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Kalos T, Tsioufis C, Dimitriadis K, Vogiatzakis N, Kasiakogias A, Iliakis P, Konstantinidis D, Xanthopoulou M, Kakouri N, Laina A, Andrikou E, Tousoulis D. P5466Exaggerated exercise blood pressure response is accompanied by increased sympathetic activity and arterial stiffness in subjects with high normal blood pressure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
The clinical importance of a hypertensive response to exercise (HRE) in subjects with high normal blood pressure (BP) is not fully elucidated, while sympathetic overactivity and arterial stiffening are linked with adverse cardiovascular prognosis.
Purpose
The aim of this study was to assess the relation of HRE with sympathetic drive as assessed by muscle sympathetic nerve activity (MSNA) and arterial stiffness in subjects with high normal BP.
Methods
42 subjects with high normal office BP [defined as office systolic BP=130–139 mmHg and office diastolic BP=85–89 mmHg (age: 53±9 years, 29 males, office BP: 134/84 mmHg, 24-hour BP: 114/72 mmHg)] with a negative treadmill exercise test (Bruce protocol) were divided into those with HRE (n=12) (peak exercise systolic BP ≥210mmHg in men and ≥190 mmHg in women) and those without HRE (n=30). Arterial stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV) values. In all participants sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography).
Results
Subjects with a HRE compared to those without exhibited higher waist circumference (108.2±5.3 vs 94.7±9.2 cm, p=0.001) and were characterized by greater levels of carotid to femoral PWV (8.5±0.8 vs 7.0±0.9 m/sec, p<0.001) and sympathetic nerve traffic as reflected by MSNA levels (41.1±1.5 vs 32.1±1.9 bursts per 100 heart beats, p<0.001), while did not differ regarding metabolic profile and left ventricular mass index (p=NS). In the total population, peak exercise systolic BP was related to 24-h systolic BP (r=0.229, p<0.05), PWV (r=0.218, p=0.002), and MSNA (r=0.214, p<0.05). Moreover, MSNA was related to waist circumference (r=0.33, p=0.004) and office systolic BP levels (r=0.31, p<0.05) but there was no association with PWV values (p=NS).
Conclusion
In subjects with high normal BP, a HRE identifies a state of arterial stiffening and sympathetic overdrive, as reflected by increased PWV and MSNA levels respectively. These finding suggest that exercise testing provides additional clinical information regarding the vascular status and modulation of sympathetic tone in this setting.
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Konstantinidis D, Tsioufis C, Dimitriadis K, Kasiakogias A, Liatakis I, Koutra E, Leontsinis I, Kouremeti M, Iliakis P, Vogiatzakis N, Karaminas N, Thomopoulos K, Tousoulis D. P6577Isolated systolic hypertension versus combined systolic-diastolic hypertension as predictors of atrial fibrillation: data from a 8-year-follow-up study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Isolated systolic hypertension (ISH) and combined systolic-diastolic hypertension (CH) are related with increased cardiovascular risk.
Purpose
The aim of the present study was to compare the predictive role of ISH and CH for the incidence of atrial fibrillation (AF) in a cohort of essential hypertensive patients.
Methods
We followed up 1605 essential hypertensives with office systolic blood pressure (BP)≥140 mmHg [mean age 58.1 years, 842 males, office BP=153/92 mmHg] for a mean period of 8 years. All subjects had at least one annual visit and at baseline underwent echocardiographic study and blood sampling for estimation of metabolic profile. Patients with baseline ISH exhibited office systolic BP ≥140 mmHg and office diastolic BP <90 mmHg, while those with CH had office systolic BP ≥140 mmHg and office diastolic BP ≥90 mmHg. Moreover, new-onset AF was defined as hospitalization for AF or compatible electrocardiographic tracings.
Results
The incidence of new-onset AF over the follow-up period was 3.4% (n=55). Patients with ISH (n=510) compared to those with CH (n=1095) were older (65±10 vs 55±11 years, p<0.0001), had at baseline lower waist circumference (95.5±12 vs 98±12 cm, p<0.0001), office systolic BP (149±10 vs 155±13 mmHg, p<0.0001), office diastolic BP (80±5 vs 98±7 mmHg, p<0.0001), while did not differ regarding left ventricular mass index and lipid levels (p=NS for all). Univariate Cox regression analysis revealed that baseline ISH (hazard ratio=4.612, p=0.013) and CH (hazard ratio=1.794, p=0.036) predicted new-onset AF. However, in multivariate Cox regression model, age (hazard ratio=1.078, p<0.001), left ventricular mass index (hazard ratio 1.012, p=0.014), left atrium diameter (hazard ratio=1.102, p<0.001) and ISH (hazard ratio=1.551, p=0.035) but not CH turned out to be independent predictors of new-onset AF episodes.
