, adhesion molecules, oxidized LDL, and blood pressure; (2 the assessment of endothelial function through the reactive hyperemia index showed a significant increase: 1.94 ± 0.18 to 2.22 ± 0.08, P=0.01. Conclusion.In individuals with stage 1 hypertension and excess body weight, high-polyphenol dark chocolate improves endothelial function.

  2. EVALUATION OF SOME ANTIOXIDANTS TREATMENT ON KIDNEY FUNCTION AND LIPID PEROXIDATION STATUS IN HYPERTENSIVE RATS INDUCED WITH L-NAME

    International Nuclear Information System (INIS)

    MATTA, T.F.

    2008-01-01

    Hypertension, the disease known as the s ilent killer , is a common problem facing peoples today with million new cases being diagnosed each year. Although a great amount of money is spent annually for the treatment and detection of this disease and its complications, current conventional treatment have done little to reduce the number of patients with hypertension. Research has found a variety of alternative therapies to be successful in reducing high blood pressure including diet, exercise, stress management, supplements and herbs.In this study, the changes in some selected biochemical blood variables, which are thought to represent risk factors coincident with hypertension and kidney function, were compared between a group of normotensive male albino rats and other group suffered from hypertension induced artificially by N-nitro-L-arginine methyl ester (L-NAME). Also, this study investigated the effects of daily administration of some antioxidants nutrients for two weeks namely carnitine, coenzyme Q 1 0 , garlic oil and their mixture on the same variables in order to show to what extent these nutrients are valid to control the levels of these variables without any deleterious effects after treatment. Fifty mg of coenzyme Q 10 and 50 mg of carnitine were daily injected intraperitoneally for two weeks in two groups of hypertensive rats while 200 mg/kg b.wt was given to another group of hypertensive rats by oral intubation. A combination of all the above mentioned nutrients was given to the fourth group. Another hypertensive group was left without any treatment and served as a recovery group. Fasting blood samples were drawn and kidney tissues were taken at the terminal of treatments.The obtained results revealed that induced hypertension caused significant (P<0.05) increase of thiobarbeturic acid reactive substances (TBARs), malondialdehyde (MAD), parathormone (PTH), renin, blood urea, creatinine, phosphorus, sodium and potassium while glutathione (GSH), calcium

  3. Colchicine Depolymerizes Microtubules, Increases Junctophilin-2, and Improves Right Ventricular Function in Experimental Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Prins, Kurt W; Tian, Lian; Wu, Danchen; Thenappan, Thenappan; Metzger, Joseph M; Archer, Stephen L

    2017-05-31

    Pulmonary arterial hypertension (PAH) is a lethal disease characterized by obstructive pulmonary vascular remodeling and right ventricular (RV) dysfunction. Although RV function predicts outcomes in PAH, mechanisms of RV dysfunction are poorly understood, and RV-targeted therapies are lacking. We hypothesized that in PAH, abnormal microtubular structure in RV cardiomyocytes impairs RV function by reducing junctophilin-2 (JPH2) expression, resulting in t-tubule derangements. Conversely, we assessed whether colchicine, a microtubule-depolymerizing agent, could increase JPH2 expression and enhance RV function in monocrotaline-induced PAH. Immunoblots, confocal microscopy, echocardiography, cardiac catheterization, and treadmill testing were used to examine colchicine's (0.5 mg/kg 3 times/week) effects on pulmonary hemodynamics, RV function, and functional capacity. Rats were treated with saline (n=28) or colchicine (n=24) for 3 weeks, beginning 1 week after monocrotaline (60 mg/kg, subcutaneous). In the monocrotaline RV, but not the left ventricle, microtubule density is increased, and JPH2 expression is reduced, with loss of t-tubule localization and t-tubule disarray. Colchicine reduces microtubule density, increases JPH2 expression, and improves t-tubule morphology in RV cardiomyocytes. Colchicine therapy diminishes RV hypertrophy, improves RV function, and enhances RV-pulmonary artery coupling. Colchicine reduces small pulmonary arteriolar thickness and improves pulmonary hemodynamics. Finally, colchicine increases exercise capacity. Monocrotaline-induced PAH causes RV-specific derangement of microtubules marked by reduction in JPH2 and t-tubule disarray. Colchicine reduces microtubule density, increases JPH2 expression, and improves both t-tubule architecture and RV function. Colchicine also reduces adverse pulmonary vascular remodeling. These results provide biological plausibility for a clinical trial to repurpose colchicine as a RV-directed therapy for PAH

  4. The effects of dihydropyridine and phenylalkylamine calcium antagonist classes on autonomic function in hypertension : The VAMPHYRE study

    NARCIS (Netherlands)

    Lefrandt, JD; Heitmann, J; Sevre, K; Castellano, M; Hausberg, M; Fallon, M; Fluckiger, L; Urbigkeit, A; Rostrup, M; Agabiti-Rosei, E; Rahn, KH; Murphy, M; Zannad, F; de Kam, PJ; van Roon, AM; Smit, AJ

    The aim of the present study was to compare the effects of a long-acting dihydropyridine (amlodipine) and a nondihydropyridine. (verapamil) on autonomic function in patients with mild to moderate hypertension. A total of 145 patients with a diastolic blood pressure (BP) between 95 and 110 mm Hg

  5. Aerobic Swim Training Restores Aortic Endothelial Function by Decreasing Superoxide Levels in Spontaneously Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Camila P. Jordão

    Full Text Available OBJECTIVE: We aimed to determine whether aerobic training decreases superoxide levels, increases nitric oxide levels, and improves endothelium-dependent vasodilation in the aortas of spontaneously hypertensive rats. METHODS: Spontaneously hypertensive rats (SHR and Wistar Kyoto rats (WKY were distributed into 2 groups: sedentary (SHRsd and WKYsd, n=10 each and swimming-trained (SHRtr, n=10 and WKYtr, n=10, respectively. The trained group participated in training sessions 5 days/week for 1 h/day with an additional work load of 4% of the animal’s body weight. After a 10-week sedentary or aerobic training period, the rats were euthanized. The thoracic aortas were removed to evaluate the vasodilator response to acetylcholine (10-10 to 10-4 M with or without preincubation with L-NG-nitro-L-arginine methyl ester hydrochloride (L-NAME; 10-4 M in vitro. The aortic tissue was also used to assess the levels of the endothelial nitric oxide synthase and nicotinamide adenine dinucleotide oxidase subunit isoforms 1 and 4 proteins, as well as the superoxide and nitrite contents. Blood pressure was measured using a computerized tail-cuff system. RESULTS: Aerobic training significantly increased the acetylcholine-induced maximum vasodilation observed in the SHRtr group compared with the SHRsd group (85.9±4.3 vs. 71.6±5.2%. Additionally, in the SHRtr group, superoxide levels were significantly decreased, nitric oxide bioavailability was improved, and the levels of the nicotinamide adenine dinucleotide oxidase subunit isoform 4 protein were decreased compared to the SHRsd group. Moreover, after training, the blood pressure of the SHRtr group decreased compared to the SHRsd group. Exercise training had no effect on the blood pressure of the WKYtr group. CONCLUSIONS: In SHR, aerobic swim training decreased vascular superoxide generation by nicotinamide adenine dinucleotide oxidase subunit isoform 4 and increased nitric oxide bioavailability, thereby improving

  6. Treatment with salvianolic acid B restores endothelial function in angiotensin II-induced hypertensive mice.

    Science.gov (United States)

    Ling, Wei Chih; Liu, Jian; Lau, Chi Wai; Murugan, Dharmani Devi; Mustafa, Mohd Rais; Huang, Yu

    2017-07-15

    Salvianolic acid B (Sal B) is one of the most abundant phenolic acids derived from the root of Danshen with potent anti-oxidative properties. The present study examined the vasoprotective effect of Sal B in hypertensive mice induced by angiotensin II (Ang II). Sal B (25mg/kg/day) was administered via oral gavage for 11days to Ang II (1.2mg/kg/day)-infused C57BL/6J mice (8-10weeks old). The vascular reactivity (both endothelium-dependent relaxations and contractions) in mouse arteries was examined by wire myography. The production of reactive oxygen species (ROS), protein level and localization of angiotensin AT 1 receptors and the proteins involved in ROS formation were evaluated using dihydroethidium (DHE) fluorescence, lucigenin-enhanced chemiluminescence, immunohistochemistry and Western blotting, respectively. The changes of ROS generating proteins were also assessed in vitro in human umbilical vein endothelial cells (HUVECs) exposed to Ang II with and without co-treatment with Sal B (0.1-10nM). Oral administration of Sal B reversed the Ang II-induced elevation of arterial systolic blood pressure in mice, augmented the impaired endothelium-dependent relaxations and attenuated the exaggerated endothelium-dependent contractions in both aortas and renal arteries of Ang II-infused mice. In addition, Sal B treatment normalized the elevated levels of AT 1 receptors, NADPH oxidase subunits (NOx-2 and NOx-4) and nitrotyrosine in arteries of Ang II-infused mice or in Ang II-treated HUVECs. In summary, the present study provided additional evidence demonstrating that Sal B treatment for 11days reverses the impaired endothelial function and with a marked inhibition of AT 1 receptor-dependent vascular oxidative stress. This vasoprotective and anti-oxidative action of Sal B most likely contributes to the anti-hypertensive action of the plant-derived compound. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Left Ventricular Myocardial Function in Children With Pulmonary Hypertension: Relation to Right Ventricular Performance and Hemodynamics.

    Science.gov (United States)

    Burkett, Dale A; Slorach, Cameron; Patel, Sonali S; Redington, Andrew N; Ivy, D Dunbar; Mertens, Luc; Younoszai, Adel K; Friedberg, Mark K

    2015-08-01

    Through ventricular interdependence, pulmonary hypertension (PH) induces left ventricular (LV) dysfunction. We hypothesized that LV strain/strain rate, surrogate measures of myocardial contractility, are reduced in pediatric PH and relate to invasive hemodynamics, right ventricular strain, and functional measures of PH. At 2 institutions, echocardiography was prospectively performed in 54 pediatric PH patients during cardiac catheterization, and in 54 matched controls. Patients with PH had reduced LV global longitudinal strain (LS; -18.8 [-17.3 to -20.4]% versus -20.2 [-19.0 to -20.9]%; P=0.0046) predominantly because of reduced basal (-12.9 [-10.8 to -16.3]% versus -17.9 [-14.5 to -20.7]%; Pright ventricular free-wall LS (r=0.64; PBrain natriuretic peptide levels correlated moderately with septal LS (r=0.48; P=0.0038). PH functional class correlated moderately with LV free-wall LS (r=-0.48; P=0.0051). The septum, shared between ventricles and affected by septal shift, was the most affected LV region in PH. Pediatric PH patients demonstrate reduced LV strain/strain rate, predominantly within the septum, with relationships to invasive hemodynamics, right ventricular strain, and functional PH measures. © 2015 American Heart Association, Inc.

  8. Chronic administration of the probiotic kefir improves the endothelial function in spontaneously hypertensive rats.

    Science.gov (United States)

    Friques, Andreia G F; Arpini, Clarisse M; Kalil, Ieda C; Gava, Agata L; Leal, Marcos A; Porto, Marcella L; Nogueira, Breno V; Dias, Ananda T; Andrade, Tadeu U; Pereira, Thiago Melo C; Meyrelles, Silvana S; Campagnaro, Bianca P; Vasquez, Elisardo C

    2015-12-30

    The beverage obtained by fermentation of milk with kefir grains, a complex matrix containing acid bacteria and yeasts, has been shown to have beneficial effects in various diseases. However, its effects on hypertension and endothelial dysfunction are not yet clear. In this study, we evaluated the effects of kefir on endothelial cells and vascular responsiveness in spontaneously hypertensive rats (SHR). SHR were treated with kefir (0.3 mL/100 g body weight) for 7, 15, 30 and 60 days and compared with non-treated SHR and with normotensive Wistar-Kyoto rats. Vascular endothelial function was evaluated in aortic rings through the relaxation response to acetylcholine (ACh). The balance between reactive oxygen species (ROS) and nitric oxide (NO) synthase was evaluated through specific blockers in the ACh-induced responses and through flow cytometry in vascular tissue. Significant effects of kefir were observed only after treatment for 60 days. The high blood pressure and tachycardia exhibited by the SHR were attenuated by approximately 15 % in the SHR-kefir group. The impaired ACh-induced relaxation of the aortic rings observed in the SHR (37 ± 4 %, compared to the Wistar rats: 74 ± 5 %), was significantly attenuated in the SHR group chronically treated with kefir (52 ± 4 %). The difference in the area under the curve between before and after the NADPH oxidase blockade or NO synthase blockade of aortic rings from SHR were of approximately +90 and -60 %, respectively, when compared with Wistar rats. In the aortic rings from the SHR-kefir group, these values were reduced to +50 and -40 %, respectively. Flow cytometric analysis of aortic endothelial cells revealed increased ROS production and decreased NO bioavailability in the SHR, which were significantly attenuated by the treatment with kefir. Scanning electronic microscopy showed vascular endothelial surface injury in SHR, which was partially protected following administration of kefir for 60 days. In addition, the

  9. The effect of TACE plus PSE on the liver function of hepatic cancer with portal hypertension and hypersplenism

    International Nuclear Information System (INIS)

    Tao Zhenglong; Jin Hongxian; Cheng Yongde; Zhan Yingjiang

    2004-01-01

    Objective: To evaluate the effect of transcatheter arterial chemoembolization (TACE) plus partial spleen embolization (PSE) on the liver function in patients with hepatocellular carcinoma (HCC). Methods: 85 patients with HCC complicated with portal hypertension and hypersplenism, including group A 45 patients with treatment of TACE plus PSE and group B 40 patients with single TACE were observed. The liver function was evaluated with Child Pugh scores before and after the procedure. Results: There was no difference in the levels of TBIL, ALT, ALB and Child Pugh scores between groups A and B (P>0.05) but remarkable change after therapy was shown at one week later (P<0.05, P<0.01). The liver function tests showed remarkable improvement in the TACE plus PSE group. Conclusion: TACE combined with PSE is a safe and effective procedure for patients with HCC associated with liver cirrhosis, portal hypertension and hypersplenism. (authors)

  10. Decreased renal function and hypertension are long-term complications of extracorporeal shock wave lithotripsy

    International Nuclear Information System (INIS)

    Williams, C.M.; Kaude, J.V.; Newman, R.C.; Peterson, J.C.; Thomas, W.C.

    1987-01-01

    Quantitative radionuclide renography performed in 21 patients 17-21 months after extracorporeal shock wave lithotripsy showed a significant decrease in the percentage of effective renal plasma flow (%ERPF) of the treated kidney; in five (24%) patients the %ERPF had decreased by more than 5 percentage units. In seven (8%) of 91 patients sustained hypertension developed that required pharmacologic treatment after lithotripsy. Decreased %ERPF of a treated kidney and hypertension may be related to a Page kidney or similar process resulting from renal trauma and hemorrhage occurring as a side effect of lithotripsy. Hypertension is an important complication of lithotripsy in about 8% of patients

  11. Evaluation with equilibrium radionuclide angiography of left ventricular systolic and diastolic function in pulmonary hypertension secondary to chronic pulmonary diseases

    International Nuclear Information System (INIS)

    Inoue, Kazuya; Sera, Kazuaki; Fukuzaki, Hisashi.

    1989-01-01

    To evaluate left ventricular systolic and diastolic function in patients with pulmonary hypertension secondary to chronic pulmonary diseases, 86 patients were studied using equilibrium radionuclide angiography with forward and reverse gating from the R wave. At rest left ventricular function, both in systolic and diastolic properties, in patients with pulmonary hypertension was significantly lower than in normal subjects (LVEF; P<0.05, PER; P<0.05, PFR; P<0.025, FF; P<0.025). During exercise left ventricular systolic function did not increase as much as in normals (LVEF; N.S., PER; N.S.). Left ventricular diastolic function during exercise was significantly lower than at rest (PFR; P<0.05, FF; P<0.001). The indices of left ventricular function obtained from radionuclide angiography had no close correlation with pulmonary hemodynamics or with blood gases. These results demonstrated that left ventricular dysfunction in patients with pulmonary hypertension was observed both at rest and during exercise, and might play an important role in reduced exercise tolerance. (author)

  12. Evaluation with equilibrium radionuclide angiography of left ventricular systolic and diastolic function in pulmonary hypertension secondary to chronic pulmonary diseases

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Kazuya; Sera, Kazuaki [National Akashi Hospital, Hyogo (Japan); Fukuzaki, Hisashi

    1989-08-01

    To evaluate left ventricular systolic and diastolic function in patients with pulmonary hypertension secondary to chronic pulmonary diseases, 86 patients were studied using equilibrium radionuclide angiography with forward and reverse gating from the R wave. At rest left ventricular function, both in systolic and diastolic properties, in patients with pulmonary hypertension was significantly lower than in normal subjects (LVEF; P<0.05, PER; P<0.05, PFR; P<0.025, FF; P<0.025). During exercise left ventricular systolic function did not increase as much as in normals (LVEF; N.S., PER; N.S.). Left ventricular diastolic function during exercise was significantly lower than at rest (PFR; P<0.05, FF; P<0.001). The indices of left ventricular function obtained from radionuclide angiography had no close correlation with pulmonary hemodynamics or with blood gases. These results demonstrated that left ventricular dysfunction in patients with pulmonary hypertension was observed both at rest and during exercise, and might play an important role in reduced exercise tolerance. (author).

  13. Cardiac MRI in pulmonary artery hypertension: correlations between morphological and functional parameters and invasive measurements

    Energy Technology Data Exchange (ETDEWEB)

    Alunni, Jean-Philippe; Otal, Philippe; Rousseau, Herve; Chabbert, Valerie [CHU Rangueil, Department of Radiology, Toulouse (France); Degano, Bruno; Tetu, Laurent; Didier, Alain [CHU Larrey, Department of Pneumology, Toulouse (France); Arnaud, Catherine [CHU Rangueil, Department of Methods in Clinical Research, Toulouse (France); Blot-Souletie, Nathalie [CHU Rangueil, Department of Cardiology, Toulouse (France)

    2010-05-15

    To compare cardiac MRI with right heart catheterisation in patients with pulmonary hypertension (PH) and to evaluate its ability to assess PH severity. Forty patients were included. MRI included cine and phase-contrast sequences, study of ventricular function, cardiac cavity areas and ratios, position of the interventricular septum (IVS) in systole and diastole, and flow measurements. We defined four groups according to the severity of PH and three groups according to IVS position: A, normal position; B, abnormal in diastole; C, abnormal in diastole and systole. IVS position was correlated with pulmonary artery pressures and PVR (pulmonary vascular resistance). Median pulmonary artery pressures and resistance were significantly higher in patients with an abnormal septal position compared with those with a normal position. Correlations were good between the right ventricular ejection fraction and PVR, right ventricular end-systolic volume and PAP, percentage of right ventricular area change and PVR, and diastolic and systolic ventricular area ratio and PVR. These parameters were significantly associated with PH severity. Cardiac MRI can help to assess the severity of PH. (orig.)

  14. Rate of change in renal function and mortality in elderly treated hypertensive patients.

    Science.gov (United States)

    Chowdhury, Enayet K; Langham, Robyn G; Ademi, Zanfina; Owen, Alice; Krum, Henry; Wing, Lindon M H; Nelson, Mark R; Reid, Christopher M

    2015-07-07

    Evidence relating the rate of change in renal function, measured as eGFR, after antihypertensive treatment in elderly patients to clinical outcome is sparse. This study characterized the rate of change in eGFR after commencement of antihypertensive treatment in an elderly population, the factors associated with eGFR rate change, and the rate's association with all-cause and cardiovascular mortality. Data from the Second Australian National Blood Pressure study were used, where 6083 hypertensive participants aged ≥65 years were enrolled during 1995-1997 and followed for a median of 4.1 years (in-trial). Following the Second Australian National Blood Pressure study, participants were followed-up for a further median 6.9 years (post-trial). The annual rate of change in the eGFR was calculated in 4940 participants using creatinine measurements during the in-trial period and classified into quintiles (Q) on the basis of the following eGFR changes: rapid decline (Q1), decline (Q2), stable (Q3), increase (Q4), and rapid increase (Q5). A rapid decline in eGFR in comparison with those with stable eGFRs during the in-trial period was associated with older age, living in a rural area, wider pulse pressure at baseline, receiving diuretic-based therapy, taking multiple antihypertensive drugs, and having blood pressure <140/90 mmHg during the study. However, a rapid increase in eGFR was observed in younger women and those with a higher cholesterol level. After adjustment for baseline and in-trial covariates, Cox-proportional hazard models showed a significantly greater risk for both all-cause (hazard ratio, 1.28; 95% confidence interval, 1.09 to 1.52; P=0.003) and cardiovascular (hazard ratio, 1.40; 95% confidence interval, 1.11 to 1.76; P=0.004) mortality in the rapid decline group compared with the stable group over a median of 7.2 years after the last eGFR measure. No significant association with mortality was observed for a rapid increase in eGFR. In elderly persons with

  15. The Dietary Approaches to Stop Hypertension Diet, Cognitive Function, and Cognitive Decline in American Older Women.

    Science.gov (United States)

    Berendsen, Agnes A M; Kang, Jae H; van de Rest, Ondine; Feskens, Edith J M; de Groot, Lisette C P G M; Grodstein, Francine

    2017-05-01

    To examine the association between long-term adherence to the Dietary Approaches to Stop Hypertension (DASH) diet with cognitive function and decline in older American women. Prospective cohort study. The Nurses' Health Study, a cohort of registered nurses residing in 11 US states. A total of 16,144 women from the Nurses' Health Study, aged ≥70 years, who underwent cognitive testing a total of 4 times by telephone from 1995 to 2001 (baseline), with multiple dietary assessments between 1984 and the first cognitive examination. DASH adherence for each individual was based on scoring of intakes of 9 nutrient or food components. Long-term DASH adherence was calculated as the average DASH adherence score from up to 5 repeated measures of diet. Primary outcomes were cognitive function calculated as the average scores of the 4 repeated measures, as well as cognitive change of the Telephone Interview for Cognitive Status score and composite scores of global cognition and verbal memory. Greater adherence to long-term DASH score was associated with better average cognitive function, irrespective of apolipoprotein E ε4 allele status [multivariable-adjusted differences in mean z-scores between extreme DASH quintiles = 0.04 (95% confidence interval, CI 0.01-0.07), P trend = .009 for global cognition; 0.04 (95% CI 0.01-0.07), P trend = .002 for verbal memory and 0.16 (95% CI 0.03-0.29), and P trend = .03 for Telephone Interview for Cognitive Status, P interaction >0.24]. These differences were equivalent to being 1 year younger in age. Adherence to the DASH score was not associated with change in cognitive function over 6 years. Our findings in the largest cohort on dietary patterns and cognitive function to date indicate that long-term adherence to the DASH diet is important to maintain cognitive function at older ages. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

  16. Left ventricular structure and diastolic function in subjects with two hypertensive parents

    DEFF Research Database (Denmark)

    Andersen, U B; Steensgaard-Hansen, F; Rokkedal, J

    2001-01-01

    -parental hypertension and 26 matched controls with normotensive parents. Families with non-insulin-dependent diabetes or morbid obesity were excluded. (i) Echocardiography; (ii) plasma concentrations of renin, angiotensin-II, aldosterone, epinephrine and norepinephrine; (iii) euglycaemic, hyperinsulinemic clamp study...

  17. Maternal protein restriction induced-hypertension is associated to oxidative disruption at transcriptional and functional levels in the medulla oblongata.

    Science.gov (United States)

    de Brito Alves, José L; de Oliveira, Jéssica M D; Ferreira, Diorginis J S; Barros, Monique A de V; Nogueira, Viviane O; Alves, Débora S; Vidal, Hubert; Leandro, Carol G; Lagranha, Cláudia J; Pirola, Luciano; da Costa-Silva, João H

    2016-12-01

    Maternal protein restriction during pregnancy and lactation predisposes the adult offspring to sympathetic overactivity and arterial hypertension. Although the underlying mechanisms are poorly understood, dysregulation of the oxidative balance has been proposed as a putative trigger of neural-induced hypertension. The aim of the study was to evaluate the association between the oxidative status at transcriptional and functional levels in the medulla oblongata and maternal protein restriction induced-hypertension. Wistar rat dams were fed a control (normal protein; 17% protein) or a low protein ((Lp); 8% protein) diet during pregnancy and lactation, and male offspring was studied at 90 days of age. Direct measurements of baseline arterial blood pressure (ABP) and heart rate (HR) were recorded in awakened offspring. In addition, quantitative RT-PCR was used to assess the mRNA expression of superoxide dismutase 1 (SOD1) and 2 (SOD2), catalase (CAT), glutathione peroxidase (GPx), Glutamatergic receptors (Grin1, Gria1 and Grm1) and GABA(A)-receptor-associated protein like 1 (Gabarapl1). Malondialdehyde (MDA) levels, CAT and SOD activities were examined in ventral and dorsal medulla. Lp rats exhibited higher ABP. The mRNA expression levels of SOD2, GPx and Gabarapl1 were down regulated in medullary tissue of Lp rats (Pmedulla. Taken together, our data suggest that maternal protein restriction induced-hypertension is associated with medullary oxidative dysfunction at transcriptional level and with impaired antioxidant capacity in the ventral medulla. © 2016 John Wiley & Sons Australia, Ltd.

  18. COX2 inhibition during nephrogenic period induces ANG II hypertension and sex-dependent changes in renal function during aging.

    Science.gov (United States)

    Reverte, Virginia; Tapia, Antonio; Loria, Analia; Salazar, Francisco; Llinas, M Teresa; Salazar, F Javier

    2014-03-01

    This study was performed to test the hypothesis that ANG II contributes to the hypertension and renal functional alterations induced by a decrease of COX2 activity during the nephrogenic period. It was also examined whether renal functional reserve and renal response to volume overload and high sodium intake are reduced in 3-4- and 9-11-mo-old male and female rats treated with vehicle or a COX2 inhibitor during nephrogenic period (COX2np). Our data show that this COX2 inhibition induces an ANG II-dependent hypertension that is similar in male and female rats. Renal functional reserve is reduced in COX2np-treated rats since their renal response to an increase in plasma amino acids levels is abolished, and their renal ability to eliminate a sodium load is impaired (P renal excretory ability is similar in both sexes during aging but does not induce the development of a sodium-sensitive hypertension. However, the prolonged high-sodium intake at 9-11 mo of age leads to a greater proteinuria in male than in female (114 ± 12 μg/min vs. 72 ± 8 μg/min; P Renal hemodynamic sensitivity to acute increments in ANG II is unaltered in both sexes and at both ages in COX2np-treated rats. In summary, these results indicate that the reduction of COX2 activity during nephrogenic period programs for the development of an ANG II-dependent hypertension, reduces renal functional reserve to a similar extent in both sexes, and increases proteinuria in males but not in females when there is a prolonged increment in sodium intake.

  19. Effect of spirapril and hydrochlorothiazide on platelet function and euglobulin clot lysis time in patients with mild hypertension

    DEFF Research Database (Denmark)

    Fonitz, Gitte (Gleerup); Petersen, J R; Mehlsen, J

    1996-01-01

    Thirteen patients with mild hypertension (untreated diastolic blood pressure of 95 to 114 mmHg) received, in random order, three successive treatments of four weeks with placebo, spirapril (6 mg daily), or hydrochlorothiazide (HCT2) (24 mg daily). At the end of each treatment, blood samples for a...... not produce any unwanted side effect on platelet function or fibrinolysis. HCT2 seems to decrease platelet activity at rest, whereas spirapril seems to some extent to decrease platelet activity at exercise....

  20. Evaluation of the relationship between radiological abnormalities and both pulmonary function and pulmonary hypertension in coal workers' pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Yildiz, O.A.; Gulbay, B.E.; Saryal, S.; Karabiylkoglu, G. [Ankara University, Ankara (Turkey). School of Medicine

    2007-05-15

    The aim of this study was to investigate the effect of the radiological evidence of emphysema, and the extent of interstitial involvement, on lung function and pulmonary arterial pressure (PAP) in patients with coal workers' pneumoconiosis (CWP). All patients showed a mild decrease in FEV1/FVC and a mild increase in FRC. Forty-four per cent of patients developed mild to moderate pulmonary hypertension. Emphysema scores correlated significantly with airflow rates, including FEV1%, FEV1/FVC and FEF25-75%, and with carbon monoxide diffusing capacity (DLCO)% predicted as well as FRC% predicted and the ratio RV/TLC, which are indices of air trapping. Additionally, profusion and global profusion scores showed significant correlation with FEV1/FVC, DLCO% predicted, specific airway conductance and smoking. Mean PAP showed a significant negative correlation with FEF50% predicted, DLCO% predicted and profusion score. The impairment of pulmonary function (mainly disturbance in airflow rates and air trapping) and pulmonary hypertension may be present, even in a simple form of CWP. The pulmonary function impairment in patients with CWP is likely to be attributable to the occurrence of emphysema. However, pulmonary hypertension was directly related to the profusion of pneumoconiotic nodules, which may result in obliteration of the vascular bed.

  1. Ocular Hypertension

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué es la hipertensión ocular? ...

  2. [Brain Perfusion, Cognitive Functions, and Vascular Age in Middle Aged Patients With Essential Arterial Hypertension].

    Science.gov (United States)

    Parfenov, V A; Ostroumova, T M; Pеrepelova, E M; Perepelov, V A; Kochetkov, A I; Ostroumova, O D

    2018-05-01

    This study aimed to assess the cognitive functions and cerebral blood flow measured with arterial spin labeling (ASL) and their possible correlations with vascular age in untreated middle-aged patients with grade 1-2 essential arterial hypertension (EAH). We examined 73 subjects aged 40-59 years (33 with EAH and 40 healthy volunteers [controls]). Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Trail Making test (part A and part B), Stroop Color and Word Test, verbal fluency test (phonemic verbal fluency and semantic verbal fluency), 10‑item word list learning task. All subjects underwent brain MRI. MRI protocol included ASL. Vascular age was calculated by two techniques - using Framingham Heart Study risk tables and SCORE project scales. Patients with EAH had lower performance on phonemic verbal fluency test and lower mean MoCA score (29.2±1.4 vs. 28.1±1.7 points) compared to controls (13.4±3.2, р=0.002; 29.2±1.4, p=0.001, respectively). White matter hyperintensities (WMH) were present in 7.5 % controls and in 51.5 % EAH patients (р=0.0002). Cerebral blood flow (CBF) in EAH patients was lower in both right (39.1±5.6 vs. 45.8±3.2 ml / 100 g / min) and left frontal lobes of the brain (39.2±6.2 и 45.2±3.6 ml / 100 g / min, respectively) compared to controls (р.

  3. Maternal separation affects dopamine transporter function in the Spontaneously Hypertensive Rat: An in vivo electrochemical study

    Directory of Open Access Journals (Sweden)

    Womersley Jacqueline S

    2011-12-01

    Full Text Available Abstract Background Attention-deficit/hyperactivity disorder (ADHD is a developmental disorder characterised by symptoms of inattention, impulsivity and hyperactivity. The spontaneously hypertensive rat (SHR is a well-characterised model of this disorder and has been shown to exhibit dopamine dysregulation, one of the hypothesised causes of ADHD. Since stress experienced in the early stages of life can have long-lasting effects on behaviour, it was considered that early life stress may alter development of the dopaminergic system and thereby contribute to the behavioural characteristics of SHR. It was hypothesized that maternal separation would alter dopamine regulation by the transporter (DAT in ways that distinguish SHR from control rat strains. Methods SHR and control Wistar-Kyoto (WKY rats were subjected to maternal separation for 3 hours per day from postnatal day 2 to 14. Rats were tested for separation-induced anxiety-like behaviour followed by in vivo chronoamperometry to determine whether changes had occurred in striatal clearance of dopamine by DAT. The rate of disappearance of ejected dopamine was used as a measure of DAT function. Results Consistent with a model for ADHD, SHR were more active than WKY in the open field. SHR entered the inner zone more frequently and covered a significantly greater distance than WKY. Maternal separation increased the time that WKY spent in the closed arms and latency to enter the open arms of the elevated plus maze, consistent with other rat strains. Of note is that, maternal separation failed to produce anxiety-like behaviour in SHR. Analysis of the chronoamperometric data revealed that there was no difference in DAT function in the striatum of non-separated SHR and WKY. Maternal separation decreased the rate of dopamine clearance (k-1 in SHR striatum. Consistent with this observation, the dopamine clearance time (T100 was increased in SHR. These results suggest that the chronic mild stress of

  4. Influence of microalbuminuria on left ventricular geometry and function in hypertensive patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Picca, Maurizio; Agozzino, Francesco; Pelosi, Giancarlo

    2003-01-01

    An increased urinary albumin excretion (UAE) is associated with an augmented risk of cardiovascular disease in diabetic patients and in non-diabetic subjects. Left ventricular hypertrophy has been demonstrated to be a powerful predictor of cardiovascular morbidity and mortality in arterial hypertension and when the ventricular geometry is concentric the relation is even stronger. This echocardiographic and Doppler study was designed to evaluate the influence of microalbuminuria on the left ventricular geometry and function in hypertensive patients with type 2 diabetes melitus. Forty-two patients (16 males, 26 females, mean age 59.6 +/- 6.7 years) with mild-to-moderate essential hypertension and type 2 diabetes mellitus were enrolled in the study. Twenty-one patients had an elevated UAE (group 1) and 21 a normal UAE (group 2). M-mode (under two-dimensional control) and Doppler echocardiography were performed after a 4-week washout period off antihypertensive therapy. The left ventricular mass index was found to be greater than the partition value of 51 g/m2.7 in both groups but was significantly higher (p diabetes mellitus, an elevated UAE is associated with an increased left ventricular mass index, a higher prevalence of a concentric left ventricular hypertrophy pattern, a depressed midwall systolic performance and a markedly impaired diastolic function...

  5. Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Saltiki Katerina

    2008-09-01

    Full Text Available Abstract Background Overt hypothyroidism has been associated with arterial hypertension and increased arterial stiffness. Results in euthyroid individuals have been conflicting. We investigated associations of thyroid function with systolic (SAP and diastolic (DAP arterial pressure in euthyroid subjects. Methods 311 euthyroid individuals (185 women, mean age 43.9 ± 9 without a history of diabetes attending a preventive medicine program were examined. Subjects receiving thyroxine (10.6% were excluded; 19.3% had hypertension, 43% had a family history for hypertension. TSH, fT4, thyroid autoantibodies, insulin, glucose were measured. The "fT4.TSH product", which has been suggested as a T4 resistance-index, was calculated. Results TSH range was 0.1–8, median 1.4 mU/L, fT4 range was 11.5–25.2 pmol/L, median 17.4. TSH and the "fT4.TSH product" were positively associated with DAP (p 2 mU/L (35.3% vs 21.3%, p = 0.045. Conclusion In euthyroid individuals the association of thyroid function with diastolic arterial pressure remains significant even when a stricter "normal range" for TSH levels is considered. The "freeT4.TSH" product appears to be an even stronger predictor of DAP, independently of HOMA insulin resistance index and obesity.

  6. A discrepancy between platelet alpha 2-receptor density and functional circulatory changes in hypertensives

    International Nuclear Information System (INIS)

    Mores, N.; Martire, M.; Pistritto, G.; Cardillo, C.; Folli, G.

    1990-01-01

    To investigate whether differences exist in peripheral alpha 2-adrenoceptors between normotensive and hypertensive subjects, we determined platelet alpha 2-adrenoceptor density in 10 (7 males) untreated essential hypertensives (mean age of 51.1 years, range of 44-59 years) and in 10 age- and sex-matched normotensive controls. Moreover, in hypertensive patients, we examined the relationship between receptor density and cardiovascular reactivity to mental arithmetic, static handgrip, and bicycle exercise, to verify the hypothesis that alpha 2-adrenoceptors might play a role in modulation of hemodynamic response to sympathetic stimuli. alpha 2-Adrenoceptor density, as calculated by binding of [3H]yohimbine to platelets, was significantly higher in essential hypertensives (314.8 +/- 38.7 fmol/mg) than in normotensive subjects (213.6 +/- 34.7 fmol/mg) (p less than 0.05), whereas receptor affinity was similar in both groups (4.0 +/- 0.5 nM hypertensives, 4.3 +/- 0.5 nM normotensives; p greater than 0.05). Mental arithmetic increased mean arterial pressure (MAP) by 21.5% from basal values and heart rate (HR) by 13.2%. During isometric exercise, MAP increased by 38.1% and HR by 24.7%, while during bicycle ergometry, mean increases in MAP and HR from baseline were of 27.2 and 54.3%, respectively. No correlation was found between platelet alpha 2-adrenoceptor density and percent changes in MAP induced by all tests, or between adrenoceptors and absolute basal and peak MAP values. Our findings suggest that in hypertensive patients, peripheral alpha 2-adrenoceptors are increased with respect to matched normotensives, but these receptors seem not to be involved in the modulation of cardiovascular adaptation to enhanced sympathetic activity

  7. Genetic and Functional Evidence Supports LPAR1 as a Susceptibility Gene for Hypertension.

    Science.gov (United States)

    Xu, Ke; Ma, Lu; Li, Yang; Wang, Fang; Zheng, Gu-Yan; Sun, Zhijun; Jiang, Feng; Chen, Yundai; Liu, Huirong; Dang, Aimin; Chen, Xi; Chun, Jerold; Tian, Xiao-Li

    2015-09-01

    Essential hypertension is a complex disease affected by genetic and environmental factors and serves as a major risk factor for cardiovascular diseases. Serum lysophosphatidic acid correlates with an elevated blood pressure in rats, and lysophosphatidic acid interacts with 6 subtypes of receptors. In this study, we assessed the genetic association of lysophosphatidic acid receptors with essential hypertension by genotyping 28 single-nucleotide polymorphisms from genes encoding for lysophosphatidic acid receptors, LPAR1, LPAR2, LPAR3, LPAR4, LPAR5, and LPAR6 and their flanking sequences, in 3 Han Chinese cohorts consisting of 2630 patients and 3171 controls in total. We identified a single-nucleotide polymorphism, rs531003 in the 3'-flanking genomic region of LPAR1, associated with hypertension (the Bonferroni corrected P=1.09×10(-5), odds ratio [95% confidence interval]=1.23 [1.13-1.33]). The risk allele C of rs531003 is associated with the increased expression of LPAR1 and the susceptibility of hypertension, particularly in those with a shortage of sleep (P=4.73×10(-5), odds ratio [95% confidence interval]=1.75 [1.34-2.28]). We further demonstrated that blood pressure elevation caused by sleep deprivation and phenylephrine-induced vasoconstriction was both diminished in LPAR1-deficient mice. Together, we show that LPAR1 is a novel susceptibility gene for human essential hypertension and that stress, such as shortage of sleep, increases the susceptibility of patients with risk allele to essential hypertension. © 2015 American Heart Association, Inc.

  8. Relationship of left ventricular systolic function to persistence or development of electrocardiographic left ventricular hypertrophy in hypertensive patients

    DEFF Research Database (Denmark)

    Okin, Peter M; Wachtell, Kristian; Gerdts, Eva

    2014-01-01

    left ventricular systolic function in patients with new or persistent ECG LVH. METHODS: Baseline and year-3 ECG LVH and left ventricular midwall shortening (MWS) were examined in 725 hypertensive patients in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic...... 1.03-3.50, P = 0.040) at year 3. CONCLUSION: Persistence or development of new ECG LVH during antihypertensive therapy is associated with an increased risk of left ventricular systolic dysfunction after 3 years' follow-up. These findings provide insight into a possible mechanism by which changes......BACKGROUND: Persistence or development of ECG left ventricular hypertrophy (LVH) by Cornell product criteria is associated with an increased risk of developing heart failure compared with regression or continued absence of LVH. We postulated that this association might be in part mediated via worse...

  9. Studies of the associations between functional beta2-adrenergic receptor variants and obesity, hypertension and type 2 diabetes in 7,808 white subjects

    DEFF Research Database (Denmark)

    Gjesing, A P; Andersen, G; Burgdorf, K S

    2007-01-01

    Functional and common Arg16Gly and Gln27Glu polymorphisms have been identified in ADRB2, the gene encoding the beta2-adrenergic receptor. These variants have previously been examined for association with obesity, hypertension and diabetes with inconclusive results.......Functional and common Arg16Gly and Gln27Glu polymorphisms have been identified in ADRB2, the gene encoding the beta2-adrenergic receptor. These variants have previously been examined for association with obesity, hypertension and diabetes with inconclusive results....

  10. Ingestion of broccoli sprouts does not improve endothelial function in humans with hypertension

    DEFF Research Database (Denmark)

    Christiansen, Buris; Bellostas Muguerza, Natalia; Petersen, Atheline Major

    2010-01-01

    be the case in humans suffering from essential hypertension. METHODS: 40 hypertensive individuals without diabetes and with normal levels of cholesterol were examined. The participants were randomized either to ingest 10 g dried broccoli sprouts, a natural donor of glucosinolates with high in vitro...... groups. Diastolic blood pressure stayed essentially unchanged in both groups, while the systolic blood pressure showed a small non significant decrease (9 mm Hg) in the interventional group from a value of 153 mm Hg at start. CONCLUSION: Daily ingestion of 10 g dried broccoli sprouts does not improve...

  11. Repeated electroacupuncture attenuating of apelin expression and function in the rostral ventrolateral medulla in stress-induced hypertensive rats.

    Science.gov (United States)

    Zhang, Cheng-Rong; Xia, Chun-Mei; Jiang, Mei-Yan; Zhu, Min-Xia; Zhu, Ji-Min; Du, Dong-Shu; Liu, Min; Wang, Jin; Zhu, Da-Nian

    2013-08-01

    Studies have revealed that apelin is a novel multifunctional peptide implicated both in blood pressure (BP) regulation and cardiac function control. Evidence shows that apelin and its receptor (APJ) in the rostral ventrolateral medulla (RVLM) may play an important role in central BP regulation; however, its role is controversial and very few reports have shown the relationship between acupuncture and apelin. Our study aims to both investigate the apelinergic system role in stress-induced hypertension (SIH) and determine whether acupuncture therapy effects on hypertension involve the apelinergic system in the RVLM. We established the stress-induced hypertensive rat (SIHR) model using electric foot-shock stressors with noise interventions. The expression of both apelin and the APJ receptor in the RVLM neurons was examined by immunohistochemical staining and Western blots. The results showed apelin expression increased remarkably in SIHR while APJ receptor expression showed no significant difference between control and SIHR groups. Microinjection of apelin-13 into the RVLM of control rats or SIHR produced pressor and tachycardic effects. Furthermore, effects induced by apelin-13 in SIHR were significantly greater than those of control rats. In addition, repetitive electroacupuncture (EA) stimulation at the Zusanli (ST-36) acupoint attenuated hypertension and apelin expression in the RVLM in SIHR; it also attenuated the pressor effect elicited by exogenous apelin-13 microinjection in SIHR. The results suggest that augmented apelin in the RVLM was part of the manifestations of SIH; the antihypertensive effects of EA might be associated with the attenuation of apelin expression and function in the RVLM, which might be a novel role for EA in SIH setting. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. PP038. Are women with gestational hypertension or preeclampsia at an increased long term risk of kidney function impairment?

    Science.gov (United States)

    Bhattacharya, S; Ayansina, D; Black, C; Hall, S; Afolabi, E; Millar, C

    2012-07-01

    Preeclampsia is known to cause impairment of kidney function in pregnancy, which manifests as proteinuria. Previous studies have found an association between preeclampsia and kidney disease but were restricted in their numbers or had a short follow up time. To assess the long term effects of hypertensive disorders of pregnancy on kidney function in later life. From the Aberdeen maternity and neonatal databank (AMND), we identified the first singleton pregnancy of all women with date of birth on or before 30th June 1969. These women were linked by means of their identifying information to the local renal biochemistry database (GRBD). GRBD captures all kidney function tests from primary and secondary care in the health region. A cohort study design was used to assess the odds ratios with 95% confidence intervals for chronic kidney disease stage 1-5 (predefined based on internationally accepted KDOQI definition) occurring at least 1year following delivery. Those with gestational hypertension and preeclampsia were compared to normotensive women using multivariate logistic regression to adjust for potential confounders. A total of 14675 women who had been linked to the RBD and had complete information regarding age, socio-economic class, smoking category, and body mass index (BMI) were included in a multivariate model. The unadjusted odds ratio (95% confidence interval) of having chronic kidney disease (according to previously stated definition) in preeclamptic women was 2.04 (1.53,2.71) and that in women with gestational hypertension was 1.37 (1.15,1.65), while the adjusted odds ratio (95% confidence interval) of having chronic kidney disease was 1.93 (1.44,2.57) and 1.36 (1.13,1.63) in preeclamptic women and women with gestational hypertension respectively compared to women who were normotensive in their first pregnancy. Women who had gestational hypertension or preeclampsia in their first pregnancy had a higher risk of impairment of renal function compared to women

  13. Azelnidipine plus olmesartan versus amlodipine plus olmesartan on arterial stiffness and cardiac function in hypertensive patients: a randomized trial

    Directory of Open Access Journals (Sweden)

    Takami T

    2013-04-01

    Full Text Available CorrigendumTakami T, Saito Y. Drug Design, Development and Therapy. 2013;7:175–183. On page 177, line 26, heading "Measurement of LVMI and LF diastolic function" should have been "Measurement of LVMI and LV diastolic function". Line 32, "Devereux et al18" should read "Devereux et al19". Line 40, "(E/e’ ratio were measured as previously described.19" should read "(E/e’ ratio were measured as previously described.20". On page 181, line 15, "baPWV with LVMI.20" should read "baPWV with LVMI.21". Line 23, "baPWV and LVMI, E/A ratio.20" should read "baPWV and LVMI, E/A ratio.21,22". Line 28 "diastolic dysfunction.21" should read "diastolic dysfunction.23". Line 38 "is high.22" should read "is high.24". Line 39, "in clinical treatment.23" should read "in clinical treatment.25". Line 57, "A recent cohort study24" should read "A recent cohort study21".On page 182, line 1, "diastolic heart failure.25" should read "diastolic heart failure.26". Line 3, "untreated hypertensive patients.26" should read "untreated hypertensive patients.27". Line 6, "linear regression analysis.27" should read "linear regression analysis.21".On page 183, the references 18 to 27 should be updated as shown below:18. Takami T. Evaluation of arterial stiffness in morning hypertension under high-dose valsartan compared to valsartan plus low-dose diuretic. Hypertens Res. 2009;32:1086–1090.19. Devereux RB, Palmieri V, Sharpe N, et al. Effects of once-daily angiotensin-converting enzyme inhibition and calcium channel blockade-based antihypertensive treatment regimens on left ventricular hypertrophy and diastolic filling in hypertension: the prospective randomized enalapril study evaluating regression of ventricular enlargement (PRESERVE trial. Circulation. 2001;104:1248–1254.20. Ito H, Ishii K, Kihara H, et al. Adding thiazide to a renin-angiotensin blocker improves left ventricular relaxation and improves heart failure in patients with hypertension. Hypertens Res. 2012;35:93

  14. Comparison of vascular function and structure of iliac artery in spontaneously hypertensive and hereditary hypertriglyceridemic rats

    Czech Academy of Sciences Publication Activity Database

    Čačányiová, S.; Cebová, M.; Kuneš, Jaroslav; Kristek, F.

    2006-01-01

    Roč. 55, č. S1 (2006), S73-S80 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) 1M0510 Grant - others:VEGA(SK) 2/6139/26 Institutional research plan: CEZ:AV0Z50110509 Keywords : spontaneous hypertension * hypertriglyceridemia * vascular reactivity Subject RIV: ED - Physiology Impact factor: 2.093, year: 2006

  15. Acute Superoxide Radical Scavenging Reduces Blood Pressure but Does Not Influence Kidney Function in Hypertensive Rats with Postischemic Kidney Injury

    Directory of Open Access Journals (Sweden)

    Zoran Miloradović

    2014-01-01

    Full Text Available Acute kidney injury (AKI is associated with significant morbidity and mortality in hypertensive surroundings. We investigated superoxide radical molecules influence on systemic haemodynamic and kidney function in spontaneously hypertensive rats (SHR with induced postischemic AKI. Experiment was performed in anesthetized adult male SHR. The right kidney was removed, and left renal artery was subjected to ischemia by clamping for 40 minutes. The treated group received synthetic superoxide dismutase mimetic TEMPOL in the femoral vein 5 minutes before, during, and 175 minutes after the period of reperfusion, while the control AKI group received the vehicle via the same route. All parameters were measured 24 h after renal reperfusion. TEMPOL treatment significantly decreased mean arterial pressure and total peripheral resistance P<0.05 compared to AKI control. It also increased cardiac output and catalase activity P<0.05. Lipid peroxidation and renal vascular resistance were decreased in TEMPOL P<0.05. Plasma creatinine and kidney morphological parameters were unchanged among TEMPOL treated and control groups. Our study shows that superoxide radicals participate in haemodynamic control, but acute superoxide scavenging is ineffective in glomerular and tubular improvement, probably due to hypertension-induced strong endothelial dysfunction which neutralizes beneficial effects of O2− scavenging.

  16. Dynamic and diverse changes in the functional properties of vascular smooth muscle cells in pulmonary hypertension.

    Science.gov (United States)

    Stenmark, Kurt R; Frid, Maria G; Graham, Brian B; Tuder, Rubin M

    2018-03-15

    Pulmonary hypertension (PH) is the end result of interaction between pulmonary vascular tone and a complex series of cellular and molecular events termed 'vascular remodelling'. The remodelling process, which can involve the entirety of pulmonary arterial vasculature, almost universally involves medial thickening, driven by increased numbers and hypertrophy of its principal cellular constituent, smooth muscle cells (SMCs). It is noted, however that SMCs comprise heterogeneous populations of cells, which can exhibit markedly different proliferative, inflammatory, and extracellular matrix production changes during remodelling. We further consider that these functional changes in SMCs of different phenotype and their role in PH are dynamic and may undergo significant changes over time (which we will refer to as cellular plasticity); no single property can account for the complexity of the contribution of SMC to pulmonary vascular remodelling. Thus, the approaches used to pharmacologically manipulate PH by targeting the SMC phenotype(s) must take into account processes that underlie dominant phenotypes that drive the disease. We present evidence for time- and location-specific changes in SMC proliferation in various animal models of PH; we highlight the transient nature (rather than continuous) of SMC proliferation, emphasizing that the heterogenic SMC populations that reside in different locations along the pulmonary vascular tree exhibit distinct responses to the stresses associated with the development of PH. We also consider that cells that have often been termed 'SMCs' may arise from many origins, including endothelial cells, fibroblasts and resident or circulating progenitors, and thus may contribute via distinct signalling pathways to the remodelling process. Ultimately, PH is characterized by long-lived, apoptosis-resistant SMC. In line with this key pathogenic characteristic, we address the acquisition of a pro-inflammatory phenotype by SMC that is essential

  17. Peptides-Derived from Thai Rice Bran Improves Endothelial Function in 2K-1C Renovascular Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Orachorn Boonla

    2015-07-01

    Full Text Available In recent years, a number of studies have investigated complementary medical approaches to the treatment of hypertension using dietary supplements. Rice bran protein hydrolysates extracted from rice is a rich source of bioactive peptides. The present study aimed to investigate the vasorelaxation and antihypertensive effects of peptides-derived from rice bran protein hydrolysates (RBP in a rat model of two kidney-one clip (2K-1C renovascular hypertension. 2K-1C hypertension was induced in male Sprague-Dawley rats by placing a silver clip around the left renal artery, whereas sham-operated rats were served as controls. 2K-1C and sham-operated rats were intragastrically administered with RBP (50 mg kg−1 or 100 mg kg−1 or distilled water continuously for six weeks. We observed that RBP augmented endothelium-dependent vasorelaxation in all animals. Administration of RBP to 2K-1C rats significantly reduced blood pressure and decreased peripheral vascular resistance compared to the sham operated controls (p < 0.05. Restoration of normal endothelial function and blood pressure was associated with reduced plasma angiotensin converting enzyme (ACE, decreased superoxide formation, reduced plasma malondialdehyde and increased plasma nitrate/nitrite (p < 0.05. Up-regulation of eNOS protein and down-regulation of p47phox protein were found in 2K-1C hypertensive rats-treated with RBP. Our results suggest that RBP possesses antihypertensive properties which are mainly due to the inhibition of ACE, and its vasodilatory and antioxidant activity.

  18. Comprehensive gene expression profiling reveals synergistic functional networks in cerebral vessels after hypertension or hypercholesterolemia.

