3251
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Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, Boutouyrie P, Cameron J, Chen CH, Cruickshank JK, Hwang SJ, Lakatta EG, Laurent S, Maldonado J, Mitchell GF, Najjar SS, Newman AB, Ohishi M, Pannier B, Pereira T, Vasan RS, Shokawa T, Sutton-Tyrell K, Verbeke F, Wang KL, Webb DJ, Willum Hansen T, Zoungas S, McEniery CM, Cockcroft JR, Wilkinson IB. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 2013; 63:636-646. [PMID: 24239664 DOI: 10.1016/j.jacc.2013.09.063] [Citation(s) in RCA: 1238] [Impact Index Per Article: 112.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/13/2013] [Accepted: 09/22/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The goal of this study was to determine whether aortic pulse wave velocity (aPWV) improves prediction of cardiovascular disease (CVD) events beyond conventional risk factors. BACKGROUND Several studies have shown that aPWV may be a useful risk factor for predicting CVD, but they have been underpowered to examine whether this is true for different subgroups. METHODS We undertook a systematic review and obtained individual participant data from 16 studies. Study-specific associations of aPWV with CVD outcomes were determined using Cox proportional hazard models and random effect models to estimate pooled effects. RESULTS Of 17,635 participants, a total of 1,785 (10%) had a CVD event. The pooled age- and sex-adjusted hazard ratios (HRs) per 1-SD change in loge aPWV were 1.35 (95% confidence interval [CI]: 1.22 to 1.50; p < 0.001) for coronary heart disease, 1.54 (95% CI: 1.34 to 1.78; p < 0.001) for stroke, and 1.45 (95% CI: 1.30 to 1.61; p < 0.001) for CVD. Associations stratified according to sex, diabetes, and hypertension were similar but decreased with age (1.89, 1.77, 1.36, and 1.23 for age ≤50, 51 to 60, 61 to 70, and >70 years, respectively; pinteraction <0.001). After adjusting for conventional risk factors, aPWV remained a predictor of coronary heart disease (HR: 1.23 [95% CI: 1.11 to 1.35]; p < 0.001), stroke (HR: 1.28 [95% CI: 1.16 to 1.42]; p < 0.001), and CVD events (HR: 1.30 [95% CI: 1.18 to 1.43]; p < 0.001). Reclassification indices showed that the addition of aPWV improved risk prediction (13% for 10-year CVD risk for intermediate risk) for some subgroups. CONCLUSIONS Consideration of aPWV improves model fit and reclassifies risk for future CVD events in models that include standard risk factors. aPWV may enable better identification of high-risk populations that might benefit from more aggressive CVD risk factor management.
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Affiliation(s)
- Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
| | - Melissa Spears
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Chris Boustred
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Margaret May
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Simon G Anderson
- Institute of Cardiovascular Sciences, University of Manchester, United Kingdom
| | - Emelia J Benjamin
- National Heart Lung and Blood Institute and Boston University's Framingham Heart Study, Cardiology Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Pierre Boutouyrie
- INSERM U 970, Paris-Descartes University, Hopital Europeen Georges Pompidou, Assistance Publique Hopitaux de Paris, Paris, France
| | - James Cameron
- Monash Cardiovascular Research Centre, MonashHEART and Monash University Department of Medicine (MMC), Melbourne, Australia
| | - Chen-Huan Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - J Kennedy Cruickshank
- King's College & King's Health Partners, St. Thomas' & Guy's Hospital, London, United Kingdom
| | - Shih-Jen Hwang
- Branch of Population Sciences, Division of Intramural Research, National Heart, Lung and Blood Institute, Bethesda, Maryland
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Stephane Laurent
- INSERM U 970, Paris-Descartes University, Hopital Europeen Georges Pompidou, Assistance Publique Hopitaux de Paris, Paris, France
| | - João Maldonado