Conclusions
In essential hypertensive patients, ISH but not CH exhibits independent prognostic value for AF. These findings support that ISH constitutes a hypertensive phenotype of particularly increased arrhythmia risk needing careful evaluation and treatment.
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Kasiakogias A, Tsioufis C, Konstantinidis D, Leontsinis I, Iliakis P, Koumelli A, Konstantinou K, Liatakis I, Siafi E, Tousoulis D. P6221Salt consumption as a predictor of cardiovascular events among hypertensive patients: a 5-year follow-up study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Salt intake is linked to hypertension but data on its association with incident cardiovascular events, especially among hypertensives, is limited.
Purpose
To examine the prospective association of different salt consumption levels with cardiovascular morbidity in a hypertensive population.
Methods
We followed 2130 hypertensive patients (age 57±12 years, 11.2% untreated) without a history of cardiovascular disease for a mean period of 5.3±3.3 years. At the baseline examination, salt intake was evaluated by a structured validated questionnaire. Accordingly, the study population was divided into three groups: hypertensives with a low (1079 patients, 51% of the population), a moderate (895 patients, 42%) and a high salt consumption (146 patients, 7%). During follow-up, patients underwent clinic visits at least yearly for management of hypertension and risk factors. The outcome studied was the composite of non-fatal cardiovascular events.
Results
The composite endpoint (19 strokes and 65 cases of coronary artery disease) occurred in 84 patients (3.9%). At baseline, increasing salt consumption was significantly associated with age, body mass index, office blood pressure and renal function. Unadjusted Cox regression analysis showed that, compared to the reference group, the risk for cardiovascular morbidity was similar in patients with moderate salt consumption (HR: 1.1, 95% CI: 0.71–1.77) but significantly higher in patients with high salt consumption (HR: 2.12, 95% CI: 1.09–4.38). This pattern was clearly sustained after adjusting for multiple risk factors including baseline blood pressure levels.
Conclusions
Among hypertensive patients, heavy salt consumption is associated with an increased cardiovascular risk, while moderate consumption does not affect patient outcome.
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Leontsinis I, Tsioufis C, Dimitriadis K, Kasiakogias A, Liatakis I, Koutra E, Kouremeti M, Iliakis P, Vogiatzakis N, Karaminas N, Asimaki E, Tousoulis D. P5459Comparison of the predictive role of changes in left ventricular mass and arterial stiffness for coronary artery disease in essential hypertension: Data from a 8-year-follow-up study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Although arterial stiffening is related to atherosclerosis progression, its prognostic role in hypertension is not fully elucidated, while augmented left ventricular mass index (LVMI) is linked to adverse outcome.
Purpose
The aim of the present study was to compare the predictive role of changes in arterial stiffness and LVMI for the incidence of coronary artery disease (CAD) in a cohort of essential hypertensive patients.
Methods
We followed up 1082 essential hypertensives (mean age 55.9 years, 562 males, office blood pressure (BP)=145/91 mmHg) free of cardiovascular disease for a mean period of 8 years. All subjects had at least one annual visit and at baseline and last visit underwent complete echocardiographic study for estimation of LVMI and measurements of arterial stiffness on the basis of carotid to femoral pulse wave velocity (PWV), by means of a computerized method. The distribution of PWV was split by the median (8.2 m/sec) and accordingly subjects were classified into those with high (n=546) and low values (n=536). Moreover, LV hypertrophy (LVH) was defined as LVMI ≥125 g/m2 in males and LVMI ≥110 g/m2 in females, while CAD was defined as the history of myocardial infarction or significant coronary artery stenosis revealed by angiography or coronary revascularization procedure.