    Directory of Open Access Journals (Sweden)

    Wei-Yi Ong

    Full Text Available Atherosclerotic stenosis of cerebral arteries or intracranial large artery disease (ICLAD is a major cause of stroke especially in Asians, Hispanics and Africans, but relatively little is known about gene expression changes in vessels at risk. This study compares comprehensive gene expression profiles in the middle cerebral artery (MCA of New Zealand White rabbits exposed to two stroke risk factors i.e. hypertension and/or hypercholesterolemia, by the 2-Kidney-1-Clip method, or dietary supplementation with cholesterol. Microarray and Ingenuity Pathway Analyses of the MCA of the hypertensive rabbits showed up-regulated genes in networks containing the node molecules: UBC (ubiquitin, P38 MAPK, ERK, NFkB, SERPINB2, MMP1 and APP (amyloid precursor protein; and down-regulated genes related to MAPK, ERK 1/2, Akt, 26 s proteasome, histone H3 and UBC. The MCA of hypercholesterolemic rabbits showed differentially expressed genes that are surprisingly, linked to almost the same node molecules as the hypertensive rabbits, despite a relatively low percentage of 'common genes' (21 and 7% between the two conditions. Up-regulated common genes were related to: UBC, SERPINB2, TNF, HNF4A (hepatocyte nuclear factor 4A and APP, and down-regulated genes, related to UBC. Increased HNF4A message and protein were verified in the aorta. Together, these findings reveal similar nodal molecules and gene pathways in cerebral vessels affected by hypertension or hypercholesterolemia, which could be a basis for synergistic action of risk factors in the pathogenesis of ICLAD.

  19. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats

    OpenAIRE

    Stephen P. Chelko; Chad W. Schmiedt; Tristan H. Lewis; Tom P. Robertson; Stephen J. Lewis

    2014-01-01

    This study compared the contractile responses elicited by angiotensin II (AII), arginine vasopressin (AVP), and 5-hydroxytryptamine (5-HT) in isolated occipital arteries (OAs) from sham-operated (SHAM) and 2-kidney, 1-clip (2K-1C) hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery) and distal segments (closer to the nodose ganglion) and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, hea...

  20. Comprehensive Gene Expression Profiling Reveals Synergistic Functional Networks in Cerebral Vessels after Hypertension or Hypercholesterolemia

    Science.gov (United States)

    Ong, Wei-Yi; Ng, Mary Pei-Ern; Loke, Sau-Yeen; Jin, Shalai; Wu, Ya-Jun; Tanaka, Kazuhiro; Wong, Peter Tsun-Hon

    2013-01-01

    Atherosclerotic stenosis of cerebral arteries or intracranial large artery disease (ICLAD) is a major cause of stroke especially in Asians, Hispanics and Africans, but relatively little is known about gene expression changes in vessels at risk. This study compares comprehensive gene expression profiles in the middle cerebral artery (MCA) of New Zealand White rabbits exposed to two stroke risk factors i.e. hypertension and/or hypercholesterolemia, by the 2-Kidney-1-Clip method, or dietary supplementation with cholesterol. Microarray and Ingenuity Pathway Analyses of the MCA of the hypertensive rabbits showed up-regulated genes in networks containing the node molecules: UBC (ubiquitin), P38 MAPK, ERK, NFkB, SERPINB2, MMP1 and APP (amyloid precursor protein); and down-regulated genes related to MAPK, ERK 1/2, Akt, 26 s proteasome, histone H3 and UBC. The MCA of hypercholesterolemic rabbits showed differentially expressed genes that are surprisingly, linked to almost the same node molecules as the hypertensive rabbits, despite a relatively low percentage of ‘common genes’ (21 and 7%) between the two conditions. Up-regulated common genes were related to: UBC, SERPINB2, TNF, HNF4A (hepatocyte nuclear factor 4A) and APP, and down-regulated genes, related to UBC. Increased HNF4A message and protein were verified in the aorta. Together, these findings reveal similar nodal molecules and gene pathways in cerebral vessels affected by hypertension or hypercholesterolemia, which could be a basis for synergistic action of risk factors in the pathogenesis of ICLAD. PMID:23874591

  1. Urine albumin/creatinine ratio and echocardiographic left ventricular structure and function in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE Study

    DEFF Research Database (Denmark)

    Wachtell, K.; Palmieri, V.; Olsen, M.H.

    2002-01-01

    in a large hypertensive population. Methods The urine albumin/creatinine ratio (UACR) and echocardiographic measures of LV structure and function were obtained in 833 patients with stage I to III hypertension and LV hypertrophy determined by electrocardiogram (ECG) (Cornell voltage-duration or Sokolow...... geometry and high LV mass are associated with high UACR independent of age, systolic blood pressure, diabetes, and race, suggesting parallel cardiac and microvascular damage....

  2. Influence of minimally invasive hematoma evacuation combined with nerve growth factor preparation on neurological function injury in patients with hypertensive cerebral hemorrhage

    OpenAIRE

    Jiang Tao; Feng Ai-Ping; Liu Lun-Bo; Huang Qi-Jun; Du Chen

    2017-01-01

    Objective: To study the influence of minimally invasive hematoma evacuation combined with nerve growth factor preparation on neurological function injury in patients with hypertensive cerebral hemorrhage. Methods: A total of 112 patients with hypertensive cerebral hemorrhage who were treated in our hospital between July 2013 and February 2016 were collected, and according to random number table, they were divided into the control group (n=56) who underwent minimally invasive he...

  3. Effect of minimally invasive evacuation of hematoma combined with Xingnaojing therapy on neurological function injury and cytokine level in patients with hypertensive cerebral hemorrhagen

    OpenAIRE

    Yong-Feng Li; Wei Li

    2017-01-01

    Objective: To study the effect of minimally invasive evacuation of hematoma combined with Xingnaojing therapy on neurological function damage and cytokine level in patients with hypertensive cerebral hemorrhage. Methods: A total of 80 patients with hypertensive cerebral hemorrhage treated in our hospital between June 2010 and September 2015 were selected as the research subjects, the treatment methods and test results were reviewed, and then they were divided into the control g...

  4. Portal Hypertension

    Science.gov (United States)

    ... Overview of Gallbladder Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Professor of Medicine, ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

  5. [Secondary hypertension].

    Science.gov (United States)

    Yoshida, Yuichi; Shibata, Hirotaka

    2015-11-01

    Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice.

  6. Secondary Hypertension

    Science.gov (United States)

    Secondary hypertension Overview Secondary hypertension (secondary high blood pressure) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, ...

  7. Evaluation of left ventricular function in obese children without hypertension by a tissue Doppler imaging study.

    Science.gov (United States)

    Ghandi, Yazdan; Sharifi, Mehrzad; Habibi, Danial; Dorreh, Fatemeh; Hashemi, Mojtaba

    2018-01-01

    The prevalence of obesity is increasing worldwide. Obese children without hypertension are becoming an important health challenge. Complications of obesity in adults are well established, but in obese children, cardiac dysfunction has not been reported clinically. The present crosssectional study investigates subclinical systolic and diastolic dysfunction using echocardiographic modalities. Twentyfive youngsters with body mass index (BMI) >30 and 25 healthy children with BMI <25 were assigned into case and control group, respectively. In all participants, complete cardiovascular examination, electrocardiography, and echocardiography were fulfilled. Echocardiography surveys included standard, pulsed wave Doppler (PWD), and tissue Doppler imaging (TDI). SPSS software, version 24. The two groups were matched for age and sex. The resting heart rate and blood pressure were markedly higher in the obese group ( P = 0.0001) though they were within the normal range in either category. Ejection fraction in the two groups was similar. Left ventricular (LV) mass ( P = 0.0001), LV mass index ( P = 0.029), left atrialtoaortic diameter ratio ( P = 0.0001), and LV enddiastolic diameter ( P = 0.008) were significantly greater in the case group, indicating cardiomegaly and subclinical systolic and diastolic dysfunction. Except for the aortic velocity, all PWD variables were considerably lower in the case group, suggesting subclinical diastolic dysfunction. All TDI parameters varied significantly between the two categories. There was a direct correlation between isovolumetric relaxation time and BMI. Obesity in children without hypertension is associated with subclinical systolic and diastolic cardiac dysfunction. We propose the evaluation of blood pressure as well as myocardial performance using PWD and TDI in all obese children without hypertension, regularly.

  8. Renal function in patients with hypertension associated congestive cardiac failure seen in a tertiary hospital.

    Science.gov (United States)

    Osuji, C U; Nwaneli, C U; Onwubere, B J; Onwubuya, E I; Ahaneku, G I

    2012-01-01

    Background. Chronic kidney disease is frequently seen in patients with congestive cardiac failure and is an independent risk factor for morbidity and mortality. The aim of this study was to determine the prevalence of chronic kidney disease in patients with hypertension associated congestive cardiac failure. Method. One hundred and fifty patients with hypertension associated congestive cardiac failure were recruited consecutively from the medical outpatient department and the medical wards of the Nnamdi Azikiwe University Teaching Hospital Nnewi over a one year period, January to December 2010. Patients' biodata and medical history were obtained, detailed physical examination done and each patient had a chest X-ray, 12 lead ECG, urinalysis, serum urea and creatinine assay done. Ethical clearance was obtained from the Ethical Review Board of our institution and data analysed using SPSS-version 16. Results. There were 86 males and 64 females with mean age 62.7 ± 12.5 years. The mean blood pressures were systolic 152.8 ± 28.5 mmHg and diastolic 94.3 ± 18 mmHg. 84.7% had blood pressure ≥140/90 mmHg on presentation. The mean GFR was 70.1 ± 31.3 mls/min. 76% of subjects had GFR <90 mls/min and no statistical significant difference between males and females, P = 0.344. The mean serum urea was 7.2 ± 51 mmol/L while the mean serum creatinine was 194 ± 416.2 mmol/L. Conclusions. This study has demonstrated that majority of patients presenting with hypertension associated congestive cardiac failure have some degree of chronic kidney disease.

  9. Left Ventricular Function Assessed by One-Point Carotid Wave Intensity in Newly Diagnosed Untreated Hypertensive Patients.

    Science.gov (United States)

    Vriz, Olga; Favretto, Serena; Jaroch, Joanna; Wojciech, Rychard; Bossone, Eduardo; Driussi, Caterina; Antonini-Canterin, Francesco; Palatini, Paolo; Loboz-Grudzien, Krystyna

    2017-01-01

    To investigate whether newly diagnosed untreated hypertensive patients show higher left ventricular (LV) contractility, as assessed by traditional echocardiographic indices and carotid wave intensity (WI) parameters, including amplitude of the peak during early (W 1 ) and late systole (W 2 ). A total of 145 untreated hypertensive patients were compared with 145 age- and sex-matched normotensive subjects. They underwent comprehensive echocardiography and WI analysis. WI analysis was performed at the level of the common carotid artery. The diameter changes were the difference between the displacement of the anterior and posterior walls, with the cursors set to track the media-adventitia boundaries 2 cm proximal to the carotid bulb and calibrated by systolic and diastolic BP. Peak acceleration was derived from blood flow velocity measured by Doppler sonography with the range-gate positioned at the center of the vessel diameter. WI was based on the calculation of (dP/dt)×(dU/dt), where dP/dt and dU/dt were the derivatives of BP (P) and velocity (U) with respect to time. One-point pulse wave velocity (PWVβ) and the interval between the R wave on ECG and the first peak of WI (R-W 1 ), using a high definition echo-tracking system implemented in the ultrasound machine (Aloka), were also derived. After adjustment for body weight, heart rate, and physical activity, the two groups had similar general characteristics and diastolic function. However, hypertensives showed significantly higher LV mass, LV ejection fraction (LVEF), circumferential and LV end-systolic stress, and one-point PWV as well as W 1 (13.646 ± 7.368 vs 9.308 ± 4.675 mmHg m/s 3 , P =.001) and W 2 (4.289 ± 2.017 vs 2.995 ± 1.868 mmHg m/s 3 , P =.001). Hypertensives were divided into tertiles according to LVEF: W 1 (11.934 ± 5.836 vs 11.576 ± 5.857 vs 17.227 ± 8.889 mmHg m/s 3 , P function. © 2016 by the American Institute of Ultrasound in Medicine.

  10. Effects of exercise on kidney function among non-diabetic patients with hypertension and renal disease: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Barcellos Franklin C

    2012-08-01

    Full Text Available Abstract Background Chronic kidney disease is an important public health threat. Such patients present high morbidity and mortality due to cardiovascular disease, with low quality of life and survival, and also high expenditure resulting from the treatment. Arterial hypertension is both a cause and a complication of kidney disease; also, arterial hypertension is a risk factor for cardiovascular disease among patients with kidney diseases. There is some evidence that exercise interventions may be beneficial to chronic kidney disease patients, but previous studies included only end-stage patients, i.e. those undergoing dialysis. This study aims to evaluate the effect of exercise on kidney function, quality of life and other risk factors for cardiovascular disease among non-diabetic chronic hypertensive kidney disease patients who are not undergoing dialysis. Methods The participants will be located through screening hypertensive patients attended within the public healthcare network in Pelotas, a city in south of Brazil. Eligible individuals will be those with glomerular filtration rate between 15 and 59 ml/min x 1.73 m2. The randomization will be done in fixed-size blocks of six individuals such that 75 participants will be allocated to each group. At baseline, information on demographic, socioeconomic, behavioral, anthropometric, blood pressure and quality-of-life variables will be collected, and laboratory tests will be performed. The intervention will consist of three weekly physical exercise sessions lasting 60–75 minutes each, with a total duration of 16 weeks. The outcomes will be the kidney function progression rate, quality of life, blood pressure, lipid profile, hemoglobin level, ultrasensitive C-reactive protein level, and ankle-arm index. The patients in both groups (intervention and control will be reassessed and compared partway through the study (8th week, at the end of the intervention (16th week and in the 8th week after

  11. DWI and complex brain network analysis predicts vascular cognitive impairment in spontaneous hypertensive rats undergoing executive function tests

    Directory of Open Access Journals (Sweden)

    Xavier eLópez-Gil

    2014-07-01

    Full Text Available The identification of biomarkers of vascular cognitive impairment is urgent for its early diagnosis. The aim of this study was to detect and monitor changes in brain structure and connectivity, and to correlate them with the decline in executive function. We examined the feasibility of early diagnostic magnetic resonance imaging to predict cognitive impairment before onset in an animal model of chronic hypertension: Spontaneously Hypertensive Rats. Cognitive performance was tested in an operant conditioning paradigm that evaluated learning, memory and behavioral flexibility skills. Behavioral tests were coupled with longitudinal diffusion weighted imaging acquired with 126 diffusion gradient directions and 0.3 mm3 isometric resolution at 10, 14, 18, 22, 26 and 40 weeks after birth. Diffusion weighted imaging was analyzed in 2 different ways, by regional characterization of diffusion tensor imaging indices, and by assessing changes in structural brain network organization based on Q-Ball tractography. Already at the first evaluated times, diffusion tensor imaging scalar maps revealed significant differences in many regions, suggesting loss of integrity in white and grey matter of spontaneously hypertensive rats when compared to normotensive control rats. In addition, graph theory analysis of the structural brain network demonstrated a significant decrease of hierarchical modularity, global and local efficacy, with predictive value as shown by regional 3-fold cross validation study. Moreover, these decreases were significantly correlated with the behavioral performance deficits observed at subsequent time points, suggesting that the diffusion weighted imaging and connectivity studies can unravel neuroimaging alterations even overt signs of cognitive impairment become apparent.

  12. Therapeutic Exercise and Hypertension

    African Journals Online (AJOL)

    Nekky Umera

    patients but may not reduce the BP of normotensive individual. Exercise function ... and mortality in all age groups; it also creates major social, personal and financial ... drug therapy by as symptomatic hypertensive and high cost of drugs particularly in a ..... Events in hypertensive patients randomized to doxagosin versus.

  13. Effects of clonidine on 24-hour hormonal secretory patterns, cardiovascular hemodynamics, and central nervous function in hypertensive adolescents.

    Science.gov (United States)

    Boyar, R M; Fixler, D F; Kaplan, N M; Graham, R M; Price, K P; Chipman, J J; Laird, W P

    1980-01-01

    To assess the potential of antihypertensive drugs for interference with somatic growth and sexual development in hypertensive children, the effect of clonidine therapy on various endocrine, cardiovascular, and neuromuscular functions has been examined in five male adolescents with idiopathic hypertension. In studies done before and at the end of 4 weeks of twice-daily clonidine therapy, in an average daily dose of 0.31 mg, no significant effects were noted in the secretory patterns of growth hormone, luteinizing hormone, follicle-stimulating hormone, prolactin, cortisol, aldosterone, or testosterone, measured in blood obtained every 20 minutes for 24 hours. In blood obtained while the patients were supine and then erect, plasma renin activity and norepinephrine levels were significantly lowered after clonidine therapy. Cardiovascular responses to dynamic exercise were little altered beyond a 17% decrease in maximal oxygen consumption. The performance of fine motor skills was minimally altered. These data provide preliminary evidence that clonidine, an antihypertensive drug that affects the adrenergic nervous system, may not interfere with normal growth and maturation in adolescent males.

  14. Interdependence of right ventricular systolic function and left ventricular filling and its association with outcome for patients with pulmonary hypertension.

    Science.gov (United States)

    Motoji, Yoshiki; Tanaka, Hidekazu; Fukuda, Yuko; Sano, Hiroyuki; Ryo, Keiko; Imanishi, Junichi; Miyoshi, Tatsuya; Sawa, Takuma; Mochizuki, Yasuhide; Matsumoto, Kensuke; Emoto, Noriaki; Hirata, Ken-ichi

    2015-04-01

    Although impaired right ventricular (RV) performance has been associated with adverse outcomes for pulmonary hypertension (PH) patients, the relationship between bi-ventricular interdependence and outcomes is not yet fully understood. We studied 96 PH patients. RV systolic function was assessed by means of RV free-wall longitudinal speckle-tracking strain (RV-free), and left ventricular (LV) filling as early diastolic transmitral flow velocity (TMF-E). RV-free ≤19 % and TMF-E functional class IV and brain natriuretic peptide >150 pg/dl (χ(2) = 1.2) was improved by the addition of RV-free (χ(2) = 5.5, p = 0.04) as well as of TMF-E (χ(2) = 11.5, p = 0.01). In conclusions, RV systolic function was shown to correlate significantly with LV filling in PH patients. In addition, not only assessment of RV systolic function, but also of a combined bi-ventricular parameter comprising RV systolic function and LV filling may well have clinical implications for more successful management of PH patients.

  15. Longitudinal association of hypertension and diabetes mellitus with cognitive functioning in a general 70-year-old population: the SONIC study.

    Science.gov (United States)

    Ryuno, Hirochika; Kamide, Kei; Gondo, Yasuyuki; Kabayama, Mai; Oguro, Ryosuke; Nakama, Chikako; Yokoyama, Serina; Nagasawa, Motonori; Maeda-Hirao, Satomi; Imaizumi, Yuki; Takeya, Miyuki; Yamamoto, Hiroko; Takeda, Masao; Takami, Yoichi; Itoh, Norihisa; Takeya, Yasushi; Yamamoto, Koichi; Sugimoto, Ken; Nakagawa, Takeshi; Yasumoto, Saori; Ikebe, Kazunori; Inagaki, Hiroki; Masui, Yukie; Takayama, Michiyo; Arai, Yasumichi; Ishizaki, Tatsuro; Takahashi, Ryutaro; Rakugi, Hiromi

    2017-07-01

    Both hypertension and diabetes in middle-aged individuals have been suggested to be predictive indicators of cognitive decline. However, the association of hypertension, diabetes and their combination with cognitive functioning is still controversial in older people. The purpose of this study was to investigate the association between cognitive decline and hypertension, diabetes, and their combination in 70-year-old people based on a 3-year longitudinal analysis. Four hundred and fifty-four people aged 70 (±1) years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) were recruited randomly from a general population and were monitored for 3 years. The data, including most of the demographics, cognitive functioning measured by the Montreal Cognitive Assessment Japanese version (MoCA-J), blood pressure, blood chemistry and other medical histories, were collected at baseline and during the follow-up. The prevalence of hypertension noted in the follow-up survey was significantly higher than than noted at baseline. The mean MoCA-J score at follow-up was not significantly different from the score obtained at baseline. However, the participants with diabetes, especially combined with hypertension at baseline, had significantly lower MoCA-J scores than those without lifestyle-related diseases. The combination of hypertension and diabetes was still a significant risk factor for cognitive decline, considering the MoCA-J scores obtained during the follow-up after adjustments at baseline, relative to sex, body mass index, dyslipidemia, smoking, excessive alcohol intake, antihypertensive treatment and education level (β=-0.14; Pdiabetes and the combination of hypertension and diabetes are clear risk factors for future cognitive decline in elderly individuals who are 70 years of age.

  16. Impact of diabetes on treatment-induced changes in left ventricular structure and function in hypertensive patients with left ventricular hypertrophy. The LIFE study

    DEFF Research Database (Denmark)

    Gerdts, E; Okin, P M; Omvik, P

    2009-01-01

    in diabetic and non-diabetic groups during treatment (33/18 vs. 28/16mmHg (ns)), diabetes was associated with higher prevalence of persistent LVH (47 vs. 39%, pdiabetes independently predicted less LV mass reduction and less improvement in stress-corrected LV midwall......BACKGROUND AND AIM: Diabetes is associated with left ventricular hypertrophy (LVH) and impaired systolic function in hypertensive patients, but less is known about its impact on LVH regression and functional improvement during antihypertensive treatment. METHODS AND RESULTS: We performed annual...... echocardiography in 730 non-diabetic and 93 diabetic patients (aged 55-80 years) with hypertension and electrocardiographic LVH during 4.8-year losartan- or atenolol-based treatment in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Baseline mean blood pressure (BP) and LV mass did...

  17. Gender differences in left ventricular structure and function during antihypertensive treatment: the Losartan Intervention for Endpoint Reduction in Hypertension Study

    DEFF Research Database (Denmark)

    Gerdts, E.; Okin, P.M.; Simone, G. de

    2008-01-01

    . Left ventricular hypertrophy was diagnosed as left ventricular mass divided by height(2.7) >or=46.7 g/m(2.7) and 49.2 g/m(2.7) in women and men, respectively, and systolic function as ejection fraction and stress-corrected midwall fractional shortening. Women included more patients with obesity......, isolated systolic hypertension, and mitral regurgitation (all Pstress-corrected midwall shortening, and prevalence of left ventricular hypertrophy were higher in women at baseline and at the end of study (all P... analyses, female gender also predicted 2% higher mean in-treatment ejection fraction and 2% higher mean stress-corrected midwall shortening (both beta=0.07; Pstress-corrected midwall shortening in spite of less...

  18. MicroRNA-22 and promoter motif polymorphisms at the Chga locus in genetic hypertension: functional and therapeutic implications for gene expression and the pathogenesis of hypertension

    Czech Academy of Sciences Publication Activity Database

    Friese, R. S.; Altshuler, A. E.; Zhang, K.; Miramontes-Gonzales, J. P.; Hightower, C. M.; Jirout, M. L.; Salem, R. M.; Gayen, J. R.; Mahapatra, N. R.; Biswas, N.; Cale, M.; Vaingankar, S. M.; Kim, H.-S.; Courel, M.; Taupenot, L.; Ziegler, M. G.; Schork, N. J.; Pravenec, Michal; Mahata, S. K.; Schmid-Schönbein, G. W.; O´Connor, D. T.

    2013-01-01

    Roč. 22, č. 18 (2013), s. 3624-3640 ISSN 0964-6906 R&D Projects: GA ČR(CZ) GAP301/10/0290; GA ČR(CZ) GAP301/12/0696 Institutional support: RVO:67985823 Keywords : Chromogranin A * spontaneously hypertensive rat * mir-22 * blood pressure * catecholamines Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 6.677, year: 2013

  19. Role of measurement of cystatin C in analyzing the results of renal function tests in patients with essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Xiaofeng, Zhang; Hongtai, Lu; Yaorong, Dong; Jing, Xia; Yi, Liu [Chinese Traditional Medicine of Shanghai Hospital, Shanghai (China)

    2003-08-01

    Objective: To explore the use of cystatin C for analysing the results of renal function tests and renal blood flow study in patients with essential hypertension. Methods: The following tests were performed in 62 patients with essential hypertension and 32 controls: plasma cystatin C (with LPET), plasma ET (with RIA), four urinary sensitive parameters for detecting early renal injury i.e. urinary Alb/Cr, NAG/Cr and {alpha}-mG/Cr (with ELISA) and renal blood flow study (with Doppler). Results: The patients could be divided into two groups: Cystatin C positive (above normal value, n=23) and cystamin C negative (n=39). Plasma ET levels in cystamin C positive group were significantly higher than those in the 32 controls. Values of the four urinary parameters in the two patient groups were very significantly higher than those in the controls (p<0.01), the difference between the two patient groups was also very significant (p<0.01). Renal arterial blood flow in the two patient groups was much different from that was no significant difference between the two groups themselves. In the patients, with the decrease of GFR, Serum creatinine levels were elevated but urea nitrogen levels remained within normal limit. Conclusion: In the cystamin C negative patients, there was already marked alteration of the renal blood flow through auto-regulation. Although GFR, serum creatinine and urea nitrogen levels remained within normal range, early renal injury, especially tubular ones had been present. As the disease worsened and cystatin levels increased, there was no progressive alteration of renal blood flow. Marked deterioration of renal glomeruli and tubular functions could be detected.

  20. Role of measurement of cystatin C in analyzing the results of renal function tests in patients with essential hypertension

    International Nuclear Information System (INIS)

    Zhang Xiaofeng; Lu Hongtai; Dong Yaorong; Xia Jing; Liu Yi

    2003-01-01

    Objective: To explore the use of cystatin C for analysing the results of renal function tests and renal blood flow study in patients with essential hypertension. Methods: The following tests were performed in 62 patients with essential hypertension and 32 controls: plasma cystatin C (with LPET), plasma ET (with RIA), four urinary sensitive parameters for detecting early renal injury i.e. urinary Alb/Cr, NAG/Cr and α-mG/Cr (with ELISA) and renal blood flow study (with Doppler). Results: The patients could be divided into two groups: Cystatin C positive (above normal value, n=23) and cystamin C negative (n=39). Plasma ET levels in cystamin C positive group were significantly higher than those in the 32 controls. Values of the four urinary parameters in the two patient groups were very significantly higher than those in the controls (p<0.01), the difference between the two patient groups was also very significant (p<0.01). Renal arterial blood flow in the two patient groups was much different from that was no significant difference between the two groups themselves. In the patients, with the decrease of GFR, Serum creatinine levels were elevated but urea nitrogen levels remained within normal limit. Conclusion: In the cystamin C negative patients, there was already marked alteration of the renal blood flow through auto-regulation. Although GFR, serum creatinine and urea nitrogen levels remained within normal range, early renal injury, especially tubular ones had been present. As the disease worsened and cystatin levels increased, there was no progressive alteration of renal blood flow. Marked deterioration of renal glomeruli and tubular functions could be detected

  1. Effects of meldonium on cognitive and clinico-functional status of elderly patients with acute myocardial infarction and arterial hypertension

    Directory of Open Access Journals (Sweden)

    Dotsenko N.J.

    2013-03-01

    Full Text Available 40 elderly patients with a diagnosis of acute myocardial infarction developed on the background of arterial hypertension were examined. The patients were divided into two groups: the main – 20 patients (18 men, 2 women, age 70.0 ± 1.8 years, and the control group – 20 patients (19 men, 1 woman, age 69.5 ± 1.6 years, who received the standard treatment of acute myocardial infarction and hypertension. "Standard therapy" included acetylsalicylic acid and clopidogrel, statins, beta-blockers and ACE inhi¬bitors, if necessary, drugs to control hypertension, according to the recom¬mendations of the Ukrainian Society of Cardiologists. In addition, the first group of patients undergoing standard therapy of AMI and hypertension was administered Vazonat® for 15 days intravenously at a dose of 1000 mg per day. Effect of Vazonat® (meldonium therapy on the clinical and functional status, exercise capacity, and cognitive status in patients with acute myocardial infarction and hypertension against the background of dyscirculatory encephalopathy was studied explored. Psycho-emotional state of patients was studied by Beck's depression scale. Cognitive status was assessed by neuropsychological tests (Schulte tables, Luria’s test for memorizing of 10 words and Luria’s pictograms. In was shown dynamics a positive effects of Vazonat® therapy on the improvement of cardio¬hemo¬dynamics (noted reduction in LVED with 55.20 ± 1.7 mm to 51.28 ± 1.5 mm (p > 0.1, an increasing transmitral flow Ve/Va from 0.98 ± 0.03 to 1.10 ± 0.04 (p < 0.05, an increasing exercise tolerance (at 6MWT distance increased by 12.8% in the main group (from 289.6 ± 12.2 m to 326.0 ± 13.5 m, an increasing the speed of active attention – time of sensorimotor reactions decreased from 68.55 ± 6.2 sec to 54.35 ± 3.52 sec (p < 0.05, increasing productivity of short-term memory, increasing the number of words in the Luria test from 5.90 ± 0.42 to 7.25 ± 0.38 (p < 0

  2. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yu San; Jaw, Fu Shan [Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei (China); Chen, Jo Yu; Tai, Mei Hwa [Dept. of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei (China); Hsu, Hsao Hsun [Dept. of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei (China)

    2014-12-15

    This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R2 = 0.340, p = 0.023), RV stroke volume (R2 = 0.406, p = 0.011), and RV cardiac output (R2 = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

  3. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension.

    Science.gov (United States)

    Huang, Yu-Sen; Hsu, Hsao-Hsun; Chen, Jo-Yu; Tai, Mei-Hwa; Jaw, Fu-Shan; Chang, Yeun-Chung

    2014-01-01

    This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R(2) = 0.340, p = 0.023), RV stroke volume (R(2) = 0.406, p = 0.011), and RV cardiac output (R(2) = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

  4. THE EYE — MIRROR OF CARDIOVASCULAR DISORDER. RELATIONSHIP OF THE RETINA FUNCTIONAL STATE AND THE HYPERTENSION SEVERITY

    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko

    2011-01-01

    Full Text Available Aim. To study the retina state by functional methods in patients with arterial hypertension (HT of various degrees. Material and methods. Patients with uncomplicated HT of 1-3 degrees (n=81 and healthy subjects (n=20 of control group were examined. Routine (direct ophthalmoscopy and functional (evaluation of contrast and color sensitivity of the retina, electroretinography methods were used. Results. Functional retinal changes (reduction in color and contrast sensitivity progressed with increasing HT degree. These changes were located in the area of central retinal artery (paramacular area and area of choroidal blood flow (macular region. Retinal bioelectrical activity disturbance was also found by the electroretinography. Conclusion. The identified functional disorders suggest the retina involvement in the pathological process even in the early HT and may be associated with its severity. It confirms a relationship of HT with disorders of eye as a target organ in HT. Published data and results of our studies can refute the point of view about impossibility of changes assessment on the eye fundus in patients with uncomplicated HT, and indicates that it was premature exclusion of the eye from the list of target organs in HT.

  5. Longitudinal and transverse right ventricular function in pulmonary hypertension: cardiovascular magnetic resonance imaging study from the ASPIRE registry.

    Science.gov (United States)

    Swift, Andrew J; Rajaram, Smitha; Capener, Dave; Elliot, Charlie; Condliffe, Robin; Wild, Jim M; Kiely, David G

    2015-09-01

    Right ventricular (RV) function is a strong predictor of outcome in cardiovascular diseases. Two components of RV function, longitudinal and transverse motion, have been investigated in pulmonary hypertension (PH). However, their individual clinical significance remains uncertain. The aim of this study was to determine the factors associated with transverse and longitudinal RV motion in patients with PH. In 149 treatment-naive patients with PH and 16 patients with suspected PH found to have mean pulmonary arterial pressure of transverse motion (fractional septum to free wall distance [f-SFD]; P = 0.002). In patients without PH, no significant difference between f-SFD and f-TAAD was identified (P = 0.442). Longitudinal RV motion was singularly associated with RV ejection fraction independent of age, invasive hemodynamics, and cardiac magnetic resonance measurements (P = 0.024). In contrast, transverse RV motion was independently associated with left ventricular eccentricity (P = 0.036) in addition to RV ejection fraction (P = 0.014). In conclusion, RV motion is significantly greater in the longitudinal direction in patients with PH, whereas patients without PH have equal contributions of transverse and longitudinal motion. Longitudinal RV motion is primarily associated with global RV pump function in PH. Transverse RV motion not only reflects global pump function but is independently influenced by ventricular interaction in patients with PH.

  6. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Huang, Yu San; Jaw, Fu Shan; Chen, Jo Yu; Tai, Mei Hwa; Hsu, Hsao Hsun

    2014-01-01

    This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R2 = 0.340, p = 0.023), RV stroke volume (R2 = 0.406, p = 0.011), and RV cardiac output (R2 = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

  7. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats.

    Science.gov (United States)

    Chelko, Stephen P; Schmiedt, Chad W; Lewis, Tristan H; Robertson, Tom P; Lewis, Stephen J

    2014-01-01

    This study compared the contractile responses elicited by angiotensin II (AII), arginine vasopressin (AVP), and 5-hydroxytryptamine (5-HT) in isolated occipital arteries (OAs) from sham-operated (SHAM) and 2-kidney, 1-clip (2K-1C) hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery) and distal segments (closer to the nodose ganglion) and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, heart rates, and plasma renin concentrations than SHAM rats. The contractile responses to AII were markedly diminished in both proximal and distal segments of OAs from 2K-1C rats as compared to those from SHAM rats. The responses elicited by AVP were substantially greater in distal than in proximal segments of OAs from SHAM rats and that AVP elicited similar responses in OA segments from 2K-1C rats. The responses elicited by 5-HT were similar in proximal and distal segments from SHAM and 2K-1C rats. These results demonstrate that continued exposure to circulating AII and AVP in 2K-1C rats reduces the contractile efficacy of AII but not AVP or 5-HT. The diminished responsiveness to AII may alter the physiological status of OAs in vivo.

  8. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats

    Directory of Open Access Journals (Sweden)

    Stephen P. Chelko

    2014-01-01

    Full Text Available This study compared the contractile responses elicited by angiotensin II (AII, arginine vasopressin (AVP, and 5-hydroxytryptamine (5-HT in isolated occipital arteries (OAs from sham-operated (SHAM and 2-kidney, 1-clip (2K-1C hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery and distal segments (closer to the nodose ganglion and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, heart rates, and plasma renin concentrations than SHAM rats. The contractile responses to AII were markedly diminished in both proximal and distal segments of OAs from 2K-1C rats as compared to those from SHAM rats. The responses elicited by AVP were substantially greater in distal than in proximal segments of OAs from SHAM rats and that AVP elicited similar responses in OA segments from 2K-1C rats. The responses elicited by 5-HT were similar in proximal and distal segments from SHAM and 2K-1C rats. These results demonstrate that continued exposure to circulating AII and AVP in 2K-1C rats reduces the contractile efficacy of AII but not AVP or 5-HT. The diminished responsiveness to AII may alter the physiological status of OAs in vivo.

  9. Value of MR phase-contrast flow measurements for functional assessment of pulmonary arterial hypertension

    International Nuclear Information System (INIS)

    Ley, Sebastian; Mereles, Derliz; Gruenig, Ekkehard; Puderbach, Michael; Schoeck, Helena; Eichinger, Monika; Ley-Zaporozhan, Julia; Fink, Christian; Kauczor, Hans-Ulrich

    2007-01-01

    Goals of our study were to compare the pulmonary hemodynamics between healthy volunteers and patients with pulmonary arterial hypertension (PAH) and correlate MR flow measurements with echocardiography. Twenty-five patients with PAH and 25 volunteers were examined at 1.5 T. Phase-contrast flow measurements were performed in the ascending aorta and pulmonary trunk, resulting in the following parameters: peak velocity (cm/s), average blood flow (l/min), time to peak velocity (ms), velocity rise gradient and pulmonary distensibility (cm 2 ). The bronchosystemic shunt was calculated. In PAH patients transthoracic echocardiography and right-heart catheterization (RHC) served as the gold standard. In comparison to volunteers, the PAH patients showed significantly reduced pulmonary velocities (P = 0.002), blood flow (P = 0.002) and pulmonary distensibility (P = 0.008). In patients, the time to peak velocity was shorter (P<0.001), and the velocity rise gradient was steeper (P = 0.002) than in volunteers. While in volunteers the peak velocity in the aorta was reached earlier, it was the reverse in patients. Patients showed a significant bronchosystemic shunt (P = 0.01). No meaningful correlation was found between MRI measurements and echocardiography or RHC. MRI is a feasible technique for the differentiation between PAH and volunteers. Further studies have to be conducted for the absolute calculation of pressure estimates. (orig.)

  10. Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy

    DEFF Research Database (Denmark)

    Olsen, M H; Hjerkinn, E; Wachtell, K

    2003-01-01

    Vascular hypertrophy and insulin resistance have been associated with abnormal left ventricular (LV) geometry in population studies. We wanted to investigate the influence of vascular hypertrophy and insulin resistance on LV hypertrophy and its function in patients with hypertension. In 89 patients...

  11. Dietary approach to stop hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

    NARCIS (Netherlands)

    Osté, M.C.J.; Gomes-neto, A.W.; Corpeleijn, E.; Gans, R.O.B.; De Borst, M.H.; Van Den Berg, E.; Soedamah-Muthu, S.S.; Kromhout, D.; Navis, G.J.; Bakker, S.J.L.

    Renal transplant recipients (RTR) are at risk of decline of graft function and premature mortality, with high blood pressure as important risk factor for both. To study the association of the Dietary Approach to Stop Hypertension (DASH) diet with these adverse events, we conducted a prospective

  12. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  13. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice....

  14. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

  15. The effects of baroreflex activation therapy on blood pressure and sympathetic function in patients with refractory hypertension: the rationale and design of the Nordic BAT study.

    Science.gov (United States)

    Gordin, Daniel; Fadl Elmula, Fadl Elmula M; Andersson, Bert; Gottsäter, Anders; Elf, Johan; Kahan, Thomas; Christensen, Kent Lodberg; Vikatmaa, Pirkka; Vikatmaa, Leena; Bastholm Olesen, Thomas; Groop, Per-Henrik; Olsen, Michael Hecht; Tikkanen, Ilkka

    2017-10-01

    To explore the effects of baroreflex activation therapy (BAT) on hypertension in patients with treatment resistant or refractory hypertension. This investigator-initiated randomized, double-blind, 1:1 parallel-design clinical trial will include 100 patients with refractory hypertension from 6 tertiary referral hypertension centers in the Nordic countries. A Barostim Neo System will be implanted and after 1 month patients will be randomized to either BAT for 16 months or continuous pharmacotherapy (BAT off) for 8 months followed by BAT for 8 months. A second randomization will take place after 16 months to BAT or BAT off for 3 months. Eligible patients have a daytime systolic ambulatory blood pressure (ABPM) of  ≥145 mm Hg, and/or a daytime diastolic ABPM of  ≥95 mm Hg after witnessed drug intake (including  ≥3 antihypertensive drugs, preferably including a diuretic). The primary end point is the reduction in 24-hour systolic ABPM by BAT at 8 months, as compared to pharmacotherapy. Secondary and tertiary endpoints are effects of BAT on home and office blood pressures, measures of indices of cardiac and vascular structure and function during follow-up, and safety. This academic initiative will increase the understanding of mechanisms and role of BAT in the refractory hypertension.

  16. Comparative effect of olmesartan and candesartan on lipid metabolism and renal function in patients with hypertension: a retrospective observational study

    Directory of Open Access Journals (Sweden)

    Nakayama Tomohiro

    2011-08-01

    Full Text Available Abstract Background Angiotensin II receptor blockers (ARBs, including olmesartan and candesartan, are widely used antihypertensive agents. Many clinical studies have demonstrated that ARBs have organ-protecting effects, e.g., cardioprotection, vasculoprotection and renoprotection. However, the effect of prolonged olmesartan monotherapy on lipid metabolism in patients with hypertension is less well studied. We performed a retrospective observational study to compare the effects of olmesartan with those of candesartan, focusing on lipid metabolism and renal function. Methods We used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and Feb 28, 2011, to identify cohorts of new olmesartan users (n = 168 and candesartan users (n = 266. We used propensity-score weighting to adjust for differences in all covariates (age, sex, comorbid diseases, previous drugs between olmesartan and candesartan users, and compared serum chemical data including serum triglyceride (TG, LDL-cholesterol (LDL-C, total cholesterol (TC, potassium, creatinine and urea nitrogen. The mean exposure of olmesartan and candesartan users was 126.1 and 122.8 days, respectively. Results After adjustment, there were no statistically significant differences in all covariates between olmesartan and candesartan users. The mean age was 60.7 and 61.0 years, and 33.4% and 33.7% of olmesartan and candesartan users were women, respectively. There were no statistically significant differences in mean values for all laboratory tests between baseline and during the exposure period in both olmesartan and candesartan users. In olmesartan users, the reduction of serum TG level was significant in comparison with that in candesartan users. Other parameters of lipid profile and renal function showed no statistically significant difference in the change from baseline to during the exposure period between olmesartan and candesartan users. Conclusions

  17. Cognitive functions and their effect on disability in learning process and knowledge application in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    S. Ya. Yanovska

    2018-02-01

    Full Text Available Arterial hypertension (AH is one of the most important medical and social problems due to the high incidence, disability and mortality of the population in Ukraine. The aim of the investigation is to determine the influence of cognitive functions on disability in learning process and knowledge application in patients with hypertension. Materials and methods. 139 patients with essential AH of II and III st. (with the consequences of a stroke at the age of 30–59 were examined. The patients were divided into 2 groups: the first group – patients with AH, stage II (29 patients and the second group – patients with AH, stage III (110 patients. An average age of the patients with stage II was 43.1 ± 3.1, with stage III – 45.3 ± 5.6. Psychological examination and disability tests were carried out according to generally accepted methods. Statistical processing was performed in Microsoft Excel and Ascess, the results of the correlation analysis were described at a confidence level of P < 0.05. Results. Light cognitive impairments were detected in all patients with stage II, stage III AH patients had moderate impairments – 25.8 % of cases and light ones – 74.2 % of cases. Significant cognitive functions affects among patients with AH stage II and stage III were determined in memory (44.4 and 97.3 %, attention (77.8 and 90.6 %, intellect (44.4 and 75.6 % and mental process (44.4 and 64.9 % of cases. Patients with stage III AH after a stroke had significant problems with their eyesight and hearing, concentration of attention and process of thinking, solving simple and complex problems. Moreover, a number of the following factors have contributed to the above-mentioned condition: emotional instability, nonconformity, desire to present themselves in a "favorable light", anxiety, depressive and paranoid tendencies, sensitive, egocentric, anosognotic response to the disease, exacerbation of accentuation of an excitable nature and low work efficiency

  18. Impact of angiotensin and endothelin converting enzymes and related bradykinin on renal functions in L-NAME hypertensive rats

    Science.gov (United States)

    Omar, Ali Zainal; Maulood, Ismail M.

    2017-09-01

    The renin-angiotensin system (RAS), one of the most important hormonal systems, controls the kidney functions by regulating fluid volume, and electrolyte balance. The current study included the effects of kinin-kallikrein system (KKS) and its interaction with both angiotensin converting enzyme (ACE) and endothelin converting enzyme (ECE) on some of kidney function test parameters. In the present experiment, rats were divided into six groups, the first group was infused with normal saline, the second group was L-NG-Nitroarginine methyl ester (L-NAME) treated rats, third group was bradykinin (BK), forth group was captopril (ACEi), fifth group was phosphoramidon (ECEi), sixth group was a combination of BK with phosphoramidon. L-NAME was intravenously infused for one hour to develop systematic hypertension in male rats. After one hour of infusion, the results showed that L-NAME significantly increased serum creatinine. While, it decreased glomerular filtration rate (GFR), and K+ excretion rate. Moreover, BK increased packed cell volume PCV%, serum creatinine and K+ ion concentration. While, it reduced GFR, serum Ca+2 ion concentration, K+ and Na+ excretion rates. On the other hand, captopril infusion showed its effect by reduction in GFR, serum Ca+2 ion and electrolyte excretion rates. Phosphoramidon an ECEi dramatically reduced serum Ca+2 ion, but it increased pH, GFR and Ca+2 excretion rate. The results suggested that BK and Captopril each alone severely reduces GFR value. Interestingly, inhibition of ET-1 production via phosphoramidon could markedly elevate GFR values.

  19. Effect of Feikangning composition in improving the pulmonary function in patients with COPD merged with pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Li-Yun Wang

    2016-12-01

    Full Text Available Objective: To explore the effect of Feikangning composition in improving the pulmonary function in patients with COPD merged with pulmonary arterial hypertension (PAH, and observe the changes of ET-1 and D-D levels before and after treatment. Methods: A total of 52 patients with COPD merged with PAH who were admitted in our hospital were included in the study and randomized into the treatment group (n=31 and the control group (n=21. The patients in the two groups were given routine treatments after admission. On this basis, the patients in the treatment group were given Feikangning composition. ET-1 and D-D levels before treatment and 1 month after treatment in the two groups were detected. FEV1, FVC, FEV1%, mPAP, TPR, and SteO2 before and after treatment in the two groups were compared. Results: FEV1, FVC, and FEV1% after treatment in the treatment group were significantly higher than those in the control group. PAP and SteO2 after treatment in the treatment group were significantly higher than those in the control group, while TPR was significantly lower than that in the control group. ET-1 and D-D levels after treatment in the treatment group were significantly lower than those in the control group. Conclusions: Feikangning composition can effectively improve the ventilation function in patients with COPD merged with PAH, and regulate the endothelin balance, with a significant efficacy.

  20. Thrombospondin-4 knockout in hypertension protects small-artery endothelial function but induces aortic aneurysms

    NARCIS (Netherlands)

    Palao, Teresa; Rippe, Catarina; van Veen, Henk; VanBavel, Ed; Swärd, Karl; Bakker, Erik N. T. P.

    2016-01-01

    Thrombospondin-4 (TSP-4) is a multidomain calcium-binding protein that has both intracellular and extracellular functions. As an extracellular matrix protein, it is involved in remodeling processes. Previous work showed that, in the cardiovascular system, TSP-4 expression is induced in the heart in

  1. Impaired microvascular reactivity and endothelial function in patients with Cushing's syndrome: Influence of arterial hypertension

    Czech Academy of Sciences Publication Activity Database

    Prázný, M.; Ježková, J.; Horová, E.; Lazárová, V.; Hána, V.; Kvasnička, J.; Pecen, Ladislav; Marek, J.; Škrha, J.; Kršek, M.

    2008-01-01

    Roč. 57, č. 1 (2008), s. 13-22 ISSN 0862-8408 Institutional research plan: CEZ:AV0Z10300504 Keywords : Cushing’s syndrome * vascular reactivity * endothelial function * oxidative stress * laser Doppler flowmetry Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 1.653, year: 2008

  2. Resistant Hypertension.

    Science.gov (United States)

    Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

    2016-01-01

    Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.

  3. Usefulness of scoring right ventricular function for assessment of prognostic factors in patients with chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Kamimura, Yoshihiro; Okumura, Naoki; Adachi, Shiro; Shimokata, Shigetake; Tajima, Fumitaka; Nakano, Yoshihisa; Hirashiki, Akihiro; Murohara, Toyoaki; Kondo, Takahisa

    2018-04-27

    Right ventricular (RV) function is associated with prognosis in chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to establish an RV dysfunction score using RV echocardiographic parameters to clarify the clinical characteristics in patients with CTEPH and to compare RV dysfunction score with parameters such as World Health Organization (WHO) functional class, hemodynamics, exercise capacity, and plasma BNP level. We enrolled 35 inpatients with CTEPH (mean age, 62 ± 15 years, 15 males). We constructed 'an RV dysfunction score' calculated as the summation of each point awarded for the presence of four parameters: tricuspid annular plane systolic excursion (TAPSE)  0.4, 1 point. TAPSE, S', RVFAC, and RV-MPI was 18.7 ± 4.8 mm, 11.9 ± 3.1 cm/s, 33.5 ± 13.9%, and 0.39 ± 0.2, respectively. The RV dysfunction score was associated with symptom [WHO functional class (p = 0.026)], hemodynamics [mean PAP (p = 0.01), cardiac index (p = 0.009), pulmonary vascular resistance (p = 0.001), and SvO 2 (p = 0.039)], exercise capacity [6-min walk distance (p = 0.046), peakVO 2 (p = 0.016), and VE/VCO 2 slope (p = 0.031)], and plasma BNP level (p = 0.005). This RV dysfunction score using the four RV echocardiographic parameters could be a simple and useful scoring system to evaluate prognostic factors in patients with CTEPH.

  4. Left Ventricular Function in Patients with Pulmonary Arterial Hypertension: The Role of Two-Dimensional Speckle Tracking Strain.

    Science.gov (United States)

    de Amorim Corrêa, Ricardo; de Oliveira, Fernanda Brito; Barbosa, Marcia M; Barbosa, Jose Augusto A; Carvalho, Taís Soares; Barreto, Michele Campos; Campos, Frederico Thadeu A F; Nunes, Maria Carmo Pereira

    2016-09-01

    Pulmonary arterial hypertension (PAH) is characterized by elevated mean pulmonary arterial pressure with abnormal right ventricular (RV) pressure overload that may alter left ventricular (LV) function. The aim of this study was to assess the impact of RV pressure overload on LV function in PAH patients using two-dimensional (2D) speckle tracking strain. The study enrolled 37 group 1 PAH patients and 38 age- and gender-matched healthy controls. LV longitudinal and radial 2D strains were measured with and without including the ventricular septum. Six-minute walk test (6MWT) and brain natriuretic peptide (BNP) levels were also obtained in patients with PAH. The mean age of patients was 46.4 ± 14.8 years, 76% women, and 16 patients (43%) had schistosomiasis. Sixteen patients (43%) were in WHO class III or IV under specific treatment for PAH. The overall 6MWT distance was 441 meters, and the BNP levels were 80 pg/mL. Patients with PAH more commonly presented with LV diastolic dysfunction and impairment of RV function when compared to controls. LV global longitudinal and radial strains were lower in patients than in controls (-17.9 ± 2.8 vs. -20.5 ± 1.9; P < 0.001 and 30.8 ± 10.5 vs. 49.8 ± 15.4; P < 0.001, respectively). After excluding septal values, LV longitudinal and radial strains remained lower in patients than in controls. The independent factors associated with global LV longitudinal strain were LV ejection fraction, RV fractional area change, and tricuspid annular systolic motion. This study showed impaired LV contractility in patients with PAH assessed by speckle tracking strain, irrespective of ventricular septal involvement. Global LV longitudinal strain was associated independently with RV fractional area change and tricuspid annular systolic motion, after adjustment for LV ejection fraction. © 2016, Wiley Periodicals, Inc.

  5. A functional 12T-insertion polymorphism in the ATP1A1 promoter confers decreased susceptibility to hypertension in a male Sardinian population.

    Science.gov (United States)

    Herrera, Victoria L; Pasion, Khristine A; Moran, Ann Marie; Zaninello, Roberta; Ortu, Maria Francesca; Fresu, Giovanni; Piras, Daniela Antonella; Argiolas, Giuseppe; Troffa, Chiara; Glorioso, Valeria; Masala, Wanda; Glorioso, Nicola; Ruiz-Opazo, Nelson

    2015-01-01

    Identification of susceptibility genes for essential hypertension in humans has been a challenge due to its multifactorial pathogenesis complicated by gene-gene and gene-environment interactions, developmental programing and sex specific differences. These concurrent features make identification of causal hypertension susceptibility genes with a single approach difficult, thus requiring multiple lines of evidence involving genetic, biochemical and biological experimentation to establish causal functional mutations. Here we report experimental evidence encompassing genetic, biochemical and in vivo modeling that altogether support ATP1A1 as a hypertension susceptibility gene in males in Sardinia, Italy. ATP1A1 encodes the α1Na,K-ATPase isoform, the sole sodium pump in vascular endothelial and renal tubular epithelial cells. DNA-sequencing detected a 12-nucleotide long thymidine (12T) insertion(ins)/deletion(del) polymorphism within a poly-T sequence (38T vs 26T) in the ATP1A1 5'-regulatory region associated with hypertension in a male Sardinian population. The 12T-insertion allele confers decreased susceptibility to hypertension (P = 0.035; OR = 0.50 [0.28-0.93]) accounting for 12.1 mmHg decrease in systolic BP (P = 0.02) and 6.6 mmHg in diastolic BP (P = 0.046). The ATP1A1 promoter containing the 12T-insertion exhibited decreased transcriptional activity in in vitro reporter-assay systems, indicating decreased α1Na,K-ATPase expression with the 12T-insertion, compared with the 12T-deletion ATP1A1 promoter. To test the effects of decreased α1Na,K-ATPase expression on blood pressure, we measured blood pressure by radiotelemetry in three month-old, highly inbred heterozygous knockout ATP1A1+/- male mice with resultant 58% reduction in ATP1A1 protein levels. Male ATP1A1+/- mice showed significantly lower blood pressure (P < 0.03) than age-matched male wild-type littermate controls. Concordantly, lower ATP1A1 expression is expected to lower Na-reabsorption in the

  6. A functional 12T-insertion polymorphism in the ATP1A1 promoter confers decreased susceptibility to hypertension in a male Sardinian population.