- Instituto de Investigação e Formação Cardiovascular, Penacova, Portugal
| | | | - Samer S Najjar
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland; MedStar Heart Research Institute, Washington, DC
| | - Anne B Newman
- Center for Aging and Population Health, Pittsburgh, Pennsylvania
| | - Mitsuru Ohishi
- Department of Geriatric Medicine, Osaka University, Osaka, Japan
| | - Bruno Pannier
- Centre d'Investigations Preventives et Cliniques, Paris, France
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra, Portugal
| | - Ramachandran S Vasan
- National Heart Lung and Blood Institute and Boston University's Framingham Heart Study, Department of Medicine, Boston University, Boston, Massachusetts
| | - Tomoki Shokawa
- Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Francis Verbeke
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Kang-Ling Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - David J Webb
- University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Tine Willum Hansen
- Research Center for Prevention and Health, Glostrup Hospital, Glostrup and Steno Diabetes Center, Glostrup, Denmark
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Carmel M McEniery
- Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Ian B Wilkinson
- Clinical Pharmacology Unit, University of Cambridge, Cambridge, United Kingdom
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3252
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Lenz T. [Current management of renal artery stenosis]. Internist (Berl) 2013; 54:1443-9. [PMID: 24217529 DOI: 10.1007/s00108-013-3324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Severe renal artery stenosis may cause renovascular hypertension; in case of bilateral narrowing or in a stenotic solitary kidney, renal insufficiency (ischemic kidney disease) or rarely pulmonary flush edema may occur. Renal artery stenosis may be treated by revascularization, using either percutaneous (balloon angioplasty, stenting) or less common open surgical procedures, both with excellent primary patency rates. However, randomized trials of renal artery angioplasty or stenting have failed to demonstrate a longer-term benefit with regard to blood pressure control and renal function over medical management alone (except for fibromuscular disease). Furthermore, endovascular procedures are associated with substantial risks. It has not yet been demonstrated that renal revascularization leads to a prolongation of event-free survival. Careful patient selection is essential to maximize the potential benefit.
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Affiliation(s)
- T Lenz
- KfH Nierenzentrum, Maxstr. 48, 67059, Ludwigshafen, Deutschland,
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3253
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Monge M, Lorthioir A, Bobrie G, Azizi M. New drug therapies interfering with the renin–angiotensin–aldosterone system for resistant hypertension. J Renin Angiotensin Aldosterone Syst 2013; 14:285-9. [DOI: 10.1177/1470320313513408] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Matthieu Monge
- Assistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France
- Inserm, Clinical Investigation Centre 9201, Paris, France
| | - Aurélien Lorthioir
- Assistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France
| | - Guillaume Bobrie
- Assistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France
| | - Michel Azizi
- Assistance Publique – Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Hypertension Unit, Paris, France
- Inserm, Clinical Investigation Centre 9201, Paris, France
- Université Paris-Descartes, Paris, France
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3254
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Burnier M, Vuignier Y, Wuerzner G. State-of-the-art treatment of hypertension: established and new drugs. Eur Heart J 2013; 35:557-62. [DOI: 10.1093/eurheartj/eht465] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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3255