Results
The incidence of CAD over the follow-up period was 3.5%. Hypertensives who developed CAD (n=38) compared to those without CAD at follow-up (n=1044) had at baseline higher waist circumference (101.7±10.1 vs 96.2±11.6 cm, p=0.004), LVMI (123.9±22.1 vs 105.8±21.3 g/m2, p=0.026), prevalence of LVH (46% vs 25%, p=0.018) and prevalence of high PWV levels (67% vs 40%, p=0.021). No difference was observed between hypertensives with CAD and those without CAD with respect to baseline office BP, serum creatinine and lipid levels (p=NS for all). By univariate Cox regression analysis, it was revealed that changes in PWV levels between baseline and last visit predicted CAD (hazard ratio=1.243, p=0.014). However, in multivariate Cox regression model baseline glomerular filtration rate (hazard ratio=1.029, p=0.015) and changes in LVMI (hazard ratio=1.036, p<0.0001) but not alterations of PWV turned out to be independent predictors of CAD.
Conclusions
In essential hypertensive patients changes in LVMI predict future development of CAD, whereas PWV alterations exhibit no independent prognostic value. These findings support that LVMI constitutes a superior prognosticator of events than PWV and its estimation is essential in order to improve overall risk stratification in hypertension.
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Manta E, Tsioufis C, Dimitriadis K, Kouremeti M, Kakouri N, Kasiakogias A, Leontsinis I, Vogiatzakis N, Konstantinidis D, Andrikou I, Liatakis I, Tousoulis D. P802Interrelationships of sympathetic nervous system activity with attended and unattended blood pressure levels in essential hypertensive patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Measurement of unattended blood pressure (BP) may provide additional information over conventionally attended BP. Moreover, hypertension is related to sympathetic drive while there are scarce data on the diverse links of attended and unattended BP with muscle sympathetic nerve activity (MSNA) in hypertensive patients.
Purpose
The aim of this study was to assess the relation of BP levels in the attended and unattended setting with MSNA in patients with essential hypertension.
Methods
We studied 38 patients with essential hypertension (age: 59±11 years, 20 males, office BP: 142/86±19/11 mmHg, 24-hour BP: 137/80±14/12 mmHg). In all participants sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both unattended BP (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, at 1-minute intervals, after 5 minutes) and attended BP were measured with the same device, on the same day of MSNA recording, in random order. Patients were divided into the combined attended and unattended hypertensive group when BP≥140/90 mmHg in both attended and unattended BP estimations and to the attended hypertensive group when only attended BP≥140/90 mmHg.
Results
Patients with combined attended and unattended hypertension (n=18) compared to those with attended hypertension (n=20) were older (61±11 vs 57±11 years, p=0.03), whereas did not differ regarding 24-h ambulatory BP levels, glucose levels, renal function and left ventricular mass index (p=NS for all). Moreover, patients with combined attended and unattended hypertension compared to those with attended hypertension were characterized by greater levels of MSNA (41.2±11.6 vs 32.2±10.1 bursts per minute, p=0.031). In all participants, sympathetic nerve traffic as assessed by resting MSNA was related to attended systolic BP (r=0.459, p=0.004), attended diastolic BP (r=0.503, p=0.001), unattended systolic BP (r=0.433, p=0.007) and unattended diastolic BP (r=0.423, p=0.008).
Conclusions
The phenotype of combined attended and unattended hypertension compared to attended hypertension is accompanied by higher sympathetic nervous system activation. Moreover, the close association of MSNA with attended and unattended BP levels in essential hypertension, further supports the key role of sympathetic drive in modulating BP.
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Iliakis P, Tsioufis C, Dimitriadis K, Konstantinidis D, Kasiakogias A, Liatakis I, Asimaki E, Leontsinis I, Kouremeti M, Vogiatzakis N, Karaminas N, Thomopoulos K, Tousoulis D. P805Changes in arterial stiffness independently predict stroke in patients with essential hypertension: Data from a 8-year-follow-up study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Although arterial stiffening is related to atherosclerosis progression, the prognostic role of its alterations in cerebrovascular events in hypertension is not fully elucidated.
Purpose
The aim of the present study was to assess the predictive role of changes inarterial stiffness for the incidence of stroke in a cohort of essential hypertensive patients.
Methods
We followed up 1082 essential hypertensives (mean age 55.9 years, 562 males, office blood pressure (BP)=145/91 mmHg) for a mean period of 8 years. All subjects had at least one annual visit and underwent blood sampling for assessment of metabolic profile, whilearterial stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV), by means of a computerized method at the initial and last visit. The distribution of baseline PWV was split by the median (8.2 m/sec) and accordingly subjects were classified into those with high (n=546) and low values (n=536). Stroke was defined as rapid onset of a new neurological deficit persisting at least 24 hours unless death supervened confirmed by computed tomography and magnetic resonance angiography and/or cerebrovascular angiography findings.