    Directory of Open Access Journals (Sweden)

    Victoria L Herrera

    Full Text Available Identification of susceptibility genes for essential hypertension in humans has been a challenge due to its multifactorial pathogenesis complicated by gene-gene and gene-environment interactions, developmental programing and sex specific differences. These concurrent features make identification of causal hypertension susceptibility genes with a single approach difficult, thus requiring multiple lines of evidence involving genetic, biochemical and biological experimentation to establish causal functional mutations. Here we report experimental evidence encompassing genetic, biochemical and in vivo modeling that altogether support ATP1A1 as a hypertension susceptibility gene in males in Sardinia, Italy. ATP1A1 encodes the α1Na,K-ATPase isoform, the sole sodium pump in vascular endothelial and renal tubular epithelial cells. DNA-sequencing detected a 12-nucleotide long thymidine (12T insertion(ins/deletion(del polymorphism within a poly-T sequence (38T vs 26T in the ATP1A1 5'-regulatory region associated with hypertension in a male Sardinian population. The 12T-insertion allele confers decreased susceptibility to hypertension (P = 0.035; OR = 0.50 [0.28-0.93] accounting for 12.1 mmHg decrease in systolic BP (P = 0.02 and 6.6 mmHg in diastolic BP (P = 0.046. The ATP1A1 promoter containing the 12T-insertion exhibited decreased transcriptional activity in in vitro reporter-assay systems, indicating decreased α1Na,K-ATPase expression with the 12T-insertion, compared with the 12T-deletion ATP1A1 promoter. To test the effects of decreased α1Na,K-ATPase expression on blood pressure, we measured blood pressure by radiotelemetry in three month-old, highly inbred heterozygous knockout ATP1A1+/- male mice with resultant 58% reduction in ATP1A1 protein levels. Male ATP1A1+/- mice showed significantly lower blood pressure (P < 0.03 than age-matched male wild-type littermate controls. Concordantly, lower ATP1A1 expression is expected to lower Na

  7. Transition of Intravenous Treprostinil to Oral Therapy in a Patient with Functional Class IV Chronic Thromboembolic Pulmonary Hypertension.

    Science.gov (United States)

    Thurber, Kristina M; Williams, Breann M; Bates, Ruth E; Frantz, Robert P

    2017-08-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual CTEPH, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with CTEPH may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42-year-old man with T12 paraplegia complicated by CTEPH (functional class IV with substantial right ventricular dysfunction) and severe pressure ulcers. In order to facilitate goals of care (hospital discharge to a skilled nursing facility where parenteral prostanoids could not be administered), he underwent rapid transition from intravenous treprostinil to oral selexipag in the form of a cross-taper over 6 days. The patient required readmission due to worsening symptoms and was transitioned back to intravenous treprostinil; he tolerated conversion to oral treprostinil for approximately 4 months, but it was subsequently discontinued due to nausea and modified goals of care. The patient underwent transition to hospice care 3 months later and eventually died from clinical deterioration. To our knowledge, this is the first report to describe transition from intravenous treprostinil to selexipag as well as conversion from parenteral treprostinil to oral treprostinil in a patient with CTEPH and illustrates the approaches to and potential issues with prostanoid transitions. Additional observations are necessary to better understand the relative roles of selexipag and oral treprostinil regarding comparative efficacy and tolerability. © 2017 Pharmacotherapy Publications, Inc.

  8. Exercise training by individuals with predialysis renal failure: cardiorespiratory endurance, hypertension, and renal function.

    Science.gov (United States)

    Boyce, M L; Robergs, R A; Avasthi, P S; Roldan, C; Foster, A; Montner, P; Stark, D; Nelson, C

    1997-08-01

    The purpose of this study was to determine the effects of 4 months of exercise training (ET) on cardiorespiratory function and endurance, blood pressure, muscle strength, hematology, blood lipids, and renal function in individuals with chronic renal failure (CRF) who were not yet on dialysis. Sixteen subjects were recruited to volunteer for participation in this study, but only eight completed all study phases. Subjects were first evaluated before and after a 2-month baseline (BL1 and BL2), after 4 months of ET, and again after 2 months of detraining (DT). ET did not change hematology, blood lipids, or echocardiographic measurements of left ventricular function and mass. Resting systolic and diastolic blood pressures decreased significantly from BL after the ET (146 +/- 15.7/87 +/- 9 mm Hg to 124 +/- 17.5/78 +/- 9.5 mm Hg; P < 0.02), and then increased significantly after DT (139 +/- 14.7 mm Hg and 87 +/- 9.9 mm Hg; P < 0.01). Peak oxygen consumption (pVO2) changed significantly during the study (1.3 +/- 0.3 L/min, 1.5 +/- 0.3 L/min, and 1.4 +/- 0.3 L/min for BL2, ET, and DT, respectively; P < 0.02), as did the VO2 at the ventilatory threshold (0.65 +/- 0.18 L/min, 0.92 +/- 0.19 L/min, and 0.68 +/- 0.23 L/min for BL2, ET, and DT, respectively; P < 0.01). Knee flexion peak torque increased after ET (43.4 +/- 25.6 Nm to 51.0 +/- 30.5 Nm; P < 0.02). GFR, as measured by creatinine clearance, continued to deteriorate during the course of the study (25.3 +/- 12.0 mL/min, 21.8 +/- 13.2 mL/min, and 21.8 +/- 13.2 mL/min for BL2, ET, and DT, respectively; P < 0.001). Individuals with predialysis CRF who undergo ET improve in functional aerobic capacity, muscular strength, and blood pressure.

  9. Successful Tricuspid Valve Replacement in a Patient with Severe Pulmonary Arterial Hypertension and Preserved Right Ventricular Systolic Function

    Directory of Open Access Journals (Sweden)

    Jamil A. Aboulhosn

    2009-01-01

    Full Text Available A 56-year-old patient with severe pulmonary hypertension developed severe tricuspid regurgitation, right-sided heart failure, and congestive hepatopathy. She was transferred for possible lung transplant and/or tricuspid valve surgery. Clinical and echocardiographic assessment provided confidence that acute tricuspid valve failure was responsible for the decompensation and that tricuspid valve replacement despite pulmonary hypertension could be performed.

  10. Pulmonary hypertension CT imaging

    International Nuclear Information System (INIS)

    Nedevska, A.

    2013-01-01

    Full text: The right heart catheterization is the gold standard in the diagnosis and determines the severity of pulmonary hypertension. The significant technical progress of noninvasive diagnostic imaging methods significantly improves the pixel density and spatial resolution in the study of cardiovascular structures, thus changes their role and place in the overall diagnostic plan. Learning points: What is the etiology, clinical manifestation and general pathophysiological disorders in pulmonary hypertension. What are the established diagnostic methods in the diagnosis and follow-up of patients with pulmonary hypertension. What is the recommended protocol for CT scanning for patients with clinically suspected or documented pulmonary hypertension. What are the important diagnostic findings in CT scan of a patient with pulmonary hypertension. Discussion: The prospect of instantaneous complex - anatomical and functional cardiopulmonary and vascular diagnostics seems extremely attractive. The contrast enhanced multislice computed (CT ) and magnetic resonance imaging are very suitable methods for imaging the structures of the right heart, with the possibility of obtaining multiple projections and three-dimensional imaging reconstructions . There are specific morphological features that, if carefully analyzed, provide diagnostic information. Thus, it is possible to avoid or at least reduce the frequency of use of invasive diagnostic cardiac catheterization in patients with pulmonary hypertension. Conclusion: This review focuses on the use of contrast-enhanced CT for comprehensive evaluation of patients with pulmonary hypertension and presents the observed characteristic changes in the chest, lung parenchyma , the structures of the right half of the heart and pulmonary vessels

  11. Mineralocorticoid hypertension

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2011-01-01

    Full Text Available Hypertension affects about 10 - 25% of the population and is an important risk factor for cardiovascular and renal disease. The renin-angiotensin system is frequently implicated in the pathophysiology of hypertension, be it primary or secondary. The prevalence of primary aldosteronism increases with the severity of hypertension, from 2% in patients with grade 1 hypertension to 20% among resistant hypertensives. Mineralcorticoid hypertension includes a spectrum of disorders ranging from renin-producing pathologies (renin-secreting tumors, malignant hypertension, coarctation of aorta, aldosterone-producing pathologies (primary aldosteronism - Conns syndrome, familial hyperaldosteronism 1, 2, and 3, non-aldosterone mineralocorticoid producing pathologies (apparent mineralocorticoid excess syndrome, Liddle syndrome, deoxycorticosterone-secreting tumors, ectopic adrenocorticotropic hormones (ACTH syndrome, congenitalvadrenal hyperplasia, and drugs with mineraocorticoid activity (locorice, carbenoxole therapy to glucocorticoid receptor resistance syndromes. Clinical presentation includes hypertension with varying severity, hypokalemia, and alkalosis. Ratio of plasma aldosterone concentraion to plasma renin activity remains the best screening tool. Bilateral adrenal venous sampling is the best diagnostic test coupled with a CT scan. Treatment is either surgical (adrenelectomy for unilateral adrenal disease versus medical therapy for idiopathic, ambiguous, or bilateral disease. Medical therapy focuses on blood pressure control and correction of hypokalemia using a combination of anti-hypertensives (calcium channel blockers, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers and potassium-raising therapies (mineralcorticoid receptor antagonist or potassium sparing diuretics. Direct aldosterone synthetase antagonists represent a promising future therapy.

  12. Cordyceps militaris improves the survival of Dahl salt-sensitive hypertensive rats possibly via influences of mitochondria and autophagy functions

    Directory of Open Access Journals (Sweden)

    Kentaro Takakura

    2017-11-01

    Full Text Available The genus Cordyceps and its specific ingredient, cordycepin, have attracted much attention for multiple health benefits and expectations for lifespan extension. We analyzed whether Cordyceps militaris (CM, which contains large amounts of cordycepin, can extend the survival of Dahl salt-sensitive rats, whose survival was reduced to ∼3 months via a high-salt diet. The survival of these life-shortened rats was extended significantly when supplemented with CM, possibly due to a minimization of the effects of stroke. Next, we analyzed the effect of CM on hypertension-sensitive organs, the central nervous systems (CNS, heart, kidney and liver of these rats. We attempted to ascertain how the organs were improved by CM, and we paid particular attention to mitochondria and autophagy functions. The following results were from CM-treated rats in comparison with control rats. Microscopically, CNS neurons, cardiomyocytes, glomerular podocytes, renal epithelial cells, and hepatocytes all were improved. However, immunoblot and immunohistochemical analysis showed that the expressions of mitochondria-related proteins, ATP synthase β subunit, SIRT3 and SOD2, and autophagy-related proteins, LC3-II/LC3-I ratio and cathepsin D all were reduced significantly in the CNS neurons, but increased significantly in the cells of the other three organs, although p62 was decreased in its expression in all the organs tested. Activity of Akt and mTOR was enhanced but that of AMPK was reduced in the CNS, while such kinase activity was completely the opposite in the other organs. Together, the influence of CM may differ between mitochondria and autophagy functioned between the two organ groups, as mitochondria and autophagy seemed to be repressed and promoted, respectively, in the CNS, while both mitochondria and autophagy were activated in the others. This could possibly be related to the steady or improved cellular activity in both the organs, which might result in the life

  13. Taurine and magnesium supplementation enhances the function of endothelial progenitor cells through antioxidation in healthy men and spontaneously hypertensive rats.

    Science.gov (United States)

    Katakawa, Mayumi; Fukuda, Noboru; Tsunemi, Akiko; Mori, Mari; Maruyama, Takashi; Matsumoto, Taro; Abe, Masanori; Yamori, Yukio

    2016-12-01

    Endothelial damage is repaired by endothelial progenitor cells (EPCs), which are pivotal in preventing cardiovascular diseases and prolonging lifespan. The WHO Cardiovascular Diseases and Alimentary Comparison Study demonstrated that dietary taurine and magnesium (Mg) intake suppresses cardiovascular diseases. We herein evaluate the effects of taurine and Mg supplementation on EPC function and oxidative stress in healthy men and spontaneously hypertensive rats (SHRs). Healthy men received taurine (3 g per day) or Mg (340 mg per day) for 2 weeks. SHRs and Wistar-Kyoto (WKY) rats were housed with high-salt drinking water (1% NaCl). The SHRs received 3% taurine solution and/or a high-Mg (600 mg per 100 g) diet for 4 weeks. Their peripheral blood mononuclear cells were separated to quantify EPC colony formation. Oxidative stress markers in their peripheral blood were evaluated using a free radical analytical system and a thiobarbituric acid reactive substance (TBARS) assay. Taurine and Mg supplementation significantly increased EPC colony numbers and significantly decreased free radical levels and TBARS scores in healthy men. Taurine and Mg supplementation significantly increased EPC colony numbers and significantly decreased TBARS scores and free radical levels in SHRs. Nicotinamide adenine dinucleotide phosphate oxidase component mRNA expression was significantly higher in the renal cortex of salt-loaded SHRs than in WKY rats, in which it was suppressed by taurine and Mg supplementation. Taurine and Mg supplementation increased EPC colony formation in healthy men and improved impaired EPC function in SHRs through antioxidation, indicating that the dietary intake of taurine and Mg may prolong lifespan by preventing the progression of cardiovascular diseases.

  14. Cordyceps militaris improves the survival of Dahl salt-sensitive hypertensive rats possibly via influences of mitochondria and autophagy functions.

    Science.gov (United States)

    Takakura, Kentaro; Ito, Shogo; Sonoda, Junya; Tabata, Koji; Shiozaki, Motoko; Nagai, Kaoru; Shibata, Masahiro; Koike, Masato; Uchiyama, Yasuo; Gotow, Takahiro

    2017-11-01

    The genus Cordyceps and its specific ingredient, cordycepin, have attracted much attention for multiple health benefits and expectations for lifespan extension. We analyzed whether Cordyceps militaris (CM), which contains large amounts of cordycepin, can extend the survival of Dahl salt-sensitive rats, whose survival was reduced to ∼3 months via a high-salt diet. The survival of these life-shortened rats was extended significantly when supplemented with CM, possibly due to a minimization of the effects of stroke. Next, we analyzed the effect of CM on hypertension-sensitive organs, the central nervous systems (CNS), heart, kidney and liver of these rats. We attempted to ascertain how the organs were improved by CM, and we paid particular attention to mitochondria and autophagy functions. The following results were from CM-treated rats in comparison with control rats. Microscopically, CNS neurons, cardiomyocytes, glomerular podocytes, renal epithelial cells, and hepatocytes all were improved. However, immunoblot and immunohistochemical analysis showed that the expressions of mitochondria-related proteins, ATP synthase β subunit, SIRT3 and SOD2, and autophagy-related proteins, LC3-II/LC3-I ratio and cathepsin D all were reduced significantly in the CNS neurons, but increased significantly in the cells of the other three organs, although p62 was decreased in its expression in all the organs tested. Activity of Akt and mTOR was enhanced but that of AMPK was reduced in the CNS, while such kinase activity was completely the opposite in the other organs. Together, the influence of CM may differ between mitochondria and autophagy functioned between the two organ groups, as mitochondria and autophagy seemed to be repressed and promoted, respectively, in the CNS, while both mitochondria and autophagy were activated in the others. This could possibly be related to the steady or improved cellular activity in both the organs, which might result in the life extension of these

  15. (−-Epicatechin Reduces Blood Pressure and Improves Left Ventricular Function and Compliance in Deoxycorticosterone Acetate-Salt Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Douglas Jackson

    2018-06-01

    Full Text Available (−-Epicatechin (E is a flavanol found in green tea and cocoa and has been shown to attenuate tumour necrosis factor alpha (TNF-α-mediated inflammation, improve nitric oxide levels, promote endothelial nitric oxide synthase (eNOS activation and inhibit NADPH oxidase. This study investigated the effect of 28 days of low epicatechin dosing (1 mg/kg/day on the cardiovascular function of deoxycorticosterone acetate (DOCA-salt hypertensive rats. Wistar rats (n = 120, 8 weeks of age underwent uninephrectomy and were randomised into four groups (uninephrectomy (UNX, UNX + E, DOCA, DOCA + E. DOCA and DOCA + E rats received 1% NaCl drinking water along with subcutaneous injections of 25 mg deoxycorticosterone-acetate (in 0.4 mL of dimethylformamide every fourth day. UNX + E and DOCA + E rats received 1 mg/kg/day of epicatechin by oral gavage. Single-cell micro-electrode electrophysiology, Langendorff isolated-heart assessment and isolated aorta and mesenteric organ baths were used to assess cardiovascular parameters. Serum malondialdehyde concentration was used as a marker of oxidative stress. Myocardial stiffness was increased and left ventricular compliance significantly diminished in the DOCA control group, and these changes were attenuated by epicatechin treatment (p < 0.05. Additionally, the DOCA + E rats showed significantly reduced blood pressure and malondialdehyde concentrations; however, there was no improvement in left ventricular hypertrophy, electrophysiology or vascular function. This study demonstrates the ability of epicatechin to reduce blood pressure, prevent myocardial stiffening and preserve cardiac compliance in hypertrophied DOCA-salt rat hearts.

  16. VASOMOTOR ENDOTHELIAL FUNCTION AND MICROCIRCULATION IN ELDERLY PATIENTS WITH ISOLATED SYSTOLIC ARTERIAL HYPERTENSION: INFLUENCE OF "DRY" CARBONIC BATHS AND GENERAL LOW-FREQUENCY MAGNETOTHERAPY

    OpenAIRE

    Alypova, Elena

    2013-01-01

    Abstract. The comparative estimation of influence of the general low-frequency magnetotherapy (GLMT) and "dry" carbonic baths (DCB) on indicators of vasomotor endothelial function and microcirculation in elderly patients with isolated systolic (ISAH) arterial hypertension has been studied. The efficiency of application the combined use of the GLMT and "dry" carbonic baths DCB for correction of revealed disorders in comparing to the monovariant use of thees medical physical factors is establis...

  17. Structural and functional changes in the heart and clinical features of heart failure with preserved left ventricular ejection fraction in patients after myocardial infarction, comorbided with arterial hypertension

    Directory of Open Access Journals (Sweden)

    V. D. Syvolap

    2013-12-01

    Full Text Available Recently, much attention was paid to left ventricular diastolic dysfunction and its role in the occurrence of chronic heart failure. In patients after myocardial infarction, diastolic dysfunction often precedes systolic dysfunction and predicts prognosis. In patients after myocardial infarction, diastolic dysfunction is caused by a violation of early diastolic relaxation in the area of increasing stiffness. Diastolic dysfunction is formed by hypertrophy, fibrosis, myocardial ischemia and arterial hypertension. Given the important role of diastolic dysfunction in the formation of heart failure in postinfarction patients with concomitant arterial hypertension, the mechanisms of its impact on clinical features and structural-functional changes of the heart is an actual problem. Objective: To determine the structural and functional changes in the heart and clinical features of heart failure with preserved left ventricular ejection fraction in patients after myocardial infarction with concomitant arterial hypertension. Materials and methods: In 91 patients with post-infarction cardiosclerosis and preserved left ventricular ejection fraction (EF > 45 % with arterial hypertension were investigated structural and functional changes in the heart and clinical features of heart failure by assessing clinical status and ultrasound of the heart. Prescription myocardial infarction ranged from 2 months to 3 years. Patients were divided into 3 groups. The first group included 50 patients with diastolic dysfunction and symptoms of heart failure (mean age 64,1 ± 1,2 years. In the second group were 31 patients with diastolic dysfunction without heart failure symptoms (mean age 59,5 ± 1,6 years. The third group consisted of 10 patients without diastolic dysfunction and manifestations of heart failure (mean age 57 ± 2,8 years. Results and discussion: 10% patients with postinfarction cardiosclerosis and concomitant hypertension with diastolic heart failure had NYHA

  18. Differentially expressed plasma microRNAs and the potential regulatory function of Let-7b in chronic thromboembolic pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Lijuan Guo

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is a progressive disease characterized by misguided thrombolysis and remodeling of pulmonary arteries. MicroRNAs are small non-coding RNAs involved in multiple cell processes and functions. During CTEPH, circulating microRNA profile endued with characteristics of diseased cells could be identified as a biomarker, and might help in recognition of pathogenesis. Thus, in this study, we compared the differentially expressed microRNAs in plasma of CTEPH patients and healthy controls and investigated their potential functions. Microarray was used to identify microRNA expression profile and qRT-PCR for validation. The targets of differentially expressed microRNAs were identified in silico, and the Gene Ontology database and Kyoto Encyclopedia of Genes and Genomes pathway database were used for functional investigation of target gene profile. Targets of let-7b were validated by fluorescence reporter assay. Protein expression of target genes was determined by ELISA or western blotting. Cell migration was evaluated by wound healing assay. The results showed that 1 thirty five microRNAs were differentially expressed in CTEPH patients, among which, a signature of 17 microRNAs, which was shown to be related to the disease pathogenesis by in silico analysis, gave diagnostic efficacy of both sensitivity and specificity >0.9. 2 Let-7b, one of the down-regulated anti-oncogenic microRNAs in the signature, was validated to decrease to about 0.25 fold in CTEPH patients. 3 ET-1 and TGFBR1 were direct targets of let-7b. Altering let-7b level influenced ET-1 and TGFBR1 expression in pulmonary arterial endothelial cells (PAECs as well as the migration of PAECs and pulmonary arterial smooth muscle cells (PASMCs. These results suggested that CTEPH patients had aberrant microRNA signature which might provide some clue for pathogenesis study and biomarker screening. Reduced let-7b might be involved in the pathogenesis of

  19. Differentially Expressed Plasma MicroRNAs and the Potential Regulatory Function of Let-7b in Chronic Thromboembolic Pulmonary Hypertension

    Science.gov (United States)

    Guo, Lijuan; Yang, Yuanhua; Liu, Jie; Wang, Lei; Li, Jifeng; Wang, Ying; Liu, Yan; Gu, Song; Gan, Huili; Cai, Jun; Yuan, Jason X.-J.; Wang, Jun; Wang, Chen

    2014-01-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease characterized by misguided thrombolysis and remodeling of pulmonary arteries. MicroRNAs are small non-coding RNAs involved in multiple cell processes and functions. During CTEPH, circulating microRNA profile endued with characteristics of diseased cells could be identified as a biomarker, and might help in recognition of pathogenesis. Thus, in this study, we compared the differentially expressed microRNAs in plasma of CTEPH patients and healthy controls and investigated their potential functions. Microarray was used to identify microRNA expression profile and qRT-PCR for validation. The targets of differentially expressed microRNAs were identified in silico, and the Gene Ontology database and Kyoto Encyclopedia of Genes and Genomes pathway database were used for functional investigation of target gene profile. Targets of let-7b were validated by fluorescence reporter assay. Protein expression of target genes was determined by ELISA or western blotting. Cell migration was evaluated by wound healing assay. The results showed that 1) thirty five microRNAs were differentially expressed in CTEPH patients, among which, a signature of 17 microRNAs, which was shown to be related to the disease pathogenesis by in silico analysis, gave diagnostic efficacy of both sensitivity and specificity >0.9. 2) Let-7b, one of the down-regulated anti-oncogenic microRNAs in the signature, was validated to decrease to about 0.25 fold in CTEPH patients. 3) ET-1 and TGFBR1 were direct targets of let-7b. Altering let-7b level influenced ET-1 and TGFBR1 expression in pulmonary arterial endothelial cells (PAECs) as well as the migration of PAECs and pulmonary arterial smooth muscle cells (PASMCs). These results suggested that CTEPH patients had aberrant microRNA signature which might provide some clue for pathogenesis study and biomarker screening. Reduced let-7b might be involved in the pathogenesis of CTEPH by

  20. The effects of acebutolol and atenolol on renal function in patients with chronic renal failure and hypertension

    International Nuclear Information System (INIS)

    Lustig, A.

    1985-03-01

    The present study determined the effects of chronic administration of acebutolol and atenolol on renal function 22 patients suffering from chronic renal failure (mean GFR of 33.7 +- 4.0 ml/min) and hypertension. Renal function and systemic haemodynamics were measured after 2 weeks of placebo treatment, after 6 weeks of oral acebutolol therapy (200 - 400 mg/day) and after 6 weeks of atenolol therapy (50 - 100 mg/day). The GFR assessed by 51 Cr EDTA clearance fell by 9.4 +- 7.4% on acebutolol therapy and 7.9 +- 7.0% on atenolol therapy. The renal blood flow assessed by 131 I-Hippuran clearance increased by 18.1 +- 6.1% on atenolol (P 0.05). Blood urea rose significantly on both agents. Both agents were found to be effective in reducing the mean arterial pressure in the supine or in the standing positions. No significant differences were found regarding their effects on renal function. Atenolol was more effective than acebutolol in reducing the heart rate. Plasma drug levels were measured. The combined levels of acebutolol and diacetolol were in the recommended therapeutic window (0.2 - 2.0 μg/ml) in 16 patients receiving acebutolol and in excess of this in 5 patients. Atenolol levels were in the recommended therapeutic window (0.1 - 1.0 μg/ml) in 10 patients and in excess of this in 10 patients. The alterations in the various parameters induced by the beta blockers in patients with GFR of less than 30 ml/min were similar to those induced in the patients who had GFR of over 30 ml/min. In conclusion: despite effective drop of blood pressure and heart rate induced by acebutolol and atenolol, these agents did not reduce the RBF and the fall in GFR noted was small magnitude and of no clinical significance. These two beta blockers may be used in patients with CRF provided caution is exercised and renal function is monitored regularly

  1. Secondary hypertension in adults.

    Science.gov (United States)

    Puar, Troy Hai Kiat; Mok, Yingjuan; Debajyoti, Roy; Khoo, Joan; How, Choon How; Ng, Alvin Kok Heong

    2016-05-01

    Secondary hypertension occurs in a significant proportion of adult patients (~10%). In young patients, renal causes (glomerulonephritis) and coarctation of the aorta should be considered. In older patients, primary aldosteronism, obstructive sleep apnoea and renal artery stenosis are more prevalent than previously thought. Primary aldosteronism can be screened by taking morning aldosterone and renin levels, and should be considered in patients with severe, resistant or hypokalaemia-associated hypertension. Symptoms of obstructive sleep apnoea should be sought. Worsening of renal function after starting an angiotensin-converting enzyme inhibitor suggests the possibility of renal artery stenosis. Recognition, diagnosis and treatment of secondary causes of hypertension lead to good clinical outcomes and the possible reversal of end-organ damage, in addition to blood pressure control. As most patients with hypertension are managed at the primary care level, it is important for primary care physicians to recognise these conditions and refer patients appropriately. Copyright: © Singapore Medical Association.

  2. Aortic Blood Flow Reversal Determines Renal Function: Potential Explanation for Renal Dysfunction Caused by Aortic Stiffening in Hypertension.

    Science.gov (United States)

    Hashimoto, Junichiro; Ito, Sadayoshi

    2015-07-01

    Aortic stiffness determines the glomerular filtration rate (GFR) and predicts the progressive decline of the GFR. However, the underlying pathophysiological mechanism remains obscure. Recent evidence has shown a close link between aortic stiffness and the bidirectional (systolic forward and early diastolic reverse) flow characteristics. We hypothesized that the aortic stiffening-induced renal dysfunction is attributable to altered central flow dynamics. In 222 patients with hypertension, Doppler velocity waveforms were recorded at the proximal descending aorta to calculate the reverse/forward flow ratio. Tonometric waveforms were recorded to measure the carotid-femoral (aortic) and carotid-radial (peripheral) pulse wave velocities, to estimate the aortic pressure from the radial waveforms, and to compute the aortic characteristic impedance. In addition, renal hemodynamics was evaluated by duplex ultrasound. The estimated GFR was inversely correlated with the aortic pulse wave velocity, reverse/forward flow ratio, pulse pressure, and characteristic impedance, whereas it was not correlated with the peripheral pulse wave velocity or mean arterial pressure. The association between aortic pulse wave velocity and estimated GFR was independent of age, diabetes mellitus, hypercholesterolemia, and antihypertensive medication. However, further adjustment for the aortic reverse/forward flow ratio and pulse pressure substantially weakened this association, and instead, the reverse/forward flow ratio emerged as the strongest determinant of estimated GFR (P=0.001). A higher aortic reverse/forward flow ratio was also associated with lower intrarenal forward flow velocities. These results suggest that an increase in aortic flow reversal (ie, retrograde flow from the descending thoracic aorta toward the aortic arch), caused by aortic stiffening and impedance mismatch, reduces antegrade flow into the kidney and thereby deteriorates renal function. © 2015 American Heart Association

  3. Hypertension hos gravide

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

  4. Effects of acute volume loading on kidney function in patients with essential hypertension, as estimated by the lithium clearance method

    DEFF Research Database (Denmark)

    Holstein-Rathlou, N H; Svendsen, U G; Leyssac, P P

    1985-01-01

    This study investigated the mechanism underlying the exaggerated natriuresis seen in patients with essential hypertension. The study used the lithium clearance method, which permits accurate determination of both proximal and distal sodium reabsorption in man. One litre of isotonic sodium chlorid...... the normal response to sodium loading being reset to a lower level. This resetting may be a secondary consequence of the high blood pressure, since lowering the pressure abolishes the phenomenon.......This study investigated the mechanism underlying the exaggerated natriuresis seen in patients with essential hypertension. The study used the lithium clearance method, which permits accurate determination of both proximal and distal sodium reabsorption in man. One litre of isotonic sodium chloride......, intravenously (i.v.), produced a significant increase in sodium excretion in patients with essential hypertension, both during and after the infusion. This increase in sodium excretion was accompanied by a significant increase in the clearance of lithium, indicating an increased output of isotonic fluid from...

  5. Iterative study of renal functions by the continuous perfusion of radioactive tracers before and after the initiation of treatment for diabetes mellitus and hypertension

    International Nuclear Information System (INIS)

    Mirouze, J.; Monnier, L.; Olivier, C.

    1975-01-01

    Glomerular filtration and renal plasma flux are measured simultaneously as a result of achieving isotopic equilibrium after the continuous perfusion of 125 I-iothalamate and 131 I-orthoiodohippurate. A good correlation is found between the clearances of 125 I-iothalamate (y) and of inulin or polyfructosan (x): y = 1.18 x + 8.43 (r 0.96; P 131 I-orthoiodohippurate (y') and para-aminohippuric acid (x'): y' = 0.62 x' + 21.2 (r = 0.93; P < 0.001). When the renal function is modified, the iothalamate is not suitable for this technique since the time necessary to reach a radioactive concentration plateau exceeds three hours. Orthoiodohippurate, on the contrary, yields good results. The main advantages of the method in this case are absence of urine collection and rapid achievement of isotopic equilibrium. The repeated study of the renal function of hypertensive patients and of diabetics makes it possible to investigate the effects of anti-hypertension drugs and insulin therapy. Since clonidin improves the clearances slightly, it may be considered for administration in cases of hypertension associated with chronic renal inadequacy. Insulin therapy very rapidly increases the glomerular filtration and renal plasma flux of diabetics by insulin extraction. This improvement depends more on metabolic and haemodynamic changes caused by the insulin than on the correction of disorders affecting the permeability of the basal glomerular membrane

  6. Urinary type IV collagen is related to left ventricular diastolic function and brain natriuretic peptide in hypertensive patients with prediabetes.

    Science.gov (United States)

    Iida, Masato; Yamamoto, Mitsuru; Ishiguro, Yuko S; Yamazaki, Masatoshi; Ueda, Norihiro; Honjo, Haruo; Kamiya, Kaichirou

    2014-01-01

    Urinary type IV collagen is an early biomarker of diabetic nephropathy. Concomitant prediabetes (the early stage of diabetes) was associated with left ventricular (LV) diastolic dysfunction and increased brain natriuretic peptide (BNP) in hypertensive patients. We hypothesized that urinary type IV collagen may be related to these cardiac dysfunctions. We studied hypertensive patients with early prediabetes (HbA1c 110, n=18), those with prediabetes (HbA1c 5.7-6.4, n=98), and those with diabetes (HbA1c>6.5 or on diabetes medications, n=92). The participants underwent echocardiography to assess left atrial volume/body surface area (BSA) and the ratio of early mitral flow velocity to mitral annular velocity (E/e'). Left ventricular diastolic dysfunction (LVDD) was defined if patients had E/e'≥15, or E/e'=9-14 accompanied by left atrial volume/BSA≥32ml/mm(2). Urinary samples were collected for type IV collagen and albumin, and blood samples were taken for BNP and HbA1c. Urinary type IV collagen and albumin increased in parallel with the deterioration of glycemic status. In hypertensive patients with prediabetes, subjects with LVDD had higher levels of BNP and urinary type IV collagen than those without LVDD. In contrast, in hypertensive patients with diabetes, subjects with LVDD had higher urinary albumin and BNP than those without LVDD. Urinary type IV collagen correlated positively with BNP in hypertensive patients with prediabetes, whereas it correlated with HbA1c in those with diabetes. In hypertensive patients with prediabetes, urinary type IV collagen was associated with LV diastolic dysfunction and BNP. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. DYNAMICS OF STRUCTURAL AND FUNCTIONAL STATUS OF MYOCARDIUM DUE TO COMBINATION THERAPY WITH AMLODIPINE AND BISOPROLOL IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    I. L. Zapesochnaya

    2015-09-01

    Full Text Available Aim. To evaluate the effect of 6-month therapy with combination of amlodipine and bisoprolol on the structural and functional status of the myocardium in hypertensive patients who work in the Far North.Material and methods. 140 hypertensive patients who live in the Khanty-Mansiysk Autonomous District - Yugra were divided into two groups depending on arrangement of working time. The first group included 72 patients who work only day shift; the second group – 68 patients who work alternate (day/night shifts. Combination therapy with amlodipine and bisoprolol assigned to all patients. Echocardiography was performed at baseline, after 12 weeks, and after 6 months of therapy.Results. The target blood pressure (BP level in group 1 was achieved in 92.9%. A share of patients with normal left ventricular (LV geometry increased from 37.5 to 44.8%; a share of patients with concentric and eccentric LV hypertrophy (LVH decreased from 30.6 to 23.9% and 19.4 to 19.2%, respectively. Target BP level in group 2 was achieved in 87.9%. A share of patients with normal LV geometry increased from 23.5 to 33.3%; while share of patients with concentric and eccentric LVH decreased from 45.6 to 38.1% and from 19.1 to 17.4%, respectively. A positive correlation between LV myocardial index and average daily systolic and diastolic BP was found.Conclusion. Revealed changes in BP and in LV structure and function due to treatment with amlodipine and bisoprolol can be considered as cardioprotective effect of this combination in hypertensive patients who work in the Far North. This effect was more pronounced in hypertensive patients working alternate (day/night shifts.

  8. DYNAMICS OF STRUCTURAL AND FUNCTIONAL STATUS OF MYOCARDIUM DUE TO COMBINATION THERAPY WITH AMLODIPINE AND BISOPROLOL IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    I. L. Zapesochnaya

    2014-01-01

    Full Text Available Aim. To evaluate the effect of 6-month therapy with combination of amlodipine and bisoprolol on the structural and functional status of the myocardium in hypertensive patients who work in the Far North.Material and methods. 140 hypertensive patients who live in the Khanty-Mansiysk Autonomous District - Yugra were divided into two groups depending on arrangement of working time. The first group included 72 patients who work only day shift; the second group – 68 patients who work alternate (day/night shifts. Combination therapy with amlodipine and bisoprolol assigned to all patients. Echocardiography was performed at baseline, after 12 weeks, and after 6 months of therapy.Results. The target blood pressure (BP level in group 1 was achieved in 92.9%. A share of patients with normal left ventricular (LV geometry increased from 37.5 to 44.8%; a share of patients with concentric and eccentric LV hypertrophy (LVH decreased from 30.6 to 23.9% and 19.4 to 19.2%, respectively. Target BP level in group 2 was achieved in 87.9%. A share of patients with normal LV geometry increased from 23.5 to 33.3%; while share of patients with concentric and eccentric LVH decreased from 45.6 to 38.1% and from 19.1 to 17.4%, respectively. A positive correlation between LV myocardial index and average daily systolic and diastolic BP was found.Conclusion. Revealed changes in BP and in LV structure and function due to treatment with amlodipine and bisoprolol can be considered as cardioprotective effect of this combination in hypertensive patients who work in the Far North. This effect was more pronounced in hypertensive patients working alternate (day/night shifts.

  9. Biology of portal hypertension.

    Science.gov (United States)

    McConnell, Matthew; Iwakiri, Yasuko

    2018-02-01

    Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized. As a secondary event, portal hypertension results in splanchnic and systemic arterial vasodilation, leading to the development of a hyperdynamic circulatory syndrome and subsequently to clinically devastating complications including gastroesophageal varices and variceal hemorrhage, hepatic encephalopathy from the formation of portosystemic shunts, ascites, and renal failure due to the hepatorenal syndrome. This review article discusses: (1) mechanisms of sinusoidal portal hypertension, focusing on HSC and LSEC biology, pathological angiogenesis, and the role of microvascular thrombosis and platelets, (2) the mesenteric vasculature in portal hypertension, and (3) future directions for vascular biology research in portal hypertension.

  10. Pulmonary hypertension in older adults.

    Science.gov (United States)

    McArdle, John R; Trow, Terence K; Lerz, Kathryn

    2007-12-01

    Pulmonary hypertension is a frequently encountered problem in older patients. True idiopathic pulmonary arterial hypertension can also be seen and requires careful exclusion in older patients. Institution of therapies must be tempered with an appreciation of individual comorbidities and functional limitations that may affect patients' ability to comply and benefit from the complex treatments available for pulmonary arterial hypertension. This article reviews the existing data on the various forms of pulmonary hypertension presenting in older patients and on appropriate therapy in this challenging population.

  11. Late evaluation of the relationship between morphological and functional renal changes and hypertension after non-operative treatment of high-grade renal injuries

    Directory of Open Access Journals (Sweden)

    Pereira Júnior Gerson

    2012-08-01

    Full Text Available Abstract Objective To evaluate the anatomical and functional renal alterations and the association with post-traumatic arterial hypertension. Methods The studied population included patients who sustained high grades renal injury (grades III to V successfully non-operative management after staging by computed tomography over a 16-year period. Beyond the review of medical records, these patients were invited to the following protocol: clinical and laboratory evaluation, abdominal computed tomography, magnetic resonance angiography, DMSA renal scintigraphy, and ambulatory blood pressure monitoring. The hypertensive patients also were submitted to dynamic renal scintigraphy (99mTc EC, using captopril stimulation to verify renal vascular etiology. Results Of the 31 patients, there were thirteen grade III, sixteen grade IV (nine lacerations, and seven vascular lesions, and two grade V injuries. All the patients were asymptomatic and an average follow up post-injury of 6.4 years. None had abnormal BUN or seric creatinine. The percentage of renal volume reduction correlates with the severity as defined by OIS. There was no evidence of renal artery stenosis in Magnetic Resonance angiography (MRA. DMSA scanning demonstrated a decline in percentage of total renal function corresponding to injury severity (42.2 ± 5.5% for grade III, 35.3 ± 12.8% for grade IV, 13.5 ± 19.1 for grade V. Six patients (19.4% had severe compromised function ( Conclusions Late results of renal function after conservative treatment of high grades renal injuries are favorable, except for patients with grades IV with vascular injuries and grade V renal injuries. Moreover, arterial hypertension does not correlate with the grade of renal injury or reduction of renal function.

  12. Association of left ventricular longitudinal and circumferential systolic dysfunction with diastolic function in hypertension: a nonlinear analysis focused on the interplay with left ventricular geometry.

    Science.gov (United States)

    Ballo, Piercarlo; Nistri, Stefano; Cameli, Matteo; Papesso, Barbara; Dini, Frank Lloyd; Galderisi, Maurizio; Zuppiroli, Alfredo; Mondillo, Sergio

    2014-02-01

    The relationships of left ventricular (LV) longitudinal and circumferential systolic dysfunction with diastolic performance in hypertensive patients have never been compared. In 532 asymptomatic hypertensive patients, circumferential function was assessed with the use of midwall fractional shortening (mFS) and stress-corrected mFS (SCmFS), whereas longitudinal function was assessed with the use of left atrioventricular plane displacement (AVPD) and systolic mitral annulus velocity (s'). Early diastolic annular velocity (e') and the E/e' ratio were measured. Global longitudinal and circumferential strain were determined in a subset of 210 patients. e' was linearly related to all systolic indexes (AVPD: R = 0.40; s': R = 0.39; mFS: R = 0.16; SCmFS: R = 0.17; all P SCmFS. Longitudinal indexes were superior to circumferential ones in predicting e' <8 cm/s, E/e' <8, and E/e' ≥13. The effect of LV geometry on LV diastolic function was evident among patients with preserved systolic longitudinal function, but was blunted among patients with impaired longitudinal function. In multivariable analyses, only longitudinal indexes remained associated with e' and E/e'. Analyses using strains provided similar results. In asymptomatic hypertensive subjects, LV diastolic performance is independently associated with longitudinal systolic dysfunction, but not with circumferential systolic dysfunction. Subtle longitudinal systolic impairment plays a role in mediating the effect of LV geometry on diastolic performance. These findings may support the need of critically revising the concept of isolated diastolic dysfunction in these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. The benefits of endurance training in cardiomyocyte function in hypertensive rats are reversed within four weeks of detraining.

    Science.gov (United States)

    Carneiro-Júnior, Miguel Araujo; Quintão-Júnior, Judson Fonseca; Drummond, Lucas Rios; Lavorato, Victor Neiva; Drummond, Filipe Rios; da Cunha, Daise Nunes Queiroz; Amadeu, Marco Aurélio; Felix, Leonardo Bonato; de Oliveira, Edilamar Menezes; Cruz, Jader Santos; Prímola-Gomes, Thales Nicolau; Mill, José Geraldo; Natali, Antonio José

    2013-04-01

    The aim of the present study was to verify the effects of low-intensity endurance training and detraining on the mechanical and molecular properties of cardiomyocytes from spontaneously hypertensive rats (SHRs). Male SHRs and normotensive control Wistar rats at 16-weeks of age were randomly divided into eight groups of eight animals: NC8 and HC8 (normotensive and hypertensive control for 8weeks); NT8 and HT8 (normotensive and hypertensive trained at 50-60% of maximal exercise capacity for 8weeks); NC12 and HC12 (normotensive and hypertensive control for 12weeks); NDT and HDT (normotensive and hypertensive trained for 8weeks and detrained for 4weeks). The total exercise time until fatigue (TTF) was determined by a maximal exercise capacity test. Resting heart rate (RHR) and systolic arterial pressure (SAP) were measured. After the treatments, animals were killed by cervical dislocation and left ventricular myocytes were isolated by enzymatic dispersion. Isolated cells were used to determine intracellular global Ca(2+) ([Ca(2+)]i) transient and cardiomyocyte contractility (1Hz; ~25°C). [Ca(2+)]i regulatory proteins were measured by Western blot, and the markers of pathologic cardiac hypertrophy by quantitative real-time polymerase chain reaction (q-RT-PCR). Exercise training augmented the TTF (NC8, 11.4±1.5min vs. NT8, 22.5±1.4min; HC8, 11.7±1.4min vs. HT8, 24.5±1.3min; Pendurance training induces positive benefits to left ventricular myocyte mechanical and molecular properties, which are reversed within 4weeks of detraining. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  15. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice. Udgivelsesdato: 2009-Jun-15...

  16. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice Udgivelsesdato: 2009/6/15...

  17. Echocardiography in Arterial Hypertension.

    Science.gov (United States)

    de Simone, Giovanni; Mancusi, Costantino; Esposito, Roberta; De Luca, Nicola; Galderisi, Maurizio

    2018-05-02

    Hypertension is a condition characterized by pressure and/or volume overloads and echocardiography is helpful and feasible to understand hemodynamic mechanisms. Echocardiographic information is sometimes critical and susceptible of modifying decision making. In this review, we provide detailed descriptions of the parameters that can be derived from a standard transthoracic echocardiogram, including some more recent techniques. We will also explain how each parameter might have impact in the evaluation of the hypertensive patient and give indications on when to refer patients to echo-labs, which parameters are critical and which ones might be redundant, and how to use the information obtained in the report. Cardiac geometry, LV systolic and diastolic function, LV pump performance, output impedance and left atrial function are parameters that might be altered in arterial hypertension, but not necessarily doctors need the whole information for decision making. The critical measures are provided.

  18. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  19. The effect of milrinone on right and left ventricular function when used as a rescue therapy for term infants with pulmonary hypertension.

    Science.gov (United States)

    James, Adam T; Corcoran, John D; McNamara, Patrick J; Franklin, Orla; El-Khuffash, Afif F

    2016-01-01

    Milrinone may be an appropriate adjuvant therapy for infants with persistent pulmonary hypertension of the newborn. We aimed to describe the effect of milrinone administration on right and left ventricular function in infants with persistent pulmonary hypertension not responding to inhaled nitric oxide after 4 hours of administration. This is a retrospective review of infants born after or at 34 weeks of gestation with persistent pulmonary hypertension who received milrinone treatment. The primary endpoint was the effect of milrinone on myocardial performance and haemodynamics, including right and left ventricular outputs, tissue Doppler velocities, right ventricle and septal strain, and strain rate. Secondary endpoints examined included duration of inhaled nitric oxide and oxygen support. A total of 17 infants with a mean (standard deviation) gestation and birth weight of 39.8 (2.0) weeks and 3.45 (0.39) kilograms, respectively, were included in the study. The first echocardiogram was performed 15 hours after the commencement of nitric oxide inhalation. Milrinone treatment was started at a median time of 1 hour after the echocardiogram and was associated with an increase in left ventricular output (p=0.04), right ventricular output (p=0.004), right ventricle strain (p=0.01) and strain rate (p=0.002), and left ventricle s` (pmilrinone as an adjunct to nitric oxide is worth further exploration, with preliminary evidence suggesting an improvement in both oxygenation and myocardial performance in this group of infants.

  20. Brief episodes of intracranial hypertension and cerebral hypoperfusion are associated with poor functional outcome after severe traumatic brain injury.

    Science.gov (United States)

    Stein, Deborah M; Hu, Peter F; Brenner, Megan; Sheth, Kevin N; Liu, Keng-Hao; Xiong, Wei; Aarabi, Bizhan; Scalea, Thomas M

    2011-08-01

    Management strategies after severe traumatic brain injury (TBI) target prevention and treatment of intracranial hypertension (ICH) and cerebral hypoperfusion (CH). We have previously established that continuous automated recordings of vital signs (VS) are more highly correlated with outcome than manual end-hour recordings. One potential benefit of automated vital sign data capture is the ability to detect brief episodes of ICH and CH. The purpose of this study was to establish whether a relationship exists between brief episodes of ICH and CH and outcome after severe TBI. Patients at the R Adams Cowley Shock Trauma Center were prospectively enrolled over a 2-year period. Inclusion criteria were as follows: age >14 years, admission within the first 6 hours after injury, Glasgow Coma Scale score GOSE). Sixty subjects were enrolled with a mean admission Glasgow Coma Scale score of 6.4 ± 3.1, a mean Head Abbreviated Injury Severity Scale score of 4.2 ± 0.7, and a mean Marshall CT score of 2.5 ± 0.9. Significant differences in the mean number of brief episodes of CPP GOSE 1-4 versus GOSE 5-8 (9.4 vs. 4.7, p = 0.02 and 9.3 vs. 4.9, p = 0.03) were found. There were significantly more mean brief episodes per day of ICP >30 (0.52 vs. 0.29, p = 0.02), CPP GOSE 1-4. Number of brief episodes of CPP <50, CPP <60, BTI <2, and BTI <3 all demonstrated high predictive power for unfavorable functional outcome (area under the curve = 0.65-0.75, p < 0.05). This study demonstrates that the number of brief 5-minute episodes of ICH and CH is predictive of poor outcome after severe TBI. This finding has important implications for management paradigms which are currently targeted to treatment rather than prevention of ICH and CH. This study demonstrates that these brief episodes may play a significant role in outcome after severe TBI.

  1. Resistant hypertension.

    Science.gov (United States)

    Wei, Fang-Fei; Zhang, Zhen-Yu; Huang, Qi-Fang; Yang, Wen-Yi; Staessen, Jan A

    2018-06-15

    The publication of the first non-randomised proof-of-concept trial of renal denervation as a treatment modality in treatment-resistant hypertension set the stage for a search for novel devices with the expectation that technology would reduce the burden of hypertension by reducing or eliminating the costly and lifelong use of blood pressure lowering medications. As we demonstrate in this review, this idea so attractive to manufacturers and invasive cardiologists and radiologists overlooked decades of careful pathophysiological research in a disease, which still remains enigmatic but remains the major cause of cardiovascular mortality worldwide. To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension. Next, we highlighted the key points required for the diagnosis of treatment-resistant hypertension, including the recording of the ambulatory blood pressure and the assessment of adherence to medication. Finally, we summarised new insights in the management of treatment-resistant hypertension by medication and devices and in the future research. Throughout our review, we focused on new evidence became available since 2013. Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.

  2. Effect of Angiotensin-Converting Enzyme Inhibitor/Calcium Antagonist Combination Therapy on Renal Function in Hypertensive Patients With Chronic Kidney Disease: Chikushi Anti-Hypertension Trial - Benidipine and Perindopril.

    Science.gov (United States)

    Okuda, Tetsu; Okamura, Keisuke; Shirai, Kazuyuki; Urata, Hidenori

    2018-02-01

    Appropriate blood pressure control suppresses progression of chronic kidney disease (CKD). If an angiotensin-converting enzyme (ACE) inhibitor is ineffective, adding a calcium antagonist is recommended. We compared the long-term effect of two ACE inhibitor/calcium antagonist combinations on renal function in hypertensive patients with CKD. Patients who failed to achieve the target blood pressure (systolic/diastolic: < 130/80 mm Hg) with perindopril monotherapy were randomized to either combined therapy with perindopril and the L-type calcium antagonist amlodipine (group A) or perindopril and the T/L type calcium antagonist benidipine (group B). The primary endpoint was the change of the estimated glomerular filtration rate (eGFR) after 2 years. Eligible patients had a systolic pressure ≥ 130 mm Hg and/or diastolic pressure ≥ 80 mm Hg and CKD (urine protein (+) or higher, eGFR < 60 min/mL/1.73 m 2 ). After excluding 38 patients achieving the target blood pressure with perindopril monotherapy, 121 patients were analyzed (62 in group A and 59 in group B). Blood pressure decreased significantly in both groups, but there was no significant change of the eGFR. However, among patients with diabetes, eGFR unchanged in group B (n = 37, 59.1 ± 15.1 vs. 61.2 ± 27.9, P = 0.273), whereas decreased significantly in group A (n = 31, 57.3 ± 16.0 vs. 53.7 ± 16.7, P = 0.005). In hypertensive patients with diabetic nephropathy, combined therapy with an ACE inhibitor and T/L type calcium antagonist may prevent deterioration of renal function more effectively than an ACE inhibitor/L type calcium antagonist combination.

  3. Adaptation, allometry, and hypertension.

    Science.gov (United States)

    Weder, A B; Schork, N J

    1994-08-01

    Essential hypertension is a "disease of civilization" but has a clear genetic component. From an evolutionary perspective, persistence in the human genome of elements capable of raising blood pressure presupposes their adaptive significance. Recently, two hypotheses that explicitly appeal to selectionist arguments, the "slavery" and "thrifty gene" theories, have been forwarded. We find neither completely successful, and we advance an alternative explanation of the adaptive importance of genes responsible for hypertension. We propose that blood pressure rises during childhood and adolescence to subserve homeostatic needs of the organism. Specifically, we contend that blood pressure is a flexible element in the repertoire of renal homeostatic mechanisms serving to match renal function to growth. The effect of modern diet and lifestyle on human growth stimulates earlier and more vigorous development, straining biologically necessary relationships between renal and general somatic growth and requiring compensation via homeostatic mechanisms preserved during evolution. Prime among such mechanisms is blood pressure, which rises as a compensation to maintain renal function in the face of greater growth. Since virtually all members of acculturated societies share in the modern lifestyle, the demands imposed by accelerated growth and development result in a populational shift to higher blood pressures, with a consequent increase in the prevalence of hypertension. We propose that hypertension is the product of maladaptation of highly genetically conserved mechanisms subserving important biological homeostatic needs. Elucidation of the mechanisms underlying hypertension will require approaches that examine the developmental processes linking growth to blood pressure.