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Cuspidi C, Muiesan ML, De Luca N, Salvetti M, Agabiti-Rosei E, Schillaci G. Echocardiography in Hypertension: a Call for Standardization from the Working Group on Heart and Hypertension of the Italian Society of Hypertension. High Blood Press Cardiovasc Prev 2013; 21:53-61. [DOI: 10.1007/s40292-013-0030-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/13/2013] [Indexed: 12/12/2022] Open
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3256
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Kario K, Robbins J, Jeffers BW. Titration of amlodipine to higher doses: a comparison of Asian and Western experience. Vasc Health Risk Manag 2013; 9:695-701. [PMID: 24235839 PMCID: PMC3821790 DOI: 10.2147/vhrm.s50077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
In this retrospective analysis, data pooled from two Phase III/IV open-label Asian studies were used to quantify the additional blood pressure efficacy achieved when titrating amlodipine from 5 mg to 10 mg in mild/moderate hypertensive patients, and compared to data pooled from three Western studies. The primary efficacy end point was the change from baseline in sitting systolic blood pressure (SBP) and diastolic blood pressure (DBP) to the specified time point (4–8 weeks, depending on the trial). For the Asian analysis (n=174), both mean SBP and DBP were significantly decreased at the final visit (SBP −13.3 mmHg, 95% confidence interval [CI] −15.5 to −11.0; DBP −9.2 mmHg, 95% CI −10.6 to −7.8; both P<0.0001). These results were similar to the Western analysis (n=369; SBP −11.5 mmHg, 95% CI −13.1 to −10.0; DBP −6.3, 95% CI −7.1 to −5.5; both P<0.0001). In summary, titration of amlodipine from 5 mg to 10 mg significantly decreased both SBP and DBP in Asian patients with mild-to-moderate hypertension.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Jichi Medical University, Shimotsuke, Japan
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3257
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Sjöblom P, Nystrom FH, Länne T, Engvall J, Östgren CJ. Microalbuminuria, but not reduced eGFR, is associated with cardiovascular subclinical organ damage in type 2 diabetes. DIABETES & METABOLISM 2013; 40:49-55. [PMID: 24200881 DOI: 10.1016/j.diabet.2013.09.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 09/19/2013] [Accepted: 09/23/2013] [Indexed: 12/29/2022]
Abstract
AIM This study explored the association between reduced estimated glomerular filtration rate (eGFR) and microalbuminuria vs. subclinical organ damage in patients with type 2 diabetes. METHODS Data from middle-aged patients with type 2 diabetes (n=706) treated in primary care were analyzed for microalbuminura, defined as a urinary albumin/creatinine ratio (uACR)≥3.0mmol/mol, and reduced eGFR, defined as<60mL/min/1.73m(2), in relation to blood pressure, pulse wave velocity (PWV), left ventricular mass index (LVMI), and carotid intima-media thickness (IMT) and lumen diameter (LD). RESULTS Patients with microalbuminuria had significantly higher 24-h ambulatory systolic blood pressure (ASBP) compared with subjects with uACR<3mg/mmol: 137 vs. 128mmHg (P<0.001). There were no differences in ASBP in patients with eGFR<60mL/min/1.73m(2). However, patients with vs. without microalbuminuria had increased PWV (11.4 vs. 10.1m/s; P<0.001), LVMI (134.4 vs. 118.6g/m(2); P<0.001), LD (7.01±0.93 vs. 6.46±0.74mm; P<0.001) and IMT (0.78 vs. 0.74mm; P=0.047), respectively. The associations between uACR vs. PWV and LVMI were more robust after adjusting for age, diabetes duration, ASBP, HbA1c, LDL-cholesterol, and antihypertensive and lipid-lowering therapy compared with uACR vs. IMT. There were no statistically significant differences in PWV, LVMI or IMT between patients with reduced (<60mL/min/1.73m(2)) vs. normal eGFR. CONCLUSION Levels of urinary albumin excretion, but not reduced eGFR, were associated with increased arterial stiffness, left ventricular mass and atherosclerosis in patients with type 2 diabetes.