Results
The incidence of stroke over the follow-up period was 2.2%. Hypertensives who had stroke (n=24) compared to those without stroke at follow-up (n=1058) were older at baseline (65±9 vs 56±12 years, p=0.032), had higher office BP levels (155±13 vs 145±15mmHg, p=0.014) and prevalence of high PWV levels (67% vs 40%, p=0.021). No difference was observed between hypertensives with stroke and those without stroke with respect to baseline renal function and lipid levels (p=NS for all). By univariate Cox regression analysis it was revealed that changes in PWV levels between baseline and last visit predicted stroke (hazard ratio=1.352, p=0.004). Moreover, in multivariate Cox regression model, baseline age (hazard ratio=1.087, p=0.03), changes in PWV (hazard ratio=1.115, p=0.024) but not changes in office BP levels turned out to be independent predictors of stroke.
Conclusions
In essential hypertensive patients, changes in PWV predict future development of stroke, independently of established confounders, including BP. These findings support that PWV constitutes a potent prognosticator of cerebrovascular events and its estimation is essential in order to improve risk stratification in hypertension.
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Kasiakogias A, Tsioufis C, Konstantinidis D, Iliakis P, Leontsinis I, Konstantinou K, Koumelli A, Kakouri N, Dimitriadis K, Tousoulis D. P5468Systolic versus diastolic blood pressure as predictors of cardiovascular events among treated hypertensive patients: a 6-year prospective study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background/Introduction
There has been a long debate regarding the association of systolic versus diastolic blood pressure with cardiovascular outcome and data regarding hypertensive patients under treatment have been conflicting.
Purpose
To investigate the association of different patterns of uncontrolled blood pressure (BP) among treated hypertensive patients.
Methods
We prospectively studied 1507 treated hypertensive patients (age 59±11 years) that are followed in the setting of a single-center, clinic-based registry. During follow-up, patients underwent regular visits for hypertension and risk factor management. Based on the cut-off limits for uncontrolled hypertension of office systolic BP≥140mmHg and diastolic BP≥90mmHg, study participants were divided into four groups: those with controlled hypertension (796 patients, 53% of the population), uncontrolled systolic BP (257 patients, 17%), uncontrolled diastolic BP (135 patients, 9%) and uncontrolled systolic and diastolic BP (319 patients, 21%). The outcome studied was the composite of cardiovascular morbidity set as coronary artery disease and stroke, and the controlled hypertension group served as reference.
Results
The median follow-up period was 6.4±3.0 years and the composite endpoint (13 strokes and 41 cases of coronary artery disease) occurred in 54 patients (3.6%). Unadjusted Cox regression analysis showed that, compared to the reference group of controlled hypertensives, the risk for cardiovascular morbidity was similar in patients with uncontrolled diastolic BP (HR: 0.88, 95% CI: 0.26–2.97) but significantly higher in patients with uncontrolled systolic BP (HR: 2.17, 95% CI: 1.08–4.36), while patients with both uncontrolled systolic and diastolic BP showed the worse prognosis (HR: 2.35, 95% CI: 1.24–4.43). This pattern of risk was overall sustained after adjusting for different sets of confounders.
Conclusions
Among treated hypertensive patients, uncontrolled systolic BP is associated with a greater risk for cardiovascular events compared to uncontrolled diastolic BP while uncontrolled systolodiastolic hypertension presents with the worse prognosis.
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Konstantinou K, Tsioufis C, Koumelli A, Mantzouranis M, Kasiakogias A, Doumas M, Tousoulis D. Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective. J Clin Hypertens (Greenwich) 2019; 21:1135-1143. [PMID: 31301119 DOI: 10.1111/jch.13622] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/30/2019] [Accepted: 05/21/2019] [Indexed: 12/16/2022]
Abstract
Arterial hypertension is a well-established cardiovascular risk factor, and blood pressure (BP) control has largely improved the prognosis of hypertensive patients. A number of studies have assessed the role of BP levels in the prognosis of patients with acute coronary syndromes. Pathophysiologic links of hypertension to acute myocardial infarction (MI) include endothelial dysfunction, autonomic nervous system dysregulation, impaired vasoreactivity, and a genetic substrate. A history of hypertension is highly prevalent among patients presenting with MI, and some, but not all, studies have associated it with a worse prognosis. Some data support that low levels of admission and in-hospital BP may indicate an increased risk for subsequent events. Risk scores used in patients with MI have, therefore, included BP levels and a history of hypertension in their variables. Of note, good long-term BP control, ideally initiated prior to discharge, should be pursued in order to improve secondary prevention.