  4. Assessment value of 3-dimensional speckle tracking imaging for changes of early left ventricular longitudinal systolic function in patients with primary hypertension

    Directory of Open Access Journals (Sweden)

    Jing Yu

    2016-08-01

    Full Text Available Objective: To study the assessment value of 3-dimensional speckle tracking imaging for changes of early left ventricular longitudinal systolic function in patients with primary hypertension. Methods: Patients with primary hypertension who were treated in our hospital from May 2012 to October 2015 were selected, and 40 patients with left ventricular normal (LVN primary hypertension and 40 patients with left ventricular remodeling (LVR primary hypertension were screened according to Ganau typing and enrolled in the LVN group and LVR group of the study respectively; 40 cases of healthy volunteers who received physical examination in our hospital during the same period were selected as control group. Ultrasonic testing was conducted to determine conventional ultrasonic indicators and 3D-STI parameters, and serum was collected to determine AngII, ALD, TGF-β1 and Ang1-7 levels. Results: LVEDd, LVPWT and LVEF of LVN group were not significantly different from those of control group, LVEF of LVR group was not significantly different from those of LVN group and control group, and LVEDd and LVPWT of LVR group were significantly higher than those of LVN group and control group; absolute values of GLS, GCS, GRS and GAS as well as serum Ang1-7 level of LVN group was significantly lower than those of control group, serum AngII, ALD and TGF-β1 levels were higher than those of control group, absolute values of GLS, GCS, GRS and GAS as well as serum Ang1-7 level of LVR group was significantly lower than those of LVN group and control group, and serum AngII, ALD and TGF-β1 levels were higher than those of LVN group and control group; absolute values of GLS, GCS, GRS and GAS were negatively correlated with serum AngII, ALD and TGF-β1 levels, and positively correlated with serum Ang1-7 level. Conclusion: 3-dimensional speckle tracking imaging can be used for early evaluation of left ventricular longitudinal systolic function in patients with primary

  5. Effect of low glomerular filtration rate on evaluating the cardiac function by N-terminal pro-brain natriuretic peptide in patients with hypertension

    International Nuclear Information System (INIS)

    Wang Lili; Li Peiyong; Guan Liang

    2013-01-01

    Objective: To assess the diagnostic accuracy of NT-proBNP in hypertension patients by observing the effect of decreased GFR on N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration in patients with different cardiac function. Methods: Eighty-nine hypertension patients were divided into two groups based on the results of UCG. Forty-three patients had normal left ventricular function and 46 patients had dysfunction. GFR, NT-proBNP and other biochemical markers of cardiac and renal function were measured. The factors affecting the NT-proBNP concentration under normal left ventricular function were analyzed, and the diagnostic value of NT-proBNP affected by normal or decreased GFR (> 80 ml/min or ≤80 ml/min) under different left ventricular functions were further assessed. The two-sample t test, rank sum test and multiple regression analysis were used to analyze their statistical difference and relationship. Results: In patients with normal left ventricular function, GFR (β=-0.361, P<0.05) and left ventricular end-diastolic diameter (LVEDD, β=0.385, P<0.05) were significant factors to NT-proBNP level. They were both meaningful compared with LVEF (β=0.189, P>0.05) and septal thickness (β=0.003, P>0.05). The median concentration of NT-proBNP was 13.18 and 24.14 μg/L in patients with normal left ventricular function and dysfunction, respectively (Z=-3.19, P<0.01). While in patients with decreased GFR, 6 cases with normal left ventricular function and 19 cases with dysfunction had a median concentration of NT-proBNP of 38.45 and 44.20 μg/L, respectively (Z=-0.45, P>0.05). In patients with normal GFR, 37 cases with normal left ventricular function and 27 cases with dysfunction had a median concentration of NT-proBNP of 12.51 and 20.31 μg/L, which was lower than that of patients with decreased GFR (Z=-2.76, both P<0.05). The NT-proBNP concentration had no significant difference between patients of normal left ventricular function with decreased GFR and

  6. Assessment of right ventricular longitudinal strain by 2D speckle tracking imaging compared with RV function and hemodynamics in pulmonary hypertension.

    Science.gov (United States)

    Li, Yidan; Wang, Yidan; Meng, Xiangli; Zhu, Weiwei; Lu, Xiuzhang

    2017-11-01

    The right ventricular longitudinal strain (RVLS) of pulmonary hypertension (PH) patients and its relationship with RV function parameters measured by echocardiography and hemodynamic parameters measured by right heart catheterization was investigated. According to the WHO functional class (FC), 66 PH patients were divided into FC I/II (group 1) and III/IV (group 2). RV function parameters were measured by echocardiographic examinations. Hemodynamic parameters were obtained by right heart catheterization. Patients in group 2 had higher systolic pulmonary artery pressure (sPAP; P good sensitivity and specificity. Evidence has shown that RVLS measurement can provide the much-needed and reliable information on RV function and hemodynamics. Therefore, this qualifies as a patient-friendly approach for the clinical management of PH patients.

  7. Aberrant Splicing Induced by Dysregulated Rbfox2 Produces Enhanced Function of CaV1.2 Calcium Channel and Vascular Myogenic Tone in Hypertension.

    Science.gov (United States)

    Zhou, Yingying; Fan, Jia; Zhu, Huayuan; Ji, Li; Fan, Wenyong; Kapoor, Isha; Wang, Yue; Wang, Yuan; Zhu, Guoqing; Wang, Juejin

    2017-12-01

    Calcium influx from activated voltage-gated calcium channel Ca V 1.2 in vascular smooth muscle cells is indispensable for maintaining myogenic tone and blood pressure. The function of Ca V 1.2 channel can be optimized by alternative splicing, one of post-transcriptional modification mechanisms. The splicing factor Rbfox2 is known to regulate the Ca V 1.2 pre-mRNA alternative splicing events during neuronal development. However, Rbfox2's roles in modulating the key function of vascular Ca V 1.2 channel and in the pathogenesis of hypertension remain elusive. Here, we report that the proportion of Ca V 1.2 channels with alternative exon 9* is increased by 10.3%, whereas that with alternative exon 33 is decreased by 10.5% in hypertensive arteries. Surprisingly, the expression level of Rbfox2 is increased ≈3-folds, presumably because of the upregulation of a dominant-negative isoform of Rbfox2. In vascular smooth muscle cells, we find that knockdown of Rbfox2 dynamically increases alternative exon 9*, whereas decreases exon 33 inclusion of Ca V 1.2 channels. By patch-clamp studies, we show that diminished Rbfox2-induced alternative splicing shifts the steady-state activation and inactivation curves of vascular Ca V 1.2 calcium channel to hyperpolarization, which makes the window current potential to more negative. Moreover, siRNA-mediated knockdown of Rbfox2 increases the pressure-induced vascular myogenic tone of rat mesenteric artery. Taken together, our data indicate that Rbfox2 modulates the functions of vascular Ca V 1.2 calcium channel by dynamically regulating the expressions of alternative exons 9* and 33, which in turn affects the vascular myogenic tone. Therefore, our work suggests a key role for Rbfox2 in hypertension, which provides a rational basis for designing antihypertensive therapies. © 2017 American Heart Association, Inc.

  8. Development of chronic heart failure in a young woman with hypertension associated with renal artery stenosis with preserved renal function

    DEFF Research Database (Denmark)

    Byrne, Christina; Abdulla, Jawdat

    2014-01-01

    A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular fil......A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated......-glomerular filtration rate as well as urine test for protein were all normal. The patient had no peripheral oedema. The transthoracic echocardiography confirmed systolic and diastolic dysfunction and an ejection fraction of 25% and left ventricular hypertrophy. Ultrasound of renal arteries and renal CT angiography...... (renal CTA) revealed a significant stenosis and an aneurysm corresponding to the right renal artery with challenges to traditional interventions....

  9. Mutant Wars2 gene in spontaneously hypertensive rats impairs brown adipose tissue function and predisposes to visceral obesity

    Czech Academy of Sciences Publication Activity Database

    Pravenec, Michal; Zídek, Václav; Landa, Vladimír; Mlejnek, Petr; Šilhavý, Jan; Šimáková, Miroslava; Trnovská, J.; Škop, V.; Marková, I.; Malínská, H.; Hüttl, M.; Kazdová, L.; Bardová, Kristina; Tauchmannová, Kateřina; Vrbacký, Marek; Nůsková, Hana; Mráček, Tomáš; Kopecký, Jan; Houštěk, Josef

    2017-01-01

    Roč. 66, č. 6 (2017), s. 917-924 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA13-04420S Institutional support: RVO:67985823 Keywords : brown adipose tissue * spontaneously hypertensive rat * quantitative trait loci * transgenic * Wars2 gene * mitochondrial proteosynthesis Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Endocrinology and metabolism (including diabetes, hormones) Impact factor: 1.461, year: 2016

  10. Functional magnetic resonance imaging of the truncus pulmonalis. Principles of magnetic resonance flux measurements for pulmonal hypertension diagnostics

    International Nuclear Information System (INIS)

    Abolmaali, N.

    2006-01-01

    This book gives a detailed introduction into the use of magnetic resonance flux measurements for the examination of pulmonal circulation. It presents the results of phantom experiments and evaluates and verifies sequence techniques optimised for the examination of the pulmonary circulation. This is followed by a description of an elegant experimental design for the quantification of pulmonal hypertension which is unique in its kind. The model can predict the consequences of acute, resistance-related pulmonal hypertension in a reproducible and reversible manner. It thus provides a means of evaluating pulmonal applications of magnetic resonance imaging. The idea for these studies and its implementation are an outstanding example of teamwork and interdisciplinary cooperation. Applying the results to the patient after the statistical analysis is only a small step. The book presents the results of extensive normal value studies which will make it possible to use the measurement technology in paediatric cardiology. Its range of application also includes congenital heart defects, especially ventricular septal defects and primary as well as secondary forms of pulmonal hypertension. It is not only suitable for primary diagnostics but also for post-treatment follow-up and assessment of patients' progress

  11. Hemodynamic, biological, and right ventricular functional changes following intraatrial shunt repair in patients with flow-induced pulmonary hypertension.

    Science.gov (United States)

    Hsu, Chih-Hsin; Roan, Jun-Neng; Wang, Jieh-Neng; Huang, Chien-Chi; Shih, Chao-Jung; Chen, Jyh-Hong; Wu, Jing-Ming; Lam, Chen-Fuh

    2017-07-01

    Atrial septal defects may result in pulmonary hypertension and right heart remodeling. We analyzed improvements in patients with flow-induced pulmonary hypertension and the activation of endothelial progenitor cells after flow reduction. This prospective cohort study included 37 patients who were admitted for an occluder implantation. Blood samples were collected before and after the procedure. We determined the number of endothelial progenitor cells in outgrowth colonies and serum Hsp27 concentrations. Daily performance and cardiothoracic ratio were reevaluated later. Closure of the defect significantly reduced the pulmonary pressure and B-type natriuretic peptide levels. The cardiothoracic ratio and daily performance status also improved. The number of endothelial progenitor cell outgrowth colony-forming units significantly increased and was positively correlated with daily performance. In patients with enhanced colony formation, Hsp27 levels were significantly increased. The implantation of an occluder successfully improved hemodynamic, right ventricular, and daily performance. Qualitative enhancement of colony formation for endothelial progenitor cells was also noted and positively correlated with daily performance. Closure of defects may serve as a valid, reliable model to obtain a deeper understanding of the modulation of endothelial progenitor cell activity and its relationship with pulmonary hypertension prognosis. © 2017 Wiley Periodicals, Inc.

  12. The correlation of deceleration capacity of rate with the cardiac function and micro-inflammatory state in patients with both primary hypertension and type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Qing-Rong Zhou

    2017-05-01

    Full Text Available Objective: To study the correlation of deceleration capacity of rate with the cardiac function and micro-inflammatory state in patients with both primary hypertension and type 2 diabetes mellitus. Methods: A total of 60 patients with both primary hypertension and type 2 diabetes mellitus who were treated in our hospital between May 2012 and February 2016 were collected as the observation group, and 50 patients with primary hypertension who were treated in our hospital during the same period were selected as the control group. According to the median of deceleration capacity of rate (DC, the observation group of patients were further divided into high DC group and low DC group (n=30. The 24 h dynamic electrocardiogram of the included patients were obtained to calculate the DC value; color Doppler diasonograph was used to measure the echocardiogram of the two groups, and obtain the left cardiac function indexes and strain rate indexes; enzyme-linked immunosorbent assay (ELISA was used to detect the contents of serum pro-inflammatory factors and anti-inflammatory factors. Results: The DC value of observation group was lower than that of control group; left cardiac function indexes IVSTd, LVIDd and LVIDs levels of low DC group and high DC group were higher than those of control group, strain rate indexes SRs, SRe and Sra levels were lower than those of control group, and serum pro-inflammatory factors CRP, IL-6, IL-18 and PCT contents were higher than those of control group while anti-inflammatory factors IL-10 and IL-13 contents were lower than those of control group; IVSTd, LVIDd and LVIDs levels of low DC group were higher than those of high DC group, SRs, SRe and Sra levels were lower than those of high DC group, and serum CRP, IL-6, IL-18 and PCT contents were higher than those of high DC group while IL-10 and IL-13 contents were lower than those of high DC group. Conclusion: DC value is lower in patients with both primary hypertension and type

  13. Alterations in blood-brain barrier function following acute hypertension: comparison of the blood-to-brain transfer of horseradish peroxidase with that of alpha-aminisobutyric acid

    International Nuclear Information System (INIS)

    Ellison, M.D.B.

    1985-01-01

    The blood-brain barrier (BBB) selectively restricts the blood-to-brain passage of many solutes owing to unique properties of cerebrovascular endothelial cell membranes. To date, experimental study of the BBB has been accomplished primarily through the use of two different methodological approaches. Morphological studies have mostly employed large molecular weight (MW) tracers to detect morphological alterations underlying increased permeability. Physiological studies, employing smaller, more physiologic tracers have successfully described, quantitatively, certain functional aspects of blood-to-brain transfer. The current work attempts to merge these two approaches and to consider barrier function/dysfunction from both a morphological and a functional perspective. Specifically, the study compares in rats, following acute hypertension, the cerebrovascular passage of 14 C-alpha-aminoisobutyric acid (AIB) and that of horseradish peroxidase (HRP). The blood-to-brain passage of AIB and HRP were compared following acute hypertension, with regard to both the distributions of the tracer extravasation patterns and the magnitude of tracer extravasation. The results of this study suggest that traditional morphological barrier studies alone do not reveal all aspects of altered barrier status and that multiple mechanisms underlying increased BBB permeability may operate simultaneously during BBB dysfunction

  14. Relationship between occupational exposure to lead and local arterial stiffness and left ventricular diastolic function in individuals with arterial hypertension

    International Nuclear Information System (INIS)

    Poreba, Rafal; Gac, Pawel; Poreba, Malgorzata; Antonowicz-Juchniewicz, Jolanta; Andrzejak, Ryszard

    2011-01-01

    Relationship between occupational exposure to lead and frequency of complications in persons with arterial hypertension has been poorly investigated. This study aimed at evaluation of the relationship between occupational exposure to lead and manifestation of an increased local arterial stiffness and left ventricular diastolic dysfunction. The studies included 105 men (mean age: 44.47 ± 9.12 years) with arterial hypertension, treated with hypotensive drugs: group I - men occupationally exposed to lead (n = 53), and group II - men not exposed to lead (n = 52). In echocardiographic examination, the left ventricular diastolic dysfunction was diagnosed significantly more frequently in group I than in group II. In eTracking examination mean values of stiffness parameter (β), augmentation index (AI) and one-point pulse wave velocity (PWV-β) were significantly higher and mean values of arterial compliance (AC) were significantly lower in group I than in group II. The logistic regression showed that in the group of persons with arterial hypertension occupationally exposed to lead a more advanced age, higher blood lead concentration and higher mean values of augmentation index represent independent risk factors of left ventricular diastolic dysfunction. The multifactorial regression showed that amongst persons with arterial hypertension occupationally exposed to lead higher blood zinc protoporphyrin concentration, a more advanced age and higher value of body mass index (BMI) represent independent risk factors of an increased local arterial stiffness. In summary, we should note that in the group of persons with arterial hypertension occupationally exposed to lead the study has demonstrated a significantly more frequent manifestation of left ventricular diastolic dysfunction and an increase in local arterial stiffness. - Highlights: → Amongst persons with AH exposed to Pb higher ZnPP represent independent risk factor of increased local arterial stiffness. → Higher Pb

  15. Pregnancy with Portal Hypertension

    Science.gov (United States)

    Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K.

    2014-01-01

    Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

  16. Renovascular hypertension

    International Nuclear Information System (INIS)

    Thomsen, H.S.; Sos, T.A.; Nielsen, S.L.; Koebenhavns Amts Sygehus, Herlev; Cornell Univ., New York

    1989-01-01

    Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

  17. Exercise Hypertension.

    Science.gov (United States)

    Schultz, Martin G; Sharman, James E

    2014-05-01

    Irrespective of apparent 'normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥210 mm Hg in men or ≥190 mm Hg in women or diastolic BP ≥110 mm Hg in men or women), a condition termed exercise hypertension or a 'hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory 'masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

  18. Comparison of effects of valsartan and amlodipine on cognitive functions and auditory p300 event-related potentials in elderly hypertensive patients.

    Science.gov (United States)

    Katada, Eiichi; Uematsu, Norihiko; Takuma, Yuko; Matsukawa, Noriyuki

    2014-01-01

    We compared the antihypertensive effect of valsartan (VAL) and amlodipine (AML) treatments in elderly hypertensive patients by examining the long-term changes in cognitive function and auditory P300 event-related potentials. We enrolled 20 outpatients, including 12 men and 8 women in the age group of 56 to 81 years who had mild to moderate essential hypertension. The subjects were randomly allocated to receive either 80 mg VAL once a day (10 patients) or 5 mg AML once a day (10 patients). Neuropsychological assessment and auditory P300 event-related potentials were obtained before initiation of VAL or AML treatment and after 6 months of the treatment with VAL or AML. Neuropsychological assessment was evaluated by conducting the Mini-Mental State Examination, the verbal fluency, word-list memory, word-list recall test, word-list recognition, and Trails B tests. Both the groups showed significantly reduced-blood pressure after 6 months of treatment, and the intergroup difference was not significant. The mean baseline Mini-Mental State Examination scores of the VAL and AML groups were not significantly different. Amlodipine treatment did not significantly affect any test score, but VAL treatment significantly increased the word-list memory and word-list recall test scores. Valsartan, and not AML, significantly reduced the mean P300 latency after 6 months. These results suggest that VAL exerts a positive effect on cognitive functions, independent of its antihypertensive effect.

  19. Influence of minimally invasive hematoma evacuation combined with nerve growth factor preparation on neurological function injury in patients with hypertensive cerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Jiang Tao

    2017-05-01

    Full Text Available Objective: To study the influence of minimally invasive hematoma evacuation combined with nerve growth factor preparation on neurological function injury in patients with hypertensive cerebral hemorrhage. Methods: A total of 112 patients with hypertensive cerebral hemorrhage who were treated in our hospital between July 2013 and February 2016 were collected, and according to random number table, they were divided into the control group (n=56 who underwent minimally invasive hematoma evacuation therapy and the observation group (n=56 who underwent minimally invasive hematoma evacuation combined with nerve growth factor preparation therapy. Serum contents of inflammatory mediators, nerve injury indexes and neurotransmitters were compared between two groups of patients before and after treatment. Results: Before treatment, there were no significant differences in serum contents of inflammatory mediators, nerve injury indexes and neurotransmitters between the two groups. After treatment, serum contents of inflammatory mediators such as CRP, PCT, IL-1β and IL-6 in observation group were lower than those in control group; serum contents of nerve injury indexes such as NSE, S100B, GEAP and MBP were lower than those in control group; serum contents of neurotransmitters such as SP, NPY, Glu and Asp were lower than those in control group while GABA and Gly were higher than those in control group. Conclusion: Minimally invasive hematoma evacuation combined with nerve growth factor preparation can effectively reduce neurological function injury, and has positive clinical significance.

  20. Evaluation of changes in left ventricular structure and function in hypertensive patients with coronary artery disease after PCI using real-time three-dimensional echocardiography.

    Science.gov (United States)

    Meng, Yanhong; Zong, Ling; Zhang, Ziteng; Han, Youdong; Wang, Yanhui

    2018-02-01

    We aimed to evaluate the changes in left ventricular structure and function in hypertensive patients with coronary artery disease before and after percutaneous coronary intervention (PCI) using real-time three-dimensional echocardiography. Two hundred and eighty hypertensive patients with coronary artery disease undergoing PCI and 120 cases who did not receive PCI in our hospital were selected as the subjects of our study. All patients were administered with routine antiplatelet, anticoagulant, lipid-lowering, antihypertensive, dilating coronary artery and other medications. The left ventricular systolic function and systolic synchrony index changes before and after subjects were treated by PCI were analyzed using three-dimensional echocardiography. At 2 days before surgery, there were no significant differences in the left ventricular end-diastolic volume, left ventricular end-systolic volume (LVESV) and ejection fraction (EF) between the two patient groups (P>0.05). At 3 months and 9 months, the two key time points after PCI, the LVESV level in the PCI group was distinctly decreased, while EF was significantly increased (P0.05); however, the parameters of time from the corresponding segment of the myocardium to the minimal systolic volume in patients in the PCI group were significantly reduced at 3 and 9 months after surgery (PPCI accurately and in real-time, which may play a significant role.

  1. Essential hypertension vs. secondary hypertension among children.

    Science.gov (United States)

    Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay; Hashmi, Syed Sharukh; Tyson, John E; Barratt, Michelle S; Hecht, Jacqueline T; Milewicz, Diane M; Boerwinkle, Eric

    2015-01-01

    The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P secondary hypertension. The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Comparison of benazepril and losartan on endothelial function and vascular stiffness in patients with Type 2 diabetes mellitus and hypertension: A randomized controlled trial.

    Science.gov (United States)

    Gismondi, Ronaldo A O C; Oigman, Wille; Bedirian, Ricardo; Pozzobon, Cesar R; Ladeira, Marcia C Boaventura; Neves, Mario F

    2015-12-01

    The purpose of this study was to compare the effects of benazepril and losartan on endothelial function and vascular stiffness, in patients with diabetes mellitus and hypertension. We included hypertensive diabetic patients with an office systolic blood pressure (BP) ⩾ 130 mmHg and/or diastolic BP ⩾ 80 mmHg. Patients were rolled over to amlodipine for 6 weeks, then we performed C-reactive protein assays, BP measurement and vascular tests; next, patients were randomized to benazepril or losartan. The tests were repeated after 12 weeks. We randomized 14 patients to benazepril and 16 to losartan. There were no differences in systolic (139 versus 134 mmHg, p = 0.618) and diastolic (82 versus 80 mmHg, p = 0.950) BP at the end of the study. C-reactive protein values were lower in the benazepril group (0.38 versus 0.42 mg/dl, p = 0.020). There was a slightly higher flow-mediated vasodilation (FMD) response in the benazepril group (45% increase, p = 0.057) than in the losartan group (19% increase, p = 0.132). Both central systolic BP (129 versus 123 mmHg, p = 0.934) and carotid-femoral pulse wave velocity (cfPWV) (8.5 versus 8.5 m/s, p = 0.280) were the same between groups. Hypertensive diabetic patients using benazepril had a greater reduction in C-reactive protein, and a slight improvement in FMD, than those taking losartan. © The Author(s) 2015.

  3. [Influence of Sympathetic Denervation of the Renal Artery on the Level of Arterial Blood Pressure, Cerebral Blood Flow and Cognitive Function In Patients With Resistant Arterial Hypertension].

    Science.gov (United States)

    Efimova, Y N; Lichikaki, A V; Lishmanov, B Y

    2017-07-01

    To study the effect of radiofrequency ablation of renal arteries on regional cerebral blood flow and cognitive function in patients with resistant arterial hypertension (AH). Transcatheter renal denervation (TRD) was performed in 17 patients with resistant AH. Examination before and after TRD included SPECT with mTc-HMPAO, 24-hours blood pressure (BP) monitoring, and comprehensive neuropsychological testing. Fifteen patients without angiographic signs of carotid atherosclerosis, coronary artery disease and AH, neurological and psychiatric disorders were investigated as control group. Compared with control group patients with AH had decreases of regional cerebral blood flow (rCBF) in right (by 13.5%, p=0.00002) and left (by 15.5%, p=0.0006) inferior frontal lobes, in right temporal brain region (by 11.5%, p=0.008); in right and left occipital lobes (by 8.2%, p=0.04). In 6 months after TRD we observed significant improvement of cognitive function, parameters of 24-hour BP monitoring, and rCBF. We also noted definite close interdependence between changes of rCBF, indices of 24-hours BP monitoring, and dynamics of cognitive function. Improvement of long-term verbal memory correlated with increases of rCBF in left superior frontal and right occipital regions while dynamics of mentation and attention correlated positively with augmentation of rCBF in right posterior parietal region. Changes of perfusion in inferior parts of left frontal lobe and in right occipital region correlated with dynamics of index of diurnal diastolic hypertension time (R2=0.64, p=0.001, and R2=0.60, p=0.03, respectively). Our results suggest, that in patients with resistant AH positive effect of TRD on levels of 24-hour mean BP as well as on indices of BP load leads to in augmentation of rCBF and improvement of cognitive function.

  4. Provider perspectives on essential functions for care management in the collaborative treatment of hypertension: the P.A.R.T.N.E.R. framework.

    Science.gov (United States)

    Hussain, Tanvir; Allen, Allyssa; Halbert, Jennifer; Anderson, Cheryl A M; Boonyasai, Romsai Tony; Cooper, Lisa A

    2015-04-01

    Care management has become a widespread strategy for improving chronic illness care. However, primary care provider (PCP) participation in programs has been poor. Because the success of care management relies on provider engagement, understanding provider perspectives is necessary. Our goal was to identify care management functions most valuable to PCPs in hypertension treatment. Six focus groups were conducted to discuss current challenges in hypertension care and identify specific functions of care management that would improve care. The study included 39 PCPs (participation rate: 83 %) representing six clinics, two of which care for large African American populations and four that are in underserved locations, in the greater Baltimore metropolitan area. This was a qualitative analysis of focus groups, using grounded theory and iterative coding. Providers desired achieving blood pressure control more rapidly. Collaborating with care managers who obtain ongoing patient data would allow treatment plans to be tailored to the changing life conditions of patients. The P.A.R.T.N.E.R. framework summarizes the care management functions that providers reported were necessary for effective collaboration: Partner with patients, providers, and the community; Arrange follow-up care; Resolve barriers to adherence; Track treatment response and progress; Navigate the health care system with patients; Educate patients & Engage patients in self-management; Relay information between patients and/or provider(s). The P.A.R.T.N.E.R. framework is the first to offer a checklist of care management functions that may promote successful collaboration with PCPs. Future research should examine the validity of this framework in various settings and for diverse patient populations affected by chronic diseases.

  5. Comparison of sodium, potassium, calcium, magnesium, zinc, copper and iron concentrations of elements in 24-h urine and spot urine in hypertensive patients with healthy renal function.

    Science.gov (United States)

    Zhang, Tianjing; Chang, Xiaoyu; Liu, Wanlu; Li, Xiaoxia; Wang, Faxuan; Huang, Liping; Liao, Sha; Liu, Xiuying; Zhang, Yuhong; Zhao, Yi

    2017-12-01

    Sodium, potassium, calcium, magnesium, zinc, copper and iron are associated with the sequela of hypertension. The most reliable method for testing those elements is by collecting 24-h urine samples. However, this is cumbersome and collection of spot urine is more convenient in some circumstance. The aim of this study was to compare the concentrations of different elements in 24-h urine and spot urine. Data was collected from a sub-study of China Salt Substitute and Stroke Study. 240 participants were recruited randomly from 12 villages in two counties in Ningxia, China. Both spot and 24-h urine specimens were collected from each patient. Routine urine test was conducted, and concentration of elements was measured using microwave digestion and Inductively Coupled Plasma-Optical Emission Spectrometry. Partial correlation analysis and Spearman correlation analysis were used to investigate the concentration of different elements and the relationship between 24- h urine and spot urine. A partial correlation in sodium, potassium, calcium, magnesium and iron was found between paired 24-h urine and spot urine samples except copper and zinc: 0.430, 0.426, 0.550, 0.221 and 0.191 respectively. Spot urine can replace 24-h urine for estimating some of the elements in hypertensive patients with normal renal function. Copyright © 2017 Elsevier GmbH. All rights reserved.

  6. α2-Adrenergic modulation of the glutamate receptor and transporter function in a chronic ocular hypertension model.

    Science.gov (United States)

    Jung, Kyoung In; Kim, Jie Hyun; Park, Chan Kee

    2015-10-15

    Excitotoxicity, glutamate-induced toxic effects to retinal ganglion cells (RGCs), is one of several mechanisms of RGC loss suggested in glaucoma. In this study, we focused on the role of glutamate transporter of glial cells as well as N-methyl-d-aspartate (NMDA) receptor with regard to glutamate toxicity in glaucoma. We also investigated whether α2-adrenoceptor activation could modulate glutamate transporters and NMDA receptors in a chronic ocular hypertension model. Brimonidine 0.15% was administered topically to the eyes of experimental glaucoma and control animals twice daily. After 8 weeks of intraocular pressure (IOP) elevation, staining with terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) revealed an increase in the ganglion cell layer, and the number of TUNEL-positive cells was reduced by brimonidine treatment (P<0.05). Animals with experimentally induced glaucoma exhibited an increase in retinal stress marker glial fibrillary acidic protein (GFAP) immunoreactivity; brimonidine treatment reduced GFAP. Excitatory amino acid transporter 1(EAAT1) expression remained stable throughout the period of chronic ocular hypertension. α2-Adrenergic treatment upregulated EAAT1 protein levels (P<0.05). NMDA receptor (GluN1) expression was stimulated by chronic elevation of IOP, and GluN1-positive cells in ganglion cell layer were co-localized with TUNEL staining. Brimonidine administration suppressed GluN1 levels (P<0.05). These results indicate that brimonidine decreased RGC apoptosis, upregulating EAAT1 and downregulating NMDA receptors. We suggest that topical brimonidine treatment may decrease the glutamate excitotoxicity through modulation of glutamate transporter and NMDA receptor in glaucoma. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Hypertension Subtypes among Hypertensive Patients in Ibadan

    OpenAIRE

    Abiodun M. Adeoye; Adewole Adebiyi; Bamidele O. Tayo; Babatunde L. Salako; Adesola Ogunniyi; Richard S. Cooper

    2014-01-01

    Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% fema...

  8. Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: a randomized, double-blind, controlled trial

    DEFF Research Database (Denmark)

    Ottesen, L.H.; Aagaard, Niels Kristian; Kiszka-Kanowitz, M.

    2001-01-01

    variable effects. Twenty-five cirrhotic patients with portal hypertension were randomized in a double-blind design to placebo or a single subcutaneous dose of a long-acting formulation of octreotide (octreotide-LAR) (20 mg). Renal function tests were performed before dosing and repeated after 30 days...... with octreotide-LAR. It is concluded that in spite of increased arterial pressure, octreotide-LAR has no significant effect on renal hemodynamics and tubular function in clinically stable cirrhotic patients with portal hypertension....

  9. Impaired left ventricular systolic function reserve limits cardiac output and exercise capacity in HFpEF patients due to systemic hypertension.

    Science.gov (United States)

    Henein, Michael; Mörner, Stellan; Lindmark, Krister; Lindqvist, Per

    2013-09-30

    Heart failure (HF) patients with preserved left ventricular (LV) ejection fraction (EF) (HFpEF) due to systemic hypertension (SHT) are known to have limited exercise tolerance. Despite having normal EF at rest, we hypothesize that these patients have abnormal systolic function reserve limiting their exercise capacity. Seventeen patients with SHT (mean age 68 ± 9 years) but no valve disease and 14 healthy individuals (mean age of 65 ± 10 years) underwent resting and peak exercise echocardiography using conventional, tissue Doppler and speckle tracking techniques. The differences between resting and peak exercise values were also analyzed (Δ). Exercise capacity was determined as the workload divided by body surface area. Resting values for left atrial (LA) volume/BSA (r=-0.66, pexercise capacity. LVEF increased during exercise in normals (mean Δ EF=10 ± 8%) but failed to do so in patients (mean Δ EF=0.6 ± 9%, pexercise in patients, to the same extent as it did in normals (0.2 ± 0.2 vs. 0.6 ± 0.3 1/s, pexercise (Δ) in LV lateral wall systolic velocity from tissue Doppler (s') (0.71, pexercise capacity independent of changes in heart rate. HFpEF patients with hypertensive LV disease have significantly limited exercise capacity which is related to left atrial enlargement as well as compromised LV systolic function at the time of the symptoms. The limited myocardial systolic function reserve seems to be underlying important explanation for their limited exercise capacity. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. Controlling Hypertension

    Centers for Disease Control (CDC) Podcasts

    Hypertension, or high blood pressure, affects one third of U.S. adults and is a leading cause of heart disease and stroke. A recent study found an increase in self-reported high blood pressure among U.S. adults, and an increase in the use of medications to control high blood pressure. In this podcast, Dr. Fleetwood Loustalot discusses the importance of controlling high blood pressure.

  11. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Directory of Open Access Journals (Sweden)

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  12. Pulmonary Hypertension

    Science.gov (United States)

    Kim, John S.; McSweeney, Julia; Lee, Joanne; Ivy, Dunbar

    2015-01-01

    Objective Review the pharmacologic treatment options for pulmonary arterial hypertension (PAH) in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. Data Sources and Study Selection Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of PAH therapies. Data Extraction Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies. Data Synthesis Specific targeted therapies developed for the treatment of adult patients with PAH have been applied for the benefit of children with PAH. With the exception of inhaled nitric oxide, there are no PAH medications approved for children in the US by the FDA. Unfortunately, data on treatment strategies in children with PAH are limited by the small number of randomized controlled clinical trials evaluating the safety and efficacy of specific treatments. The treatment options for PAH in children focus on endothelial-based pathways. Calcium channel blockers are recommended for use in a very small, select group of children who are responsive to vasoreactivity testing at cardiac catheterization. Phosphodiesterase type 5 inhibitor therapy is the most-commonly recommended oral treatment option in children with PAH. Prostacyclins provide adjunctive therapy for the treatment of PAH as infusions (intravenous and subcutaneous) and inhalation agents. Inhaled nitric oxide is the first line vasodilator therapy in persistent pulmonary hypertension of the newborn, and is commonly used in the treatment of PAH in the Intensive Care Unit (ICU). Endothelin receptor antagonists have been shown to improve exercise tolerance and survival in adult patients with PAH. Soluble Guanylate Cyclase Stimulators are the first drug class to be FDA approved for the treatment of chronic thromboembolic pulmonary hypertension. Conclusions Literature and data supporting the

  13. ACE inhibition with spirapril improves diastolic function at rest independent of vasodilation during treatment with spirapril in mild to moderate hypertension

    DEFF Research Database (Denmark)

    Petersen, J R; Drabaek, H; Fornitz, Gitte Gleerup

    1996-01-01

    mass), and Doppler-derived atrial to early (A/E)-ratio velocity time integrals (VTI) were measured at the end of each of the four periods. Spirapril lowered the A/E-ratio VTIs (0.57, 0.12-1.00) (P ....44-1.25), and the drug normalized the A/E-ratio VTI in those patients with elevated values. The hemodynamic variables, left ventricular mass, and end-systolic wall stress were unchanged during all three treatments. There were no significant changes in mean blood pressure during the treatment periods. These results...... indicate that spirapril lowers A/E ratio within four weeks in patients with mild to moderate essential hypertension. It thereby seems able to improve left ventricular diastolic function. The effect is not dependent upon changes in hemodynamic variables, blood pressure, left ventricular mass, or end...

  14. ACE inhibition with spirapril improves diastolic function at rest independent of vasodilation during treatment with spirapril in mild to moderate hypertension

    DEFF Research Database (Denmark)

    Petersen, J R; Drabaek, H; Gleerup, Christian Peter-Ole G.

    1996-01-01

    the patients entered three periods lasting four weeks each, wherein they were treated with placebo, spirapril, or hydrochlorothiazide. Blood pressure, hemodynamic variables (stroke volume, heart rate, cardiac output, index of contractility, and systemic vascular resistance), echocardiography (left ventricular...... mass), and Doppler-derived atrial to early (A/E)-ratio velocity time integrals (VTI) were measured at the end of each of the four periods. Spirapril lowered the A/E-ratio VTIs (0.57, 0.12-1.00) (P ... indicate that spirapril lowers A/E ratio within four weeks in patients with mild to moderate essential hypertension. It thereby seems able to improve left ventricular diastolic function. The effect is not dependent upon changes in hemodynamic variables, blood pressure, left ventricular mass, or end...

  15. Diagnostic accuracy of cardiovascular magnetic resonance imaging of right ventricular morphology and function in the assessment of suspected pulmonary hypertension results from the ASPIRE registry

    Directory of Open Access Journals (Sweden)

    Swift Andrew J

    2012-06-01

    Full Text Available Abstract Background Cardiovascular Magnetic Resonance (CMR imaging is accurate and reproducible for the assessment of right ventricular (RV morphology and function. However, the diagnostic accuracy of CMR derived RV measurements for the detection of pulmonary hypertension (PH in the assessment of patients with suspected PH in the clinic setting is not well described. Methods We retrospectively studied 233 consecutive treatment naïve patients with suspected PH including 39 patients with no PH who underwent CMR and right heart catheterisation (RHC within 48hours. The diagnostic accuracy of multiple CMR measurements for the detection of mPAP ≥ 25 mmHg was assessed using Fisher’s exact test and receiver operating characteristic (ROC analysis. Results Ventricular mass index (VMI was the CMR measurement with the strongest correlation with mPAP (r = 0.78 and the highest diagnostic accuracy for the detection of PH (area under the ROC curve of 0.91 compared to an ROC of 0.88 for echocardiography calculated mPAP. Late gadolinium enhancement, VMI ≥ 0.4, retrograde flow ≥ 0.3 L/min/m2 and PA relative area change ≤ 15% predicted the presence of PH with a high degree of diagnostic certainty with a positive predictive value of 98%, 97%, 95% and 94% respectively. No single CMR parameter could confidently exclude the presence of PH. Conclusion CMR is a useful alternative to echocardiography in the evaluation of suspected PH. This study supports a role for the routine measurement of ventricular mass index, late gadolinium enhancement and the use of phase contrast imaging in addition to right heart functional indices in patients undergoing diagnostic CMR evaluation for suspected pulmonary hypertension.

  16. Hormones and Hypertension

    Science.gov (United States)

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Resources • Find-an-Endocrinologist: www.hormone.org or ...

  17. Pulmonary Hypertension in Scleroderma

    Science.gov (United States)

    PULMONARY HYPERTENSION IN SCLERODERMA PULMONARY HYPERTENSION Pulmonary hypertension (PH) is high blood pressure in the blood vessels of the lungs. If the high ... the right side of the heart. Patients with scleroderma are at increased risk for developing PH from ...

  18. Hypertension and Spina Bifida

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Hypertension A disease that often goes undetected. What is hypertension? Hypertension, also called high blood pressure , is a condition in which the arteries of ...

  19. Intracranial Hypertension Research Foundation

    Science.gov (United States)

    ... PARTNERSHIPS Meet our Fundraising Partners Tweet Welcome Intracranial hypertension (IH) is the general term for the neurological ... high. (Old names for IH include Benign Intracranial Hypertension and Pseudotumor Cerebri). The Intracranial Hypertension Research Foundation ...

  20. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... What do I need to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and ... Should an HIV patient be tested for pulmonary hypertension? HIV patients know that medical supervision is critical ...

  1. Effects of Single and Combined Losartan and Tempol Treatments on Oxidative Stress, Kidney Structure and Function in Spontaneously Hypertensive Rats with Early Course of Proteinuric Nephropathy.

    Directory of Open Access Journals (Sweden)

    Danijela Karanovic

    Full Text Available Oxidative stress has been widely implicated in both hypertension and chronic kidney disease (CKD. Hypertension is a major risk factor for CKD progression. In the present study we have investigated the effects of chronic single tempol (membrane-permeable radical scavenger or losartan (angiotensin II type 1 receptor blocker treatment, and their combination on systemic oxidative status (plasma thiobarbituric acid-reactive substances (pTBARS production, plasma antioxidant capacity (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid, pABTS, erythrocyte antioxidant enzymes activities and kidney oxidative stress (kTBARS, kABTS, kidney antioxidant enzymes activities, kidney function and structure in spontaneously hypertensive rats (SHR with the early course of adriamycin-induced nephropathy. Adult SHR were divided into five groups. The control group received vehicle, while the other groups received adriamycin (2 mg/kg, i.v. twice in a 21-day interval, followed by vehicle, losartan (L,10 mg/kg/day, tempol (T,100 mg/kg/day or combined T+L treatment (by gavage during a six-week period. Adriamycin significantly increased proteinuria, plasma lipid peroxidation, kidney protein oxidation, nitrite excretion, matrix metalloproteinase-1 (MMP-1 protein expression and nestin immunostaining in the kidney. Also, it decreased kidney antioxidant defense, kidney NADPH oxidase 4 (kNox4 protein expression and abolished anti-inflammatory response due to significant reduction of kidney NADPH oxidase 2 (kNox2 protein expression in SHR. All treatments reduced protein-to-creatinine ratio (marker of proteinuria, pTBARS production, kidney protein carbonylation, nitrite excretion, increased antioxidant capacity and restored kidney nestin expression similar to control. Both single treatments significantly improved systemic and kidney antioxidant defense, bioavailability of renal nitric oxide, reduced kMMP-1 protein expression and renal injury, thus retarded CKD progression

  2. A randomized and double-blind comparison of isradipine and spirapril as monotherapy and in combination on the decline in renal function in patients with chronic renal failure and hypertension

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    2001-01-01

    Treatment of hypertension in patients with chronic renal failure has been shown to postpone the decline in renal function. Treatment with an ACE inhibitor has been shown to be superior to conventional antihypertensive treatment, but it is not known how an ACE inhibitor compares to treatment with ...

  3. Effects of telmisartan and olmesartan on insulin sensitivity and renal function in spontaneously hypertensive rats fed a high fat diet

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    Hayato Yanagihara

    2016-07-01

    Full Text Available Although telmisartan, an angiotensin II receptor blocker (ARB, has an agonistic action for proliferator-activated receptor (PPAR-γ in vitro, it remains to be determined whether telmisartan exerts such an action in vivo using a non-toxic dose (<5 mg/kg in rats. To address the issue, telmisartan (2 mg/kg and olmesartan (2 mg/kg, another ARB without PPAR-γ agonistic action, were given to spontaneously hypertensive rats (SHR fed a high fat diet (HFD. HFD decreased plasma adiponectin, and caused insulin resistance, hypertriglyceridemia and renal damage, which were improved by ARBs. Protective effects of telmisartan and olmesartan did not significantly differ. In addition, in vitro study showed that 1 μM of telmisartan did not elevate the mRNA expression of adipose protein 2, which is a PPAR-γ-stimulated adipogenic marker gene, in preadipocytes with 3% albumin. To obtain 1 μM of plasma concentration, oral dose of telmisartan was calculated to be 6 mg/kg, which indicates that PPAR-γ agonistic action is negligible with a non-toxic dose of telmisartan (<5 mg/kg in rats. This study showed that 2 mg/kg of telmisartan and olmesartan ameliorated insulin resistance, hypertriglyceridemia and renal damage in SHR fed a HFD. As beneficial effects of telmisartan and olmesartan did not significantly differ, these were mediated through the PPAR-γ-independent actions.

  4. Structure and Function of the Hypertension Variant A486V of G Protein-coupled Receptor Kinase 4

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    Allen, Samantha J.; Parthasarathy, Gopal; Darke, Paul L.; Diehl, Ronald E.; Ford, Rachael E.; Hall, Dawn L.; Johnson, Scott A.; Reid, John C.; Rickert, Keith W.; Shipman, Jennifer M.; Soisson, Stephen M.; Zuck, Paul; Munshi, Sanjeev K.; Lumb, Kevin J. (Merck)

    2015-07-01

    G-protein-coupled receptor (GPCR) kinases (GRKs) bind to and phosphorylate GPCRs, initiating the process of GPCR desensitization and internalization. GRK4 is implicated in the regulation of blood pressure, and three GRK4 polymorphisms (R65L, A142V, and A486V) are associated with hypertension. Here, we describe the 2.6 Å structure of human GRK4α A486V crystallized in the presence of 5'-adenylyl β,γ-imidodiphosphate. The structure of GRK4α is similar to other GRKs, although slight differences exist within the RGS homology (RH) bundle subdomain, substrate-binding site, and kinase C-tail. The RH bundle subdomain and kinase C-terminal lobe form a strikingly acidic surface, whereas the kinase N-terminal lobe and RH terminal subdomain surfaces are much more basic. In this respect, GRK4α is more similar to GRK2 than GRK6. A fully ordered kinase C-tail reveals interactions linking the C-tail with important determinants of kinase activity, including the αB helix, αD helix, and the P-loop. Autophosphorylation of wild-type GRK4α is required for full kinase activity, as indicated by a lag in phosphorylation of a peptide from the dopamine D1 receptor without ATP preincubation. In contrast, this lag is not observed in GRK4α A486V. Phosphopeptide mapping by mass spectrometry indicates an increased rate of autophosphorylation of a number of residues in GRK4α A486V relative to wild-type GRK4α, including Ser-485 in the kinase C-tail.

  5. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  6. INFLUENCE OF ABDOMINAL OBESITY ON HEART STRUCTURAL AND FUNCTIONAL CHANGES AND POSSIBILITY OF THEIR PHARMACOLOGICAL CORRECTION IN PATIENTS WITH ARTERIAL HYPERTENSION

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    V. R. Veber

    2008-01-01

    Full Text Available Aim. To study clinical and epidemiological features of arterial hypertension (HT combined with abdominal obesity (AO and pharmacological correction of left ventricle myocardium structural and functional disorders.Material and methods. Single-stage epidemiological study was conducted in Novgorod region population (n=4840. All patients with HT were revealed and analyzed depending on age and gender. Patients with HT grade 2 were split in two groups. 124 women (aged 49,36±1,2 y.o. and 126 men (aged 50,15±1,8 y.o. with HT and AO were included in the first group. 127 women (aged 50,05±1,7 y.o. and 125 men (aged 49,61±1,6 y.o. with HT and normal body mass index were included in the second group. Anthropometric and echocardiography examination was performed before and after 1, 3 and 6 months of therapy (metoprolol, nebivolol, amlodipine, lisinopril.Results. High prevalence of HT was revealed: 44,4% in men and 48,7% in women. AO was observed 5,4 times more often in women than this in men (18,5% and 3,4%, respectively, р<0,001. Combination of HT and AO was also revealed 5,3 times more often in women than this in men (14,3% and 2,7%, respectively, р<0,001. AO in patients with HT contributes to development of left ventricle concentric hypertrophy and diastolic dysfunction.Conclusion. Antihypertensive therapy does not prevent left ventricle hypertrophy and diastolic dysfunction in hypertensive patients with AO.

  7. Evaluation of recently validated non- invasive formula using basic lung functions as new screening tool for pulmonary hypertension in idiopathic pulmonary fibrosis patients

    International Nuclear Information System (INIS)

    Ghanem, Maha K; Makhlouf, Hoda A; Agmy, Gamal R; Imam, Hisham M K; Fouad, Doaa A

    2009-01-01

    A prediction formula for mean pulmonary artery pressure (MPAP) using standard lung function measurement has been recently validated to screen for pulmonary hypertension (PH) in idiopathic pulmonary fibrosis (IPF) patients. To test the usefulness of this formula as a new non invasive screening tool for PH in IPF patients. Also, to study its correlation with patients' clinical data, pulmonary function tests, arterial blood gases (ABGs) and other commonly used screening methods for PH including electrocardiogram (ECG), chest X ray (CXR), trans-thoracic echocardiography (TTE) and computerized tomography pulmonary angiography (CTPA). Cross-sectional study of 37 IPF patients from tertiary hospital. The accuracy of MPAP estimation was assessed by examining the correlation between the predicted MPAP using the formula and PH diagnosed by other screening tools and patients' clinical signs of PH. There was no statistically significant difference in the prediction of PH using cut off point of 21 or 25 mm Hg (p0 = 0.24). The formula-predicted MPAP greater than 25 mm Hg strongly correlated in the expected direction with O2 saturation (r = - 0.95, P 0.05). The prediction formula for MPAP using standard lung function measurements is a simple non invasive tool that can be used as TTE to screen for PH in IPF patients and select those who need right heart catheterization. (author)

  8. [Effect of monotherapy with nebivolol, bisoprolol, carvedilol on the state of vegetative nervous system and sexual function in men with arterial hypertension].

    Science.gov (United States)

    Mustafaev, I I; Nurmamedova, G S

    2013-01-01

    Aim of the study was to assess effect of monotherapy with nebivolol, bisoprolol, carvedilol for 2 months on sexual function in men with arterial hypertension (AH). Men with 1-2 degree of AH (n=75, age 35-55 years, mean age 48+/-3,5 years) received monotherapy with these drugs for 2 months. Registration of parameters of heart rate variability (HRV), Dopplerography of penile arteries, and the Vasilchenko questionnaire were implemented at the end of 4 months of placebo period and after 2 months of therapy with a study drug. Therapy with bisoprolol, carvedilol, and nebivolol was associated with significant elevation of parasympathetic part of vegetative nervous system tone, improvement of systolic blood flow in cavernous and dorsal arteries. Analysis of data obtained by Vasilchenko questionnaire demonstrated improvement of psychic and erectile components of sexual function. Thus bisoprolol, carvedilol, and nebivolol did not worsen sexual function of men with AH, improved spectral parameters of HRV and vascular blood flow in arteries of cavernous bodies.

  9. Long-term diet-induced hypertension in rats is associated with reduced expression and function of small artery SKCa, IKCa, and Kir2.1 channels

    DEFF Research Database (Denmark)

    Gradel, Anna Katrina Jógvansdóttir; Salomonsson, Max; Sørensen, Charlotte Mehlin

    2018-01-01

    in long-term diet-induced hypertension in rats. Hypothesis: A 28-week diet rich in fat, fructose, or both, will lead to changes in K+ transporter expression and function, which is associated with increased blood pressure and decreased arterial function. Methods and Results: Male Sprague Dawley rats......RNA expression of vascular K+ transporters, and vessel myography in small mesenteric arteries. BW was increased in the High Fat and High Fat/Fruc groups, and SBP was increased in the High Fat/Fruc group. mRNA expression of SKCa, IKCa, and Kir2.1 K+ channels were reduced in the High Fat/Fruc group. Reduced EDH......-type relaxation to acetylcholine was seen in the High Fat and High Fat/Fruc groups. Ba2+-sensitive dilatation to extracellular K+ was impaired in all experimental diet groups. Conclusions: Reduced expression and function of SKCa, IKCa and Kir2.1 channels is associated with elevated blood pressure in rats fed...