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Affiliation(s)
- P Sjöblom
- Skärblacka Primary Health Care Centre, Stationsvägen 2, 61732 Skärblacka, Sweden; Department of Local Care Finspång, County Council of Östergötland, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - F H Nystrom
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Endocrinology and Metabolism, Linköping University Hospital, Linköping, Sweden
| | - T Länne
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - J Engvall
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Clinical Physiology, County Council of Östergötland, Linköping, Sweden
| | - C J Östgren
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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3258
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Lackland DT. How will the growing threat of resistant hypertension impact the future treatment of high blood pressure? Expert Rev Cardiovasc Ther 2013; 11:1541-6. [DOI: 10.1586/14779072.2013.851002] [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: 11/08/2022]
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3259
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Affiliation(s)
- Michael Bursztyn
- Department of Medicine, Mount-Scopus, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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3260
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Are we Evaluating Correctly the Risk Accompanying Blood Pressure? The Case of White Coat and Masked Hypertension and Blood Pressure Variability. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0360-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3261
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Koumaras C, Tziomalos K, Stavrinou E, Katsiki N, Athyros VG, Mikhailidis DP, Karagiannis A. Effects of renin-angiotensin-aldosterone system inhibitors and beta-blockers on markers of arterial stiffness. ACTA ACUST UNITED AC 2013; 8:74-82. [PMID: 24139833 DOI: 10.1016/j.jash.2013.09.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 08/23/2013] [Accepted: 09/11/2013] [Indexed: 01/29/2023]
Abstract
Antihypertensive agents may, even within the same class, exert variable effects on arterial stiffness variables. Nebivolol could have a better impact than atenolol on arterial stiffness, by increasing the bioavailability of endothelium-derived nitric oxide. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) increase plasma renin activity (enhancing the production of angiotensin II via non-ACE-related pathways) whereas aliskiren does not, potentially affecting central hemodynamics differently. We compared the effects of two renin-angiotensin-aldosterone system (RAAS) inhibitors (quinapril and aliskiren) and 2 beta-blockers (atenolol and nebivolol) on arterial stiffness variables. Treatment-naïve patients (n = 72; 68.1% males; age, 47.6 ± 10.6 years) with uncomplicated stage I-II essential hypertension were randomly assigned to quinapril, aliskiren, atenolol, or nebivolol for 10 weeks. Central systolic and diastolic blood pressure (BP), central pulse pressure (PP), augmentation index (AIx), and pulse wave velocity (PWV) were measured at baseline, 2, and 10 weeks. The same measurements were performed in 20 normotensive subjects (65.0% males; age, 40.0 ± 8.9 years). Peripheral and central systolic and diastolic BP, peripheral PP, and PWV were significantly and similarly reduced by all agents. However, PWV continued to decline between the second and last visit in patients on quinapril and aliskiren but did not change in those on nebivolol or atenolol. Central PP and AIx decreased in patients on quinapril, aliskiren, and nebivolol but did not change in those taking atenolol. The decrease in central PP and AIx did not differ between patients on quinapril, aliskiren, and nebivolol. Despite similar reductions in peripheral BP, atenolol is less effective than nebivolol and RAAS inhibitors in improving central pulsatile hemodynamics. Aliskiren exerts similar effects on markers of arterial stiffness as quinapril. The clinical relevance of these differences remains to be established.
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Affiliation(s)
- Charalambos Koumaras
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Eirini Stavrinou
- Department of Nephrology, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Vasilios G Athyros
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, UK.
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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3262
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Li WY, Jin J, Chen J, Guo Y, Tang J, Tan S. Circulating microRNAs as potential non-invasive biomarkers for the early detection of hypertension-related stroke. J Hum Hypertens 2013; 28:288-91. [PMID: 24132136 DOI: 10.1038/jhh.2013.94] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/15/2013] [Accepted: 08/20/2013] [Indexed: 12/19/2022]
Abstract
Hypertension is one of the most important risk and modifiable factors for stroke. Crucial in managing the cerebrovascular damage caused by long-lasting and inadequately treated hypertension is not only lowering arterial blood pressure but also early predicting subtypes of hypertension-related stroke and applying more effective interventions. Accumulating evidence suggested that circulating microRNAs (miRNAs) could be developed as biomarkers for early recognition of the onset of a variety of diseases. The role of miRNAs has been extensively reviewed, involving cardiac hypertrophy, hypertensive heart failure, kidney failure and renal fibrosis. miRNA research in stroke is still in its infancy, although there are few literatures reviewing the role of miRNAs in the processes of hypertension-related stroke. This review summarizes current advances in miRNAs regulation of critical pathogenic process underlying hypertension, ischemic stroke and hemorrhagic stroke, and highlights the potential of using circulating miRNAs as noninvasive biomarkers for the early detection of hypertension-related stroke.