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Konstantinou K, Tsioufis C, Mantzouranis E, Vogiatzakis N, Koumelli A, Kasiakogias A, Leontsinis I, Iliakis P, Liatakis I, Koutra E, Konstantinidis D, Tousoulis D. BLOOD PRESSURE VARIABILITY IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000572508.53360.6d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Fragoulis C, Tsioufis C, Dimitriadis K, Kasiakogias A, Iliakis P, Konstantinidis D, Siafi E, Andrikou I, Mantzouranis M, Kouremeti M, Leontsinis I, Lagiou F, Tousoulis D. COMPARISON OF THE CLINICAL CHARACTERISTICS OF PATIENTS WITH HYPERTENSIVE URGENCIES AND EMERGENCIES IN A TERTIARY HOSPITAL. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000571360.20944.f8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Kasiakogias A, Tsioufis C, Iliakis P, Konstantinidis D, Liatakis I, Kalos T, Koutra E, Kakouri N, Kouremeti M, Leontsinis I, Andrikou I, Sideris K, Dimitriadis K, Mantzouranis M, Tousoulis D. VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND TIME IN THERAPEUTIC RANGE AS PREDICTORS OF CARDIOVASCULAR EVENTS. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000571156.22612.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dimitriadis K, Tsioufis C, Iliakis P, Kasiakogias A, Andrikou I, Leontsinis I, Konstantinidis D, Tousoulis D. Future Anti-aldosterone Agents. Curr Pharm Des 2019; 24:5548-5554. [DOI: 10.2174/1381612825666190222145116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/13/2019] [Indexed: 11/22/2022]
Abstract
Background:
Targeting the renin-angiotensin-aldosterone axis is one of the most important therapeutic
pathways for blood pressure control, renal and cardiovascular protection.
Objective:
In this review, the new nonsteroidal mineralcorticoid receptor antagonists will be presented with a
special focus on finerenone and its randomized controlled trials along with an introduction to the clinically promising
aldosterone synthase inhibitors.
Method:
We conducted an in-detail review of the literature in order to draft a narrative review on the field.
Results:
Development of new anti-aldosterone agents focusing on the diverse components of aldosterone production
and action is now taking place. Nonsteroidal mineralοcorticoid receptor antagonists are safe and effective
therapeutic solutions with finerenone being the most well-studied agent with promising clinical data extending its
efficacy in diabetes mellitus, chronic kidney disease and heart failure. Aldosterone synthase inhibitors impact the
hormonal balance but there are still limitations regarding the duration of action and adverse effect of the glycolcorticoid
axis.
Conclusion:
Novel third-generation, nonsteroidal mineralocorticoid receptor antagonists seem to offer great
advantages, which may lead to a wider use of mineralocorticoid receptor antagonists. Future randomized controlled
trials are needed to evaluate significant perspectives.
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Tsioufis KP, Dimitriadis K, Kasiakogias A, Drosos G, Karaminas N, Iliakis P, Damianaki K, Tousoulis D. THE PREDICTIVE ROLE OF VISIT-TO-VISIT GLOMERULAR FILTRATION RATE VARIABILITY FOR CARDIOVASCULAR AND RENAL OUTCOMES IN ESSENTIAL HYPERTENSION: DATA FROM A GREEK 8-YEAR-FOLLOW-UP STUDY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32393-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Tsioufis KP, Dimitriadis K, Michas C, Iliakis P, Kasiakogias A, Leontsinis I, Kakouri N, Kourementi M, Tousoulis D. COMPARISON OF ESTABLISHED RISK SCORES FOR PREDICTION OF CORONARY ARTERY DISEASE AND STROKE IN ESSENTIAL HYPERTENSION: DATA FROM A GREEK 8-YEAR-FOLLOW-UP STUDY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Andrikou I, Tsioufis C, Konstantinidis D, Kasiakogias A, Dimitriadis K, Leontsinis I, Andrikou E, Sanidas E, Kallikazaros I, Tousoulis D. Renal resistive index in hypertensive patients. J Clin Hypertens (Greenwich) 2018; 20:1739-1744. [PMID: 30362245 DOI: 10.1111/jch.13410] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/16/2018] [Accepted: 09/07/2018] [Indexed: 11/29/2022]
Abstract
Spectral Doppler ultrasonography provides the evaluation of renal resistive index (RRI), a noninvasive and reproducible measure to investigate arterial compliance and/or resistance. RRI seems to possess an important role in the evaluation of diverse cases of secondary hypertension. In essential hypertension, RRI is associated with subclinical markers of target organ damage and reflects renal disease progression beyond albuminuria and creatinine clearance. Also, RRI can estimate cardiovascular and renal risk. The evaluation of RRI may also help the therapeutic decisions. Given its simple assessment, RRI emerges as a simple method and a "multifunctional" tool that could help on the cardiovascular risk evaluation of the hypertensive patient.