  10. ANTIHYPERTENSIVE EFFICACY AND INFLUENCE ON SEXUAL FUNCTION OF VALSARTAN AND VALSARTAN AND HYDROCHLOROTHIAZIDE COMBINATION IN SMOKERS VERSUS NON-SMOKERS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. I. Podzolkov

    2013-01-01

    Full Text Available Aim. To study antihypertensive efficacy and safety of valsartan-based therapy as well as influence of treatment on several aspects of sexual function.Material and methods. Hypertensive patients (n=650 in 53 medical institutions of Russia were enrolled to the prospective multicenter observation study, 37.5% of smokers and 62.5% non-smokers. The evaluation of therapy efficacy was based on analysis of systolic (SBP and diastolic (DBP blood pressure (BP changes. Safety and compliance of treatment was also analyzed. The evaluation of sexual function was performed with 5 universal questions selected form the International Index of Erectile Function. These ques- tions could be asked in both men and women. The valsartan dose was 80–320 mg OD. A combination of the valsartan with hydrochlorothiazide (12.5–25 mg/d, amlodipine (5–10 mg/d or any other antihypertensive was allowed.Results. Significant similar decrease of SBP and DBP was observed in smoking and non-smoking patients (37.4/17.8 and 36.7/16.5 mm Hg respectively, р<0.01 vs baseline. Differences in SBP and DBP changes were not significant between groups. Target BP level (<140/90 mmHg was reached in 81.9% smokers and 76.0% non-smokers.After 20 weeks of treatment the number of patients without sexual activity and with 1–2 successful sexual attempts in the last 4 weeks significantly decreased from 44.7 to 32.8% and from 29.1% to 23.2%, respectively (р<0.05. Significant increase in the number of patients with 5–6 and 7–10 successful sexual attempts was observed (from 6.1 to 13.6% and from 3.2 to 5.9% respectively, р<0.05. The treatment resulted in significant increase in the number of patients, who evaluated their sexual life satisfaction as ″very satisfied″ (from 8.2 to 14.8%, <0.01.Conclusion. Comparable antihypertensive efficacy and safety were demonstrated for valsartan based therapy in smoking and non-smoking patients. During the course of treatment there was a significant

  11. ANTIHYPERTENSIVE EFFICACY AND INFLUENCE ON SEXUAL FUNCTION OF VALSARTAN AND VALSARTAN AND HYDROCHLOROTHIAZIDE COMBINATION IN SMOKERS VERSUS NON-SMOKERS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. I. Podzolkov

    2015-09-01

    Full Text Available Aim. To study antihypertensive efficacy and safety of valsartan-based therapy as well as influence of treatment on several aspects of sexual function.Material and methods. Hypertensive patients (n=650 in 53 medical institutions of Russia were enrolled to the prospective multicenter observation study, 37.5% of smokers and 62.5% non-smokers. The evaluation of therapy efficacy was based on analysis of systolic (SBP and diastolic (DBP blood pressure (BP changes. Safety and compliance of treatment was also analyzed. The evaluation of sexual function was performed with 5 universal questions selected form the International Index of Erectile Function. These ques- tions could be asked in both men and women. The valsartan dose was 80–320 mg OD. A combination of the valsartan with hydrochlorothiazide (12.5–25 mg/d, amlodipine (5–10 mg/d or any other antihypertensive was allowed.Results. Significant similar decrease of SBP and DBP was observed in smoking and non-smoking patients (37.4/17.8 and 36.7/16.5 mm Hg respectively, р<0.01 vs baseline. Differences in SBP and DBP changes were not significant between groups. Target BP level (<140/90 mmHg was reached in 81.9% smokers and 76.0% non-smokers.After 20 weeks of treatment the number of patients without sexual activity and with 1–2 successful sexual attempts in the last 4 weeks significantly decreased from 44.7 to 32.8% and from 29.1% to 23.2%, respectively (р<0.05. Significant increase in the number of patients with 5–6 and 7–10 successful sexual attempts was observed (from 6.1 to 13.6% and from 3.2 to 5.9% respectively, р<0.05. The treatment resulted in significant increase in the number of patients, who evaluated their sexual life satisfaction as ″very satisfied″ (from 8.2 to 14.8%, <0.01.Conclusion. Comparable antihypertensive efficacy and safety were demonstrated for valsartan based therapy in smoking and non-smoking patients. During the course of treatment there was a significant

  12. Effects of telmisartan combined with nifedipine controlled release tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension

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    Feng Guo

    2017-10-01

    Full Text Available Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension. Methods: A total of 92 cases of patients with coronary heart disease with mild to moderate hypertension were selected as the object of observation, according to the random data table, they were divided into the control group (n=46 and observation group (n=46, and patients in the control group were treated with Nifedipine Controlled Release Table therapy, on this basis, the observation group patients were given telmisartan treatment, two groups were treated for 6 months. The levels of the blood pressure, inflammatory factors, vascular endothelial function and left ventricular function compared between the two groups before and after treatment. Results: There were no significant differences in the levels of SBP, DBP, hs-CRP, TNF-α, NO, ET-1, LVEF, LVEDD and LVESD in the two groups before treatment. After treatment, two groups of SBP, DBP, hs-CRP, TNF-α, ET-1, LVEDD and LVESD levels were significantly lower than those in the same group before treatment, and after treatment, the levels of SBP, DBP, hs-CRP, TNF-α, ET-1 and LVESD in the observation group were significantly lower than those in the control group, while there were no significant difference in the level of LVEDD between the two groups after treatment; Compared with level in the group before treatment, the levels of NO and LVEF in the two groups were significantly increased, and the observation group [(82.13±19.01 µmol/L, (52.83±7.45%] was significantly higher than the control group [(67.37±13.08 µmol/L, (49.47±6.96%]. Conclusion: Telmisartan combined with Nifedipine Controlled Release Table in treating coronary heart disease with mild to moderate hypertension, can effectively control blood pressure, reduce the

  13. Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients.

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    Marjolein eHuijts

    2013-11-01

    Full Text Available Background – White matter lesions (WMLs, asymptomatic lacunar infarcts, brain microbleeds (BMBs and enlarged perivascular spaces (EPVS have been identified as silent lesions due to cerebral small vessel disease (cSVD. All these markers have been individually linked to cognitive functioning, but are also strongly correlated with each other. The combined effect of these markers on cognitive function has never been studied and would possibly provide more useful information on the effect on cognitive function. Methods – Brain MRI and extensive neuropsychological assessment were performed in 189 patients at risk for cSVD (112 hypertensive patients and 77 first-ever lacunar stroke patients. We rated the presence of any asymptomatic lacunar infarct, extensive WMLs, any deep BMB, and moderate to extensive EPVS in the basal ganglia. The presence of each marker was summed to an ordinal score between 0 and 4. Associations with domains of cognitive function (memory, executive function, information processing speed and overall cognition were analyzed with correlation analyses. Results – Correlation analyses revealed significant associations between accumulating cSVD burden and decreased performance on all cognitive domains (all p≤.001. Results remained significant for information processing speed (r=-.181, p=.013 and overall cognition (r=-.178, p=.017, after correction for age and sex. Testing of trend using linear regression analyses revealed the same results. Discussion – We tested a new approach to capture total brain damage resulting from cSVD and found that accumulation of MRI burden of cSVD is associated with decreased performance on tests of information processing speed and overall cognition, implying that accumulating brain damage is accompanied by worse cognitive functioning.

  14. Valutazione morfo-funzionale in pazienti ipertesi con stenosi dell'arteria renale; Correlazioni tra angiografia e scintigrafia dinamica. Morpho-functional evaluation in hypertensive patients with renal artery stenosis; Correlations between angiography and radionuclide renography

    Energy Technology Data Exchange (ETDEWEB)

    Cuocolo, A; Celentano, L; Nappi, A [Naples Univ. (Italy). Ist. di Scienze Radiologiche; Neumann, R D; Salvatore, M [Naples Univ. (Italy). Cattedra di Medicina Nucleare

    1991-01-01

    Renovascula hypertension is the most important and common cause of secondary hypertension. We studied 10 patients with arterial hypertension and different degrees of renal artery stenosis to assess the usefulness of dynamic radionuclide renography in evaluating renal perfusion and funcion, and to compare funcional radionuclide results to the morphological findings of renal angiography. Computer-assisted dynamic renal with {sup 00m}Tc diethylenetriaminepentaacetic acid (DTPA) and {sup 131}I orthoiodohippurate (OIH), and renal artheriography were also employed in all patients. In all patients, radionuclide results matched angiography findings in quality. In particular, 3 patients with hemodynamical insignificant renal artery stenosis exhibited normal perfusion and function at dynamic radionuclide renography. Seven patients had significant renal artery stenosis and associated functional changes at dynamic radionuclide renography. Quantitative comparison of all patients showed a significant correlation (r=0.866, p<0.001) between the degree of renal artery stenosis, quantified as the percentage of narrowing as compared to adjacent/contralateral normal vessel diameter, and the results of split renal function, as assessed during OIH studies and expressed per kidney as a percentage of the net total counts of both kidneys. In conclusion, our results demonstrated dynamic radionuclide renography to be a valuable secondary to renal artery stenosis in hypertensive patients, providing complementary results to arteriography.

  15. Diagnostic and prognostic value of right ventricular strain in patients with pulmonary arterial hypertension and relatively preserved functional capacity studied with echocardiography and magnetic resonance.

    Science.gov (United States)

    da Costa Junior, Augusto Alberto; Ota-Arakaki, Jaquelina Sonoe; Ramos, Roberta Pulcheri; Uellendahl, Marly; Mancuso, Frederico José Neves; Gil, Manuel Adan; Fischer, Cláudio Henrique; Moises, Valdir Ambrosio; de Camargo Carvalho, Antonio Carlos; Campos, Orlando

    2017-01-01

    Right ventricular (RV) dysfunction harbingers adverse prognosis in pulmonary arterial hypertension (PAH). Although conventional two-dimensional echocardiography (2DE) is limited for RV systolic function quantitation, RV strain can be a useful tool. The diagnostic and prognostic impact of 2DE speckle-tracking RV longitudinal strain was evaluated, including other 2DE systolic indexes, in a group of PAH patients without severe impairment of functional capacity, chronic pulmonary thromboembolism or left ventricular dysfunction. Sixty-six group I PAH patients, 67 % NYHA functional class I or II (none in IV) were studied by 2DE to obtain: RV fractional area change, tricuspid annular plane systolic excursion, RV myocardial performance index, tissue Doppler tricuspid annulus systolic velocity. Global, free wall (RVFreeWSt) and septal RV longitudinal systolic strain were obtained. RV ejection fraction by cardiac magnetic resonance (CMR-RVEF) was also assessed. All patients were followed up to 3.9 years (mean 3.3 years). Combined endpoints were hospitalization for worsening PAH or cardiovascular death. Among all the 2DE indexes of RV systolic function, RVFreeWSt exhibited the best correlation with CMR-RVEF (r = 0.83; p < 0.005). Combined endpoints occurred in 15 (22.7 %) patients (6 hospitalizations and 9 deaths). Multivariate analysis identified RVFreeWSt ≤-14 % as the only 2DE independent variable associated with combined endpoints [HR 4.66 (1.25-17.37); p < 0.05]. We conclude that RVFreeWSt may be a suitable non-geometric 2DE surrogate of CMR-RVEF in PAH patients, constituting a powerful independent predictor of long-term outcome in this cohort with relatively preserved functional capacity.

  16. Alterations of the Gut Microbiome in Hypertension

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    Qiulong Yan

    2017-08-01

    Full Text Available Introduction: Human gut microbiota is believed to be directly or indirectly involved in cardiovascular diseases and hypertension. However, the identification and functional status of the hypertension-related gut microbe(s have not yet been surveyed in a comprehensive manner.Methods: Here we characterized the gut microbiome in hypertension status by comparing fecal samples of 60 patients with primary hypertension and 60 gender-, age-, and body weight-matched healthy controls based on whole-metagenome shotgun sequencing.Results: Hypertension implicated a remarkable gut dysbiosis with significant reduction in within-sample diversity and shift in microbial composition. Metagenome-wide association study (MGWAS revealed 53,953 microbial genes that differ in distribution between the patients and healthy controls (false discovery rate, 0.05 and can be grouped into 68 clusters representing bacterial species. Opportunistic pathogenic taxa, such as, Klebsiella spp., Streptococcus spp., and Parabacteroides merdae were frequently distributed in hypertensive gut microbiome, whereas the short-chain fatty acid producer, such as, Roseburia spp. and Faecalibacterium prausnitzii, were higher in controls. The number of hypertension-associated species also showed stronger correlation to the severity of disease. Functionally, the hypertensive gut microbiome exhibited higher membrane transport, lipopolysaccharide biosynthesis and steroid degradation, while in controls the metabolism of amino acid, cofactors and vitamins was found to be higher. We further provided the microbial markers for disease discrimination and achieved an area under the receiver operator characteristic curve (AUC of 0.78, demonstrating the potential of gut microbiota in prediction of hypertension.Conclusion: These findings represent specific alterations in microbial diversity, genes, species and functions of the hypertensive gut microbiome. Further studies on the causality relationship between

  17. Effects of Tianmagouteng particles on brain cognitive function in spontaneously hypertensive rats with hyperactivity of liver-yang: A [F-18] FDG micro-PET imaging study.

    Science.gov (United States)

    Zhang, Xiu-Jing; Sun, Tian-Cai; Liu, Zi-Wang; Wang, Feng-Jiao; Wang, Yong-De; Liu, Jing

    2017-11-01

    To collect visualized proof of Tianmagouteng particles (TMGTP) in alleviating cognitive dysfunction and to explore its effects on brain activity in spontaneously hypertensive rats (SHRs) with hyperactivity of liver-yang (Gan Yang Shang Kang, GYSK). Sixteen SHRs were randomized into treatment group and non-treatment. The SHR with GYSK was induced by gavaging aconite decoction (10mL/kg at 0.2g/mL). After the SHR models were prepared, the rats in the treatment group were administered TMGTP (10mL/kg) once a day for 14days.The rats in the non-treatment group or normal rats (control group) received an equivalent volume of saline. Morris water maze test was conducted before and after the treatment to observe cognitive function. Fluorine 18-deoxy glucose [F-18]FDG micro-PET brain imaging scans was performed after treatment. Data were analyzed with two-sample t-test (Pfunctions, TMGTP induced strong brain activity in the following sites: right dorsolateral nucleus and ventrolateral nucleus of thalamus, amygdala, left met thalamus, cerebellum leaflets, original crack, front cone crack, loop-shaped leaflets; but deactivation of right medial frontal gyrus, bilateral corpus callosum, hippocampus, and left dentate gyrus. TMGTP could alleviate cognitive dysfunction in SHRs with GYSK, which was possibly by inducing alteration of glucose metabolism in different brain regions with corresponding functions. Copyright © 2017. Published by Elsevier Masson SAS.

  18. [Primary and secondary arterial hypertension - update 2016].

    Science.gov (United States)

    Sanner, Bernd; Hausberg, Martin

    2016-06-01

    In patients with hypertension without diabetes and with an increased risk of cardiovascular complications a blood pressure of below 130 mmHg should be targeted. Hypertensive patients with an age above 80 years should be treated in the same way as younger hypertensive patients if they are otherwise healthy and functionally independent. On the other hand frail elderly patients could have an increased morbidity and mortality with intensive blood pressure control. In patients with resistant hypertension spironolactone was the most effective drug when given in addition to their baseline drugs (ACE-inhibitor/angiotensin receptor antagonist, calcium channel blocker and thiazide diuretic). © Georg Thieme Verlag KG Stuttgart · New York.

  19. Utility of Tissue Doppler Imaging in the Echocardiographic Evaluation of Left and Right Ventricular Function in Dogs with Myxomatous Mitral Valve Disease with or without Pulmonary Hypertension.

    Science.gov (United States)

    Baron Toaldo, M; Poser, H; Menciotti, G; Battaia, S; Contiero, B; Cipone, M; Diana, A; Mazzotta, E; Guglielmini, C

    2016-05-01

    In human medicine, right ventricular (RV) functional parameters represent a tool for risk stratification in patients with congestive heart failure caused by left heart disease. Little is known about RV alterations in dogs with left-sided cardiac disorders. To assess RV and left ventricular (LV) function in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH). One-hundred and fourteen dogs: 28 healthy controls and 86 dogs with MMVD at different stages. Prospective observational study. Animals were classified as healthy or having MMVD at different stages of severity and according to presence or absence of PH. Twenty-eight morphological, echo-Doppler, and tissue Doppler imaging (TDI) variables were measured and comparison among groups and correlations between LV and RV parameters were studied. No differences were found among groups regarding RV echo-Doppler and TDI variables. Sixteen significant correlations were found between RV TDI and left heart echocardiographic variables. Dogs with PH had significantly higher transmitral E wave peak velocity and higher E/e' ratio of septal (sMV) and lateral (pMV) mitral annulus. These 2 variables were found to predict presence of PH with a sensitivity of 84 and 72%, and a specificity of 71 and 80% at cut-off values of 10 and 9.33 for sMV E/e' and pMV E/e', respectively. No association between variables of RV function and different MMVD stage and severity of PH could be detected. Some relationships were found between echocardiographic variables of right and left ventricular function. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  20. Effects of dopamine D1 receptor blockade in the prelimbic prefrontal cortex or lateral dorsal striatum on frontostriatal function in Wistar and Spontaneously Hypertensive Rats.

    Science.gov (United States)

    Gauthier, Jamie M; Tassin, David H; Dwoskin, Linda P; Kantak, Kathleen M

    2014-07-15

    Attention Deficit Hyperactivity Disorder (ADHD) is associated with dysfunctional prefrontal and striatal circuitry and dysregulated dopamine neurotransmission. Spontaneously Hypertensive Rats (SHR), a heuristically useful animal model of ADHD, were evaluated against normotensive Wistar (WIS) controls to determine whether dopamine D1 receptor blockade of either prelimbic prefrontal cortex (plPFC) or lateral dorsal striatum (lDST) altered learning functions of both interconnected sites. A strategy set shifting task measured plPFC function (behavioral flexibility/executive function) and a reward devaluation task measured lDST function (habitual responding). Prior to tests, rats received bilateral infusions of SCH 23390 (1.0 μg/side) or vehicle into plPFC or lDST. Following vehicle, SHR exhibited longer lever press reaction times, more trial omissions, and fewer completed trials during the set shift test compared to WIS, indicating slower decision-making and attentional/motivational impairment in SHR. After reward devaluation, vehicle-treated SHR responded less than WIS, indicating relatively less habitual responding in SHR. After SCH 23390 infusions into plPFC, WIS expressed the same behavioral phenotype as vehicle-treated SHR during set shift and reward devaluation tests. In SHR, SCH 23390 infusions into plPFC exacerbated behavioral deficits in the set shift test and maintained the lower rate of responding in the reward devaluation test. SCH 23390 infusions into lDST did not modify set shifting in either strain, but produced lower rates of responding than vehicle infusions after reward devaluation in WIS. This research provides pharmacological evidence for unidirectional interactions between prefrontal and striatal brain regions, which has implications for the neurological basis of ADHD and its treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. [Analysis of variability of cardiac rhythm and sexual function in men with arterial hypertension during therapy with biosporolol and nebivolol].

    Science.gov (United States)

    Nurmamedova, G S; Mustafaev, I I

    2012-01-01

    The aim of the work was to study effect of bisoprolol and nebivolol therapy on the sexual function of men with AH. 20 men aged 35-55 (48 +/- 3.5) yr with grade I and II AH received either drug for 2 months. Cardiac rhythm variability (CRV) was estimated in the end of the 4-week placebo period and after 2-month monotherapy. Dopplerography of penile arteries and a questionnaire study (as described by Vasilchenko) were conducted. Both drugs significantly increased the tone of the parasympathetic component of the vegetative nervous system, improved systolic blood flow in cavernous and dorsal arteries. The questionnaire study failed to revel significant changes of the sexual function. It is concluded that biosporolol and nebivolol did not compromise the sexual function of men with AH; they improve spectral CRV characteristics and blood flow in cavernous arteries.

  2. Hypertension in women

    OpenAIRE

    Hage, Fadi G; Mansur, Sulaf J; Xing, Dongqi; Oparil, Suzanne

    2013-01-01

    Hypertension is the most common modifiable risk factor for cardiovascular disease, the leading cause of death in both men and women. The prevalence and severity of hypertension rise markedly with age, and blood pressure control becomes more difficult with aging in both genders, particularly in women. In addition, there are forms of hypertension that occur exclusively in women, e.g., hypertension related to menopause, oral contraceptive use, or pregnancy (e.g., chronic hypertension, gestationa...

  3. Diagnostic accuracy of cardiovascular magnetic resonance imaging for assessment of right ventricular morphology and function in pulmonary artery hypertension

    Directory of Open Access Journals (Sweden)

    Eman Ramzy Ali

    2017-07-01

    Conclusions: CMR imaging is likely to increase in importance as the optimal reference method for assessment of early structural (morphological and functional parameters of the right ventricle for evaluation of patients with suspected PH valuable for assessment of treatment response, follow up and prognosis.

  4. Metformin Improves Endothelial Function and Reduces Blood Pressure in Diabetic Spontaneously Hypertensive Rats Independent from Glycemia Control : Comparison to Vildagliptin

    NARCIS (Netherlands)

    Hamidi Shishavan, Mahdi; Henning, Robert H; van Buiten, Azuwerus; Goris, Maaike; Deelman, Leo E; Buikema, Hendrik

    2017-01-01

    Metformin confers vascular benefits beyond glycemia control, possibly via pleiotropic effects on endothelial function. In type-1-diabetes-mellitus (T1DM-)patients metformin improved flow-mediated dilation but also increased prostaglandin(PG)-F-2 alpha, a known endothelial-contracting factor. To

  5. Assessing healthcare professional knowledge, attitudes, and practices on hypertension management. Announcing a new World Hypertension League resource.

    Science.gov (United States)

    Campbell, Norm R C; Dashdorj, Naranjargal; Baatarsuren, Uurtsaikh; Myanganbayar, Maral; Dashtseren, Myagmartseren; Unurjargal, Tsolmon; Zhang, Xin-Hua; Veiga, Eugenia Velludo; Beheiry, Hind Mamoun; Mohan, Sailesh; Almustafa, Bader; Niebylski, Mark; Lackland, Daniel

    2017-09-01

    To assist hypertension control programs and specifically the development of training and education programs on hypertension for healthcare professionals, the World Hypertension League has developed a resource to assess knowledge, attitudes, and practices on hypertension management. The resource assesses: (1) the importance of hypertension as a clinical and public health risk; (2) education in national or international hypertension recommendations; (3) lifestyle causes of hypertension; (4) measurement of blood pressure, screening, and diagnosis of hypertension; (5) lifestyle therapy counseling; (6) cardiovascular risk assessment; (7) antihypertensive drug therapy; and (8) adherence to therapy. In addition, the resource assesses the attitudes and practices of healthcare professionals for task sharing/shifting, use of care algorithms, and use of registries with performance reporting functions. The resource is designed to help support the Global Hearts Alliance to provide standardized and enhanced hypertension control globally. ©2017 Wiley Periodicals, Inc.

  6. The ratio of (18)F-FDG activity uptake between the right and left ventricle in patients with pulmonary hypertension correlates with the right ventricular function.

    Science.gov (United States)

    Yang, Tao; Wang, Lei; Xiong, Chang-Ming; He, Jian-Guo; Zhang, Yan; Gu, Qing; Zhao, Zhi-Hui; Ni, Xin-Hai; Fang, Wei; Liu, Zhi-Hong

    2014-05-01

    It is known that patients with pulmonary hypertension (PH) can have elevated F-FDG uptake in the right ventricle (RV) on PET imaging. This study was designed to assess possible relationship between FDG uptake of ventricles and the function/hemodynamics of the RV in patients with PH. Thirty-eight patients with PH underwent FDG PET imaging in both fasting and glucose-loading conditions. The standard uptake value (SUVs) corrected for partial volume effect in both RV and left ventricle (LV) were measured. The ratio of FDG uptake between RV to LV (SUVR/L) was calculated. Right heart catheterization and cardiac magnetic resonance (CMR) were performed in all patients within 1 week. The FDG uptake levels by the ventricles were compared with the result form the right heart catheterization and CMR. The SUV of RV (SUVR) and SUV of LV were significantly higher in glucose-loading condition than in fasting condition. In both fasting and glucose-loading conditions, SUVR and SUVR/L showed reverse correlation with right ventricular ejection fraction derived from CMR. In addition, in both fasting and glucose-loading conditions, SUVR and SUVR/L showed positive correlations with pulmonary vascular resistance. However, only SUVR/L in glucose-loading condition could independently predict right ventricular ejection fraction after adjusted for age, body mass index, sex, mean right atrial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance (P = 0.048). The FDG uptake of RV increases with decreased right ventricular function in patients with PH. Increased FDG uptake ratio between RV and LV might be useful to assess the right ventricular function.

  7. Change in endothelial function state under the influence of antihypertensive therapy in patients with arterial hypertension and high cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Turlyun T.S.

    2014-03-01

    Full Text Available The article analyzes the indicators characterizing endothelial function in patients of distinguished groups at the initial stage of the study (visit 1 and during the treatment (visit 2. At baseline levels of endothelin-1 in the blood of patients of all groups did not differ significantly between the groups distinguished. After treatment, the dynamics of the indicator in all groups was positive and statistically significant (p0,60.

  8. Systolic hypertension in adult nigerians with hypertension

    International Nuclear Information System (INIS)

    Opadijo, O.G.; Salami, T.A.T.; Sanya, E.O.; Omotoso, A.B.O.

    2007-01-01

    To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. Newly diagnosed adult hypertensives, with blood pressure 140/90mm Hg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy (LVH), heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 (7.8%) were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven (35.3%) were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight (81.7%) cases had combined systolic and diastolic pressures. Twenty-nine (13.3%) patients had systolic hypertension. Twenty-five (86.2%) of these 29 were aged 50 years and above and 20 (69.0%) were aged 60 years and above. Eleven (5.0%) patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ

  9. Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension

    International Nuclear Information System (INIS)

    Kang, Ki-Woon; Chang, Hyuk-Jae; Kim, Young-Jin; Choi, Byoung-Wook; Yang, Woo-In; Shim, Chi-Young; Ha, Jongwon; Chung, Namsik; Lee, Hye-Sun

    2011-01-01

    Increased stiffness of the pulmonary vascular bed is known to increase mortality in patients with pulmonary arterial hypertension (PAH); and pulmonary artery (PA) stiffness is also thought to be associated with exercise capacity. The purpose of the present study was to investigate whether cardiac magnetic resonance imaging (CMRI)-derived PA distensibility index correlates with PA stiffness estimated on right heart catheterization (RHC) and predicts functional capacity (FC) in patients with PAH. Thirty-five consecutive PAH patients (23% male, mean age, 44±13 years; 69% idiopathic) underwent CMRI, RHC, and 6-min walk test (6MWT). PA distensibility indices were derived from cross-sectional area change (%) in the transverse view, perpendicular to the axis of the main PA, on CMRI [(maximum area-minimum area)/minimum area during cardiac cycle]. Among the PA stiffness indices, pulmonary vascular resistance (PVR) and PA capacitance were calculated using hemodynamic dataset from RHC. CMRI-derived PA distensibility was inversely correlated with PVR (R 2 =0.34, P 2 =0.35, P 2 =0.61, P<0.001). Furthermore, PA distensibility <20% predicted poor FC (<400 m in 6MWT) with a sensitivity of 82% and a specificity of 94%. Non-invasive CMRI-derived PA distensibility index correlates with PA stiffness and can predict FC in patients with PAH. (author)

  10. Differential effects of Rho-kinase inhibitor and angiotensin II type-1 receptor antagonist on the vascular function in hypertensive rats induced by chronic l-NAME treatment

    Directory of Open Access Journals (Sweden)

    Bainian Chen

    2012-10-01

    Full Text Available Little attention has been paid to the effect of Rho-kinase inhibitor on the vascular dysfunction of nitric oxide-deficient hypertension. We aimed to investigate whether the Rho-kinase inhibitor fasudil showed beneficial effect on the vascular dysfunction of the NG-nitro-l-arginine methyl ester (l-NAME treated rat, as well as to compare the differential effects of fasudil and angiotensin II receptor antagonist valsartan on vascular function. In the present study, both valsartan and fasudil exerted antihypertensive action on the l-NAME-treated rats, while only valsartan attenuated the cardiac hypertrophy. Treatment with valsartan showed improvement on vascular reactivity to norepinephrine, KCl and CaCl2, whereas fasudil therapy showed little effect on vasoconstriction. Endothelium-dependent vasodilation to acetylcholine was reduced in the NO-deficient group but was normalized by the fasudil therapy. The increased expression of RhoA and Rho-kinase (ROCK in the vasculature was corrected well to normal level by either valsartan or fasudil administration, which seemed to be at least partially responsible for the beneficial effect of the drug infusion. These findings suggest that the angiotensin II receptor antagonist interferes more with the contractile response than Rho-kinase inhibitor, whereas inhibition of Rho-kinase activity exhibits a better improvement on vasorelaxation than blockade of angiotensin II receptor.

  11. Erectile Dysfunction in 101 Consecutive Hypertensive Patients and ...

    African Journals Online (AJOL)

    In a 6 month prospective questionnaire study of 101 consecutive newly referred hypertensive patients and 86 normotensive volunteers, the relationship of erectile dysfunction and hypertension in these patients was studied using a modified international index of erectile function (IIEF). The mean age of the hypertensive ...

  12. Renovascular hypertension - imaging and treatment

    International Nuclear Information System (INIS)

    Brkljačić, B.

    2015-01-01

    Full text: Imaging is very important in diagnosing renovascular hypertension (RVHT). The role of color duplex Doppler, CT angiography, MR angiography and DS angiography will be presented, advantages and disadvantages discussed. The treatment of RVHT can be medical, surgical or endovascular. Endovascular treatment is a domain of vascular interventional radiology; endovascular treatment of renovascular hypertension consists of PTA alone or PTA and stenting of renal arteries in patients who have haemodynamically significant stenosis of renal artery due to fibromuscular dysplasia or atherosclerosis. Atherosclerotic renal artery stenosis results in increased production of renin, angiotensin II, aldosterone; plasma rennin activity of is increased in renal vein of ischemic kidney that retains sodium and water. Atherosclerotic lesions are typically ostial. Long-standing hypertension damages intrarenal vessels of unprotected kidney. Hypertension and renal failure may persist after removal of stenotic kidney. It usually affects older people. Fibromuscular dysplasia is non-atherosclerotic, is more common in women, occurs at younger age (average 35 yrs). Treatment of choice is PTA alone. Results are much better than in atherosclerotic RAS, where PTA + stenting are indicated. Endovascular treatment may result in complications, minor local or major complications, mostly related to the interventional technique. While PTA for the treatment of FMD is clearly indicated, the conflicting data exist over years regarding indications, benefits, complications and advantages of PTA / stent over medical therapy for treatment of atherosclerotic renovascular hypertension. Although 25-30% of patients with impaired renal function can recover glomerular filtration after revascularization, many have no apparent change in kidney function and 19-25% experience a significant loss of kidney function, some as a result of atheroemboli. The results of ASTRAL, STAR and CORAL studies will be presented

  13. [The influence of carbon dioxide baths differing in the total mineralization levels on the functional state of the cardiovascular system of the patients presenting with hypertensive disease associated with coronary heart disease].

    Science.gov (United States)

    L'vova, N V; Tupitsyna, Iu Iu; Badalov, N G; Krasnikov, V E; Lebedeva, O D

    2013-01-01

    The results of the study on the influence of carbon dioxide baths differing in the total mineralization levels on the clinical course of hypertensive disease associated with coronary heart disease and on various functional systems of the body. The data obtained provide an insight into the role of salt concentrations (10 and 20 g/l) in carbon dioxide bath water (1.2 g/l) applied for the traditional treatment of the patients with hypertensive disease associated with concomitant coronary heart disease and musculoskeletal pathology. Highly mineralized bath water has a greater influence on the functional state of the cardiovascular system by causing a more pronounced decrease in peripheral vascular resistance and hypotensive effect. Baths with a salt concentration of 20 g/l markedly reduced pain and had anti-inflammatory effect in the patients with pathology of support and locomotor organs.

  14. Hypertensive retinopathy (image)

    Science.gov (United States)

    ... retina from high blood pressure is called hypertensive retinopathy. It occurs as the existing high blood pressure ... flame hemorrhages and cotton wool spots. As hypertensive retinopathy progresses, hard exudates can appear around the macula ...

  15. Hypertensive heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000163.htm Hypertensive heart disease To use the sharing features on this page, please enable JavaScript. Hypertensive heart disease refers to heart problems that occur because of ...

  16. Chronic Hypertension in Pregnancy

    Science.gov (United States)

    ... org/ by guest on June 19, 2018 Chronic Hypertension in Pregnancy Ellen W. Seely, MD; Cynthia Maxwell, ... M any women have been diag- nosed with hypertension (blood pressure Ͼ 140/ 90 mm Hg) when ...

  17. Effects of Dietary Approaches to Stop Hypertension (DASH Eating Plan on Inflammation and Liver Functional Tests among Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Leila Azadbakht

    2012-04-01

    Full Text Available Background: Considering that the new cardiovascular risk factors are important among type 2 diabetes. We evaluated the effects of the Dietary Approaches to Stop Hypertension (DASH eating pattern on inflammation and novel cardiovascular risk factors in type 2 diabetic patients.Materials and Method: In this eight-weeks crossover randomized clinical trail, 31 type 2 diabetic patients were on a control diet or the DASH diet. Fruits, vegetables, whole grains, low-fat dairy products are consumed in high amounts in this diet. However, saturated fat, total fat, cholesterol, refined grains, and sweets are recommended in low amounts. DASH diet had a total of 2,400 mg sodium per day. There was a four week washout between two trial phases. C-reactive protein level, coagulation indices and hepatic function tests were measured at baseline and after each phase of trial.Results: The mean percent change for plasma C-reactive protein level was -26.9±3.5% after the DASH diet and-5.1±3.8% after the control diet (p=0.001. Both alanine aminotransferase and aspartate aminotransferase levels were significantly reduced after consuming the DASH diet compared to the control diet (-14.8±3.0 % vs -6.6±3.4%; p=0.001, -29.4±3.7% vs -5.9±1.4%; p=0.001, respectively. The DASH diet reduced the plasma fibrinogen level compared to the control diet (-11.4±3.6% and 0.5±3.4%; p=0.03, respectively. Conclusion: Among diabetic patients, the DASH diet can play an important role in reducing inflammation, plasma levels of fibrinogen and liver aminotranferases. Future long-term studies are recommended.

  18. Maskeret hypertension i graviditeten

    DEFF Research Database (Denmark)

    Fischer, Margit Bistrup; Thingaard, Ebbe; Andersen, Anita Sylvest

    2018-01-01

    Hypertension during pregnancy is one of the leading causes of maternal and foetal morbidity and mortality. Monitoring of blood pressure is therefore an essential part of prenatal care. Masked hypertension, where blood pressure levels are elevated at home despite normal blood pressure levels...... monitored in a clinical setting, may lead to cardiovascular and obstetric complications equal to those of sustained hypertension. This article discusses masked hypertension and the need for further investigation of blood pressure monitoring during pregnancy....

  19. Maskeret hypertension i graviditeten

    DEFF Research Database (Denmark)

    Fischer, Margit Bistrup; Thingaard, Ebbe; Andersen, Anita Sylvest

    2018-01-01

    Hypertension during pregnancy is one of the leading causes of maternal and foetal morbidity and mortality. Monitoring of blood pressure is therefore an essential part of prenatal care. Masked hypertension, where blood pressure levels are elevated at home despite normal blood pressure levels monit...... monitored in a clinical setting, may lead to cardiovascular and obstetric complications equal to those of sustained hypertension. This article discusses masked hypertension and the need for further investigation of blood pressure monitoring during pregnancy....

  20. Pulmonary artery and right ventricle assessment in pulmonary hypertension. Correlation between functional parameters of ECG-gated CT and right-side heart catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Abel, Elodie; Jankowski, Adrien [Clinique univ. de radiologie et imagerie medicale, CHU Grenoble (France); Pison, Christophe [Clinique univ. de pneumologie, CHU Grenoble (France); Bosson, Jean Luc [Dept. of Statistics, CIC, CHU Grenoble (France); Bouvaist, Helene [Clinique univ. de cardiologie, CHU Grenoble (France); Ferretti, Gilbert R. [Clinique univ. de radiologie et imagerie medicale, CHU Grenoble (France); Univ. J. Fourier, Grenoble (France); INSERM U 823, Inst. A. Bonniot, la Tronche (France)], e-mail: gferretti@chu-grenoble.fr

    2012-09-15

    Background: Right ventricular function predicts outcome in patients with pulmonary hypertension (PH). Therefore accurate assessment of right ventricular function is essential to graduate severity, assess follow-up, and response to therapy. Purpose: To evaluate whether PH severity could be assessed using electrocardiography-gated CT (ECG-gated CT) functional parameters. A further objective was to evaluate cardiac output (CO) using two ECG-gated CT methods: the reference Simpson technique and the fully automatic technique generated by commercially available cardiac software. Material and Methods: Our institutional review board approved this study; patient consent was not required. Twenty-seven patients who had undergone ECG-gated CT and right heart catheterization (RHC) were included. Two independent observers measured pulmonary artery (PA) diameter, PA distensibility, aorta diameter, right ventricular cardiac output (CT-RVCO) and right ventricular ejection fraction (CT-RVEF) with automatic and Simpson techniques on ECG-gated CT. RHC-CO and mean pulmonary arterial pressure (mPAP) were measured on RHC. Relationship between ECG-gated CT and RHC measurements was tested with linear regression analysis. Results: Inter-observer agreement was good for all measurements (r > 0.7) except for CT-RVCO calculated with Simpson's technique (r = 0.63). Pulmonary artery (PA) distensibility was significantly correlated to mPAP (r = -0.426, P = 0.027). CT-RVEF was correlated with mPAP only when issued from Simpson technique (r = -0.417, P = 0.034). CT-RVEF was not significantly correlated to RHC-CO (P > 0.2). CT-RVCO measured with Simpson technique (r = 0.487, P = 0.010) and automatic segmentation (r = 0.549, P 0.005) correlated equally with RHC-CO. Conclusion: CT-RVEF and CT-RVCO measured on ECG-gated CT are significantly correlated, respectively, to mPAP and RHC-CO in this population with severe reduction of the right ventricular ejection fraction and could be useful for

  1. Pulmonary artery and right ventricle assessment in pulmonary hypertension. Correlation between functional parameters of ECG-gated CT and right-side heart catheterization

    International Nuclear Information System (INIS)

    Abel, Elodie; Jankowski, Adrien; Pison, Christophe; Bosson, Jean Luc; Bouvaist, Helene; Ferretti, Gilbert R.

    2012-01-01

    Background: Right ventricular function predicts outcome in patients with pulmonary hypertension (PH). Therefore accurate assessment of right ventricular function is essential to graduate severity, assess follow-up, and response to therapy. Purpose: To evaluate whether PH severity could be assessed using electrocardiography-gated CT (ECG-gated CT) functional parameters. A further objective was to evaluate cardiac output (CO) using two ECG-gated CT methods: the reference Simpson technique and the fully automatic technique generated by commercially available cardiac software. Material and Methods: Our institutional review board approved this study; patient consent was not required. Twenty-seven patients who had undergone ECG-gated CT and right heart catheterization (RHC) were included. Two independent observers measured pulmonary artery (PA) diameter, PA distensibility, aorta diameter, right ventricular cardiac output (CT-RVCO) and right ventricular ejection fraction (CT-RVEF) with automatic and Simpson techniques on ECG-gated CT. RHC-CO and mean pulmonary arterial pressure (mPAP) were measured on RHC. Relationship between ECG-gated CT and RHC measurements was tested with linear regression analysis. Results: Inter-observer agreement was good for all measurements (r > 0.7) except for CT-RVCO calculated with Simpson's technique (r = 0.63). Pulmonary artery (PA) distensibility was significantly correlated to mPAP (r = -0.426, P = 0.027). CT-RVEF was correlated with mPAP only when issued from Simpson technique (r = -0.417, P = 0.034). CT-RVEF was not significantly correlated to RHC-CO (P > 0.2). CT-RVCO measured with Simpson technique (r = 0.487, P = 0.010) and automatic segmentation (r = 0.549, P 0.005) correlated equally with RHC-CO. Conclusion: CT-RVEF and CT-RVCO measured on ECG-gated CT are significantly correlated, respectively, to mPAP and RHC-CO in this population with severe reduction of the right ventricular ejection fraction and could be useful for evaluating

  2. Expanding the definition and classification of hypertension.

    Science.gov (United States)

    Giles, Thomas D; Berk, Bradford C; Black, Henry R; Cohn, Jay N; Kostis, John B; Izzo, Joseph L; Weber, Michael A

    2005-09-01

    Cardiovascular abnormalities are frequently the cause, as well as the effect, of elevated blood pressure. As such, early cardiovascular disease (CVD) may be established before identifiable blood pressure thresholds are crossed. To identify individuals at risk for CVD at an earlier point in the disease process, as well as to avoid labeling persons as hypertensive who are at low risk for CVD, the Hypertension Writing Group proposes incorporating the presence or absence of cardiovascular risk factors, early disease markers, and target organ damage into the definition and classification scheme of hypertension. To describe both the complexity and progressive nature of hypertension, the following definition is proposed: "Hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. Early markers of the syndrome are often present before blood pressure elevation is observed; therefore, hypertension cannot be classified solely by discrete blood pressure thresholds. Progression is strongly associated with functional and structural cardiac and vascular abnormalities that damage the heart, kidneys, brain, vasculature, and other organs and lead to premature morbidity and death." Classification of hypertension must involve assessing global cardiovascular risk to situate an individual's risk for CVD and events along a continuum. As knowledge of early CVD continues to evolve, the approach to classifying individuals along that continuum can be expected to evolve accordingly. The four categories currently used to classify hypertension are normal, prehypertension, and stages 1 and 2 hypertension. The population identified with prehypertension includes a subgroup with early CVD. We believe it would be preferable to classify all individuals as either normal or hypertensive, based on their cardiovascular evaluation, using the four categories of normal and stages 1, 2, and 3 hypertension.

  3. Hypertension after kidney transplantation

    NARCIS (Netherlands)

    Dobrowolski, L.C.

    2016-01-01

    Hypertension increases the cardiovascular risk in kidney transplant recipients (KTRs). In chapter 2 we found that hypertension was highly prevalent in adult (77.2%), paediatric (62.7%) and young adult (86.4%) KTRs. Transition from the paediatric to adult care did not affect hypertension and there

  4. Hypertension in pregnancy

    Directory of Open Access Journals (Sweden)

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  5. Genetik og hypertension

    DEFF Research Database (Denmark)

    Ellervik, Christina; Tarnow, Lisa; Pedersen, Erling Bjerregaard

    2009-01-01

    Monogenic forms of hypertension are very rare, but have a well-characterized heredity. Primary hypertension is very common with a complex and polygenic heredity. Primary hypertension arises due to an interaction between multiple genetic and environmental factors. Its heredity is unknown, although...

  6. Pulmonary Hypertension in Pregnancy: Critical Care Management

    Directory of Open Access Journals (Sweden)

    Adel M. Bassily-Marcus

    2012-01-01

    Full Text Available Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Imaging workup may have undesirable radiation exposure. Pulmonary artery catheter remains the gold standard for diagnosing pulmonary hypertension, although its use in the intensive care unit for other conditions has slowly fallen out of favor. Goal-directed bedside echocardiogram and lung ultrasonography provide attractive alternatives. Basic principles of managing pulmonary hypertension with right ventricular failure are maintaining right ventricular function and reducing pulmonary vascular resistance. Fluid resuscitation and various vasopressors are used with caution. Pulmonary-hypertension-targeted therapies have been utilized in pregnant women with understanding of their safety profile. Mainstay therapy for pulmonary embolism is anticoagulation, and the treatment for amniotic fluid embolism remains supportive care. Multidisciplinary team approach is crucial to achieving successful outcomes in these difficult cases.

  7. The Evolving Classification of Pulmonary Hypertension.

    Science.gov (United States)

    Foshat, Michelle; Boroumand, Nahal

    2017-05-01

    - An explosion of information on pulmonary hypertension has occurred during the past few decades. The perception of this disease has shifted from purely clinical to incorporate new knowledge of the underlying pathology. This transfer has occurred in light of advancements in pathophysiology, histology, and molecular medical diagnostics. - To update readers about the evolving understanding of the etiology and pathogenesis of pulmonary hypertension and to demonstrate how pathology has shaped the current classification. - Information presented at the 5 World Symposia on pulmonary hypertension held since 1973, with the last meeting occurring in 2013, was used in this review. - Pulmonary hypertension represents a heterogeneous group of disorders that are differentiated based on differences in clinical, hemodynamic, and histopathologic features. Early concepts of pulmonary hypertension were largely influenced by pharmacotherapy, hemodynamic function, and clinical presentation of the disease. The initial nomenclature for pulmonary hypertension segregated the clinical classifications from pathologic subtypes. Major restructuring of this disease classification occurred between the first and second symposia, which was the first to unite clinical and pathologic information in the categorization scheme. Additional changes were introduced in subsequent meetings, particularly between the third and fourth World Symposia meetings, when additional pathophysiologic information was gained. Discoveries in molecular diagnostics significantly progressed the understanding of idiopathic pulmonary arterial hypertension. Continued advancements in imaging modalities, mechanistic pathogenicity, and molecular biomarkers will enable physicians to define pulmonary hypertension phenotypes based on the pathobiology and allow for treatment customization.

  8. A STUDY OF CHANGES IN DEFORMATION AND METABOLISM IN LEFT VENTRICLE AS A FUNCTION OF HYPERTROPHY IN SPONTANEOUS HYPERTENSIVE RATS USING MICROPET TECHNOLOGY

    Energy Technology Data Exchange (ETDEWEB)

    Gullberg, Grant, T; Huesman, Ronald, H; Reutter, Bryan, W; Sitek, Arkadiusz; Veress, Alexander, I; Weiss, Jeffrey, A; Yang, Yongfeng

    2017-06-13

    Problem: In the case of hypertrophy caused by pressure overload (hypertension) there is an increase in cardiac mass and modification cardiac metabolism. Aim: This study was designed to study the changes in glucose metabolism, ejection fraction, and deformation in the left ventricle with the progression of hypertrophy in spontaneous hypertensive rats (SHR). Methods: Dynamic PET data were acquired using the microPET II at UC Davis. Two rats were imaged at 10-week intervals for 18 months. Each time a dose of approximately 1- 1.5 mCi of F-18-FDG was injected into a normotensive Wistar Kyoto (WKY) rat and the same dose was injected into a SHR rat. Each rat was imaged using a gated dynamic acquisition for 80 minutes acquiring list mode data with cardiac gating of approximately 600-900 million total counts. For the analysis of glucose of metabolism, the list mode data were histogrammed into a dynamic sequence (42 frames over 80 mins). For each time frame, projection data of 1203 140x210 sinograms of 0.582 mm bins were formed by summing the last three gates before and one after the R-wave trigger to correspond to the diastolic phase of the cardiac cycle. Dynamic sequences of 128x128x83 matrices of 0.4x0.4x0.582 mm3 voxels in x, y, and z were reconstructed using an iterative MAP reconstruction which used a prior that penalized the high frequency components of the reconstruction using appropriate weighting between 26 nearest neighboring voxels. Time activity curves were generated from the dynamic reconstructed sequence for the blood and left ventricular tissue regions of interest which were fit to a 2-compartment model to obtain a least squares fit for the kinetic parameters. For the analysis of deformation, the list mode data were histogrammed into 8 gates of the cardiac cycle, each gate was the total sum of the later 60 mins of the 80 min acquisition. Images of 128x128x83 matrices for each gate were reconstructed using the same iterative MAP reconstruction used to

  9. Idiopathic portal hypertension

    International Nuclear Information System (INIS)

    Han, Tae Kyun; Ryu, Dae Sik; Kim, Heung Chul; Hur, Hun; Eom, Kyeung Tae; Namkung, Sook; Park, Man Soo; Hwang, Woo Chul; Lee, Kwan Seop

    1996-01-01

    To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

  10. SECONDARY (ENDOCRINE HYPERTENSION: LECTURE

    Directory of Open Access Journals (Sweden)

    M. Yu. Yukina

    2016-01-01

    Full Text Available Hypertension is a  very common disease with high morbidity and reduction in quality of life. Endocrine disorders are the most common cause of secondary hypertension affecting ~3% of the population. Primary aldosteronism can be the cause of endocrine hypertension more often than other endocrine disorders. Other less common causes of endocrine hypertension include Cushing syndrome, pheochromocytoma, thyroid disorders, and hyperparathyroidism. Endocrine hypertension is potentially curable if the underlying cause is identified and treated accordingly. Younger age at manifestation of resistance to multiple antihypertensive drugs, together with other clinical signs of an endocrine disorder, should raise the suspicion and prompt the appropriate evaluation.

  11. Inhibition of the JAK2/STAT3/SOSC1 Signaling Pathway Improves Secretion Function of Vascular Endothelial Cells in a Rat Model of Pregnancy-Induced Hypertension

    Directory of Open Access Journals (Sweden)

    Jian-Ying Luo

    2016-11-01

    Full Text Available Background/Aims: The present study aimed to investigate the effects of the JAK2/STAT3/SOSC1 signaling pathway on the secretion function of vascular endothelial cells (VECs in a rat model of pregnancy-induced hypertension (PIH. Methods: A PIH rat model was established. Forty-eight pregnant Sprague-Dawley female rats were selected and assigned into four groups: the normal group (normal non-pregnant rats, the non-PIH group (pregnant rats without PIH, the PIH group (pregnant rats with PIH and the AG490 group (pregnant rats with PIH treated with AG490. Systolic blood pressure (SBP and urinary protein (UP were measured. The expressions of JAK2/STAT3/SOSC1 signaling pathway-related proteins in placenta tissues were detect by Western blotting. Radioimmunoassay was applied to detect serum levels of nitric oxide (NO, super oxide dismutase (SOD, placental growth factor (PGF, thromboxane B2 (TXB2 and endothelin (ET. Enzyme-linked immunosorbent assay (ELISA was used to determine serum levels of interleukin-6 (IL-6, interleukin-10 (IL-10 and tumor necrosis factor-α (TNF-α. Results: Compared with the normal and non-PIH groups, the PIH and AG490 groups had higher SBP and UP levels at 17th and 25th day of pregnancy. The expressions of p/t-JAK2, p/t-STAT3 and SOSC1 in the PIH and AG490 groups were higher than those in the non-PIH group, while the expressions of p/t-JAK2, p/t-STAT3 and SOSC1 in the AG490 group were lower than those in the PIH group. Compared with the non-PIH group, serum levels of ET, TXB2, IL-6 and TNF-α were increased in the PIH and AG490 groups, while serum levels of NO, SOD, 6-keto-PGF1a and IL-10 levels were reduced. Furthermore, the AG490 had lower serum levels of ET, TXB2, IL-6 and TNF-α and higher serum levels of NO, SOD, 6-keto-PGF1a and IL-10 than those in the PIH group. Conclusion: Our study provides evidence that inhibition of the JAK2/STAT3/SOSC1 signaling pathway could improve the secretion function of VECs in PIH rats.

  12. Dual neural endopeptidase/endothelin-converting [corrected] enzyme inhibition improves endothelial function in mesenteric resistance arteries of young spontaneously hypertensive rats

    DEFF Research Database (Denmark)

    Lemkens, Pieter; Nelissen, Jelly; Meens, Merlijn J P M T

    2012-01-01

    BACKGROUND: Endothelin-1 (ET1) is a potent vasoconstrictor peptide with pro-mitogenic and pro-inflammatory properties and is therefore of interest in the development of endothelial dysfunction, endothelium-dependent flow-related remodeling, and hypertension-related remodeling. ET1 can be formed t...

  13. LONG-TERM EFFECTS OF PROTEIN-RESTRICTED DIET ON ALBUMINURIA AND RENAL-FUNCTION IN IDDM PATIENTS WITHOUT CLINICAL NEPHROPATHY AND HYPERTENSION

    NARCIS (Netherlands)

    DULLAART, RPF; BEUSEKAMP, BJ; MEIJER, S; VANDOORMAAL, JJ; SLUITER, WJ

    OBJECTIVES - To determine the long-term effects of an LPD on albuminuria and renal hemodynamics in IDDM patients without nephropathy. RESEARCH DESIGN AND METHODS - We selected 31 patients with overnight albuminuria between 10 and 200 g/min and without hypertension from a referral-based diabetic

  14. Effects of cilnidipine on sympathetic nerve activity and cardiorenal function in hypertensive patients with type 2 diabetes mellitus: association with BNP and aldosterone levels.