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Affiliation(s)
- W Y Li
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - J Jin
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - J Chen
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Y Guo
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - J Tang
- KingMed Diagnostics Group, KingMed College of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China
| | - S Tan
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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3263
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Courand PY, Gaudebout N, Mouly-Bertin C, Thomson V, Fauvel JP, Bricca G, Lantelme P. Biological, electrical and echocardiographic indices versus cardiac magnetic resonance imaging in diagnosing left ventricular hypertrophy. Hypertens Res 2013; 37:444-51. [PMID: 24132010 DOI: 10.1038/hr.2013.147] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/27/2013] [Accepted: 09/09/2013] [Indexed: 01/20/2023]
Abstract
The aim of this study was to compare the diagnostic performance of N-terminal pro-brain natriuretic peptide (NT-proBNP), electrocardiographic (ECG) criteria and transthoracic echocardiography (TTE) versus cardiac magnetic resonance imaging in detecting left ventricular hypertrophy (LVH). The study included 42 hypertensive subjects with mean±s.d. age 48.1±12.3 years, 57.1% men, 24-h ambulatory blood pressure 144/89 mm Hg, left ventricular ejection fraction >50%, without symptoms of heart failure, and not taking any drugs that interfere with hormonal regulation. The accuracies of the methods in detecting LVH were compared at two diagnostic LVH cutoffs: low, 83 g m(-2) in men and 67 g m(-2) in women; and high, 96 g m(-2) in men and 81 g m(-2) in women. With the low and high LVH cutoffs, the areas under the receiver-operating characteristic curves and the optimal values for NT-proBNP were 0.761, 0.849, 200 and 421 pg ml(-1), respectively. An NT-proBNP level under 30 pg ml(-1) ruled out LVH with 100% sensitivity. The optimal values and literature-based values of NT-proBNP allowed a correct classification of 73-81% of the subjects. In 80-90% of the cases, the diagnostic accuracy of NT-proBNP was close to that of ECG criteria but lower than that of TTE criteria. Interestingly, combining ECG criteria and NT-proBNP level improved the diagnostic performance to be at least comparable to that of TTE: the percentages of correctly classified subjects were 73-95% vs. 67-86%, respectively. Of note, the range considers both diagnostic LVH cutoffs. The simultaneous use of ECG criteria and NT-proBNP plasma levels seemed to be powerful enough to detect LVH in most hypertensive subjects.
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Affiliation(s)
- Pierre-Yves Courand
- 1] Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France [2] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [3] Hôpital Nord-Ouest, Villefranche sur Saône, France
| | - Nathalie Gaudebout
- Cardiology Department, Hôpital Nord Ouest, Villefranche-sur-Saône, France
| | - Carine Mouly-Bertin
- Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Vivien Thomson
- Radiology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Jean-Pierre Fauvel
- 1] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [2] Hôpital Nord-Ouest, Villefranche sur Saône, France [3] Nephrology and hypertension Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Giampiero Bricca
- 1] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [2] Hôpital Nord-Ouest, Villefranche sur Saône, France
| | - Pierre Lantelme
- 1] Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France [2] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [3] Hôpital Nord-Ouest, Villefranche sur Saône, France [4] Cardiology Department, Hôpital Nord Ouest, Villefranche-sur-Saône, France
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3264
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Blood pressure and retinal small arteries. J Hypertens 2013; 31:1946-7. [PMID: 24107726 DOI: 10.1097/hjh.0b013e328364bcf1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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3265
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Ruilope LM. Difficult-to-Control or Resistant Hypertension? CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0359-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3266
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Mitchell A. [Arterial hypertension and chronic kidney disease]. MMW Fortschr Med 2013; 155:55-57. [PMID: 24340391 DOI: 10.1007/s15006-013-2231-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- A Mitchell
- Klinik für Nephrologie, universitätsklinikum Essen.