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Kasiakogias A, Tsioufis C, Dimitriadis K, Konstantinidis D, Koutra E, Kyriazopoulos K, Kyriazopoulos I, Liatakis I, Mantzouranis M, Philippou C, Galanakos S, Andrikou I, Michas C, Aragiannis D, Tousoulis D. P1540Comparison of the European Society of Hypertension stratification and European Society of Cardiology HeartScore for prediction of coronary artery disease and stroke in essential hypertension. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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42
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Mantzouranis M, Tsioufis C, Kintis K, Kasiakogias A, Katsi V, Ifantis A, Galanakos S, Koumelli A, Tambaki M, Syrmali K, Tousoulis D. 3027Changes in arterial stiffness independently predict stroke in patients with essential hypertension: Data from a Greek 8-year-follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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43
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Konstantinidis D, Tsioufis C, Dimitriadis K, Kasiakogias A, Galanakos S, Iliakis P, Nikolopoulou L, Liatakis I, Aragiannis D, Kyriazopoulos K, Andrikou E, Koutra E, Tousoulis D. P4479Isolated systolic hypertension and combined systolic-diastolic hypertension for prediction of new-onset diabetes mellitus: Data from a 8-year-follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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44
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Kalos T, Tsioufis C, Dimitriadis K, Kasiakogias A, Konstantinidis D, Liatakis I, Katsi V, Tolis P, Andrikou E, Koutra E, Tousoulis D. P669Exaggerated exercise blood pressure response is accompanied by increased sympathetic activity and arterial stiffness in subjects with high normal blood pressure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dimitriadis K, Tsioufis C, Andrikou E, Andrikou I, Fragoulis C, Iliakis P, Kalos T, Kasiakogias A, Konstantinidis D, Koutra E, Leontsinis I, Liatakis I, Petras D, Tousoulis D. P1542Changes in uric acid independently predict coronary artery disease in essential hypertension: Data from a Greek 8-year-follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dimitriadis K, Tsioufis C, Kasiakogias A, Konstantinidis D, Michas C, Iliakis P, Fragoulis C, Kouremeti M, Syrmali K, Kintis K, Voutsinas M, Chatzis ST, Kallikazaros I, Tousoulis D. P1278The predictive role of visit-to-visit glomerular filtration rate variability for cardiovascular and renal outcomes in essential hypertension: data from a Greek 8-year-follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kasiakogias A, Tsioufis C, Dimitriadis K, Konstantinidis D, Iliakis P, Charilas G, Galanakos S, Katsarou R, Kallikazaros I, Tousoulis D. 110Combined patterns of obesity and smoking status for prediction of coronary artery disease: a 4-year follow-up study on treated hypertensive patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dimitriadis K, Tsioufis C, Kasiakogias A, Konstantinidis D, Galanakos S, Iliakis P, Ifantis A, Liatakis I, Andrikou E, Koutra E, Tousoulis D. P6572Isolated systolic hypertension versus combined systolic-diastolic hypertension as predictors of coronary artery disease and stroke: Data from a 8-year-follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dimitriadis K, Tsioufis C, Kasiakogias A, Konstantinidis D, Andrikou I, Iliakis I, Kalos T, Tolis P, Katsarou R, Kallikazaros I, Tousoulis D. P6574Isolated systolic hypertension versus combined systolic-diastolic hypertension as predictors of atrial fibrillation: Data from a 8-year-follow-up study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Damianaki K, Tsioufis C, Dimitriadis K, Konstantinidis D, Kasiakogias A, Iliakis I, Tambaki M, Syrmali K, Kintis K, Petras D, Tousoulis D. P2852Exercise heart rate during treadmill test is related to renal functional reserve in essential hypertensive patients: A novel link between the heart and the kidneys. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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