    Science.gov (United States)

    Tanaka, Masami; Sekioka, Risa; Nishimura, Takeshi; Ichihara, Atsuhiro; Itoh, Hiroshi

    2014-12-01

    Hypertension stimulates the sympathetic nervous system and this phenomenon is exacerbated by diabetes mellitus. We investigated the effects of cilnidipine, an N/L-type calcium channel blocker, on aspects of this system in patients with type 2 diabetes mellitus. In 33 hypertensive patients with type 2 diabetes mellitus treated with a calcium channel blocker other than cilnidipine, we evaluated the influence of switching to cilnidipine on blood pressure, heart rate, catecholamine, plasma renin and aldosterone concentration, brain natriuretic peptide, urine liver-type fatty acid binding protein, and urinary albumin excretion ratio in the same patients by a cross-over design. Other biochemical parameters were also evaluated. Switching to cilnidipine did not change blood pressure but caused reduction in catecholamine concentrations in blood and urine and plasma aldosterone concentration, accompanied by significant reduction in brain natriuretic peptide, urine liver-type fatty acid binding protein, and albumin excretion ratio. These parameters other than brain natriuretic peptide were significantly increased after cilnidipine was changed to the original calcium channel blocker. In 33 hypertensive patients with type 2 diabetes mellitus, compared to other calcium channel blockers, cilnidipine suppressed sympathetic nerve activity and aldosterone, and significantly improved markers of cardiorenal disorders. Therefore, cilnidipine may be an important calcium channel blocker for use in combination with renin-angiotensin-aldosterone system inhibitors when dealing with hypertension complicated with diabetes mellitus. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. CHANGES IN RENAL-FUNCTION INDUCED BY ACE-INHIBITION IN THE CONSCIOUS 2-KIDNEY, ONE-CLIP GOLDBLATT HYPERTENSIVE DOG

    NARCIS (Netherlands)

    JONKER, GJ; VISSCHER, CA; DEZEEUW, D; HUISMAN, RM; PIERS, DA; BEEKHUIS, H; VANDERHEM, GK

    In order to study why the diagnostic sensitivity of I-123-hippurate renography for a renal artery stenosis is improved by angiotensin converting enzyme (ACE-) inhibition we used the model of the conscious chronically instrumented two-kidney, one-clip Goldblatt hypertensive dog. Urine flow (UV),

  16. Magnetic resonance imaging in pulmonary hypertension. Magnetresonanztomographie bei pulmonaler Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Neuhold, A.; Stiskal, M.; Czerny, C. (Institut fuer Bildgebende Diagnostik, Rudolfinerhaus, Vienna (Austria)); Frank, H.; Globits, S.; Glogar, D.; Mlczoch, J. (Universitaetsklinik fuer Kardiologie, Vienna (Austria))

    1992-09-01

    We examined 23 patients with pulmonary hypertension of varying aetiology by MRI and compared the results with those of right heart catheterisation. The best correlation was obtained between right ventricular mural thickness and mean pulmonary pressure (R = 0.91, p = 0.001). There was significant correlation (R = 0.85, p = 0.001) for the diameter of the inferior vena cava, which was dilated in all patients with pulmonary hypertension. There was no significant correlation between mean pulmonary pressure and the diameters of the superior vena cava or the main pulmonary artery branches (R = 0.55 and 0.75 respectively, p < 0.05). Amongst functional measurements there was a correlation between right ventricular ejection fraction and mean pulmonary artery pressure (R = 0.71, p = 0.001). There was no correlation between right ventricular end-systolic and end-diastolic volume. In all patients with pulmonary hypertension, dynamic flow sensitive gradient echo sequences showed the presence of tricuspid insufficiency. A further semiquantitative criterion for the presence of pulmonary hypertension in 4 patients (17%) was an abnormal signal from the main pulmonary artery in early to mid-systole shown on T[sub 1]-weighted transverse sections. (orig./GDG).

  17. Imaging nuclear medicine techniques for diagnostic evaluation of arterial hypertension

    International Nuclear Information System (INIS)

    Eisenberg, B.M.; Linss, G.

    1989-01-01

    Arterial hypertension may be caused by a malfunction of organs and in turn may lead to secondary organic lesions. Modern diagnostic nuclear medicine is applied for function studies in order to detect or exclude secondary hypertension and functional or perfusion disturbances due to hypertension, or to assess and follow up hemodynamic conditions and cardiac functions prior to and during therapy. The article presents a survey of imaging diagnostic nuclear medicine techniques for the eamination of the heart, the brain, the kidneys and endocrine glands in patients with arterial hypertension, discussing the methods with a view to obtainable information, limits of detection, and indications. (orig.) [de

  18. Rationale and design of the ranolazine PH-RV study: a multicentred randomised and placebo-controlled study of ranolazine to improve RV function in patients with non-group 2 pulmonary hypertension.

    Science.gov (United States)

    Han, Yuchi; Forfia, Paul R; Vaidya, Anjali; Mazurek, Jeremy A; Park, Myung H; Ramani, Gautam; Chan, Stephen Y; Waxman, Aaron B

    2018-01-01

    A major determining factor on outcomes in patients with pulmonary arterial hypertension (PAH) is right ventricular (RV) function. Ranolazine, which is currently approved for chronic stable angina, has been shown to improve RV function in an animal model and has been shown to be safe in small human studies with PAH. We aim to study the effect of ranolazine on RV function using cardiovascular magnetic resonance (CMR) in patients with pulmonary hypertension (non-group 2 patients) and monitor the effect of ranolazine on metabolism using metabolic profiling and changes of microRNA. This study is a longitudinal, randomised, double-blind, placebo-controlled, multicentre proof-of-concept study in 24 subjects with pulmonary hypertension and RV dysfunction treated with ranolazine over 6 months. Subjects who meet the protocol definition of RV dysfunction (CMR RV ejection fraction (EF) <45%) will be randomised to ranolazine or placebo with a ratio of 2:1. Enrolled subjects will be assessed for functional class, 6 min walk test and health outcome based on SF-36 tool. Peripheral blood will be obtained for N-terminal-pro brain natriuretic peptide, metabolic profiling, and microRNA at baseline and the conclusion of the treatment period. CMR will be performed at baseline and the conclusion of the treatment period. The primary outcome is change in RVEF. The exploratory outcomes include clinical, other CMR parameters, metabolic and microRNA changes. The trial protocol was approved by Institutional Review Boards. The trial findings will be disseminated in scientific journals and meetings. NCT01839110 and NCT02829034; Pre-results.

  19. Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arterial hypertension: the ExPAH study protocol.

    Science.gov (United States)

    Chia, Karen S W; Faux, Steven G; Wong, Peter K K; Holloway, Cameron; Assareh, Hassan; McLachlan, Craig S; Kotlyar, Eugene

    2017-02-06

    Pulmonary hypertension (PH) is a potentially life-threatening condition characterised by elevated pulmonary artery pressure. Early stage PH patients are often asymptomatic. Disease progression is associated with impairment of right ventricular function and progressive dyspnoea. Current guidelines recommend exercise training (grade IIa, level B). However, many questions remain regarding the mechanisms of improvement, intensity of supervision and optimal frequency, duration and intensity of exercise. This study will assess the effect of an outpatient rehabilitation programme on haemodynamics and cardiac right ventricular function in patients with pulmonary arterial hypertension (PAH), a subgroup of PH. This randomised controlled trial involves both a major urban tertiary and smaller regional hospital in New South Wales, Australia. The intervention will compare an outpatient rehabilitation programme with a control group (home exercise programme). Participants will be stable on oral PAH-specific therapy. The primary outcome measure will be right ventricular ejection fraction measured by cardiac MRI. Secondary outcomes will include haemodynamics measured by right heart catheterisation, endurance, functional capacity, health-related quality of life questionnaires and biomarkers of cardiac function and inflammation. Ethical approval has been granted by St Vincent's Hospital, Sydney (HREC/14/SVH/341). Results of this study will be disseminated through presentation at scientific conferences and in scientific journals. ACTRN12615001041549; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Use of β-Blockers in Pulmonary Hypertension.

    Science.gov (United States)

    Perros, Frédéric; de Man, Frances S; Bogaard, Harm J; Antigny, Fabrice; Simonneau, Gérald; Bonnet, Sébastien; Provencher, Steeve; Galiè, Nazzareno; Humbert, Marc

    2017-04-01

    Contrasting with the major attention that left heart failure has received, right heart failure remains understudied both at the preclinical and clinical levels. However, right ventricle failure is a major predictor of outcomes in patients with precapillary pulmonary hypertension because of pulmonary arterial hypertension, and in patients with postcapillary pulmonary hypertension because of left heart disease. In pulmonary hypertension, the status of the right ventricle is one of the most important predictors of both morbidity and mortality. Paradoxically, there are currently no approved therapies targeting the right ventricle in pulmonary hypertension. By analogy with the key role of β-blockers in the management of left heart failure, some authors have proposed to use these agents to support the right ventricle function in pulmonary hypertension. In this review, we summarize the current knowledge on the use of β-blockers in pulmonary hypertension. © 2017 American Heart Association, Inc.

  1. Noncirrhotic portal hypertension.

    Science.gov (United States)

    Da, Ben L; Koh, Christopher; Heller, Theo

    2018-05-01

    Noncirrhotic portal hypertension represents a heterogeneous group of liver disorders that is characterized by portal hypertension in the absence of cirrhosis. The purpose of this review is to serve as a guide on how to approach a patient with noncirrhotic portal hypertension with a focus on recent developments. Recent studies pertaining to noncirrhotic portal hypertension have investigated aetiological causes, mechanisms of disease, noninvasive diagnostic modalities, clinical characteristics in the paediatric population and novel treatment targets. Noncirrhotic portal hypertension is an underappreciated clinical entity that can be difficult to diagnosis without a healthy suspicion. Diagnosis then relies on a comprehensive understanding of the causes and clinical manifestations of this disease, as well as a careful interpretation of the liver biopsy. Noninvasive approaches to diagnosis may play a significant role moving forward in this disease. Treatment in NCPH remains largely targeted at the individual sequalae of portal hypertension.

  2. Hypertension in Danish seafarers

    DEFF Research Database (Denmark)

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...... who had statutory medical examinations was studied from the beginning of October 2011 to the end of June 2012. The medical examination included measurements of blood pressure. The prevalence of hypertension in the study po- pulation was stratified by age, work place on board, smoking status, alcohol...

  3. Pediatric portal hypertension

    Science.gov (United States)

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  4. Hypertension og hyperlipidaemi

    DEFF Research Database (Denmark)

    Hansen, Henrik Steen; Larsen, Mogens Lytken

    2009-01-01

    Hypertension and hyperlipidemia are well-established and partially overlapping risk factors for cardiovascular disease. Analyses of cardiovascular morbidity in relationship to changes in blood pressure and in serum cholesterol levels have shown that combined reduction of both risk factors...... are important to achieve a reduction in morbidity. Statins have been shown to be effective in preventing both coronary and cerebrovascular events in both hypertensive and normotensive cases. Consequently, most recent guidelines recommend that statin treatment be considered in hypertensive patients aged less...

  5. Prevalence of KCNJ5 mutations and functional impact of a novel KCNJ5-insT149 mutation in aldosterone producing adenoma causing resistant hypertension

    OpenAIRE

    Kuppusamy, Maniselvan

    2014-01-01

    Primary aldosteronism (PA), a common form of secondary hypertension, is characterized by an excess autonomous aldosterone secretion. In a percentage ranging from a half to two thirds of the cases it is due to a surgically curable aldosterone-producing adenoma (APA) and in the rest to bilateral adrenal hyperplasia. The molecular mechanisms underlying aldosterone hypersecretion are unknown. Recent evidences suggest that amino acid residue substitutions in the selectivity filter of the Kir3....

  6. 42. Hypertension: Morbidity review

    Directory of Open Access Journals (Sweden)

    Hamzullah khan

    2015-10-01

    Conclusions: hypertension is a major modifiable risk factor for coronary artery disease, stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.

  7. The new hypertension guidelines.

    Science.gov (United States)

    Stern, Ralph H

    2013-10-01

    The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

  8. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  9. Contributions of pulmonary hypertension to HIV-related cardiac dysfunction

    Directory of Open Access Journals (Sweden)

    Godsent C. Isiguzo

    2013-09-01

    Conclusion: Immune-suppression affects the cardiac function adversely and coexisting pulmonary hypertension contributes to poor systolic and diastolic function in affected patients. The subtle nature of presentation of pulmonary hypertension and other cardiac dysfunctions in HIV/AIDS patients demand a high-index of suspicion and early intervention if detected, to ensure better care for these emerging threats to our patients.

  10. Out of proportion pulmonary hypertension in obstructive lung diseases.

    Science.gov (United States)

    Chatterjee, Kshitij; Tarawneh, Ahmad R; Alam, Shoaib

    2018-03-01

    Pulmonary hypertension is common (25-90%) in chronic obstructive pulmonary diseases (COPDs). Severe pulmonary hypertension, however, is quite rare (1-3%). The term 'out of proportion' pulmonary hypertension is still widely used. New guidelines instead propose to use the term 'Severe pulmonary hypertension' if mean pulmonary arterial pressure at least 35 mmHg or cardiac index (CI) is less than 2.0 l/min/m on right heart catheterization (RHC). Why only a minority of COPD patients develop severe pulmonary hypertension is unclear. When present, severe pulmonary hypertension in COPD is associated with increased dyspnea and decreased survival and often does not closely correlate with degree of obstructive abnormality on pulmonary function testing. COPD patients with severe pulmonary hypertension experience circulatory limitation at maximum exercise, and not ventilatory limitation, which is typical for moderate-to-severe COPD patients with no or moderate pulmonary hypertension. There is no conclusive evidence to support or completely reject the possibility of the use of specific pulmonary arterial hypertension (PAH) therapies in pulmonary hypertension associated with COPD. In mild-to-moderate COPD patients who have severe and progressive symptoms, and have evidence of severe pulmonary hypertension on RHC, specific PAH therapies may be used similar to WHO group-I PAH guidelines.

  11. EPOXYEICOSATRIENOIC ACID ANALOG ATTENUATES ANGIOTENSIN II HYPERTENSION AND KIDNEY INJURY

    Directory of Open Access Journals (Sweden)

    Md. Abdul Hye Khan

    2014-09-01

    Full Text Available Epoxyeicosatrienoic acids (EETs contribute to blood pressure regulation leading to the concept that EETs can be therapeutically targeted for hypertension and the associated end-organ damage. In the present study, we investigated anti-hypertensive and kidney protective actions of an EET analog, EET-B in angiotensin II (ANG II-induced hypertension. EET-B was administered in drinking water for 14 days (10mg/kg/d and resulted in a decreased blood pressure elevation in ANG II hypertension. At the end of the two-week period, blood pressure was 30 mmHg lower in EET analog-treated ANG II hypertensive rats. The vasodilation of mesenteric resistance arteries to acetylcholine was impaired in ANG II hypertension; however, it was improved with EET-B treatment. Further, EET-B protected the kidney in ANG II hypertension as evidenced by a marked 90% decrease in albuminuria and 54% decrease in nephrinuria. Kidney histology demonstrated a decrease in renal tubular cast formation in EET analog-treated hypertensive rats. In ANG II hypertension, EET-B treatment markedly lowered renal inflammation. Urinary monocyte chemoattractant protein-1 excretion was decreased by 55% and kidney macrophage infiltration was reduced by 52% with EET-B treatment. Overall, our results demonstrate that EET-B has anti-hypertensive properties, improves vascular function, and decreases renal inflammation and injury in ANG II hypertension.

  12. Does hypertension remain after kidney transplantation?

    Directory of Open Access Journals (Sweden)

    Gholamreza Pourmand

    2015-05-01

    Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

  13. Idiopathic noncirrhotic portal hypertension: current perspectives.

    Science.gov (United States)

    Riggio, Oliviero; Gioia, Stefania; Pentassuglio, Ilaria; Nicoletti, Valeria; Valente, Michele; d'Amati, Giulia

    2016-01-01

    The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis. Physicians should learn to look for this condition in a number of clinical settings, including cryptogenic cirrhosis, a disease known to be associated with INCPH, drug administration, and even chronic alterations in liver function tests. Once INCPH is clinically suspected, liver histology becomes mandatory for the correct diagnosis. However, pathologists should be familiar with the histological features of INCPH, especially in cases in which histology is not only requested to exclude liver cirrhosis.

  14. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...... but includes vascular lesions and portal fibrosis. Patient management follows the current recommendations for variceal bleeding....

  15. Pulmonary Arterial Hypertension

    Science.gov (United States)

    ... heart). This type of pulmonary hypertension was called “secondary pulmonary hypertension” but is now referred to as PH, because the cause is known to be from lung disease, heart disease, or chronic thromboemboli (blood clots). Pulmonary Arterial Hypertension (PAH) used to be ...

  16. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Hypertension (High Blood Pressure) KidsHealth / For Teens / Hypertension (High Blood Pressure) What's ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  17. Cervical Spondylosis and Hypertension

    Science.gov (United States)

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  18. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    OBJECTIVE:: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS:: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS:: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION:: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  19. Hypertension in women.

    Science.gov (United States)

    Pimenta, Eduardo

    2012-02-01

    Hypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. However, the prevalence of hypertension is predicted to increase more among women than men. Combined oral contraceptives (COCs) can induce hypertension in a small group of women and, increase CV risk especially among those with hypertension. Both COC-related increased CV risk and blood pressure (BP) returns to pretreatment levels by 3 months of its discontinuation. The effects of menopause and hormone replacement therapy (HRT) on BP are controversial, and COCs and HRT containing the new generation progestin drospirenone are preferred in women with established hypertension. Despite the high incidence of cancer in women, CV disease remains the major cause of death in women and comparable benefit of antihypertensive treatment have been demonstrated in both women and men.

  20. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    OBJECTIVE: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  1. Prediction of primary vs secondary hypertension in children.

    Science.gov (United States)

    Baracco, Rossana; Kapur, Gaurav; Mattoo, Tej; Jain, Amrish; Valentini, Rudolph; Ahmed, Maheen; Thomas, Ronald

    2012-05-01

    Despite current guidelines, variability exists in the workup of hypertensive children due to physician preferences. The study evaluates primary vs secondary hypertension diagnosis from investigations routinely performed in hypertensive children. This retrospective study included children 5 to 19 years with primary and secondary hypertension. The proportions of abnormal laboratory and imaging tests were compared between primary and secondary hypertension groups. Risk factors for primary vs secondary hypertension were evaluated by logistic regression and likelihood function analysis. Patients with secondary hypertension were younger (5-12 years) and had a higher proportion of abnormal creatinine, renal ultrasound, and echocardiogram findings. There was no significant difference in abnormal results of thyroid function, urine catecholamines, plasma renin, and aldosterone. Abnormal renal ultrasound findings and age were predictors of secondary hypertension by regression and likelihood function analysis. Children aged 5 to 12 years with abnormal renal ultrasound findings and high diastolic blood pressures are at higher risk for secondary hypertension that requires detailed evaluation. © 2012 Wiley Periodicals, Inc.

  2. Disrupted white matter structure underlies cognitive deficit in hypertensive patients

    International Nuclear Information System (INIS)

    Li, Xin; Ma, Chao; Zhang, Junying; Chen, Yaojing; Zhang, Zhanjun; Sun, Xuan; Chen, Kewei

    2016-01-01

    Hypertension is considered a risk factor of cognitive impairments and could result in white matter changes. Current studies on hypertension-related white matter (WM) changes focus only on regional changes, and the information about global changes in WM structure network is limited. We assessed the cognitive function in 39 hypertensive patients and 37 healthy controls with a battery of neuropsychological tests. The WM structural networks were constructed by utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. The direct and indirect correlations among cognitive impairments, brain WM network disruptions and hypertension were analyzed with structural equation modelling (SEM). Hypertensive patients showed deficits in executive function, memory and attention compared with controls. An aberrant connectivity of WM networks was found in the hypertensive patients (P Eglob = 0.005, P Lp = 0.005), especially in the frontal and parietal regions. Importantly, SEM analysis showed that the decline of executive function resulted from aberrant WM networks in hypertensive patients (p = 0.3788, CFI = 0.99). These results suggest that the cognitive decline in hypertensive patients was due to frontal and parietal WM disconnections. Our findings highlight the importance of brain protection in hypertension patients. (orig.)

  3. Total plasma homocysteine is associated with hypertension in Type I diabetic patients

    DEFF Research Database (Denmark)

    Neugebauer, S; Tarnow, L; Stehouwer, C D

    2002-01-01

    between plasma homocysteine concentrations, methylenetetrahydrofolate reductase gene polymorphism, hypertension, diabetic microvascular and macrovascular complications associated with kidney function. METHODS: Vascular complications, hypertension, methylenetetrahydrofolate reductase genotype (RFLP...... was an independent determinant of plasma homocysteine, the methylenetetrahydrofolate reductase gene polymorphism was neither associated with diabetic vascular complications nor with hypertension. CONCLUSION/INTERPRETATION: Increased plasma homocysteine concentrations but not the T allele per se, enhance the risk...... of hypertension and of CHD in Danish Type I diabetic patients with normal renal function....

  4. Cadmium in blood and hypertension

    International Nuclear Information System (INIS)

    Eum, Ki-Do; Lee, Mi-Sun; Paek, Domyung

    2008-01-01

    Objectives:: This study is to examine the effect of cadmium exposure on blood pressure in Korean general population. Methods:: The study population consisted of 958 men and 944 women who participated in the 2005 Korean National Health and Nutrition Examination Survey (KNHANES), in which blood pressure and blood cadmium were measured from each participant. Results:: The mean blood cadmium level was 1.67 μg/L (median level 1.55). The prevalence of hypertension was 26.2%. The blood cadmium level was significantly higher among those subjects with hypertension than those without (mean level 1.77 versus 1.64 μg/dL). After adjusting for covariates, the odds ratio of hypertension comparing the highest to the lowest tertile of cadmium in blood was 1.51 (95% confidence interval 1.13 to 2.05), and a dose-response relationship was observed. Systolic, diastolic, and mean arterial blood pressure were all positively associated with blood cadmium level, and this effect of cadmium on blood pressure was markedly stronger when the kidney function was reduced. Conclusions:: Cadmium exposures at the current level may have increased the blood pressure of Korean general population

  5. Cadmium in blood and hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Eum, Ki-Do; Lee, Mi-Sun [Department of Environmental Health, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul (Korea, Republic of); Paek, Domyung [Department of Environmental Health, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul (Korea, Republic of)], E-mail: paekdm@snu.ac.kr

    2008-12-15

    Objectives:: This study is to examine the effect of cadmium exposure on blood pressure in Korean general population. Methods:: The study population consisted of 958 men and 944 women who participated in the 2005 Korean National Health and Nutrition Examination Survey (KNHANES), in which blood pressure and blood cadmium were measured from each participant. Results:: The mean blood cadmium level was 1.67 {mu}g/L (median level 1.55). The prevalence of hypertension was 26.2%. The blood cadmium level was significantly higher among those subjects with hypertension than those without (mean level 1.77 versus 1.64 {mu}g/dL). After adjusting for covariates, the odds ratio of hypertension comparing the highest to the lowest tertile of cadmium in blood was 1.51 (95% confidence interval 1.13 to 2.05), and a dose-response relationship was observed. Systolic, diastolic, and mean arterial blood pressure were all positively associated with blood cadmium level, and this effect of cadmium on blood pressure was markedly stronger when the kidney function was reduced. Conclusions:: Cadmium exposures at the current level may have increased the blood pressure of Korean general population.

  6. Hypertension and Cardiac Arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation......) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  7. Comparison of diagnostic capability of macular ganglion cell complex and retinal nerve fiber layer among primary open angle glaucoma, ocular hypertension, and normal population using Fourier-domain optical coherence tomography and determining their functional correlation in Indian population

    Directory of Open Access Journals (Sweden)

    Nabanita Barua

    2016-01-01

    Full Text Available Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier-domain (FD optical coherence tomography (OCT among primary open angle glaucoma (POAG and ocular hypertension (OHT versus normal population. Setting and Design: Single centric, cross-sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group. After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD-OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t-test, Pearson′s coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P 0.5 when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715. Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross-sectional imaging was not valuable.

  8. Hypertensive thalamic hemorrhage

    International Nuclear Information System (INIS)

    Munaka, Masahiro; Nishikawa, Michio; Hirai, Osamu; Kaneko, Takaaki; Watanabe, Syu; Fukuma, Jun; Handa, Hajime

    1988-01-01

    In the past six years, we have had experience with 40 patients with hypertensive thalamic hemorrhages, as verified by CT scan at our hospital within 24 hours. These patients were classified into the following three groups according to the location of the bleeding point and the size of the hematoma: (1) anteromedial (4 cases), (2) posterolateral (16 cases), and (3) massive (20 cases). The (1) and (2) hematomas were small (less than 3 cm in diameter), while those in (3) were large (more than 3 cm in diameter). Twenty cases (50% of all the thalamic hematomas) were small hematomas. The characteristic clinical symptoms of the anteromedial type were a mild disturbance of consciousness and thalamic dementia, while those of the posterolateral type were motor and sensory disturbance, and thalamic aphasia, respectively. Twenty cases (50%) were large hematomas. The clinical symptoms of these cases were mainly consciousness disturbance; 7 of them expired. Based on this experience, it may be considered that the patients whose hematoma size was larger than 3 cm had a poor prognosis and that the patients with the posterolateral type had a poor functional diagnosis. (author)

  9. Melatonin, mitochondria and hypertension.

    Science.gov (United States)

    Baltatu, Ovidiu C; Amaral, Fernanda G; Campos, Luciana A; Cipolla-Neto, Jose

    2017-11-01

    Melatonin, due to its multiple means and mechanisms of action, plays a fundamental role in the regulation of the organismal physiology by fine tunning several functions. The cardiovascular system is an important site of action as melatonin regulates blood pressure both by central and peripheral interventions, in addition to its relation with the renin-angiotensin system. Besides, the systemic management of several processes, melatonin acts on mitochondria regulation to maintain a healthy cardiovascular system. Hypertension affects target organs in different ways and cellular energy metabolism is frequently involved due to mitochondrial alterations that include a rise in reactive oxygen species production and an ATP synthesis decrease. The discussion that follows shows the role played by melatonin in the regulation of mitochondrial physiology in several levels of the cardiovascular system, including brain, heart, kidney, blood vessels and, particularly, regulating the renin-angiotensin system. This discussion shows the putative importance of using melatonin as a therapeutic tool involving its antioxidant potential and its action on mitochondrial physiology in the cardiovascular system.

  10. Antihypertensive Drugs and the Sexually Active Hypertensive Male ...

    African Journals Online (AJOL)

    Background: Erectile dysfunction (ED) has made the initiations of therapy and continued therapy increasingly problematic in the management of the hypertensive male. There are reports suggesting beneficial effects of angiotensin II antagonists on sexual function. The effects of losartan on ED in Nigerian hypertensive men ...

  11. Apical Hypertrophic Cardiomyopathy in Association with PulmonaryArtery Hypertension

    Directory of Open Access Journals (Sweden)

    Mehdi Peighambari

    2012-09-01

    Full Text Available Apical Hypertrophic Cardiomyopathy is an uncommon condition constituting 1% -2% of the cases with Hypertrophic Cardiomyopathy (HCM diagnosis. We interestingly report two patients with apical hypertrophic cardiomyopathy in association with significant pulmonary artery hypertension without any other underlying reason for pulmonary hypertension. The patients were assessed by echocardiography, cardiac catheterization and pulmonary function parameters study.

  12. The renogram in renovascular hypertension

    International Nuclear Information System (INIS)

    Geyskes, G.G.

    1987-01-01

    This thesis comprises five reports on studies with renograms, radionuclide investigations of individual renal function in patients suspected of renovascular hypertension. The main question was to determine whether the renogram could trace functional changes in a kidney with a stenosed artery, before and after percutaneous transluminal angioplasty (PTA) treatment. In a given patient these functional changes could provide information on the significance of the artery stenosis as a cause of that patients' hypertension, and to some extent predict the blood pressure response after PTA treatment. An important issue in these studies is the registration of the renal effects created by captopril on the renogram. This drug with its specific inhibition of the conversion of angiotensine I to angiotensine II, amplifies the impairment of the glomerular filtration rate (GFR) in a kidney behind a stenosis. Captopril-induced deterioration of the GFR can be shown by renography, especially when it occurs in only one of two kidneys and for that reason does escape detection by overall renal function studies. 157 refs.; 16 figs.; 12 tabs

  13. Managing hypertension: relevant biomarkers and combating bioactive compounds

    Directory of Open Access Journals (Sweden)

    Bryan Singharaj

    2017-06-01

    Full Text Available Hypertension is one of the most common chronic diseases which affects many people who belong to a higher age range. The standard definition that is offered to the general public has a minimum age of 18 years to be diagnosed with hypertension. Many studies have been conducted in the hopes of finding consistent data that provides information on the biomarkers of hypertension and effective forms of treatment. However, there is a tendency for skewed data due to the ineffectiveness of diagnosing hypertension, due to variability in technique or even negligence. Interestingly, research has indicated that there are connections to certain biomarkers of hypertension. However,the results have been deemed inconclusive. Moreover, the results provide promising data for future studies that have an emphasis on biomarkers. The biomarkers that have been consistently brought to researchers’ attention include the following: circulating C-reactive protein (CRP, plasminogen activator inhibitor-1 (PAI-1, urinary albumin:creatinine ratio (UACR, and aldosterone:renin ratio (ARR. These four biomarkers have become the foundation of multiple hypertension studies, even though the only formal conclusion drawn from these studies is that there is a wide range of variables that have some kind of influence on hypertension. More recently, treatment options for hypertension have increasingly become an emphasis for studies, with research predicting that nutrition plays a key role in the managing of diseases. Furthermore, the role of bioactive compounds has gained traction in hypertension research, being loosely correlated to managing specific biomarkers. Ultimately, these correlations to bioactive compounds like antioxidants would demonstrate that certain functional foods have the capacity to help treat hypertension. The modality is to find an alternative option for managing or treating hypertension through natural sources of food or food products fortified with ingredients to

  14. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  15. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren

    2004-01-01

    to increased arterial blood pressure. Subjects with established arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin......Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic...... hemodynamics in cirrhosis. The most characteristic findings in cirrhotic patients are vasodilatation with low systemic vascular resistance, increased cardiac output, high arterial compliance, secondary activation of counterregulatory systems (sympathetic nervous system, renin-angiotensin-aldosterone system...

  16. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... well as sleep apnea, are common causes of secondary pulmonary hypertension. Other causes include the following: Congestive heart failure Birth defects in the heart Chronic pulmonary thromboembolism (blood clots in the pulmonary arteries) Acquired immunodeficiency syndrome ( ...

  17. Hypertension and Anaesthesia

    African Journals Online (AJOL)

    worldwide, and is a major risk factor for coronary artery disease, myocardial ... pressure falls in different categories of systolic and diastolic pressure the higher ... Without this consensus, the management of the elderly hypertensive patient.

  18. Diabetes + Hypertension (comorbidity)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set provides de-identified population data for diabetes and hypertension comorbidity prevalence in Allegheny County.

  19. Understanding idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Markey, Keira A; Mollan, Susan P; Jensen, Rigmor H

    2016-01-01

    Idiopathic intracranial hypertension is a disorder characterised by raised intracranial pressure that predominantly affects young, obese women. Pathogenesis has not been fully elucidated, but several causal factors have been proposed. Symptoms can include headaches, visual loss, pulsatile tinnitus...

  20. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  1. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both...... supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia......, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society...

  2. Diabetes Mellitus and Hypertension

    OpenAIRE

    Tuğrul, Armağan

    2014-01-01

    Hypertension is a major worldwide health problem. Its prevalence is 1.5-2 times higher in diabetic population than that in non-diabetic individuals. Its pathogenesis depends on diabetic nephropathy in type 1, whereas may be multifactorial in type 2 diabetes mellitus. In diabetics, angiotensin converting enzyme inhibitors are most widely preferred in the treatment of hypertension because of their numerous desirable effects. In this article, the most recent data are presented on the relationshi...

  3. Hypertension og hjernen

    DEFF Research Database (Denmark)

    Christensen, Hanne; Strandgaard, Svend

    2009-01-01

    Hypertension is a major and modifiable risk factor of stroke and dementia. Hypertension causes remodelling of the cerebral resistance vessels, impairing their tolerance to very low blood pressure. In primary prevention of stroke, the effect of beta-blockers is inferior to other classes...... of antihypertensives. In secondary prevention of stroke, ACE-inhibitors and angiotensin blockers may be recommended as first choice drugs. Lowering of the blood pressure is, however, more important than the choice of drug. Udgivelsesdato: 2009-Jun-8...

  4. Cervical Spondylosis and Hypertension

    OpenAIRE

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

  5. Thromboembolic chronicle pulmonary Hypertension

    International Nuclear Information System (INIS)

    Ovalle, Amador

    2003-01-01

    The thromboembolic chronicle pulmonary Hypertension, also well known as chronic lung thromboembolism not resolved; it is a form not very common of lung thromboembolism. Until very recently was considered a rare curiosity of autopsy, but as the methods of diagnoses have improved and our attitude has changed, the incidence of this nosological entity has experienced a notable increment, but the most excellent in this illness is maybe that it is a form of lung hypertension, potentially recoverable

  6. Renovascular hypertension: bibliographic review

    International Nuclear Information System (INIS)

    Cruz Guzman, Luis Fernando

    2011-01-01

    A review of the literature on the management of the renovascular disease is performed to provide better attention to patients. Renovascular hypertension is defined. The clinical implications and complications of the disease are determined. Pharmacological and surgical management are specified. Endovascular therapy has allowed to determine some indication in the management of hypertension renovascular. Instances where endovascular therapy has been beneficial are detailed. The new interventions for the management of renovascular disease are exposed [es

  7. Asymmetric dimethylarginine as a prognostic marker for cardiovascular complications in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Osama Tayeh

    2011-06-01

    Conclusions: ADMA is elevated in hypertensive patients. Elevated ADMA concentrations are associated with impaired endothelium functions, which are demonstrated by NO reduction in the sera of hypertensive patients. ADMA is correlated positively with the traditional cardiovascular risk factors. Also there was a strong significant negative correlation between NO and ADMA levels in the whole hypertensive groups.

  8. VALSARTAN REGULATES MYOCARDIAL AUTOPHAGY AND MITOCHONDRIAL TURNOVER IN EXPERIMENTAL HYPERTENSION

    Science.gov (United States)

    Zhang, Xin; Li, Zi-Lun; Crane, John A.; Jordan, Kyra L.; Pawar, Aditya S.; Textor, Stephen C.; Lerman, Amir; Lerman, Lilach O.

    2014-01-01

    Renovascular hypertension alters cardiac structure and function. Autophagy is activated during left ventricular hypertrophy and linked to adverse cardiac function. The Angiotensin II receptor blocker Valsartan lowers blood pressure and is cardioprotective, but whether it modulates autophagy in the myocardium is unclear. We hypothesized that Valsartan would alleviate autophagy and improve left ventricular myocardial mitochondrial turnover in swine renovascular hypertension. Domestic pigs were randomized to control, unilateral renovascular hypertension, and renovascular hypertension treated with Valsartan (320 mg/day) or conventional triple therapy (Reserpine+hydralazine+hydrochlorothiazide) for 4 weeks post 6-weeks of renovascular hypertension (n=7 each group). Left ventricular remodeling, function and myocardial oxygenation and microcirculation were assessed by multi-detector computer tomography, blood-oxygen-level-dependent magnetic resonance imaging and microcomputer tomography. Myocardial autophagy, markers for mitochondrial degradation and biogenesis, and mitochondrial respiratory-chain proteins were examined ex vivo. Renovascular hypertension induced left ventricular hypertrophy and myocardial hypoxia, enhanced cellular autophagy and mitochondrial degradation, and suppressed mitochondrial biogenesis. Valsartan and triple therapy similarly decreased blood pressure, but Valsartan solely alleviated left ventricular hypertrophy, ameliorated myocardial autophagy and mitophagy, and increased mitochondrial biogenesis. In contrast, triple therapy only slightly attenuated autophagy and preserved mitochondrial proteins, but elicited no improvement in mitophagy. These data suggest a novel potential role of Valsartan in modulating myocardial autophagy and mitochondrial turnover in renovascular hypertension-induced hypertensive heart disease, which may possibly bolster cardiac repair via a blood pressure-independent manner. PMID:24752430

  9. Sex differences in T cells in hypertension.

    Science.gov (United States)

    Tipton, Ashlee J; Sullivan, Jennifer C

    2014-12-01

    Hypertension is a major risk factor for cardiovascular disease, stroke, and end-organ damage. There is a sex difference in blood pressure (BP) that begins in adolescence and continues into adulthood, in which men have a higher prevalence of hypertension compared with women until the sixth decade of life. Less than 50% of hypertensive adults in the United States manage to control their BP to recommended levels using current therapeutic options, and women are more likely than are men to have uncontrolled high BP. This, is despite the facts that more women compared with men are aware that they have hypertension and that women are more likely to seek treatment for the disease. Novel therapeutic targets need to be identified in both sexes to increase the percentage of hypertensive individuals with controlled BP. The purpose of this article was to review the available literature on the role of T cells in BP control in both sexes, and the potential therapeutic application/implications of targeting immune cells in hypertension. A search of PubMed was conducted to determine the impact of sex on T cell-mediated control of BP. The search terms included sex, gender, estrogen, testosterone, inflammation, T cells, T regulatory cells, Th17 cells, hypertension, and blood pressure. Additional data were included from our laboratory examinations of cytokine expression in the kidneys of male and female spontaneously hypertensive rats (SHRs) and differential gene expression in both the renal cortex and mesenteric arterial bed of male and female SHRs. There is a growing scientific literature base regarding the role of T cells in the pathogenesis of hypertension and BP control; however, the majority of these studies have been performed exclusively in males, despite the fact that both men and women develop hypertension. There is increasing evidence that although T cells also mediate BP in females, there are distinct differences in both the T-cell profile and the functional impact of sex

  10. Spatial Memory in Spontaneously Hypertensive Rats (SHR)

    NARCIS (Netherlands)

    Sontag, Thomas-A.; Fuermaier, Anselm B. M.; Hauser, Joachim; Kaunzinger, Ivo; Tucha, Oliver; Lange, Klaus W.

    2013-01-01

    The spontaneously hypertensive rat (SHR) is an established animal model of ADHD. It has been suggested that ADHD symptoms arise from deficits in executive functions such as working memory, attentional control and decision making. Both ADHD patients and SHRs show deficits in spatial working memory.

  11. Extrahepatic complications to cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens H; Bendtsen, Flemming

    2014-01-01

    In addition to complications relating to the liver, patients with cirrhosis and portal hypertension develop extrahepatic functional disturbances of multiple organ systems. This can be considered a multiple organ failure that involves the heart, lungs, kidneys, the immune systems, and other organ...

  12. Relationship of endothelial dysfunction with degree of renal function damage and lipidemic profile in patients with type 2 diabetes mellitus and hypertension

    Directory of Open Access Journals (Sweden)

    Pertseva N.O.

    2014-09-01

    Full Text Available In the article defining relationship between endothelial dysfunction, the degree of renal and lipidemic profile damage in 234 patients with type 2 diabetes mellitus with hypertension was carried depending on the quality of glycemic control. It is shown that the deepening of endothelial dysfunction in patients with insufficient and poor compensation tightly correlates with the degree of renal and lipidemic disorders. In these patients there was a significant increase in the level of albuminuria, reduction in glomerular filtration rate, increase of concentrations of urea and creatinine. Against the background of poor hyperglycemia, compensation total cholesterol, low density lipoprotein content increases by 73,3% (p<0.05, hype¬rtriglyceridemia twice exceeds the control values. In patients with type 2 diabetes mellitus with poor compensation the most significant correlation links were observed between the concentration of endothelin-1 and the level of microalbuminuria (r=+0,79, as well as the content of low density lipoprotein cholesterol (r=+0.81. Thrombomodulin concentration is in direct correlation with microalbuminuria (r=+0.76, hypercholesterolemia (r=+0.80 and hypertriglyceridemia (r=+0.83, indicating to increasing interaction between the pathogenetic mechanisms which cause depression of endothelial dysfunction, renal and dyslipidemic disorders with increasing hyperglycemia.

  13. Pulmonary arterial hypertension secondary to chronic thromboemboli

    International Nuclear Information System (INIS)

    Crysikopoulos, H.; Forrest, J.V.; Olson, L.K.; Roberts, A.C.

    1989-01-01

    The authors report their experience in 150 patients with pulmonary arterial hypertension secondary to chronic pulmonary embolism (CPE). Plain film findings are variable, commonly nonspecific. Occasionally nonuniformity of pulmonary perfusion or truncation of central pulmonary arteries suggest CPE. Multiple, large, unmatched perfusion defects are the most common scintigraphic observations. CT can exclude conditions mimicking CPE, particularly fibrosing mediastinitis. Pulmonary arteriography depicts the location and distribution of emboli. CPE is becoming an increasingly important entity to recognize because of available surgical treatment. Thromboendarterectomy may improve functional status and survival. The diagnosis should be considered in any patient with pulmonary arterial hypertension

  14. Management of diabetic hypertensives

    Science.gov (United States)

    Ganesh, Jai; Viswanathan, Vijay

    2011-01-01

    Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP) reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives. PMID:22145142

  15. Hypertension in postmenopausal women: how to approach hypertension in menopause.

    Science.gov (United States)

    Modena, Maria Grazia

    2014-09-01

    During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

  16. Vulnerability of the frontal and parietal regions in hypertensive patients during working memory task.

    Science.gov (United States)

    Li, Xin; Wang, Wenxiao; Wang, Ailin; Li, Peng; Zhang, Junying; Tao, Wuhai; Zhang, Zhanjun

    2017-05-01

    Hypertension is related with cognitive decline in the elderly. The frontal-parietal executive system plays an important role in cognitive aging and is also vulnerable to damage in elderly patients with hypertension. Examination of the brain's functional characteristics in frontal-parietal regions of hypertension is likely to be important for understanding the neural mechanisms of hypertension's effect on cognitive aging. We address this issue by comparing hypertension and control-performers in a functional MRI study. Twenty-eight hypertensive patients and 32 elderly controls were tested with n-back task with two load levels. The hypertensive patients exhibited worse executive and memory abilities than control subjects. The patterns of brain activation changed under different working memory loads in the hypertensive patients, who exhibited reduced activation only in the precentral gyrus under low loads and reduced activation in the middle frontal gyrus, left medial superior frontal gyrus and right precuneus under high loads. Thus, more regions of diminished activation were observed in the frontal and parietal regions with increasing task difficulty. More importantly, we found that lower activation in changed frontal and parietal regions was associated with worse cognitive function in high loads. The results demonstrate the relationship between cognitive function and frontoparietal functional activation in hypertension and their relevance to cognitive aging risk. Our findings provide a better understanding of the mechanism of cognitive decline in hypertension and highlight the importance of brain protection in hypertension.

  17. IGF-1 deficiency impairs cerebral myogenic autoregulation in hypertensive mice.

    Science.gov (United States)

    Toth, Peter; Tucsek, Zsuzsanna; Tarantini, Stefano; Sosnowska, Danuta; Gautam, Tripti; Mitschelen, Matthew; Koller, Akos; Sonntag, William E; Csiszar, Anna; Ungvari, Zoltan

    2014-12-01

    Aging impairs autoregulatory protection in the brain, exacerbating hypertension-induced cerebromicrovascular injury, neuroinflammation, and development of vascular cognitive impairment. Despite the importance of the age-related decline in circulating insulin-like growth factor-1 (IGF-1) levels in cerebrovascular aging, the effects of IGF-1 deficiency on functional adaptation of cerebral arteries to high blood pressure remain elusive. To determine whether IGF-1 deficiency impairs autoregulatory protection, hypertension was induced in control and IGF-1-deficient mice (Igf1(f/f)+TBG-iCre-AAV8) by chronic infusion of angiotensin-II. In hypertensive control mice, cerebral blood flow (CBF) autoregulation was extended to higher pressure values and the pressure-induced tone of middle cerebral arteries (MCAs) was increased. In hypertensive IGF-1-deficient mice, autoregulation was markedly disrupted, and MCAs did not show adaptive increases in myogenic tone. In control mice, the mechanism of adaptation to hypertension involved upregulation of TRPC channels in MCAs and this mechanism was impaired in hypertensive IGF-1-deficient mice. Likely downstream consequences of cerebrovascular autoregulatory dysfunction in hypertensive IGF-1-deficient mice included exacerbated disruption of the blood-brain barrier and neuroinflammation (microglia activation and upregulation of proinflammatory cytokines and chemokines), which were associated with impaired hippocampal cognitive function. Collectively, IGF-1 deficiency impairs autoregulatory protection in the brain of hypertensive mice, potentially exacerbating cerebromicrovascular injury and neuroinflammation mimicking the aging phenotype.

  18. Radionuclide assessment of portal hypertension syndrome

    International Nuclear Information System (INIS)

    Aliev, M.A.; Khusain, Sh.K.; Alpeisova, Sh.T.

    2005-01-01

    This paper presents review of radionuclide studies for portal hypertension patients. Presented results showed that portal hypertension signs were revealed for the first group patients. The signs become apparent by splenomegaly and increase of colloid accumulation in it. Accumulation of the chemical in spleen was evidence of ingestion rate increase of reticuloendothelial system owing to its hyperplasia as well as liver phagocytic activity decrease due to pathological paren-chematous process and inter liver blockade. The most typical scintigraphic signs of portal hypertension were determined according chemical accumulation decreased in spleen and marrow sequentially. It is determined radionuclide method contributes to assessment of structural and functional aberrations character in liver and spleen for cirrhosis patients. (author)

  19. Knowledge and awareness of hypertension among patients with systemic hypertension.

    Science.gov (United States)

    Familoni, B. Oluranti; Ogun, S. Abayomi; Aina, A. Olutoyin

    2004-01-01

    BACKGROUND: In Nigeria, systemic hypertension is the commonest noncommunicable disease, and public awareness about hypertension and its determinants is poor. This study aims to assess the knowledge and level of awareness of the disease among hypertensive patients attending the medical outpatient clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH). METHODOLOGY: Hypertensive patients who attended the medical outpatient clinic during the one-year study period and gave their consent were recruited into the study. Response to a questionnaire on various aspects of hypertension was analyzed using the STATA for Windows software. RESULTS: There were 254 hypertensive patients, of which 111 were males and 143 were females, giving a male: female ratio of 1:1.3. The mean age (SD) of the patients was 51 years +/- 12.2; 52.4% of the participants were aware that hypertension was the commonest noncommunicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure. Only about one-third (35.4%) of the patients knew that hypertension should ideally be treated for life, while 58.3% believed that antihypertensive drugs should be used only when there are symptoms. The remaining 6.3% believed that the treatment of hypertension should be for periods ranging from two weeks to five years but not for life. CONCLUSION: This study has demonstrated inadequate knowledge of hypertension in patients with hypertension in our study population. Conscious efforts should be made and time set aside to health educate hypertensive patients. Organization of "hypertensive club or society" could be encouraged. These will reduce dissemination of false or inaccurate information by hypertensive patients to the public and its attendant dangers. PMID:15160976

  20. [Hypertension in females].

    Science.gov (United States)

    Cífková, Renata

    2015-05-01

    Hypertension is the most common cardiovascular disorder affecting more males in younger age groups; in the age group of 45-64, it is equally frequent in both genders, it is more common in elderly females. Blood pressure increases more in females around the menopause. Use of hormonal replacement therapy is not associated with an BP increase but, because of increased risk of coronary events, stroke, and thromboembolic events, HRT is not re-commended in CVD prevention. There is a similar decrease in BP by antihypertensive drugs in both genders as well as benefit from antihypertensive treatment. Women report about a double rate of adverse events of antihypertensive drugs. Oral contraception use is associated with a mild BP increase in most women and development of overt hypertension in about 5 %. Pre-eclampsia is associated with increased risk of developing CVD later in life (more frequent development of hypertension, myocardial infarction, and stroke).

  1. Pulmonary hypertension in patients with Martorell hypertensive leg ulcer: a case control study

    Science.gov (United States)

    2012-01-01

    Background Martorell hypertensive ischemic leg ulcer (Martorell ulcer) is characterized by distinct alterations in the arteriolar wall of subcutaneous vessels, leading to progressive narrowing of the vascular lumen and increase of vascular resistance. These changes are similar to the alterations observed in pulmonary arterioles in patients with chronic pulmonary hypertension (PH). This study was aimed to assess an association between the two disorders. Methods In this case–control study, 14 patients with Martorell ulcer were clinically assessed for the presence of pulmonary hypertension using transthoracic Doppler echocardiography. Data from patients were compared to 28 matched hypertensive controls. Results Systolic pulmonary arterial pressure (sPAP) in patients with Martorell ulcer was significantly higher than in the control group (33.8 ± 16.9 vs 25.3 ± 6.5 mmHg, p = 0.023); the prevalence of pulmonary hypertension was 31% (5/14) in patients and 7% (2/28) in controls (p = 0.031). No differences were seen in left heart size and function between patients and controls. Conclusion This study provides first evidence that subcutaneous arteriolosclerosis, the hallmark of Martorell ulcer, is associated with PH. These findings suggest that patients with Martorell leg ulcer might be at significant risk to develop elevated pulmonary arterial pressure. Patients with leg ulcers who present with dyspnea should be evaluated by echocardiography for the presence of pulmonary hypertension. PMID:22686459

  2. Clinically significant change in stroke volume in pulmonary hypertension

    NARCIS (Netherlands)

    van Wolferen, S.A.; van de Veerdonk, M.C.; Mauritz, G.J.; Jacobs, W.; Marcus, J.T.; Marques, K.M.J.; Bronzwaer, J.G.F.; Heijmans, M.W.; Boonstra, A.; Postmus, P.E.; Westerhof, N.; Noordegraaf, A.V.

    2011-01-01

    Background: Stroke volume is probably the best hemodynamic parameter because it reflects therapeutic changes and contains prognostic information in pulmonary hypertension (PH). Stroke volume directly reflects right ventricular function in response to its load, without the correction of compensatory

  3. Exercise scintirenography in normotensive young offspring of essential hypertensives

    International Nuclear Information System (INIS)

    Kong Fanzhen; Zhang Chenggang; Zhao Deshan

    2004-01-01

    Objective: To observe whether there is potential renal function decline in normotensive young offspring of essential hypertensives and to probe into the possible mechanism giving rise to it, providing some clues to the study of the pathogenic and hereditary mechanism of essential hypertension. Methods: Using 99 Tc m -DTPA as the imaging agent, authors performed rest and exercise scintirenography in normotensive young offspring of essential hypertensives [NOH, 31 cases, 14 males, 17 females; mean age: (23.2 ± 4.1) years], normotensive young off-spring of non-hypertensives [NON, 31 cases, 20 males, 11 females; mean age: (23.1±3.6) years], some of the hypertensive parents [21 cases, 5 males, 16 females; mean age: (53.0 ± 5.61) years] and old non-hypertensive subjects [10 cases, 6 males, 4 females; mean age: (53.7 ± 5.2) years]. The results were analyzed with the software of SPSS 10.0 for Windows. Results: Though all of the rest renal function indexes from NOH were within the normal range, there were significant differences between most of those indexes from NOH and those from NON, e. g., t p and MTT from NOH were significantly delayed than those from NON; exercise made these differences more significant, and after exercise, glomerular filtration rate (GFR) and RI were significantly lower, and 20/P was significantly higher. There were 4, 5, 2 cases showing abnormal exercise scintirenography in NOH, hypertensive parents and old non-hypertensive subjects, respectively, but none in NON group. Conclusions: There is potential renal function decline in normotensive young offspring of essential hypertensives. The kidney may play an important role in the pathogenic and hereditary mechanism of essential hypertension

  4. Peripheral adrenergic receptors in hypertension

    NARCIS (Netherlands)

    Michel, M. C.; Brodde, O. E.; Insel, P. A.

    1990-01-01

    Increased sympathoadrenal activity appears to play an important role in the development or maintenance of elevated blood pressure in hypertensive patients and various animal models of hypertension. Alterations of adrenergic receptor number or responsiveness might contribute to this increased

  5. Radiation-induced renovascular hypertension

    International Nuclear Information System (INIS)

    Staab, G.E.; Tegtmeyer, C.J.; Constable, W.C.

    1976-01-01

    Radiation is known to produce changes in the small vessels and interstitium of the kidneys resulting in hypertension. Two cases of renal artery stenosis and resultant hypertension secondary to abdominal irradiation are reported and the literature is reviewed

  6. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance

  7. Knowing hypertension and diabetes

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2015-01-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology...... for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy...

  8. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected but u...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  9. Hypertension and renovascular disease

    DEFF Research Database (Denmark)

    Hasbak, P; Ibsen, H; Jensen, Lars Thorbjørn

    2002-01-01

    The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21%), nephr......The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21...

  10. [The leptin concentration in patients with primary arterial hypertension].