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3267
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Kardiovaskuläre Komplikationen bei chronischer Niereninsuffizienz. Monatsschr Kinderheilkd 2013. [DOI: 10.1007/s00112-013-2948-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3268
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Zhang T, Fu B. Opinions on the new blood pressure target in chronic kidney disease recommended by 2013 ESH/ESC guidelines for the management of arterial hypertension. J Hypertens 2013; 31:2320-1. [PMID: 24096261 DOI: 10.1097/hjh.0b013e3283659ff6] [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]
Affiliation(s)
- Tongyan Zhang
- Department of Nephrology and Rheumatology, Second Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, Tianjin, China
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3269
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Karabacak M, Dogan A, Turkdogan AK, Kapci M, Duman A, Akpinar O. Mean platelet volume is increased in patients with hypertensive crises. Platelets 2013; 25:423-6. [DOI: 10.3109/09537104.2013.830181] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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3270
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3271
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Waeber B, Feihl F. Do Optimal Antihypertensive Drug Regimens Allow Blood Pressure Normalization in All Patients With Resistant Hypertension? Hypertension 2013; 62:680-1. [DOI: 10.1161/hypertensionaha.113.01800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Bernard Waeber
- From the Division of Pathophysiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - François Feihl
- From the Division of Pathophysiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
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3272
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Can we use mineralocorticoid receptor blockade in diabetic patients with resistant hypertension? Yes we can! But it may be a double-edged sword. J Hypertens 2013; 31:1948-51. [DOI: 10.1097/hjh.0b013e328364bcdf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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3273
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Baulmann J. [Isolated systolic hypertension. Therapy or not?]. MMW Fortschr Med 2013; 155:51-52. [PMID: 24279157 DOI: 10.1007/s15006-013-2171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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3274
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Barrios V, Escobar C. Azilsartan medoxomil in the treatment of hypertension: the definitive angiotensin receptor blocker? Expert Opin Pharmacother 2013; 14:2249-61. [PMID: 24070321 DOI: 10.1517/14656566.2013.834887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Azilsartan medoxomil is the newest angiotensin receptor blocker marketed for the treatment of arterial hypertension. The aim of this article was to review the available evidence about this drug alone or combined with other antihypertensive agents in the treatment of hypertensive population. AREAS COVERED For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSHs) and keywords including azilsartan or azilsartan medoxomil or angiotensin receptor blockers or renin angiotensin system or chlorthalidone and hypertension. References of the retrieved articles were also screened for additional studies. There were no language restrictions. EXPERT OPINION Azilsartan medoxomil has a potent and persistent ability to inhibit binding of angiotensin II to AT1 receptors, which may play a role in its superior blood pressure (BP) -lowering efficacy compared with other drugs, including ramipril, candesartan, valsartan or olmesartan, without an increase of side effects. Chlortalidone is a diuretic which significantly differs from other classic thiazides and has largely demonstrated clinical benefits in outcome trials. The fixed-dose combination of azilsartan and chlorthalidone has been shown to be more effective than other potent combinations of angiotensin receptor blockers plus hydrochlorothiazide, with a good tolerability profile.
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Affiliation(s)
- Vivencio Barrios
- Hospital Ramon y Cajal, Department of Cardiology , Madrid 28034 , Spain +34 91 336 8665 ;
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3275
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Avolio A. Central aortic blood pressure and management of hypertension: confirmation of a paradigm shift? Hypertension 2013; 62:1005-7. [PMID: 24060887 DOI: 10.1161/hypertensionaha.113.02125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alberto Avolio
- Australian School of Advanced Medicine, 2 Technology Place, Macquarie University, North Ryde, NSW 2109, Sydney, Australia.