    Science.gov (United States)

    Jołda-Mydłowska, Beata; Przewłocka-Kosmala, Monika; Zyśko, Dorota; Gajek, Jacek; Mazurek, Walentyna

    2006-01-01

    Leptin seems to play a role in the pathogenesis of arterial hypertension by activation of the sympathetic nervous system, influencing water - electrolyte balance and vascular remodeling. It is not known whether leptin is a factor participating in the pathogenesis of primary arterial hypertension or its higher concentration in patients with arterial hypertension reflects only the presence of other factors leading to increased blood pressure. The aim of the study was to try to estimate the leptin participation in the development of the arterial hypertension, to evaluate the concentration of leptin in blood serum of patients with mild, moderate and severe arterial hypertension and to determine the relationships between the observed leptin concentration, arterial hypertension degree according to WHO criteria and body mass. The investigations were performed on 74 untreated patients aged 19-74 years (mean 47 +/- 12 years ). In this group there were 33 women aged 35-74 years (mean 51 +/- 10 years) and 41 men aged 19-73 years (mean 45 +/- 14 years). The mild arterial hypertension was observed in 24 patients, moderate hypertension in 34 patients and severe hypertension in 16. The obesity, identified when BMI was equal or higher than 30 kg/m2, was observed in 4 patients with mild hypertension, in 9 with moderate hypertension and in 6 with severe hypertension. All patients had normal renal function. The leptin concentration was determined by the radioimmunological method using the Human Leptin RIA Kit by LINCO Research, Inc. (Cat# HL-81 K). The analysis of the obtained results was performed using Statistica for Windows PL.V5.0. The concentration of leptin in patients with mild hypertension was 3.61 +/- 2.22 ng/ml, in patients with moderate hypertension was 12.65 +/- 8.48 and in patients with severe hypertension 33.51 +/- 28.45 ng/ml. The concentration of leptin in obese patients was 24.83 +/- 26.60 and in patients without obesity was 10.57 +/- 11.99 ng/ml. 1. In patients with

  11. Adaptation of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR into French-Canadian and English-Canadian

    Directory of Open Access Journals (Sweden)

    Donna Coffin

    2008-01-01

    Full Text Available BACKGROUND: The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR is the first disease-specific instrument for assessing patient-reported symptoms, functioning and quality of life (QoL in pulmonary arterial hypertension (PAH.

  12. Hyperuricemia in Childhood Primary Hypertension

    OpenAIRE

    Feig, Daniel I.; Johnson, Richard J.

    2003-01-01

    Experimental animal models suggest that uric acid might have a pathogenic role in the early development of primary hypertension. We hypothesized that serum uric acid is correlated with blood pressure in children with new-onset, untreated, primary hypertension. We evaluated 125 consecutive children referred to the Baylor Pediatric Renal Program for evaluation of hypertension. None of the subjects had previously been evaluated or treated for hypertension. The children ranged in age from 6 to 18...

  13. Hypertension and experimental stroke therapies

    OpenAIRE

    O'Collins, Victoria E; Donnan, Geoffrey A; Macleod, Malcolm R; Howells, David W

    2013-01-01

    Hypertension is an established target for long-term stroke prevention but procedures for management of hypertension in acute stroke are less certain. Here, we analyze basic science data to examine the impact of hypertension on candidate stroke therapies and of anti-hypertensive treatments on stroke outcome. Methods: Data were pooled from 3,288 acute ischemic stroke experiments (47,899 animals) testing the effect of therapies on infarct size (published 1978–2010). Data were combined using meta...

  14. Chronic brain ischemia in patients with arterial hypertension and hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.Ye. Kovalenko

    2017-02-01

    Full Text Available The questions of the pathogenesis of chronic brain ischemia in patients with hypertension and hypothyroidism are studied. Examples of some results of authors’ research are listed. According to the research, patients with hypertensive dyscirculatory encephalopathy and hypothyroidism have deterioration of blood supply to the brain by reducing the reactivity of the vascular wall, decrease in the functional activity of the brain, impairement of cognitive function and increase in the anxiety and depression.

  15. EMERGENCY STATES IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. A. Gurevich

    2014-01-01

    Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.

  16. Advances in the treatment of portal hypertension in cirrhosis.

    Science.gov (United States)

    Kimer, N; Wiese, S; Mo, S; Møller, S; Bendtsen, F

    2016-08-01

    Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension.

  17. Advances in the treatment of portal hypertension in cirrhosis

    DEFF Research Database (Denmark)

    Kimer, Nina; Wiese, S; Mo, S S

    2016-01-01

    Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led...... to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas...... of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension....

  18. Hyponatremic Hypertensive Syndrome in an Obese man with Renal Ischemia

    International Nuclear Information System (INIS)

    Saeed, K.

    2006-01-01

    Renovascular hypertension occasionally manifests as an electrolyte disorder. The combination of hyponetrimia and renovascular hypertension occasionally manifests as an electrolyte disorder. The combination of hyponatremia and renovascular hypertension is known as hyponatremic-hypertensive syndrome. This syndrome was initially reported in children. Here we describe a 45 year-old Saudi man who was admitted to the hospital with generalized body weakness and inability to walk. He was confused and was noted to have severe hypertension and very low serum sodium and potassium. The patient was recently started on captopril for blood pressure control, which was discontinued because of deterioration renal function. Color Doppler renal ultrasound, and magnetic resonance angiography confirmed the diagnosis of renal artery stenosis. (author)

  19. Systolic hypertension: an increasing clinical challenge in Asia

    Science.gov (United States)

    Park, Jeong Bae; Kario, Kazuomi; Wang, Ji-Guang

    2015-01-01

    Systolic hypertension, the predominant form of hypertension in patients aged over 50–60 years, is a growing health issue as the Asian population ages. Elevated systolic blood pressure is mainly caused by arterial stiffening, resulting from age-related vascular changes. Elevated systolic pressure increases the risk of cardiovascular disease, mortality and renal function decline, and this risk may increase at lower systolic pressure levels in Asian than Western subjects. Hence, effective systolic pressure lowering is particularly important in Asians yet blood pressure control remains inadequate despite the availability of numerous antihypertensive medications. Reasons for poor blood pressure control include low awareness of hypertension among health-care professionals and patients, under-treatment, and tolerability problems with antihypertensive drugs. Current antihypertensive treatments also lack effects on the underlying vascular pathology of systolic hypertension, so novel drugs that address the pathophysiology of arterial stiffening are needed for optimal management of systolic hypertension and its cardiovascular complications. PMID:25503845

  20. Interaction of hypertension and age in visual selective attention performance.

    Science.gov (United States)

    Madden, D J; Blumenthal, J A

    1998-01-01

    Previous research suggests that some aspects of cognitive performance decline as a joint function of age and hypertension. In this experiment, 51 unmedicated individuals with mild essential hypertension and 48 normotensive individuals, 18-78 years of age, performed a visual search task. The estimated time required to identify a display character and shift attention between display positions increased with age. This attention shift time did not differ significantly between hypertensive and normotensive participants, but regression analyses indicated some mediation of the age effect by blood pressure. For individuals less than 60 years of age, the error rate was greater for hypertensive than for normotensive participants. Although the present design could detect effects of only moderate to large size, the results suggest that effects of hypertension may be more evident in a relatively general measure of performance (mean error rate) than in the speed of shifting visual attention.

  1. Primary lung hypertension in-patient with hypertension portal

    International Nuclear Information System (INIS)

    Restrepo Uribe; Villa Restrepo, Alfredo

    1990-01-01

    Thorax x-rays were reviewed in 18 patients with portal hypertension. In 28% of these we found radiologic signs of pulmonary hypertension of the precapillary type. The existing relation between primary pulmonary hypertension and portal hypertension has been established in different scientific papers. In the published series the incidence of primary pulmonary hypertension is less than the one of found in these patients the physiopathology of this association is reviewed, and as a hypothetic manner it is postulated the possible roll of the hypoxaemia of the residents, at the altitude of the Bogota city. (2.640 mts) as a helping factor in this phenomenon

  2. Effects of renal denervation with a standard irrigated cardiac ablation catheter on blood pressure and renal function in patients with chronic kidney disease and resistant hypertension.

    Science.gov (United States)

    Kiuchi, Márcio Galindo; Maia, George Luiz Marques; de Queiroz Carreira, Maria Angela Magalhães; Kiuchi, Tetsuaki; Chen, Shaojie; Andrea, Bruno Rustum; Graciano, Miguel Luis; Lugon, Jocemir Ronaldo

    2013-07-01

    Evaluation of the safety and efficacy of renal denervation with a standard irrigated cardiac ablation catheter (SICAC) in chronic kidney disease (CKD) patients with refractory hypertension. Twenty-four patients were included and treated with a SICAC. Denervation was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n = 16), 3 (n = 4), and 4 (n = 4). Data were obtained at baseline and monthly until 180th day of follow-up. Baseline values of blood pressure (mean ± SD) were 186 ± 19 mmHg/108 ± 13 mmHg in the office, and 151 ± 18 mmHg/92 ± 11 mmHg by 24 h ambulatory blood pressure monitoring (ABPM). Office blood pressure values at 180th day after the procedure were 135 ± 13 mmHg/88 ± 7 mmHg (P < 0.0001, for both comparisons). The mean ABPM decreased to 132 ± 15 mmHg/85 ± 11 mmHg at the 180th day after the procedure (P < 0.0001 for systolic and P = 0.0015 for diastolic). Estimated glomerular filtration (mean ± SD) increased from baseline (64.4 ± 23.9 mL/min/1.73 m(2)) to the 180th day (85.4 ± 34.9 mL/min/1.73 m(2), P < 0.0001) of follow-up. The median urine albumin:creatinine ratio decreased from baseline (48.5, IQR: 35.8-157.2 mg/g) to the 180th day after ablation (ACR = 15.7, IQR: 10.3-34.2 mg/g, P = 0.0017). No major complications were seen. The procedure using SICAC seemed to be feasible, effective, and safe resulting in a better control of BP, a short-term increase in estimated glomerular filtration rate, and reduced albuminuria. Although encouraging, our data are preliminary and need to be validated in the long term.

  3. The impact of a multidisciplinary self-care management program on quality of life, self-care, adherence to anti-hypertensive therapy, glycemic control, and renal function in diabetic kidney disease: A Cross-over Study Protocol.

    Science.gov (United States)

    Helou, Nancy; Talhouedec, Dominique; Shaha, Maya; Zanchi, Anne

    2016-07-19

    Diabetic kidney disease, a global health issue, remains associated with high morbidity and mortality. Previous research has shown that multidisciplinary management of chronic disease can improve patient outcomes. The effect of multidisciplinary self-care management on quality of life and renal function of patients with diabetic kidney disease has not yet been well established. The aim of this study is to evaluate the impact of a multidisciplinary self-care management program on quality of life, self-care behavior, adherence to anti-hypertensive treatment, glycemic control, and renal function of adults with diabetic kidney disease. A uniform balanced cross-over design is used, with the objective to recruit 40 adult participants with diabetic kidney disease, from public and private out-patient settings in French speaking Switzerland. Participants are randomized in equal number into four study arms. Each participant receives usual care alternating with the multidisciplinary self- care management program. Each treatment period lasts three months and is repeated twice at different time intervals over 12 months depending on the cross-over arm. The multidisciplinary self-care management program is led by an advanced practice nurse and adds nursing and dietary consultations and follow-ups, to the habitual management provided by the general practitioner, the nephrologist and the diabetologist. Data is collected every three months for 12 months. Quality of life is measured using the Audit of Diabetes-Dependent Quality of Life scale, patient self-care behavior is assessed using the Revised Summary of Diabetes Self-Care Activities, and adherence to anti-hypertensive therapy is evaluated using the Medication Events Monitoring System. Blood glucose control is measured by the glycated hemoglobin levels and renal function by serum creatinine, estimated glomerular filtration rate and urinary albumin/creatinine ratio. Data will be analyzed using STATA version 14. The cross

  4. Decoding white coat hypertension

    Science.gov (United States)

    Bloomfield, Dennis A; Park, Alex

    2017-01-01

    There is arguably no less understood or more intriguing problem in hypertension that the “white coat” condition, the standard concept of which is significantly blood pressure reading obtained by medical personnel of authoritative standing than that obtained by more junior and less authoritative personnel and by the patients themselves. Using hospital-initiated ambulatory blood pressure monitoring, the while effect manifests as initial and ending pressure elevations, and, in treated patients, a low daytime profile. The effect is essentially systolic. Pure diastolic white coat hypertension appears to be exceedingly rare. On the basis of the studies, we believe that the white coat phenomenon is a common, periodic, neuro-endocrine reflex conditioned by anticipation of having the blood pressure taken and the fear of what this measurement may indicate concerning future illness. It does not change with time, or with prolonged association with the physician, particularly with advancing years, it may be superimposed upon essential hypertension, and in patients receiving hypertensive medication, blunting of the nighttime dip, which occurs in about half the patients, may be a compensatory mechanisms, rather than an indication of cardiovascular risk. Rather than the blunted dip, the morning surge or the widened pulse pressure, cardiovascular risk appears to be related to elevation of the average night time pressure. PMID:28352632

  5. Angiography for renal hypertension

    International Nuclear Information System (INIS)

    Chuang, V.P.; Ernst, C.B.

    1985-01-01

    As angioplasty and operative techniques have become more precise and successful, so have evaluation techniques. Preoperative arteriography is indispensible for deciding on the appropriate treatment modality and the specifics of the procedure. Arteriography, therefore, remains the cornerstone in managing renovascular hypertension and renal arterial disease

  6. Children and Hypertension.

    Science.gov (United States)

    Carter, Denise

    1983-01-01

    Since children as young as seven years old can suffer from hypertension, all children should have blood pressure checked during physical examinations. Guidelines for testing children's blood pressure are presented along with suggestions about what schools and parents can do to help deal with the problem. (PP)

  7. Project "Hypertension Alert."

    Science.gov (United States)

    Sailors, Emma Lou

    1983-01-01

    "Hypertension Alert," a 1979-80 blood pressure screening-awareness project of the Yonkers, New York Public Schools, is described. Data is analyzed in tables for ethnic composition, and range of blood pressure readings for the high school, junior high school, and elementary school students tested. (Author/JMK)

  8. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  9. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Jan ... Pressure" This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  10. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Andersen, Niels Holmark; Svendsen, Tage Lysbo

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  11. Fermented milk for hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Reimer, Christina; Ibsen, Hans

    2012-01-01

    Fermented milk has been suggested to have a blood pressure lowering effect through increased content of proteins and peptides produced during the bacterial fermentation. Hypertension is one of the major risk factors for cardiovascular disease world wide and new blood pressure reducing lifestyle...

  12. Nitroglycerin kan give hypertension

    DEFF Research Database (Denmark)

    Mørup, Peter; Levinsen, Tine Holbæk; Hovind, Peter

    2011-01-01

    Hg. The conclusion was that her response was a paradoxical response to glycerylnitrate, orthostatism and a pathological response to massage of the carotid artery. This is the third reported case on paradoxical hypertension induced by glyceryl nitrates. It is speculated that dysfunction of the cerebral bloodflow...

  13. Hypertension and physical exercise: The role of oxidative stress.

    Science.gov (United States)

    Korsager Larsen, Monica; Matchkov, Vladimir V

    2016-01-01

    Oxidative stress is associated with the pathogenesis of hypertension. Decreased bioavailability of nitric oxide (NO) is one of the mechanisms involved in the pathogenesis. It has been suggested that physical exercise could be a potential non-pharmacological strategy in treatment of hypertension because of its beneficial effects on oxidative stress and endothelial function. The aim of this review is to investigate the effect of oxidative stress in relation to hypertension and physical exercise, including the role of NO in the pathogenesis of hypertension. Endothelial dysfunction and decreased NO levels have been found to have the adverse effects in the correlation between oxidative stress and hypertension. Most of the previous studies found that aerobic exercise significantly decreased blood pressure and oxidative stress in hypertensive subjects, but the intense aerobic exercise can also injure endothelial cells. Isometric exercise decreases normally only systolic blood pressure. An alternative exercise, Tai chi significantly decreases blood pressure and oxidative stress in normotensive elderly, but the effect in hypertensive subjects has not yet been studied. Physical exercise and especially aerobic training can be suggested as an effective intervention in the prevention and treatment of hypertension and cardiovascular disease via reduction in oxidative stress. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  14. Renal scintigraphy with captopril for the investigation of arterial hypertension

    International Nuclear Information System (INIS)

    Nitzsche, E.; Strauss, E.; Moser, E.; Grosser, G.; Sankt Marienkrankenhaus, Frankfurt am Main; Rump, C.; Keller, E.; Meyer, E.

    1991-01-01

    Renal artery stenosis (RAS) is a rare cause of hypertension. Radiological tests can disclose the morphological changes, but not their functional effect on renal function and perfusion. Normalization of the blood pressure can be achieved by intervention (operation, percutaneous transluminal renal angiography; PTRA), in cases of prolonged RAS-induced hypertension long-term preservation of the organ function is most important. The purpose of this study was the validation of captopril renography as a screening test for hypertension secondary to RAS prior to PTRA. Captopril renography with 99m Tc-MAG 3 has a high sensitivity (94%) and acceptable specificity (88%) for the screening of hypertensive patients. The positive predictive value is 74% and the negative predictive value 98%, compared with the 'gold standard' of angiography. (orig.) [de

  15. EFFICACY AND SAFETY OF INHALED NITRIC OXIDE USE IN PATIENTS WITH PULMONARY HYPERTENSION AND CHRONIC HEART FAILURE III-IV FUNCTIONAL CLASS, SURVIVED LEFT VENTRICULAR MYOCARDIAL INFARCTION: RESULTS OF NON-RANDOMIZED COMAPARIVE STUDY

    Directory of Open Access Journals (Sweden)

    P. N. Pavlenko

    2011-01-01

    Full Text Available Aim – assessment of the influence of inhaled nitric oxide (NO on the course of pulmonary hypertension (PH in patients with chronic heartfailure (CHF III–IV functional class (FC, myocardial infarction (MI.Materials and methods. Results of comparative non-randomized study that included 45 patients (26 men and 19 women aged 51 to 98 years with PH III–IV functional class, left ventricular myocardial infarction. In the study, patients underwent physical examination and Doppler echocardiography, and assessed FC LH (carried out with six-minute walking test, to determine the degree of dyspnea by Borg.Results. Symptoms of CHF and PH regressed in both groups of patients against the background of the therapy. Conclusion. It is established that the use of inhaled NO is a safe therapy and helps to reduce mean pulmonary arterial pressure (PAPmean in patients with PH and CHF III–IV FC, myocardial infarction. The method of inhaled NO is simple and easy to use.

  16. EFFICACY AND SAFETY OF INHALED NITRIC OXIDE USE IN PATIENTS WITH PULMONARY HYPERTENSION AND CHRONIC HEART FAILURE III-IV FUNCTIONAL CLASS, SURVIVED LEFT VENTRICULAR MYOCARDIAL INFARCTION: RESULTS OF NON-RANDOMIZED COMAPARIVE STUDY

    Directory of Open Access Journals (Sweden)

    P. N. Pavlenko

    2014-07-01

    Full Text Available Aim – assessment of the influence of inhaled nitric oxide (NO on the course of pulmonary hypertension (PH in patients with chronic heartfailure (CHF III–IV functional class (FC, myocardial infarction (MI.Materials and methods. Results of comparative non-randomized study that included 45 patients (26 men and 19 women aged 51 to 98 years with PH III–IV functional class, left ventricular myocardial infarction. In the study, patients underwent physical examination and Doppler echocardiography, and assessed FC LH (carried out with six-minute walking test, to determine the degree of dyspnea by Borg.Results. Symptoms of CHF and PH regressed in both groups of patients against the background of the therapy. Conclusion. It is established that the use of inhaled NO is a safe therapy and helps to reduce mean pulmonary arterial pressure (PAPmean in patients with PH and CHF III–IV FC, myocardial infarction. The method of inhaled NO is simple and easy to use.

  17. Hypertension, a health economics perspective.

    Science.gov (United States)

    Alcocer, Luis; Cueto, Liliana

    2008-06-01

    The economic aspects of hypertension are critical to modern medicine. The medical, economic, and human costs of untreated and inadequately controlled hypertension are enormous. Hypertension is distributed unequally and with iniquity in different countries and regions of the world. Treatment of hypertension requires an investment over many years to prolong disease-free quality years of life. The high prevalence and high cost of the disease impacts on the microeconomics and macroeconomics of countries and regions. The criteria used for inclusion in clinical guidelines for hypertension impact on the cost and cost/utility of diagnosis or treatment.

  18. Pulmonary Hypertension and Pulmonary Vasodilators.

    Science.gov (United States)

    Keller, Roberta L

    2016-03-01

    Pulmonary hypertension in the perinatal period can present acutely (persistent pulmonary hypertension of the newborn) or chronically. Clinical and echocardiographic diagnosis of acute pulmonary hypertension is well accepted but there are no broadly validated criteria for echocardiographic diagnosis of pulmonary hypertension later in the clinical course, although there are significant populations of infants with lung disease at risk for this diagnosis. Contributing cardiovascular comorbidities are common in infants with pulmonary hypertension and lung disease. It is not clear who should be treated without confirmation of pulmonary vascular disease by cardiac catheterization, with concurrent evaluation of any contributing cardiovascular comorbidities. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [Hypertension in polycystic ovary syndrome].

    Science.gov (United States)

    Ben Salem Hachmi, L; Ben Salem Hachmi, S; Bouzid, C; Younsi, N; Smida, H; Bouguerra, R; Ben Slama, C

    2006-01-01

    Polycystic ovary syndrome (PCOS) is associated with multiple cardiovascular risk factors. The aims of this study are to investigate the prevalence of hypertension in a female population with PCOS and to correlate hypertension with her clinical and hormonal profile. it is a transversal study of 79 PCOS patients with mean age of 25 +/- 7 years (range 13-44). PCOS diagnosis is made by Rotterdam consensus criteria's (2003). WHO definition of hypertension is used (BP 140/90 mmHg). Blood pressure is measured three times in each patient. Ovarian echography and biochemical assays (GnRH test, androgens, cholesterol, triglycerides, and oral glucose tolerance test) are made before the 5th day of the menstrual cycle. 12% of PCOS women have hypertension. Family history of hypertension is not a predictive factor of hypertension in our study. PCOS patients with hypertension are not significantly older than those without hypertension (28.4 +/- 6.5 vs. 25.2 +/- 7; p = 0.12). If compared to PCOS women without hypertension, those with hypertension have a significantly higher BMI (39.2 +/- 7 vs. 29.6; p = 0.0004). PCOS patients with and without hypertension do not differ significantly in their level of androgens and total cholesterol. Triglycerides level is higher in PCOS patients with hypertension (p = 0.06). In oral glucose tolerance test, areas under the curve of insulin and glucose are significantly higher in PCOS patients with hypertension (respectively p = 0.06 and 0.02). The area under the curve of LH during GnRH test is lower in PCOS patients with hypertension (p = 0.04).

  20. Myocardial Performance Index in Childhood Onset Essential Hypertension and White Coat Hypertension.

    Science.gov (United States)

    Gupta-Malhotra, Monesha; Hamzeh, Rabih K; Poffenbarger, Tim; McNiece-Redwine, Karen; Hashmi, Syed Shahrukh

    2016-03-01

    As a global measure of ventricular systolic and diastolic function, the myocardial performance index (MPI) can be an early indicator of hypertensive cardiomyopathy in children with essential hypertension (EH). Children with untreated newly diagnosed EH and white coat hypertension (WCH) by a 24-hour ambulatory blood pressure monitoring (ABPM), both groups without any identifiable etiology for the hypertension, were enrolled for the study. Echocardiograms and vascular ultrasounds for carotid artery intimal medial thickness were performed on all children prior to therapy. Diastolic function (peak E and A velocities, E/A ratio, isovolumic relaxation time, and deceleration times) and MPI were evaluated by simultaneous transmitral and transaortic spectral Doppler flow velocities. Systolic function was evaluated by shortening fraction and ejection fraction. A cohort of 66 children (24 with EH, 42 with WCH, males 61%, median age of 13 years, range 10-17 years) were enrolled in the study. The demographic, anthropometric, laboratory tests, vascular ultrasound, and conventional echocardiographic parameters were similar between the 2 groups. There was a very small difference in MPI between the EH and WCH children (0.28 SD: 0.07 vs. 0.31 SD: 0.08, P = 0.045). However, in EH children, MPI increased by 0.14 units for every 10 unit increase in mean ABPM systolic BP (95% confidence interval: 0.03-0.25). We found the increasing MPI was associated with increasing 24-hour mean systolic BP in children with EH. Therefore, MPI may have utility as a single, quick, noninvasive method of detection and tracking of subclinical hypertensive heart disease. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. The evolving definition of systemic arterial hypertension.

    Science.gov (United States)

    Ram, C Venkata S; Giles, Thomas D

    2010-05-01

    Systemic hypertension is an important risk factor for premature cardiovascular disease. Hypertension also contributes to excessive morbidity and mortality. Whereas excellent therapeutic options are available to treat hypertension, there is an unsettled issue about the very definition of hypertension. At what level of blood pressure should we treat hypertension? Does the definition of hypertension change in the presence of co-morbid conditions? This article covers in detail the evolving concepts in the diagnosis and management of hypertension.

  2. Pulmonary hypertension associated with lung diseases and hypoxemia.

    Science.gov (United States)

    Cuttica, Michael J

    2016-05-01

    Pulmonary hypertension that develops in the setting of underlying lung diseases such as COPD or idiopathic pulmonary fibrosis (IPF) is associated with decreased functional status, worsening hypoxemia and quality of life, and increased mortality. This complication of lung disease is complex in its origin and carries a unique set of diagnostic and therapeutic issues. This review attempts to provide an overview of mechanisms associated with the onset of pulmonary hypertension in COPD and IPF, touches on appropriate evaluation, and reviews the state of knowledge on treating pulmonary hypertension related to underlying lung disease.

  3. Mitochondrial Cyclophilin D in Vascular Oxidative Stress and Hypertension.

    Science.gov (United States)

    Itani, Hana A; Dikalova, Anna E; McMaster, William G; Nazarewicz, Rafal R; Bikineyeva, Alfiya T; Harrison, David G; Dikalov, Sergey I

    2016-06-01

    Vascular superoxide (O˙2 (-)) and inflammation contribute to hypertension. The mitochondria are an important source of O˙2 (-); however, the regulation of mitochondrial O˙2 (-) and the antihypertensive potential of targeting the mitochondria remain poorly defined. Angiotensin II and inflammatory cytokines, such as interleukin 17A and tumor necrosis factor-α (TNFα) significantly contribute to hypertension. We hypothesized that angiotensin II and cytokines co-operatively induce cyclophilin D (CypD)-dependent mitochondrial O˙2 (-) production in hypertension. We tested whether CypD inhibition attenuates endothelial oxidative stress and reduces hypertension. CypD depletion in CypD(-/-) mice prevents overproduction of mitochondrial O˙2 (-) in angiotensin II-infused mice, attenuates hypertension by 20 mm Hg, and improves vascular relaxation compared with wild-type C57Bl/6J mice. Treatment of hypertensive mice with the specific CypD inhibitor Sanglifehrin A reduces blood pressure by 28 mm Hg, inhibits production of mitochondrial O˙2 (-) by 40%, and improves vascular relaxation. Angiotensin II-induced hypertension was associated with CypD redox activation by S-glutathionylation, and expression of the mitochondria-targeted H2O2 scavenger, catalase, abolished CypD S-glutathionylation, prevented stimulation mitochondrial O˙2 (-), and attenuated hypertension. The functional role of cytokine-angiotensin II interplay was confirmed by co-operative stimulation of mitochondrial O˙2 (-) by 3-fold in cultured endothelial cells and impairment of aortic relaxation incubated with combination of angiotensin II, interleukin 17A, and tumor necrosis factor-α which was prevented by CypD depletion or expression of mitochondria-targeted SOD2 and catalase. These data support a novel role of CypD in hypertension and demonstrate that targeting CypD decreases mitochondrial O˙2 (-), improves vascular relaxation, and reduces hypertension. © 2016 American Heart Association, Inc.

  4. Imaging nuclear medicine techniques for diagnostic evaluation of arterial hypertension. Bildgebende nuklearmedizinische Diagnostik bei arterieller Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Eisenberg, B M; Linss, G

    1989-01-01

    Arterial hypertension may be caused by a malfunction of organs and in turn may lead to secondary organic lesions. Modern diagnostic nuclear medicine is applied for function studies in order to detect or exclude secondary hypertension and functional or perfusion disturbances due to hypertension, or to assess and follow up hemodynamic conditions and cardiac functions prior to and during therapy. The article presents a survey of imaging diagnostic nuclear medicine techniques for the eamination of the heart, the brain, the kidneys and endocrine glands in patients with arterial hypertension, discussing the methods with a view to obtainable information, limits of detection, and indications. (orig.).

  5. Renal sympathetic denervation attenuates hypertension and vascular remodeling in renovascular hypertensive rats.

    Science.gov (United States)

    Li, Peng; Huang, Pei-Pei; Yang, Yun; Liu, Chi; Lu, Yan; Wang, Fang; Sun, Wei; Kong, Xiang-Qing

    2017-01-01

    Li P, Huang P, Yang Y, Liu C, Lu Y, Wang F, Sun W, Kong X. Renal sympathetic denervation attenuates hypertension and vascular remodeling in renovascular hypertensive rats. J Appl Physiol 122: 121-129, 2017. First published October 14, 2016; doi:10.1152/japplphysiol.01019.2015-Sympathetic activity is enhanced in patients with essential or secondary hypertension, as well as in various hypertensive animal models. Therapeutic targeting of sympathetic activation is considered an effective antihypertensive strategy. We hypothesized that renal sympathetic denervation (RSD) attenuates hypertension and improves vascular remodeling and renal disease in the 2-kidney, 1-clip (2K1C) rat model. Rats underwent 2K1C modeling or sham surgery; then rats underwent RSD or sham surgery 4 wk later, thus resulting in four groups (normotensive-sham, normotensive-RSD, 2K1C-sham, and 2K1C-RSD). Norepinephrine was measured by ELISA. Echocardiography was used to assess heart function. Fibrosis and apoptosis were assessed by Masson and TUNEL staining. Changes in mean arterial blood pressure in response to hexamethonium and plasma norepinephrine levels were used to evaluate basal sympathetic nerve activity. The 2K1C modeling success rate was 86.8%. RSD reversed the elevated systolic blood pressure induced by 2K1C, but had no effect on body weight. Compared with rats in the 2K1C-sham group, rats in the 2K1C-RSD group showed lower left ventricular mass/body weight ratio, interventricular septal thickness in diastole, left ventricular end-systolic diameter, and left ventricular posterior wall thickness in systole, whereas fractional shortening and ejection fraction were higher. Right kidney apoptosis and left kidney hypertrophy were not changed by RSD. Arterial fibrosis was lower in animals in the 2K1C-RSD group compared with those in the 2K1C-sham group. RSD reduced plasma norepinephrine and basal sympathetic activity in rats in the 2K1C-RSD group compared with rats in the 2K1C-sham group. These

  6. Hepatic angiography: Portal hypertension

    International Nuclear Information System (INIS)

    Oliver, T.W. Jr.; Sones, P.J. Jr.

    1985-01-01

    Portal hypertension is usually a manifestation of underlying hepatic parenchymal disease, although it may be secondary to portal or hepatic venous thrombosis and rarely to hyperdynamic portal states. Portal hypertension may present as encephalopathy, ascites, jaundice, hepatic failure, or catastrophic upper gastrointestinal hemorrhage. Radiologic investigation should include indirect or direct measurements of portal pressure, assessment of portal venous perfusion, visualization of collaterals, and demonstration of arterial and venous anatomy for potential shunt procedure. Following survival of initial variceal bleeding, the most effective procedure to prevent recurrent hemorrhage is a shunt to decompress the varices. The decision whether to intervene medically or surgically during the acute hemorrhagic episode as well as the type of shunt used to prevent future hemorrhage is the subject of continuing controversy

  7. [Exercise in arterial hypertension].

    Science.gov (United States)

    Predel, Hans-Georg; Schramm, Thomas

    2006-09-01

    Regular endurance training has established itself as a major therapeutic principle in the specter of nonpharmacological measures in arterial hypertension. An initial medical check as well as an adequate technique, dosage and intensity of the prescribed exercise training are mandatory. With respect to the concomitant pharmacological treatment, it should be considered that the beneficial effects of lifestyle modification will not be counteracted by the chosen antihypertensive drug but, ideally, synergistically supported. Based on the individual clinical situation, principally all antihypertensive drugs recommended by the current European guidelines, may be prescribed as mono- or combination therapy.beta-receptor blockers are especially capable of controlling excessive exercise-induced blood pressure increase; however, they have metabolic and exercise physiological limitations. The neutrality concerning metabolic and exercise physiological parameters as well as the positive profile of side effects favor ACE inhibitors, long-acting calcium channel blockers and especially AT(1) antagonists in physically active hypertensive patients with concomitant metabolic syndrome.

  8. [Chronic hypertension and pregnancy].

    Science.gov (United States)

    Lecarpentier, Edouard; Tsatsaris, Vassili

    2012-09-01

    Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal mortality and morbidity. The management of patients with chronic hypertension requires a multidisciplinary approach prior to conception, during pregnancy and post-partum. In the preconception period, fetotoxic agents should be discontinued. It is also essential to undertake a full cardiovascular examination which may, in some cases, question the possibility of pregnancy. During pregnancy, blood pressure should be monitored and controlled, but not necessarily returned to a normal value. Low blood pressure levels could indeed lead to placental hypoperfusion and fetal growth restriction. Close clinical, biological and ultrasound monitoring is recommended, even postpartum, since those patients are at higher risk for preeclampsia.

  9. Adrenal Mass Causing Secondary Hypertension.

    Science.gov (United States)

    Robinson, Darlene Y

    2015-11-01

    Most hypertensive patients have essential (primary) hypertension; only 5% to 10% have a secondary cause. Two clinical characteristics suggestive of secondary hypertension are early onset (hypertension (>180/110 mm Hg). When faced with these findings, clinicians should consider a secondary cause of hypertension. A 22-year-old woman being evaluated for asthma exacerbation in the emergency department was noted to have severe persistent hypertension. Additional evaluation revealed severe hypokalemia, metabolic alkalosis, and hypernatremia. The patient was admitted to the hospital for blood pressure management, electrolyte replacement, and further evaluation of presumed hyperaldosteronism. Diagnostic imaging revealed a large adrenal mass. Surgical resection was performed, leading to a diagnosis of hyperaldosteronism caused by adrenal carcinoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Secondary hypertension is far less common than essential hypertension; however, considering the large volume of patients seen in emergency departments, it is likely that some will have secondary hypertension. Emergency physicians should be aware of the clinical characteristics that suggest secondary hypertension so that the appropriate diagnostic and treatment pathways can be pursued. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina

    2015-01-01

    Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.

  11. Epidemiology of hypertensive kidney disease.

    Science.gov (United States)

    Udani, Suneel; Lazich, Ivana; Bakris, George L

    2011-01-01

    The prevalence of hypertension, chronic kidney disease (CKD) and end-stage renal disease (ESRD) attributable to hypertension continues to rise worldwide. Identifying the precise prevalence of CKD attributable to hypertension is difficult owing to the absence of uniform criteria to establish a diagnosis of hypertensive nephropathy. Despite the increasing prevalence of CKD-associated hypertension, awareness of hypertension among individuals with CKD remains suboptimal and rates of blood-pressure control remain poor. Targeted subgroups involved in studies of CKD seem to reach better rates of blood-pressure control, suggesting that this therapeutic goal can be achieved in patients with CKD. Elevated blood-pressure levels are associated with CKD progression. However, the optimal blood-pressure level and pharmacological agent remains unclear. Physicians treating patients with CKD must recognize the importance of maintaining optimal salt and volume balance to achieve blood-pressure goals. Furthermore, agents that modify the renin-angiotensin-aldosterone axis can be an important adjunct to therapy and physicians must monitor expected changes in serum creatinine and electrolyte levels after their administration. Hypertension remains a common factor complicating CKD. Future investigations identifying early signs of hypertension-related CKD, increasing awareness of the effects of hypertension in CKD and determining optimal therapeutic interventions might help reduce the incidence of hypertensive nephropathy.

  12. Angiography in portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Zeitler, E

    1982-04-05

    We report on the cooperative possibilities the radiologist has as to diagnosis and therapy of portal hypertension. The catheter angiography allows to make a differentiation between pre- and intrahepatic bloc and the localization of bleeding esophagus varices. Only after all endoscopic measures with sclerotherapy and Laser coagulation have failed, catheter angiography will be carried out as a therapeutic measure. The future development, however, will give the opportunity to a series of therapeutic attempts on the field of interventional radiology.

  13. Renal denervation and hypertension.

    Science.gov (United States)

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  14. Angiography in portal hypertension

    International Nuclear Information System (INIS)

    Zeitler, E.

    1982-01-01

    We report on the cooperative possibilities the radiologist has as to diagnosis and therapy of portal hypertension. The catheter angiography allows to make a differentiation between pre- and intrahepatic bloc and the localization of bleeding esophagus varices. Only after all endoscopic measures with sclerotherapy and Laser coagulation have failed, catheter angiography will be carried out as a therapeutic measure. The future development, however, will give the opportunity to a series of therapeutic attempts on the field of interventional radiology. (orig.) [de

  15. Therapeutic strategies in pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Leonello eFuso

    2011-04-01

    Full Text Available Pulmonary hypertension (PH is a life-threatening condition characterized by elevated pulmonary arterial pressure. It is clinically classified into five groups: patients in the first group are considered to have pulmonary arterial hypertension (PAH whereas patients of the other groups have PH that is due to cardiopulmonary or other systemic diseases. The management of patients with PH has advanced rapidly over the last decade and the introduction of specific treatments especially for PAH has lead to an improved outcome. However, despite the progress in the treatment, the functional limitation and the survival of these patients remain unsatisfactory and there is no cure for PAH. Therefore the search for an ideal therapy still goes on. At present, two levels of treatment can be identified: primary and specific therapy. Primary therapy is directed at the underlying cause of the PH. It also includes a supportive therapy consisting in oxygen supplementation, diuretics, and anticoagulation which should be considered in all patients with PH. Specific therapy is directed at the PH itself and includes treatment with vasodilatators such as calcium channel blockers and with vasodilatator and pathogenetic drugs such as prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors. These drugs act in several pathogenetic mechanisms of the PH and are specific for PAH although they might be used also in the other groups of PH. Finally, atrial septostomy and lung transplantation are reserved for patients refractory to medical therapy. Different therapeutic approaches can be considered in the management of patients with PH. Therapy can be established on the basis of both the clinical classification and the functional class. It is also possible to adopt a goal-oriented therapy in which the timing of treatment escalation is determined by inadequate response to known prognostic indicators.

  16. Managing hypertension by polyphenols.

    Science.gov (United States)

    Fernández-Arroyo, Salvador; Camps, Jordi; Menendez, Javier A; Joven, Jorge

    2015-06-01

    Some polyphenols, obtained from plants of broad use, induce a favorable endothelial response in hypertension and beneficial effects in the management of other metabolic cardiovascular risks. Previous studies in our laboratories using the calyces of Hibiscus sabdariffa as a source of polyphenols show that significant effects on hypertension are noticeable in humans only when provided in high amounts. Available data are suggestive in animal models and ex vivo experiments, but data in humans are difficult to acquire. Additionally, and despite the low bioavailability of polyphenols, intervention studies provide evidence for the protective effects of secondary plant metabolites. Assumptions on public health benefits are limited by the lack of scientific knowledge, robust data derived from large randomized clinical trials, and an accurate assessment of the bioactive components provided by common foodstuff. Because it is likely that clinical effects are the result of multiple interactions among different polyphenols rather than the isolated action of unique compounds, to provide polyphenol-rich botanical extracts as dietary supplements is a suggestive option. Unfortunately, the lack of patent perspectives for the pharmaceutical industries and the high cost of production and release for alimentary industries will hamper the performance of the necessary clinical trials. Here we briefly discuss whether and how such limitations may complicate the extensive use of plant-derived products in the management of hypertension and which steps are the necessary to deal with the predictable complexity in a possible clinical practice. Georg Thieme Verlag KG Stuttgart · New York.

  17. [Resistant hypertension: An update].

    Science.gov (United States)

    Renna, N F

    2018-02-04

    An estimated 10% to 20% of hypertensive patients could be considered resistant to treatment (RH). These are patients who are not controlled using three drugs, at the maximum tolerated doses, including a diuretic, as well as those with high blood pressure controlled using four or more drugs. The term is used to identify patients that might benefit from special diagnostic and/or therapeutic consideration. The term 'refractory hypertension' has recently been proposed as a novel phenotype of antihypertensive failure. It refers to patients whose blood pressure cannot be controlled with maximum treatment. The first studies of this phenotype indicate that it is rare and affects less than 5% of patients with RH. Adherence to or compliance with medical treatment is key to defining resistant hypertension. Closer attention has been paid to clinical and experimental research since the first scientific statement for the diagnosis, assessment and treatment of RH from the American Heart Association, and in the European guidelines, was published in 2008. This review will set out the concepts relating to prevalence, prognosis and compliance and cover the latest developments on this subject. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Hypertensive target organ damage in Ghanaian civil servants with hypertension.

    Directory of Open Access Journals (Sweden)

    Juliet Addo

    2009-08-01

    Full Text Available Low levels of detection, treatment and control of hypertension have repeatedly been reported from sub Saharan Africa, potentially increasing the likelihood of target organ damage.A cross-sectional study was conducted on 1015 urban civil servants aged > or = 25 years from seven central government ministries in Accra, Ghana. Participants diagnosed to have hypertension were examined for target organ involvement. Hypertensive target organ damage was defined as the detection of any of the following: left ventricular hypertrophy diagnosed by electrocardiogram, reduction in glomerular filtration rate, the presence of hypertensive retinopathy or a history of a stroke.Of the 219 hypertensive participants examined, 104 (47.5% had evidence of target organ damage. The presence of target organ damage was associated with higher systolic and diastolic blood pressure levels. The odds of developing hypertensive target organ damage was five to six times higher in participants with blood pressure (BP > or = 180/110 mmHg compared to those with BP < 140/90 mmHg, and there was a trend to higher odds of target organ damage with increasing BP (p = 0.001. Women had about lower odds of developing target organ damage compared to men.The high prevalence of target organ damage in this working population associated with increasing blood pressure, emphasises the need for hypertension control programs aimed at improving the detection of hypertension, and importantly addressing the issues inhibiting the effective treatment and control of people with hypertension in the population.

  19. Milan hypertensive rat as a model for studying cation transport abnormality in genetic hypertension

    International Nuclear Information System (INIS)

    Ferrari, P.; Barber, B.R.; Torielli, L.; Ferrandi, M.; Salardi, S.; Bianchi, G.

    1987-01-01

    Environmental factors, genetic polymorphisms, and different experimental designs have been the main impediments to evaluating a genetic association between cell membrane cation transport abnormalities and human essential or genetic hypertension. We review the results obtained in the Milan hypertensive strain of rats (MHS) and in its appropriate control normotensive strain (MNS) to illustrate our approach to defining the role of cation transport abnormality in a type of genetic hypertension. Before the development of a difference in blood pressure between the two strains, the comparison of kidney and erythrocyte functions showed that MHS had an increased glomerular filtration rate and urinary output, and lower plasma renin and urine osmolality. Kidney cross-transplantation between the strains showed that hypertension is transplanted with the kidney. Proximal tubular cell volume and sodium content were lower in MHS while sodium transport across the brush border membrane vesicles of MHS was faster. Erythrocytes in MHS were smaller and had lower sodium concentration, and Na+-K+ cotransport and passive permeability were faster. The differences in volume, sodium content, and Na+-K+ cotransport between erythrocytes of the two strains persisted after transplantation of bone marrow to irradiated F1 (MHS X MNS) hybrids. Moreover, in normal segregating F2 hybrid populations there was a positive correlation between blood pressure and Na+-K+ cotransport. These results suggest a genetic and functional link in MHS between cell membrane cation transport abnormalities and hypertension. Thus, erythrocyte cell membrane may be used for approaching the problem of defining the genetically determined molecular mechanism underlying the development of a type of essential hypertension. 35 references

  20. [Control of hypertension in nursing homes].

    Science.gov (United States)

    Thomas, J M; Alvarez, W; Mulaj, M; De Breucker, S; Leeman, M; Pepersack, T

    2006-09-01

    In a cross sectional study we determined prevalence of hypertension among institutionalized old subjects. Prevalence of hypertension was 69%. Among detected hypertensive patients, 76% received an antihypertensive drug treatment. 61% of the declared hypertensive patients and 80% of the treated hypertensive patients had their blood pressure controlled. The general practitioners should better detect and treat this common geriatric problem associated with a high comorbidity.

  1. Taste and hypertension in humans

    DEFF Research Database (Denmark)

    Roura, Eugeni; Foster, Simon; Winklebach, Anja

    2016-01-01

    The association between salty taste and NaCl intake with hypertension is well-established, although it is far from completely understood. Other taste types such as sweet, umami or bitter have also been related to alterations in blood pressure. Here, we review the mutual relationship between taste...... and hypertension to identify potential avenues to better control blood pressure. This review focuses on published data involving humans, with the exception of a section on molecular mechanisms. There is compelling evidence to suggest that changes in salty taste sensitivity can be used to predict the onset...... of hypertension. This goes hand in hand with the medical concept of sodium sensitivity, which also increases with age, particularly in hypertensive patients. The association of hypertension with the loss of taste acuity less definitive with some data/conclusions masked by the use of anti-hypertensive drugs...

  2. Short-Term Red Wine Consumption Promotes Differential Effects on Plasma Levels of High-Density Lipoprotein Cholesterol, Sympathetic Activity, and Endothelial Function in Hypercholesterolemic, Hypertensive, and Healthy Subjects

    Science.gov (United States)

    Andrade, Ana CM; Cesena, Fernando HY; Consolim-Colombo, Fernanda M; Coimbra, Silmara R; Benjó, Alexandre M; Krieger, Eduardo M; da Luz, Protasio Lemos

    2009-01-01

    OBJECTIVES: To compare the metabolic, hemodynamic, autonomic, and endothelial responses to short-term red wine consumption in subjects with hypercholesterolemia or arterial hypertension, and healthy controls. METHODS: Subjects with hypercholesterolemia (n=10) or arterial hypertension (n=9), or healthy controls (n=7) were given red wine (250 mL/night) for 15 days. Analyses were performed before and after red wine intake. RESULTS: Red wine significantly increased the plasma levels of HDL-cholesterol in the controls, but not in the other groups. The effects on hemodynamic measurements were mild, non-significantly more prominent in healthy subjects, and exhibited high interindividual variability. Across all participants, mean blood pressure decreased 7 mmHg (p <0.01) and systemic vascular resistance decreased 7% (p = 0.05). Heart rate and cardiac output did not significantly change in any group. Red wine enhanced muscle sympathetic fibular nerve activity in hypercholesterolemic and hypertensive patients, but not in controls. At baseline, brachial artery flow-mediated dilation was impaired in patients with hypercholesterolemia and arterial hypertension; red wine restored the dilation in the hypercholesterolemic group but not in the hypertensive group. CONCLUSIONS: Red wine elicits different metabolic, autonomic, and endothelial responses among individuals with hypercholesterolemia or arterial hypertension and healthy controls. Our findings highlight the need to consider patient characteristics when evaluating the response to red wine. PMID:19488610

  3. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over ...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates....

  4. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates....

  5. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun...

  6. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael; Jeppesen, Jørgen; Larsen, Mogens

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun-15...

  7. Impact of hepatitis C oral therapy in portal hypertension.

    Science.gov (United States)

    Libânio, Diogo; Marinho, Rui Tato

    2017-07-14

    Chronic hepatitis C is a leading cause of morbidity and mortality, mainly related to fibrosis/cirrhosis and portal hypertension. Direct antiviral agents are highly effective and safe and can now cure > 90% of the patients. Sustained viral response (SVR) after interferon-based regimens has been associated with improvement in liver function, fibrosis and portal hypertension in a significant proportion of patients, although a point of no return seems to exist from which viral elimination is no longer capable of preventing portal hypertension progression and liver decompensation. Indeed, although SVR is associated with improvement of hepatic venous pressure gradients and therefore a decreased risk of de novo esophageal varices, several studies show that viral clearance does not eliminate the risk of variceal progression, liver decompensation and death in patients with pre-established portal hypertension. Although evidence about the effects of direct antiviral agents (DAAs) on clinically significant outcomes is still scarce and with short follow-up, DAAs can decrease the burden of the disease if patients are timely treated before significant fibrosis and portal hypertension develops. Studies with longer follow-up are waited to establish the real magnitude of hepatitis C treatment on portal hypertension. Future studies should also focus on predictors of portal hypertension resolution since it can influence management and avoid unnecessary monitoring.

  8. Cerebrovascular mental stress reactivity is impaired in hypertension

    Directory of Open Access Journals (Sweden)

    Naqvi Tasneem Z

    2009-07-01

    Full Text Available Abstract Background Brachial artery reactivity in response to shear stress is altered in subjects with hypertension. Since endothelial dysfunction is generalized, we hypothesized that carotid artery (CA reactivity would also be altered in hypertension. Purpose To compare (CA endothelium-dependent vasodilation in response to mental stress in normal and hypertensive subjects. Methods We evaluated CA reactivity to mental stress in 10 young healthy human volunteers (aged 23 ± 4 years, 20 older healthy volunteers (aged 49 ± 11 years and in 28 patients with essential hypertension (aged 51 ± 13 years. In 10 healthy volunteers and 12 hypertensive subjects, middle cerebral artery (MCA PW transcranial Doppler was performed before and 3 minutes after mental stress. Results Mental stress by Stroop color word conflict, math or anger recall tests caused CA vasodilation in young healthy subjects (0.61 ± 0.06 to 0.65 ± 0.07 cm, p Conclusion Mental stress produces CA vasodilation and is accompanied by an increase in CA and MCA blood flow in healthy subjects. This mental stress induced CA vasodilation and flow reserve is attenuated in subjects with hypertension and may reflect cerebral vascular endothelial dysfunction. Assessment of mental stress induced CA reactivity by ultrasound is a novel method for assessing the impact of hypertension on cerebrovascular endothelial function and blood flow reserve.

  9. Treatment goals of pulmonary hypertension.

    LENUS (Irish Health Repository)

    McLaughlin, Vallerie V

    2013-12-24

    With significant therapeutic advances in the field of pulmonary arterial hypertension, the need to identify clinically relevant treatment goals that correlate with long-term outcome has emerged as 1 of the most critical tasks. Current goals include achieving modified New York Heart Association functional class I or II, 6-min walk distance >380 m, normalization of right ventricular size and function on echocardiograph, a decreasing or normalization of B-type natriuretic peptide (BNP), and hemodynamics with right atrial pressure <8 mm Hg and cardiac index >2.5 mg\\/kg\\/min(2). However, to more effectively prognosticate in the current era of complex treatments, it is becoming clear that the "bar" needs to be set higher, with more robust and clearer delineations aimed at parameters that correlate with long-term outcome; namely, exercise capacity and right heart function. Specifically, tests that accurately and noninvasively determine right ventricular function, such as cardiac magnetic resonance imaging and BNP\\/N-terminal pro-B-type natriuretic peptide, are emerging as promising indicators to serve as baseline predictors and treatment targets. Furthermore, studies focusing on outcomes have shown that no single test can reliably serve as a long-term prognostic marker and that composite treatment goals are more predictive of long-term outcome. It has been proposed that treatment goals be revised to include the following: modified New York Heart Association functional class I or II, 6-min walk distance ≥ 380 to 440 m, cardiopulmonary exercise test-measured peak oxygen consumption >15 ml\\/min\\/kg and ventilatory equivalent for carbon dioxide <45 l\\/min\\/l\\/min, BNP level toward "normal," echocardiograph and\\/or cardiac magnetic resonance imaging demonstrating normal\\/near-normal right ventricular size and function, and hemodynamics showing normalization of right ventricular function with right atrial pressure <8 mm Hg and cardiac index >2.5 to 3.0 l\\/min\\/m(2).

  10. [Hepatopulmonary syndrome and portopulmonary hypertension].

    Science.gov (United States)

    Marcu, Cristina; Schiffer, Eduardo; Aubert, John-David; Vionnet, Julien; Yerly, Patrick; Deltenre, Pierre; Marot, Astrid

    2017-08-30

    Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are two frequent pulmonary complications of liver disease. Portal hypertension is a key element in the pathogenesis of both disorders, which are however distinct in terms of pathogenesis, diagnosis and treatment. HPS corresponds to an abnormal arterial oxygenation in relation with the development of intrapulmonary vascular dilatations. POPH is a pulmonary arterial hypertension in the setting of portal hypertension and elevated pulmonary vascular resistance. As both diseases are associated with an increased risk of morbidity and mortality, it is important to screen and evaluate the severity of these two disorders particularly in liver transplant candidates.

  11. Vascular inflammatory cells in hypertension

    Directory of Open Access Journals (Sweden)

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  12. ESSENTIAL ARTERIAL HYPERTENSION AND RISK FACTORS ASSOCIATED WITH HYPERTENSIVE NEPHROPATHY

    Directory of Open Access Journals (Sweden)

    Boban Milojković

    2014-12-01

    Full Text Available Arterial hypertension is a major risk factor that predisposes to cardiovascular disorders and is responsible for most of the morbidity and mortality in patients. Hypertension is closely associated with the kidney, because kidney disease can be both the cause and consequence of increased blood pressure. Elevation of blood pressure is a strong independent risk factor for hypertensive nephropathy and development of ESRD. The pathogenesis of ischemic hypertensive nephropathy (IHN is multifactoral, and in addition to blood pressure other factors contribute to the development of this renal pathology and its progression to end-stage renal disease. These include obesity, smoking, male gender and other still unknown risk factors. The aim of this paper was to analyse the association between essential arterial hypertension and renal hypertensive disease and prevalence of other atherosclerotic risk factors in patients with developed hypertensive renal disease. In this prospective cross sectional study 283 patients of both genders with diagnosed essential hypertension and hypertensive renal disease were analysed. The anamnestic data related to age, duration of hypertension, history of smoking, presence of hypertensive retinopathy, hypertrophy of the left chamber and data about previous renal diseases were collected through conversation and medical documentation. The clinical examination comprise determination of blood pressure, body mass index (BMI, lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, serum urea and creatinine, urine, albumin and protein concentration. The total number of 283 patients (185 males and 98 females with HN was analyzed. The analysis revealed significantly higher proportion of males aged over 60 years with IHN. The mean age of examined hypertensive patients with IHN is 62.6±8.8 years with duration of hypertension 19.8±5.9 years. All examined patients had hypertensive retinopathy and

  13. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  14. Prevalence and persistence of masked hypertension in treated hypertensive patients

    NARCIS (Netherlands)

    Verberk, Willem J.; Thien, Theo; Kroon, Abraham A.; Lenders, Jacques W. M.; van Montfrans, Gert A.; Smit, Andries J.; de Leeuw, Peter W.

    2007-01-01

    Background: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the

  15. Prevalence and persistence of masked hypertension in treated hypertensive patients.

    NARCIS (Netherlands)

    Verberk, W.J.; Thien, Th.; Kroon, A.A.; Lenders, J.W.M.; Montfrans, G.A. van; Smit, A.J.; Leeuw, P.W. de

    2007-01-01

    BACKGROUND: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the

  16. Prevalence and persistence of masked hypertension in treated hypertensive patients

    NARCIS (Netherlands)

    Verberk, Willem J.; Thien, Theo; Kroon, Abraham A.; Lenders, Jacques W. M.; van Montfrans, Gert A.; Smit, Andries J.; de Leeuw, Peter W.

    2007-01-01

    BACKGROUND: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the

  17. Dietary habits of hypertensive patients in a tertiary hypertension ...

    African Journals Online (AJOL)

    Introduction: The prescriptions regarding non-pharmacological care in the management of hypertension has been carefully defined by the various practice guidelines. However, there is paucity of data on dietary practices in our environment, therefore this study set out to determine the dietary practices of hypertensive ...

  18. Drug induced hypertension--An unappreciated cause of secondary hypertension.

    Science.gov (United States)

    Grossman, Alon; Messerli, Franz H; Grossman, Ehud

    2015-09-15

    Most patients with hypertension have essential hypertension or well-known forms of secondary hypertension, such as renal disease, renal artery stenosis, or common endocrine diseases (hyperaldosteronism or pheochromocytoma). Physicians are less aware of drug induced hypertension. A variety of therapeutic agents or chemical substances may increase blood pressure. When a patient with well controlled hypertension is presented with acute blood pressure elevation, use of drug or chemical substance which increases blood pressure should be suspected. Drug-induced blood pressure increases are usually minor and short-lived, although rare hypertensive emergencies associated with use of certain drugs have been reported. Careful evaluation of prescription and non-prescription medications is crucial in the evaluation of the hypertensive individual and may obviate the need for expensive and unnecessary evaluations. Discontinuation of the offending agent will usually achieve adequate blood pressure control. When use of a chemical agent which increases blood pressure is mandatory, anti-hypertensive therapy may facilitate continued use of this agent. We summarize the therapeutic agents or chemical substances that elevate blood pressure and their mechanisms of action. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Pre-Hypertension and Hypertension in Adolescence: How much ...

    African Journals Online (AJOL)

    Background: Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease. Previous studies have documented that hypertension may begin in adolescence, perhaps even in childhood. Objectives: This study set out to determine ...

  20. Liquorice: a root cause of secondary hypertension

    OpenAIRE

    Varma, Ravi; Ross, Calum N.

    2017-01-01

    We describe a patient presenting with hypertension and hypokalaemia who was ultimately diagnosed with liquorice- induced pseudohyperaldosteronism. This rare cause of secondary hypertension illustrates the importance of a methodical approach to the assessment of hypertension.

  1. ORIGINAL ARTICLES Hypertension Guideline 2003 Update

    African Journals Online (AJOL)

    reduction of BP in the elderly and in those with severe hypertension should .... management of hypertension in adults by health care .... They may demonstrate postural and post- ..... Persons with severe hypertension fall into three categories.

  2. Genetics Home Reference: pulmonary arterial hypertension

    Science.gov (United States)

    ... Home Health Conditions Pulmonary arterial hypertension Pulmonary arterial hypertension Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  3. Isolated Systolic Hypertension: A Health Concern?

    Science.gov (United States)

    Isolated systolic hypertension: A health concern? Is having a high top number (systolic) blood pressure, but a normal bottom number (diastolic) ... mm Hg, you have a common type of high blood pressure called isolated systolic hypertension. Isolated systolic hypertension can ...

  4. Cardiac and renal damage in the elderly hypertensive

    Directory of Open Access Journals (Sweden)

    Jean Ribstein

    2002-03-01

    Full Text Available In the elderly patient with essential hypertension of long duration or de novo systolic hypertension, the prevalence of co-morbid conditions, be they apparent or not, the burden of associated diseases and the alteration in nutritional status and lifestyle, result in specific problems with regards to hypertension-related target organ damage. Accumulating data suggest that left ventricular (LV remodelling is a common finding in the nor-motensive elderly, and that LV hypertrophy (LVH will herald the development of heart failure in a fraction of patients with either systolic/diastolic or isolated systolic hypertension. Increased arterial stiffness, as well as impaired myocardial relaxation, reduced early diastolic filling and decreased ?-adrenergic responsiveness, contribute to the large prevalence of abnormalities in LV function in the elderly hypertensive. The response to exercise is clearly attenuated, and coronary heart disease, although highly prevalent, may be misdiagnosed because symptoms are altered. The elderly hypertensive is exquisitely sensitive to both volume depletion and excessive sodium intake, due to a marked sodium sensitivity of blood pressure (BP. A decline in renal blood flow and glomerular filtration rate (GFR is a common finding in the elderly. Although structural alterations attributed to age and hypertension may differ, hypertension is often looked upon as an accelerated form of ageing with regards to the heart and the kidney. Lifestyle modifications and initial monotherapy with a low-dose diuretic are warranted in the elderly hypertensive with no co-morbidity; a variety of specific approaches are considered when associated clinical conditions are present. Blockers of the renin-angiotensin system (RAS may be the preferred first-line agents in many patients with cardiac or renal damage.

  5. Pharmacotherapy for mild hypertension

    Directory of Open Access Journals (Sweden)

    Diana Diao

    2012-01-01

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  6. Nocturnal Hypertension: Neglected Issue in Comprehensive Hypertension Management

    Directory of Open Access Journals (Sweden)

    Andi Kristanto

    2016-09-01

    Full Text Available The body circardian rhythm affects blood pressure variability at day and night, therefore blood pressure at day and night might be different. Nocturnal hypertension is defined as increase of blood pressure >120/70mmHg at night, which is caused by disturbed circadian rhythm, and associated with higher cardiovascular and cerebrovascular events also mortality in hypertensive patients. Nocturnal hypertension and declining blood pressure pattern, can only be detected by continuous examination for 24 hours, also known as ambulatory blood pressure measurement (ABPM. Chronotherapy, has become a strategy for managing the hypertensive nocturnal patients, by taking hypertensive medication at night to obtain normal blood pressure decrease in accordance with the normal circadian rhythm and, improving blood pressure control.

  7. [Clinicofunctional features of arterial hypertension in chronic broncho-obstructive syndrome].

    Science.gov (United States)

    Zadionchenko, V S; Kuz'micheva, N V; Sviridov, A A; Ol'kha, R P; Kashcheeva, E V

    2000-01-01

    To describe clinicofunctional features of essential and pulmogenic hypertension in chronic bronchoobstructive syndrome, 24-h profile of arterial pressure (AP), intracardiac hemodynamics and to propose differential diagnostic criteria for these hypertension forms. 24-h monitoring of arterial pressure (MAP), cardiohemodynamics, external respiration function (ERF) and blood gases examinations were made in 100 hypertensive subjects with chronic obstructive bronchitis and bronchial asthma. Significant differences were found between the groups of essential and pulmogenic hypertension by major values of MAP, echo-CG and ERF. Early disturbances in diastolic function of both the ventricles in essential and pulmonary hypertension in chronic bronchial obstruction arise long before clinical, x-ray and ECG signs of chronic pulmonary heart. The findings enable formulation of criteria of differential diagnosis of essential and pulmogenic hypertension and identify the latter as an independent nosological entity.

  8. Exercise renogram. A new approach documents renal involvement in systemic hypertension

    International Nuclear Information System (INIS)

    Clorius, J.H.; Schmidlin, P.

    1983-01-01

    Hippurate functional scintiscans were obtained in 51 hypertensive patients and in 15 controls. The authors investigated the influence that posture and exercise have on hippurate kinetics in patients with hypertension. A posture- or exercise-induced disturbance of renal hippurate transport was sought. All persons were examined in prone and standing positions, as well as during exercise. When prone and upright renograms were compared, 24% of the hypertensives demonstrated bilateral orthostatic renal dysfunction. Exercise caused the hippurate transport disturbance to increase. Fifty-seven percent of all hypertensives developed evidence of marked, bilateral, renal dysfunction during ergometric stress, so that exercise renography was shown to be a more sensitive test of the presence of transient tubular dysfunction in hypertension than the standing renogram. In normotensive controls the hippurate functional scintigram failed to be influenced by posture and exercise. The results suggest presence in hypertension of transient, posture- and exercise-mediated alterations of renal cortical blood flow

  9. The exercise renogram. A new approach documents renal involvement in systemic hypertension

    International Nuclear Information System (INIS)

    Clorius, J.H.; Schmidlin, P.

    1983-01-01

    Hippurate functional scintiscans were obtained in 51 hypertensive patients and in 15 controls. We investigated the influence that posture and exercise have on hippurate kinetics in patients with hypertension. A posture- or exercise-induced disturbance of renal hippurate transport was sought. All persons were examined in prone and standing positions, as well as during exercise. When prone and upright renograms were compared, 24% of the hypertensives demonstrated bilateral orthostatic renal dysfunction. Exercise caused the hippurate transport disturbance to increase. Fifty-seven percent of all hypertensives developed evidence of marked, bilateral, renal dysfunction during ergometric stress, so that exercise renography was shown to be a more sensitive test of the presence of transient tubular dysfunction in hypertension than the standing renogram. In normotensive controls the hippurate functional scintigram failed to be influenced by posture and exercise. The results suggest presence in hypertension of transient, posture- and exercise-mediated alterations of renal cortical blood flow

  10. Oxidative Stress in Hypertension: Role of the Kidney

    Science.gov (United States)

    Araujo, Magali

    2014-01-01

    Abstract Significance: Renal oxidative stress can be a cause, a consequence, or more often a potentiating factor for hypertension. Increased reactive oxygen species (ROS) in the kidney have been reported in multiple models of hypertension and related to renal vasoconstriction and alterations of renal function. Nicotinamide adenine dinucleotide phosphate oxidase is the central source of ROS in the hypertensive kidney, but a defective antioxidant system also can contribute. Recent Advances: Superoxide has been identified as the principal ROS implicated for vascular and tubular dysfunction, but hydrogen peroxide (H2O2) has been implicated in diminishing preglomerular vascular reactivity, and promoting medullary blood flow and pressure natriuresis in hypertensive animals. Critical Issues and Future Directions: Increased renal ROS have been implicated in renal vasoconstriction, renin release, activation of renal afferent nerves, augmented contraction, and myogenic responses of afferent arterioles, enhanced tubuloglomerular feedback, dysfunction of glomerular cells, and proteinuria. Inhibition of ROS with antioxidants, superoxide dismutase mimetics, or blockers of the renin-angiotensin-aldosterone system or genetic deletion of one of the components of the signaling cascade often attenuates or delays the onset of hypertension and preserves the renal structure and function. Novel approaches are required to dampen the renal oxidative stress pathways to reduced O2−• rather than H2O2 selectivity and/or to enhance the endogenous antioxidant pathways to susceptible subjects to prevent the development and renal-damaging effects of hypertension. Antioxid. Redox Signal. 20, 74–101. PMID:23472618

  11. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    Directory of Open Access Journals (Sweden)

    Alberto Francisco Rubio-Guerra

    2010-09-01

    Full Text Available Alberto Francisco Rubio-Guerra1, Hilda Vargas-Robles2, Luz Maria Ramos-Brizuela1, Bruno Alfonso Escalante-Acosta21Metabolic Clinic, Hospital General de Ticomán SS DF, Mexico; 2Department of Molecular Biomedicine, Centro de Investigacion y de Estudios Avanzados del IPN, MexicoAbstract: Nitric oxide (NO is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients.Keywords: tetrahydrobiopterin, endothelial dysfunction, diabetes, hypertension, oxidative stress, nitric oxide, eNOS synthase uncoupling

  12. Assessment of knowledge about hypertension

    Directory of Open Access Journals (Sweden)

    Paweł Węgorowski

    2017-07-01

    Patient knowledge about hypertension and its effects can affect the effectiveness of treatment. Medical education should be of paramount importance for medical staff, with particular attention to the self-control of blood pressure by patients. In summary, it is important to note that due to the high risk of complications, both treatment and prevention of hypertension are important.

  13. Resistant Hypertension and Cardiorenovascular Risk

    Directory of Open Access Journals (Sweden)

    Prkacin Ingrid

    2017-06-01

    Full Text Available Studies have documented independent contribution of sympathetic activation to the cardiovascular disease continuum. Hypertension is one of the leading modifiable factors. Most if not all the benefit of antihypertensive treatment depends on blood pressure lowering, regardless how it is obtained. Resistant hypertension is defined as blood pressure that remains uncontrolled in spite of the concurrent use of three antihypertensive drugs of different classes. Ideally, one of the three drugs should be a diuretic, and all drugs should be prescribed at optimal dose amounts. Poor adherence to antihypertensive therapy, undiscovered secondary causes (e.g. obstructive sleep apnea, primary aldosteronism, renal artery stenosis, and lifestyle factors (e.g. obesity, excessive sodium intake, heavy alcohol intake, various drug interactions are the most common causes of resistant hypertension. Cardio(renovascular morbidity and mortality are significantly higher in resistant hypertensive than in general hypertensive population, as such patients are typically presented with a long-standing history of poorly controlled hypertension. Early diagnosis and treatment is needed to avoid further end-organ damage to prevent cardiorenovascular remodeling. Treatment strategy includes lifestyle changes, adding a mineralocorticoid receptor antagonist, treatment adherence in cardiovascular prevention and, in case of failure to control blood pressure, renal sympathetic denervation or baroreceptor activation therapy. The comparative outcomes in resistant hypertension deserve better understanding. In this review, the most current approaches to resistant hypertension and cardiovascular risk based on the available literature evidence will be discussed.

  14. Endocrine hypertension – Cushing's syndrome

    Science.gov (United States)

    Singh, Yashpal; Kotwal, Narendra; Menon, A. S.

    2011-01-01

    Hypertension is a major and frequent comorbid finding of Cushing's syndrome. This review discusses the etiology and pathophysiology of hypertension in Cushing's syndrome, while suggesting methods of management of this condition. It also provides an overview of diagnosis and management strategies in this disease. PMID:22145133

  15. The Immune System in Hypertension

    Science.gov (United States)

    Trott, Daniel W.; Harrison, David G.

    2014-01-01

    While hypertension has predominantly been attributed to perturbations of the vasculature, kidney, and central nervous system, research for almost 50 yr has shown that the immune system also contributes to this disease. Inflammatory cells accumulate in the kidneys and vasculature of humans and experimental animals with hypertension and likely…

  16. Erythrocyte 22Na+ influx in hypertension

    International Nuclear Information System (INIS)

    Shalev, O.; Eaton, J.W.; Ben-Ishay, D.

    1984-01-01

    We assessed 22Na+ uptake by erythrocytes (RBC) from 38 individuals with essential hypertension and 37 healthy controls. All subjects were male, white, non-obese and with normal renal function, obviating sex, race, hormonal, ponderal and renal factors known to influence RBC Na+ handling. The mean +/- sem 22Na+ uptake of the patients was 284 +/- 16 mumole/liter RBC/hour while that of normal controls was 249 +/- 11 mumole/liter RBC/hour; although the difference reached borderline significance, individual values showed considerable overlap. Consequently, in our population, RBC 22Na+ uptake is not a reliable marker for essential hypertension. We believe that previous studies should be reassessed with regard to patients' characteristics and future studies employ rigorous criteria in selection of subjects

  17. Mechanisms of Fetal Programming in Hypertension

    Directory of Open Access Journals (Sweden)

    John Edward Jones

    2012-01-01

    Full Text Available Events that occur in the early fetal environment have been linked to long-term health and lifespan consequences in the adult. Intrauterine growth restriction (IUGR, which may occur as a result of nutrient insufficiency, exposure to hormones, or disruptions in placental structure or function, may induce the fetus to alter its developmental program in order to adapt to the new conditions. IUGR may result in a decrease in the expression of genes that are responsible for nephrogenesis as nutrients are rerouted to the development of more essential organs. Fetal survival under these conditions often results in low birth weight and a deficit in nephron endowment, which are associated with hypertension in adults. Interestingly, male IUGR offspring appear to be more severely affected than females, suggesting that sex hormones may be involved. The processes of fetal programming of hypertension are complex, and we are only beginning to understand the underlying mechanisms.

  18. Obliterative portal venopathy without portal hypertension: an underestimated condition.

    Science.gov (United States)

    Guido, Maria; Sarcognato, Samantha; Sonzogni, Aurelio; Lucà, Maria Grazia; Senzolo, Marco; Fagiuoli, Stefano; Ferrarese, Alberto; Pizzi, Marco; Giacomelli, Luciano; Colloredo, Guido

    2016-03-01

    Obliterative portal venopathy without portal hypertension has been described by a single study in a limited number of patients, thus very little is known about this clinical condition. This study aimed to investigate the prevalence of obliterative portal venopathy and its clinical-pathological correlations in patients with cryptogenic chronic liver test abnormalities without clinical signs of portal hypertension. We analysed 482 liver biopsies from adults with non-cirrhotic cryptogenic chronic liver disorders and without any clinical signs of portal hypertension, consecutively enrolled in a 5-year period. Twenty cases of idiopathic non-cirrhotic portal hypertension diagnosed in the same period, were included for comparison. Histological findings were matched with clinical and laboratory features. Obliterative portal venopathy was identified in 94 (19.5%) of 482 subjects and in all 20 cases of idiopathic non-cirrhotic portal hypertension: both groups shared the entire spectrum of histological changes described in the latter condition. The prevalence of incomplete fibrous septa and nodular regenerative hyperplasia was higher in the biopsies of idiopathic non-cirrhotic portal hypertension (P = 0.006 and P = 0.002), a possible hint of a more advanced stage of the disease. The two groups also shared several clinical laboratory features, including a similar liver function test profile, concomitant prothrombotic conditions and extrahepatic autoimmune disorders. Obliterative portal venopathy occurs in a substantial proportion of patients with unexplained chronic abnormal liver function tests without portal hypertension. The clinical-pathological profile of these subjects suggests that they may be in an early (non-symptomatic) stage of idiopathic non-cirrhotic portal hypertension. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Androgens and Hypertension in Men and Women: a Unifying View.

    Science.gov (United States)

    Moretti, Costanzo; Lanzolla, Giulia; Moretti, Marta; Gnessi, Lucio; Carmina, Enrico

    2017-05-01

    This review was designed to revaluate the androgen role on the mechanisms of hypertension and cardiovascular risks in both men and women. Sex steroids are involved in the regulation of blood pressure, but pathophysiological mechanism is not well understood. Androgens have an important effect on metabolism, adipose and endothelial cell function, and cardiovascular risk in both men and women. A focal point in this contest is represented by the possible gender-specific regulation of different tissues and in particular of the adipose cell. Available data confirm that androgen deficiency is linked to increased prevalence of hypertension and cardiovascular diseases. Adipocyte dysfunction seems to be the main involved mechanism. Androgen replacement reduces inflammation state in man, protecting by metabolic syndrome progression. In women, androgen excess has been considered as promoting factor of cardiovascular risk. However, recent data suggest that excessive androgen production has little effect per se in inducing hypertension in young women of reproductive age. Also in postmenopausal women, data on relative androgen excess and hypertension are missing, while adrenal androgen deficiency has been associated to increased mortality. Molecular mechanisms linking androgen dysregulation to hypertension are almost Unknown, but they seem to be related to increased visceral fat, promoting a chronic inflammatory state through different mechanisms. One of these may involve the recruitment and over-activation of NF-kB, a ubiquitous transcription factor also expressed in adipose cells, where it may cause the production of cytokines and other immune factors. The NF-kB signalling pathway may also influence brown adipogenesis leading to the preferential enlargement of visceral adipocytes. Chronic inflammation and adipocyte dysfunction may alter endothelial function leading to hypertension. Both in men and in women, particularly in the post-menopausal period, hypoandrogenism seems to be

  20. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  1. Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'

    OpenAIRE

    Pelosi, Paolo; Vargas, Maria

    2012-01-01

    Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, ...

  2. Dutch guideline for the management of hypertensive crisis -- 2010 revision

    NARCIS (Netherlands)

    van den Born, B. J. H.; Beutler, J. J.; Gaillard, C. A. J. M.; de Gooijer, A.; van den Meiracker, A. H.; Kroon, A. A.

    2011-01-01

    Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated

  3. Management of hypertension in pregnancy.

    Science.gov (United States)

    Chung, N A; Beevers, D G; Lip, G Y

    2001-01-01

    Hypertension is an important cause of both maternal and fetal morbidity and mortality in pregnant women. There are still no definitive guidelines as to when and how patients should be treated, but it is important that appropriate treatment is initiated early in patients at highest risk and they are closely monitored. Hypertension in pregnancy can be a difficult condition to diagnose and treat because of the numerous and differing classification systems that have been used in the past. One classification system, which accounts for the multisystem involvement which can occur in pre-eclampsia and eclampsia, divides hypertension in pregnancy into 3 main groups: pre-eclampsia, gestational hypertension and chronic hypertension. Little benefit to the fetus has been shown from treating gestational and chronic hypertension, but studies in this area have been small and would not have had the power to show a difference in outcome between treated and untreated groups. However, the reduction in morbidity and mortality in the treatment of pre-eclampsia is significant. Therefore, all pregnancies complicated by hypertension require monitoring to detect the possible onset of superimposed pre-eclampsia/eclampsia. Institutions should have a management strategy for those mothers with severe hypertension including a multidisciplinary approach, where the patient is to be monitored and which antihypertensive agents are to be used. It should not be forgotten that the definitive treatment for severe hypertension is delivery of the fetus despite risks to fetal morbidity and mortality. This will reduce blood pressure, but hypertension per se may still persist post partum requiring short term therapy.

  4. Prevalence of pulmonary hypertension in sickle cell anaemia ...

    African Journals Online (AJOL)

    ... subjected to echocardiography and pulmonary hypertension was deduced from their cardiac tricuspid regurgitant jet velocity. Other parameters measured were age, body mass index, full blood count, red cell indices, foetal haemoglobin, chest X-ray, liver function tests, lactate dehydrogenase and pulmonary function tests.

  5. Pulmonary arterial hypertension

    Science.gov (United States)

    2013-01-01

    Pulmonary arterial hypertension (PAH) is a chronic and progressive disease leading to right heart failure and ultimately death if untreated. The first classification of PH was proposed in 1973. In 2008, the fourth World Symposium on PH held in Dana Point (California, USA) revised previous classifications. Currently, PH is devided into five subgroups. Group 1 includes patients suffering from idiopathic or familial PAH with or without germline mutations. Patients with a diagnosis of PAH should systematically been screened regarding to underlying mutations of BMPR2 gene (bone morphogenetic protein receptor type 2) or more rarely of ACVRL1 (activine receptor-like kinase type 1), ENG (endogline) or Smad8 genes. Pulmonary veno occusive disease and pulmonary capillary hemagiomatosis are individualized and designated as clinical group 1'. Group 2 'Pulmonary hypertension due to left heart diseases' is divided into three sub-groups: systolic dysfonction, diastolic dysfonction and valvular dysfonction. Group 3 'Pulmonary hypertension due to respiratory diseases' includes a heterogenous subgroup of respiratory diseases like PH due to pulmonary fibrosis, COPD, lung emphysema or interstitial lung disease for exemple. Group 4 includes chronic thromboembolic pulmonary hypertension without any distinction of proximal or distal forms. Group 5 regroup PH patients with unclear multifactorial mechanisms. Invasive hemodynamic assessment with right heart catheterization is requested to confirm the definite diagnosis of PH showing a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg and a normal pulmonary capillary wedge pressure (PCWP) of ≤ 15 mmHg. The assessment of PCWP may allow the distinction between pre-capillary and post-capillary PH (PCWP > 15 mmHg). Echocardiography is an important tool in the management of patients with underlying suspicion of PH. The European Society of Cardiology and the European Respiratory Society (ESC-ERS) guidelines specify its role

  6. Hypertension in Patients with Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: wolney@cardiol.br [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2015-03-15

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

  7. Hypertension in Patients with Cancer

    International Nuclear Information System (INIS)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade

    2015-01-01

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality

  8. Vascular Remodeling in Experimental Hypertension

    Directory of Open Access Journals (Sweden)

    Norma R. Risler

    2005-01-01

    Full Text Available The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts and noncellular (extracellular matrix components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.

  9. Does exercise pulmonary hypertension exist?

    Science.gov (United States)

    Lau, Edmund M; Chemla, Denis; Whyte, Kenneth; Kovacs, Gabor; Olschewski, Horst; Herve, Philippe

    2016-09-01

    The exercise definition of pulmonary hypertension using a mean pulmonary artery pressure threshold of greater than 30 mmHg was abandoned following the 4th World Pulmonary Hypertension Symposium in 2008, as this definition was not supported by evidence and healthy individuals frequently exceed this threshold. Meanwhile, the clinical value of exercise pulmonary hemodynamic testing has also been questioned. Recent data support the notion that an abnormal pulmonary hemodynamic response during exercise (or exercise pulmonary hypertension) is associated with symptoms and exercise limitation. Pathophysiologic mechanisms accounting for the development of exercise pulmonary hypertension include increased vascular resistance, excessive elevation in left atrial pressure and/or increased volume of trapped air during exercise, resulting in a steep rise in pulmonary artery pressure relative to cardiac output. Recent evidence suggests that exercise pulmonary hypertension may be defined by a mean pulmonary artery pressure surpassing 30 mmHg together with a simultaneous total pulmonary resistance exceeding 3 WU. Exercise pulmonary hypertension is a clinically relevant entity and an improved definition has been suggested based on new evidence. Exercise pulmonary hemodynamics may help unmask early or latent disease, particularly in populations that are at high risk for the development of pulmonary hypertension.

  10. [Vascular aging, arterial hypertension and physical activity].

    Science.gov (United States)

    Schmidt-Trucksäss, A; Weisser, B

    2011-11-01

    The present review delineates the significance of intima-media-thickness, arterial stiffness and endothelial function for vascular aging. There is profound evidence for an increase in intima-media-thickness and vascular stiffness not only during healthy aging but induced also by cardiovascular risk factors. There is a central role of arterial hypertension for this progression in both structural factors. In addition, both parameters are strongly associated with cardiovascular risk. Endothelial function measured as postischemic flow-mediated vasodilatation is a functional parameter which is decreased both in healthy aging and by cardiovascular risk factors. Physical activity modifies the influence of aging and risk factors on endothelial function. A positive influence of endurance exercise on vascular stiffness and endothelial function has been demonstrated in numerous studies. In long-term studies, regular physical activity has been shown to reduce the progression of intima-media-thickness. Thus, arterial hypertension accelerates vascular aging, while physical activity has a positive influence on a variety of vascular parameters associated with vascular aging. © Georg Thieme Verlag KG Stuttgart · New York.

  11. OBESITY-INDUCED HYPERTENSION: INTERACTION OF NEUROHUMORAL AND RENAL MECHANISMS

    Science.gov (United States)

    Hall, John E.; do Carmo, Jussara M.; da Silva, Alexandre A.; Wang, Zhen; Hall, Michael E.

    2015-01-01

    Excess weight gain, especially when associated with increased visceral adiposity, is a major cause of hypertension, accounting for 65–75% of the risk for human primary (essential) hypertension. Increased renal tubular sodium reabsorption impairs pressure natriuresis and plays an important role in initiating obesity hypertension. The mediators of abnormal kidney function and increased blood pressure during development of obesity hypertension include 1) physical compression of the kidneys by fat in and around the kidneys, 2) activation of the renin-angiotensin-aldosterone system (RAAS), and 3) increased sympathetic nervous system (SNS) activity. Activation of the RAAS system is likely due, in part, to renal compression as well as SNS activation. However, obesity also causes mineralocorticoid receptor activation independent of aldosterone or angiotensin II. The mechanisms for SNS activation in obesity have not been fully elucidated but appear to require leptin and activation of the brain melanocortin system. With prolonged obesity and development of target organ injury, especially renal injury, obesity-associated hypertension becomes more difficult to control, often requiring multiple antihypertensive drugs and treatment of other risk factors, including dyslipidemia, insulin resistance and diabetes, and inflammation. Unless effective anti-obesity drugs are developed, the impact of obesity on hypertension and related cardiovascular, renal and metabolic disorders is likely to become even more important in the future as the prevalence of obesity continues to increase. PMID:25767285

  12. Studies on arterial stiffness and wave reflections in hypertension.

    Science.gov (United States)

    Safar, Michel E; Levy, Bernard I

    2015-01-01

    Patho-physiological and pharmacological studies have consistently noticed that, with the exception of subjects with end-stage renal disease, total intravascular blood volume is not increased in patients with chronic hypertension. Because the mean circulatory pressure is enhanced in such subjects, it was postulated that the compliance of the cardiovascular system could be abnormally low in this particular population. This simple observation has influenced a great part of our experimental and clinical research directed toward subjects with hypertension and their relationship with the compliance of the vascular system. These works started between 1970 and 1980 by methodological investigations and validations followed by analysis of clinical situations that showed that venous and mostly arterial stiffness were significantly increased in hypertensive patients independently of blood pressure level. During the same time, we assessed the role of endothelium on the large arterial wall mechanical properties in normotensive and hypertensive rats. Thereafter more specific directions have been developed, affecting large arteries structure and function and arterial wall remodeling, including their consequences on central and peripheral hemodynamics. In parallel, epidemiological studies identified the pulsatile hemodynamic parameters as major independent predictors of cardiovascular risks. The consequences of these alterations on clinical pharmacology and therapeutics in hypertension are analyzed in detail. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Masked Uncontrolled Hypertension in CKD.

    Science.gov (United States)

    Agarwal, Rajiv; Pappas, Maria K; Sinha, Arjun D

    2016-03-01

    Masked uncontrolled hypertension (MUCH) is diagnosed in patients treated for hypertension who are normotensive in the clinic but hypertensive outside. In this study of 333 veterans with CKD, we prospectively evaluated the prevalence of MUCH as determined by ambulatory BP monitoring using three definitions of hypertension (daytime hypertension ≥135/85 mmHg; either nighttime hypertension ≥120/70 mmHg or daytime hypertension; and 24-hour hypertension ≥130/80 mmHg) or by home BP monitoring (hypertension ≥135/85 mmHg). The prevalence of MUCH was 26.7% by daytime ambulatory BP, 32.8% by 24-hour ambulatory BP, 56.1% by daytime or night-time ambulatory BP, and 50.8% by home BP. To assess the reproducibility of the diagnosis, we repeated these measurements after 4 weeks. Agreement in MUCH diagnosis by ambulatory BP was 75-78% (κ coefficient for agreement, 0.44-0.51), depending on the definition used. In contrast, home BP showed an agreement of only 63% and a κ coefficient of 0.25. Prevalence of MUCH increased with increasing clinic systolic BP: 2% in the 90-110 mmHg group, 17% in the 110-119 mmHg group, 34% in the 120-129 mmHg group, and 66% in the 130-139 mmHg group. Clinic BP was a good determinant of MUCH (receiver operating characteristic area under the curve 0.82; 95% confidence interval 0.76-0.87). In diagnosing MUCH, home BP was not different from clinic BP. In conclusion, among people with CKD, MUCH is common and reproducible, and should be suspected when clinic BP is in the prehypertensive range. Confirmation of MUCH diagnosis should rely on ambulatory BP monitoring. Copyright © 2016 by the American Society of Nephrology.

  14. Mechanisms of hypertension in renal radiation

    International Nuclear Information System (INIS)

    Juncos, L.; Cornejo, J.C.; Cejas, H.; Broglia, C.

    1990-01-01

    This study was undertaken to investigate the role played by renal functional and structural changes in the development of radiation-induced hypertension. Four groups of rats were studied: (1) left kidney radiated, (2) sham procedure, (3) uninephrectomy followed 3 weeks later by radiation of the contralateral kidney, and (4) uninephrectomy followed by sham procedure 3 weeks later. All radiated rats became hypertensive at 12 weeks (p less than 0.05) and had higher protein excretion (p less than 0.05). In the presence of an intact contralateral kidney, radiation causes mild-to-moderate histological abnormalities, and therefore, creatinine clearance and water and sodium handling do not change. Plasma renin activity increased in this group (p less than 0.05). Radiated uninephrectomized rats showed decreased creatinine clearance (p less than 0.05), but renin activity remained unchanged. These rats developed severe histological abnormalities in glomeruli, interstitia, tubuli, and vessels resulting in increased sodium and water output. The average of individual tubular and interstitial scores correlated significantly with both water intake and output but not with sodium excretion. These studies suggest that in the presence of an intact kidney, renin is an important determinant in the development or maintenance of radiation hypertension, whereas in the absence of the contralateral kidney, severe histological changes and renal failure are prominent despite increased water intake and output. The more severe glomerular sclerosis and proteinuria in the latter model could be related to diminished renal mass

  15. Idiopathic intracranial hypertension in pediatric patients

    Directory of Open Access Journals (Sweden)

    Nada Jirásková

    2008-11-01

    Full Text Available Nada Jirásková, Pavel RozsívalDepartment of Ophthalmology, University Hospital, Hradec Králové, Czech RepublicPurpose: To evaluate retrospectively the features, treatment, and outcome of idiopathic intracranial hypertension (IIH in children.Methods: Nine patients, 15 years and younger, diagnosed with IIH. Inclusion criteria were papilledema, normal brain computer tomography or magnetic resonance imaging, cerebrospinal fluid pressure greater than 250 mm H2O, normal cerebrospinal fluid content, and a nonfocal neurologic examination except for sixth nerve palsy.Results: Of the nine patients, eight were girls. Five girls were overweight and one boy was obese. The most common presenting symptom was headache (5 patients. Diplopia or strabismus did not occur in our group. Visual field abnormalities were present in all eyes, and severe visual loss resulting in light perception vision occurred in both eyes of one patient. Eight patients were treated medically with acetazolamide alone, and one girl needed a combination of acetazolamide and corticosteroids. This girl also required optic nerve sheath decompression surgery. Resolution of papilledema and recovery of visual function occurred in all patients.Conclusions: Idiopathic intracranial hypertension in prepubertal children is rather uncommon. Prompt diagnosis and management are important to prevent permanent visual loss.Keywords: idiopathic intracranial hypertension, pediatric, treatment

  16. pre-hypertension and hypertension in apparently healthy ...

    African Journals Online (AJOL)

    user

    hypertension among urban adolescents in Calabar, south eastern Nigeria. This was a ... disease later in life but also to significantly increase .... beam balance is not available (Paynter and ..... keeping with work done among Nigerian School.

  17. Ethical Dilemmas when Diagnosing Hypertension

    Directory of Open Access Journals (Sweden)

    Sandra Santana López

    2012-12-01

    Full Text Available A review on the ethical dilemmas in the diagnosis of hypertension and some elements in the emergence of the bioethics concept was performed. Ethical conflicts that appear at each stage of diagnosis of hypertension: at the time of providing the information, at the point of indication and performance of diagnostic tests, when communicating the diagnosis and during subsequent decision making were identified. We conclude that technological development will introduce new ethical decisions in the diagnosis of hypertension that will increasingly involve the interests of society and create, in one way or another, ethical and moral conflict in the decision making process.

  18. [Hypertension in women after menopause].

    Science.gov (United States)

    Beaufils, Michel

    2006-06-01

    Menopause coincides with an increase in the incidence of hypertension in women. A direct role of estrogen deprivation in this increased blood pressure remains a topic of debate. Menopause probably accelerates the arterial changes related to aging. Hormone replacement therapy does not influence blood pressure significantly and is not contraindicated in hypertensive women. The effect of hormone replacement treatment on cardiovascular risk was recently the object of controversy. It does not increase risk except in cases of late treatment in older women who already have atherosclerosis. Hypertension management in women is otherwise similar to management in men.

  19. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates. Udgivelsesdato: 2009-Jun-8...

  20. [The magnetotherapy of hypertension patients].

    Science.gov (United States)

    Ivanov, S G; Smirnov, V V; Solov'eva, F V; Liashevskaia, S P; Selezneva, L Iu

    1990-01-01

    A study was made of the influence of the constant MKM2-1 magnets on patients suffering from essential hypertension. Continuous action of the magnetic field, created by such magnets, on the patients with stage II essential hypertension was noted to result in a decrease of arterial pressure without the occurrence of any side effects and in a simultaneous reduction of the scope of drug administration. Apart from that fact, magnetotherapy was discovered to produce a beneficial effect on the central hemodynamics and microcirculation. The use of the MKM2-1 magnets may be regarded as a feasible method of the treatment of essential hypertension patients at any medical institution.

  1. Hypertensive thalamic hematoma treated by CT stereotactic evacuation (with two cases reports)

    International Nuclear Information System (INIS)

    Wang Hongsheng; Zhu Fengqing

    2002-01-01

    Objective: To investigate new surgical method to treat hypertensive thalamic hematoma. Methods: Two medial-degree coma patients with hypertensive thalamic hematoma were treated by CT stereotactic evacuation. Results: One week after operation the two patients regained consciousness. The function of paraplegic appendage restored partly, and one patient could take care of himself. Conclusion: CT stereotactic evacuation to treat hypertensive thalamic hematoma has the advantages of small trauma, little complication and good clinical results. The authors suggest that it be selected firstly in treating hypertensive thalamic hematoma

  2. [Renal hemodynamics and albuminuria in patients with arterial hypertension].

    Science.gov (United States)

    Stríbrná, J; Englis, M; Peregrin, J; Belán, A; Růzicka, M

    1995-12-06

    The cause of hyperalbuminuria in hypertonic patients can be functional or irreversible structural changes. The objective of the present investigation was an attempt to differentiate these two possibilities by comparing data of hypertonic patients with normal albuminuria (albumin excretion value for microalbuminuria. The results suggest that microalbuminuria in hypertensive patients is as a rule a manifestation of structural renal changes, while also functional and reversible changes participate. The asset of treatment of hypertension by angioplasty of the renal arteries was manifested not only in the renal haemodynamics but also by reduced albuminuria.

  3. Autoregulation of cerebral circulation in hypertension

    International Nuclear Information System (INIS)

    Strandgaard, S.

    1978-01-01

    The present work deals with the effects of high blood pressure on cerebrovascular autoregulation, i.e. the mechanism that ensures a constant blood flow in the brain tissue by way of varying the calibre of the smallest resistance vessels. It has been shown that in patients with severe, untreated or uncontrolled hypertension, the lower limit of autoregulation of cerebral blood flow is shifted towards high blood pressure, thus decreasing the tolerance to acute hypotension. This is a functional correlate of the morphological changes present in hypertensive arterioles, i.e. wall thickening and luminal narrowing. Observations in a group of effectively treated hypertensive patients strongly suggest that a readaptation of autoregulation towards normal may take place during long-term entihypertensive treatment. Thus, the present findings should not be interpreted as a warning against clinical blood pressure lowering, which is known from other studies to protect the patient against stroke. Rather, the present observations are a support of the view that a severely elevated blood pressure should be lowered gradually, without aiming at an immediate normalization. It has also been demonstrated that some hypertensive patients do not readapt their cerebrovascular autoregulation towards normal during treatment, and may be better served in the long run with a blood pressure somewhat above normal. An upper blood pressure limit of autoregulation of cerebral blood flow has been demonstrated in man and experimental animal in the present and other investigations. With a blood pressure rise of 40-60% above the resting awake level, autoregulation may fail, and cerebral blood flow increases. At the upper limit of autoregulation, a ''sausage-string'' pattern has been observed in the cat's pial arterioles. It has been shown by vessel calibre measurements to consist of localized dilatations superimposed on autoregulatory arteriolar constriction. At higher pressures, vasodilatation becomes

  4. Diuretics for Hypertension: A Review and Update.

    Science.gov (United States)

    Roush, George C; Sica, Domenic A

    2016-10-01

    This review and update focuses on the clinical features of hydrochlorothiazide (HCTZ), the thiazide-like agents chlorthalidone (CTDN) and indapamide (INDAP), potassium-sparing ENaC inhibitors and aldosterone receptor antagonists, and loop diuretics. Diuretics are the second most commonly prescribed class of antihypertensive medication, and thiazide-related diuretics have increased at a rate greater than that of antihypertensive medications as a whole. The latest hypertension guidelines have underscored the importance of diuretics for all patients, but particularly for those with salt-sensitive and resistant hypertension. HCTZ is 4.2-6.2 systolic mm Hg less potent than CTDN, angiotensin-converting enzyme inhibitors, beta blockers, and calcium channel blockers by 24-hour measurements and 5.1mm Hg systolic less potent than INDAP by office measurements. For reducing cardiovascular events (CVEs), HCTZ is less effective than enalapril and amlodipine in randomized trials, and, in network analysis of trials, it is less effective than CTDN and HCTZ-amiloride. Combined with thiazide-type diuretics, potassium-sparing agents decrease ventricular ectopy and reduce the risk for sudden cardiac death relative to thiazide-type diuretics used alone. A recent synthesis of 44 trials has shown that the relative potencies in milligrams among spironolactone (SPIR), amiloride, and eplerenone (EPLER) are approximately from 25 to 10 to 100, respectively, which may be important when SPIR is poorly tolerated. SPIR reduces proteinuria beyond that provided by other renin angiotensin aldosterone inhibitors. EPLER also reduces proteinuria and has beneficial effects on endothelial function. While guidelines often do not differentiate among specific diuretics, this review demonstrates that these distinctions are important for managing hypertension. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Renal sympathetic denervation for resistant hypertension.

    Science.gov (United States)

    Froeschl, Michael; Hadziomerovic, Adnan; Ruzicka, Marcel

    2013-05-01

    Resistant hypertension is an increasingly prevalent health problem associated with important adverse cardiovascular outcomes. The pathophysiology that underlies this condition involves increased function of both the sympathetic nervous system and the renin-angiotensin II-aldosterone system. A crucial link between these 2 systems is the web of sympathetic fibres that course within the adventitia of the renal arteries. These nerves can be targeted by applying radiofrequency energy from the lumen of the renal arteries to renal artery walls (percutaneous renal sympathetic denervation [RSD]), an approach that has attracted great interest. This paper critically reviews the evidence supporting the use of RSD. Small studies suggest that RSD can produce dramatic blood pressure reductions: In the randomized Symplicity HTN-2 trial of 106 patients, the mean fall in blood pressure at 6 months in patients who received the treatment was 32/12 mm Hg. However, there are limitations to the evidence for RSD in the treatment of resistant hypertension. These include the small number of patients studied; the lack of any placebo-controlled evidence; the fact that blood pressure outcomes were based on office assessments, as opposed to 24-hour ambulatory monitoring; the lack of longer-term efficacy data; and the lack of long-term safety data. Some of these concerns are being addressed in the ongoing Renal Denervation in Patients With Uncontrolled Hypertension (Symplicity HTN-3) trial. The first percutaneous RSD system was approved by Health Canada in the spring of 2012. But until more and better-quality data are available, this procedure should generally be reserved for those patients whose resistant hypertension is truly uncontrolled. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  6. The novel organic mononitrate NDHP attenuates hypertension and endothelial dysfunction in hypertensive rats

    OpenAIRE

    Luciano L. Paulo; Josiane Campos Cruz; Zhengbing Zhuge; Alynne Carvalho-Galvão; Maria C.R. Brandão; Thiago F. Diniz; Sarah McCann Haworth; Petrônio F. Athayde-Filho; Virginia S. Lemos; Jon O. Lundberg; Marcelo F. Montenegro; Valdir A. Braga; Mattias Carlström

    2018-01-01

    Rationale: Development and progression of cardiovascular diseases, including hypertension, are often associated with impaired nitric oxide synthase (NOS) function and nitric oxide (NO) deficiency. Current treatment strategies to restore NO bioavailability with organic nitrates are hampered by undesirable side effects and development of tolerance. In this study, we evaluated NO release capability and cardiovascular effects of the newly synthesized organic nitrate 1, 3-bis (hexyloxy) propan-2-y...

  7. Definition and classification of pulmonary hypertension.

    Science.gov (United States)

    Humbert, Marc; Montani, David; Evgenov, Oleg V; Simonneau, Gérald

    2013-01-01

    Pulmonary hypertension is defined as an increase of mean pulmonary arterial pressure ≥25 mmHg at rest as assessed by right heart catheterization. According to different combinations of values of pulmonary wedge pressure, pulmonary vascular resistance and cardiac output, a hemodynamic classification of pulmonary hypertension has been proposed. Of major importance is the pulmonary wedge pressure which allows to distinguish pre-capillary (pulmonary wedge pressure ≤15 mmHg) and post-capillary (pulmonary wedge pressure >15 mmHg) pulmonary hypertension. Pre-capillary pulmonary hypertension includes the clinical groups 1 (pulmonary arterial hypertension), 3 (pulmonary hypertension due to lung diseases and/or hypoxia), 4 (chronic thrombo-embolic pulmonary hypertension) and 5 (pulmonary hypertension with unclear and/or multifactorial mechanisms). Post-capillary pulmonary hypertension corresponds to the clinical group 2 (pulmonary hypertension due to left heart diseases).

  8. [Diagnostic of secondary hypertension in clinical practice].

    Science.gov (United States)

    Somlóová, Z; Rosa, J; Petrák, O; Strauch, B; Zelinka, T; Holaj, R; Widimský, J

    2011-09-01

    Arterial hypertension is a common worldwide disease with a prevalence of approximately 26%. Secondary cause is known in 5-10% of patients with hypertension. We should think of secondary hypertension in all patients with resistant hypertension, in patients with sudden deterioration in the control of hypertension and in patients with laboratory and clinical signs of diseases associated with secondary hypertension. It is important to distinguish between secondary hypertension and pseudo-resistance (noncompliance to treatment, white coat syndrome). Secondary causes of hypertension can be divided into endocrine (primary aldosteronism, pheochromocytoma, hypercortisolism, hyperparathyreoidism), renal - renovascular and renal parenchymal hypertension, and other causes as sleep apnoe syndrome, hypertension in pregnancy, coarctation of the aorta and intracranial tumors.

  9. Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions

    NARCIS (Netherlands)

    Serne, EH; Gans, ROB; ter Maaten, JC; ter Wee, PM; Donker, AM; Stehouwer, CDA

    Objective: In patients with essential hypertension, defects in both the metabolic and vascular actions of insulin have been described. Impaired microvascular function, a well-established abnormality in essential hypertension, may explain part of these defects. In the present study we investigated

  10. Echographic and hemodynamic parameters in patients with hepatic cirrhosis and portal hypertension

    International Nuclear Information System (INIS)

    Rikhsieva, L.Eh.; Akhmedzhanova, Sh.Sh.; Myasnik, B.N.; Khodzhibekov, M.Kh.

    1989-01-01

    The efficiency of combined echoradionuclide investigation for the identification of the severity of portal hypertension and the determination of clear-cut criteria for the differentiation of stages of portal hypertension with reference to functional potentials of renal hemodynamics and systemic circulation at large is demonstrated

  11. Definition and classification of hypertension: an update.

    Science.gov (United States)

    Giles, Thomas D; Materson, Barry J; Cohn, Jay N; Kostis, John B

    2009-11-01

    Since the publication of a paper by the American Society of Hypertension, Inc. Writing Group in 2003, some refinements have occurred in the definition of hypertension. Blood pressure is now recognized as a biomarker for hypertension, and a distinction is made between the various stages of hypertension and global cardiovascular risk. This paper discusses the logic underlying the refinements in the definition of hypertension. 2009 Wiley Periodical, Inc.

  12. Biomarkers in white-coat hypertension

    OpenAIRE

    Martin, Catherine Ann

    2017-01-01

    The introduction of ambulatory blood pressure monitoring in the 1960s provided new insights into the nature of high blood pressure disorders. Blood pressure is now categorised into four quadrants:normotension, masked hypertension, hypertension and white-coat hypertension. In white-coat hypertension blood pressure is elevated when taken at the doctor’s office but normal if taken outside the doctor’s office. Several controversies are associated with white-coat hypertension, which are discuss...

  13. Sex differences in primary hypertension

    Science.gov (United States)

    2012-01-01

    Men have higher blood pressure than women through much of life regardless of race and ethnicity. This is a robust and highly conserved sex difference that it is also observed across species including dogs, rats, mice and chickens and it is found in induced, genetic and transgenic animal models of hypertension. Not only do the differences between the ovarian and testicular hormonal milieu contribute to this sexual dimorphism in blood pressure, the sex chromosomes also play a role in and of themselves. This review primarily focuses on epidemiological studies of blood pressure in men and women and experimental models of hypertension in both sexes. Gaps in current knowledge regarding what underlie male-female differences in blood pressure control are discussed. Elucidating the mechanisms underlying sex differences in hypertension may lead to the development of anti-hypertensives tailored to one's sex and ultimately to improved therapeutic strategies for treating this disease and preventing its devastating consequences. PMID:22417477

  14. Intracranial Hypertension: Medication and Surgery

    Science.gov (United States)

    ... fallen out of favor, unless there is a secondary inflammatory process caused by an underlying disease like ... have little effect on headaches caused by intracranial hypertension, they may temporarily affect the intensity of a ...

  15. Hypertension presenting early in pregnancy

    OpenAIRE

    Melvin, Audrey; Kinsley, Brendan

    2015-01-01

    Key Clinical Message Paraganglioma in pregnancy is an exceedingly rare and potentially life?threatening diagnosis. It is important that the clinicians consider secondary causes when women present with hypertension in early pregnancy.

  16. Liver Disease and Pulmonary Hypertension

    Science.gov (United States)

    Facebook Twitter Instagram YouTube About PHA Contact Join Careers Store My Account Donate Patients About PH Diagnosis Treatments Newly ... areas © 2017 Pulmonary Hypertension Association. All Rights Reserved. Facebook Twitter Instagram YouTube

  17. Liver Hypertension: Treatment in Infancy !

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Liver Hypertension: Treatment in Infancy ! Liver Disease > Heart. No good non-invasive method. Repeated measurements problematic. Drug efficacy 50% at best. No predictors of response. We Need YOU !!

  18. [Menopause: Hypertension and vascular disease].

    Science.gov (United States)

    Zilberman, J M

    Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. What is hypertension in diabetes?

    DEFF Research Database (Denmark)

    Hansen, K W; Poulsen, P L; Ebbehøj, E

    2001-01-01

    AIMS: To establish reference data for ambulatory blood pressure (AMBP) in normotensive, normoalbuminuric Type 1 diabetic patients and characterize the relation to clinic blood pressure (BP). To evaluate the statement of the third working party of the British Hypertension Society (BHS) that a target...... clinic BP in diabetes diabetic patients, who had never received anti-hypertensive drugs. Clinic BP was determined as the mean of at least three auscultatory...

  20. Radiological imaging in endocrine hypertension

    Directory of Open Access Journals (Sweden)

    Chandan J Das

    2011-01-01

    Full Text Available While different generations of assays have played important role in elucidating causes of different endocrine disorders, radiological techniques are instrumental in localizing the pathology. This statement cannot be truer in any disease entity other than endocrine hypertension. This review makes an effort to highlight the role of different radiological modalities, especially ultrasonography, computed tomography and magnetic resonance imaging, in the evaluation of different causes of endocrine hypertension.