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3276
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Cuspidi C, De Luca N, Muiesan ML. Echocardiography in Hypertension. High Blood Press Cardiovasc Prev 2013; 20:261-4. [DOI: 10.1007/s40292-013-0024-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 11/29/2022] Open
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3277
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3278
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Chatzikyrkou C, Menne J. Diabetes: Legacy effects of RAS blockade in diabetes mellitus. Nat Rev Nephrol 2013; 9:566-8. [PMID: 24018412 DOI: 10.1038/nrneph.2013.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christos Chatzikyrkou
- Department of Nephrology and Hypertension, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
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3279
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Recommandations européennes HTA : faut-il les suivre ? Presse Med 2013; 42:1155-8. [DOI: 10.1016/j.lpm.2013.08.001] [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: 11/20/2022] Open
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3280
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Oliveras A, de la Sierra A. Resistant hypertension: patient characteristics, risk factors, co-morbidities and outcomes. J Hum Hypertens 2013; 28:213-7. [PMID: 23985879 DOI: 10.1038/jhh.2013.77] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 07/17/2013] [Indexed: 11/09/2022]
Abstract
Among the vast population of hypertensive subjects, between 10 and 15% do not achieve an adequate blood pressure (BP) control despite the use of at least three antihypertensive agents. This group, designated as having resistant hypertension (RH), represents one of the most important clinical challenges in hypertension evaluation and management. Resistant hypertensives are characterized by several clinical particularities, such as a longer history of hypertension, obesity and other accompanying factors, such as diabetes, left ventricular hypertrophy, albuminuria and renal dysfunction. In addition to other diagnostic and therapeutic maneuvers, such as excluding secondary hypertension, ensuring treatment adherence and optimizing therapeutic schemes, ambulatory BP monitoring (ABPM) is crucial in the clinical evaluation of patients with RH. ABPM distinguish between those with out-of-office BP elevation (true resistant hypertensives) and those having white-coat RH (WCRH; normalcy of 24-h BPs), the prevalence of the latter estimated in about one-third of the population with RH. True resistant hypertensives also exhibit more frequently other co-morbidities, more severe target organ damage and a worse cardiovascular prognosis, in comparison to those with WCRH. Some device-based therapies have recently been developed for treatment of RH. This requires a better characterization of a potential candidate population. A better knowledge of the clinical features of resistant hypertensive subjects, the confirmation of elevated BP values out of the doctor's office, and improvements in the search for secondary causes would help to select those candidates for newer therapies, once the pharmacological possibilities have been exhausted.
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Affiliation(s)
- A Oliveras
- Department of Nephrology, Hospital del Mar, Barcelona, Spain
| | - A de la Sierra
- Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Terrassa, Spain
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3281
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Clinical Management of Resistant Hypertension. High Blood Press Cardiovasc Prev 2013; 20:251-6. [DOI: 10.1007/s40292-013-0022-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 01/09/2023] Open
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3282
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Mountfort K, Mahfoud F, Schmieder R, Davies J, Kandzari DE, Weil J, Whitbourn R. Catheter-based Renal Sympathetic Denervation - Long-term Symplicity™ Renal Denervation Clinical Evidence, New Data and Future Perspectives. Interv Cardiol 2013; 8:118-123. [PMID: 29588763 PMCID: PMC5808595 DOI: 10.15420/icr.2013.8.2.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 09/05/2013] [Indexed: 12/14/2022] Open
Abstract
Hypertension is one of the most prevalent chronic diseases worldwide and the incidence of resistant hypertension is increasing. Catheter-based renal denervation (RDN) offers a new approach to reaching blood pressure goals by targeting the renal nerves. The technique has demonstrated significant and sustained reductions in blood pressure (BP) in the Symplicity HTN-1 and Symplicity HTN-2 clinical trials. The Global SYMPLICITY Registry aims to demonstrate safety and effectiveness in a 'real-world' patient population. Real-world RDN experience has emphasised that patient selection is crucial to successful outcomes; a multidisciplinary referral network is recommended to increase awareness of the procedure and identify patients who are likely to respond best to RDN. Further advances in catheter technology have led to the development of the multi-electrode Symplicity Spyral™ multi-electrode catheter; preliminary data from the feasibility study using the Symplicity Spyral catheter indicate clinical efficacy and procedural safety with reduced procedure times. The Symplicity Spyral catheter is not yet commercially available. The indications of RDN may also expand beyond resistant hypertension - encouraging data have been seen in patients with moderate treatment resistant hypertension. Furthermore, RDN may be beneficial in other clinical states characterised by sympathetic nervous system overactivation including heart failure and chronic kidney disease. Additional data are needed to evaluate the efficacy of RDN in these disease states.
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Affiliation(s)
- Katrina Mountfort
- Katrina Mountfort, Medical Writer, Radcliffe Cardiology Based on Presentations at a Medtronic Sponsored Symposium held at EuroPCR 2013, Paris, France, on 21 May 2013
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
- Medizinische Klinik IV, Universitätsklinikum Erlangen, Erlangen, Germany
- Consultant Cardiologist, Hammersmith Hospital, Imperial College London, London, UK
- Chief Scientific Officer, Director, Interventional Cardiology, Piedmont Heart Institute, Atlanta, Georgia, US
- CardioMed Herzzentrum Nord, Sana Klinikum Lübeck, Akademisches Lehrkrankenhaus der Universität zu Lübeck, Lübeck, Germany
- Director, Cardiac Catheterization Labs and Coronary Intervention, The Cardiovascular Research Centre, University of Melbourne and Australian Catholic University, Melbourne, Australia
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Roland Schmieder
- Medizinische Klinik IV, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Justin Davies
- Consultant Cardiologist, Hammersmith Hospital, Imperial College London, London, UK
| | - David E Kandzari
- Chief Scientific Officer, Director, Interventional Cardiology, Piedmont Heart Institute, Atlanta, Georgia, US
| | - Joachim Weil
- CardioMed Herzzentrum Nord, Sana Klinikum Lübeck, Akademisches Lehrkrankenhaus der Universität zu Lübeck, Lübeck, Germany
| | - Robert Whitbourn
- Director, Cardiac Catheterization Labs and Coronary Intervention, The Cardiovascular Research Centre, University of Melbourne and Australian Catholic University, Melbourne, Australia
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3283
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Global cardiovascular risk assessment in the management of primary hypertension: the role of the kidney. Int J Hypertens 2013; 2013:542646. [PMID: 23984048 PMCID: PMC3745834 DOI: 10.1155/2013/542646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 07/08/2013] [Indexed: 12/14/2022] Open
Abstract
The knowledge of each patient's global risk profile is a prerequisite for effective therapeutic strategies in primary hypertension. Detecting the presence of subclinical organ damage at the cardiac, vascular, and renal levels is key for stratifying cardiovascular risk and may also be helpful in choosing antihypertensive agents and in monitoring the effectiveness of treatment. A systematic, in-depth search for subclinical organ damage, however, may be difficult to carry out because of logistic and economic problems related to the high prevalence of hypertension in the population. Renal abnormalities such as microalbuminuria and reduction in glomerular filtration rate have proven to be powerful predictors of cardiovascular and renal outcome. Thanks to their relatively low cost and wide applicability, more widespread use of these tests in the diagnostic workup will help detect subsets of patients at greater risk for whom additional preventive and therapeutic treatment is advisable.
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3284
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Takai S, Jin D, Sakonjo H, Takubo T, Nakanishi T. Significance of the Vascular Concentration of Angiotensin II–Receptor Blockers on the Mechanism of Lowering Blood Pressure in Spontaneously Hypertensive Rats. J Pharmacol Sci 2013; 123:371-9. [DOI: 10.1254/jphs.13167fp] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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