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Zeng W, Chu TTW, Ho CS, Lo CWS, Chan ASL, Kong APS, Tomlinson B, Chan SW. Lack of Effects of Renin-Angiotensin-Aldosterone System Activity and Beta-Adrenoceptor Pathway Polymorphisms on the Response to Bisoprolol in Hypertension. Front Cardiovasc Med 2022; 9:842875. [PMID: 35433877 PMCID: PMC9010557 DOI: 10.3389/fcvm.2022.842875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/10/2022] [Indexed: 01/02/2023] Open
Abstract
Purpose This study examined the effects of plasma renin activity (PRA), angiotensin II (Ang II) and aldosterone (PAC) concentrations as well as common polymorphisms in the β1-Adrenoceptor gene (ADRB1) and the G-protein α-Subunit (Gαs) protein gene the G protein α-Subunit 1 gene (GNAS) on the blood pressure (BP) and heart rate (HR) response to bisoprolol in Chinese patients with hypertension. Methods Patients with sitting clinic systolic BP (SBP) 140–169 mmHg and/or diastolic BP (DBP) 90–109 mmHg after placebo run-in were treated with open-label bisoprolol 2.5 mg daily for 6 weeks. Patients diagnosed as having primary aldosteronism or renal artery stenosis were excluded. PRA, Ang II and PAC concentrations were measured after the placebo run-in and after 6 weeks of treatment. The Ser49Gly and Arg389Gly polymorphisms in ADRB1 and the c.393C > T polymorphism in GNAS were genotyped by the TaqMan® assay. Results In 99 patients who completed the study, baseline PAC levels were significantly associated with baseline DBP and plasma potassium on univariate but not on multivariate linear regression analysis. PRA, Ang II, and PAC concentrations at baseline were not associated with changes in BP with bisoprolol treatment, but the values were all significantly reduced (PRA −0.141 ± 0.595 ng/mL/h, Ang II −2.390 ± 5.171 pmol/L and aldosterone −51.86 ± 119.1 pg/mL; all P < 0.05) following 6 weeks of bisoprolol treatment. There were no significant differences in BP or HR responses in patients with baseline PRA above or below the PRA cut-point of 0.65 ng/mL/h or the median value of 0.9 ng/ml/hour. There were no significant associations of the ADRB1 and GNAS polymorphisms with the clinic and ambulatory BP and HR responses to bisoprolol. Conclusion Baseline PRA, PAC and Ang II concentrations showed no significant association with the BP response to bisoprolol treatment, but all these parameters were reduced after 6 weeks of treatment with bisoprolol. The two common polymorphisms in ADRB1 and the c.393C > T polymorphism in GNAS had no significant association with the BP and HR response to bisoprolol in these patients.
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Affiliation(s)
- Weiwei Zeng
- Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, China
| | - Tanya T. W. Chu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Chung Shun Ho
- Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Clara W. S. Lo
- Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Alan S. L. Chan
- Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Alice P. S. Kong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Brian Tomlinson
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Faculty of Medicine, Macau University of Science and Technology, Macau, Macau SAR, China
- *Correspondence: Brian Tomlinson,
| | - Sze Wa Chan
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, Hong Kong SAR, China
- Sze Wa Chan,
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Schwarz V, Mahfoud F, Lauder L, Reith W, Behnke S, Smola S, Rissland J, Pfuhl T, Scheller B, Böhm M, Ewen S. Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19. Clin Res Cardiol 2020; 109:1500-1506. [PMID: 32749557 PMCID: PMC7399595 DOI: 10.1007/s00392-020-01688-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/07/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The spread of the novel coronavirus SARS-CoV-2 and the guidance from authorities for social distancing and media reporting lead to significant uncertainty in Germany. Concerns have been expressed regarding the underdiagnosing of harmful diseases. We explored the rates of emergency presentations for acute coronary syndrome (ACS) and acute cerebrovascular events (ACVE) before and after spread of SARS-CoV-2. METHODS We analyzed all-cause visits at a tertiary university emergency department and admissions for ACS and ACVE before (calendar weeks 1-9, 2020) and after (calendar weeks 10-16, 2020) the first coronavirus disease (COVID-19) case in the region of the Saarland, Germany. The data were compared with the same period of the previous year. RESULTS In 2020 an average of 346 patients per week presented at the emergency department whereas in 2019 an average of 400 patients presented up to calendar week 16 (p = 0.018; whole year 2019 = 395 patients per week). After the first COVID-19 diagnosis in the region, emergency department visit volume decreased by 30% compared with the same period in 2019 (p = 0.0012). Admissions due to ACS decreased by 41% (p = 0.0023 for all; Δ - 71% (p = 0.007) for unstable angina, Δ - 25% (p = 0.42) for myocardial infarction with ST-elevation and Δ - 17% (p = 0.28) without ST-elevation) compared with the same period in 2019 and decreased from 142 patients in calendar weeks 1-9 to 62 patients in calendar weeks 10-16. ACVE decreased numerically by 20% [p = 0.25 for all; transient ischemic attack: Δ - 32% (p = 0.18), ischemic stroke: Δ - 23% (p = 0.48), intracerebral haemorrhage: Δ + 57% (p = 0.4)]. There was no significant change in ACVE per week (p = 0.7) comparing calendar weeks 1-9 (213 patients) and weeks 10-16 (147 patients). Testing of 3756 samples was performed to detect 58 SARS-CoV-2 positive patients (prevalence 1,54%, thereof one patient with myocardial and two with cerebral ischemia) up to calendar week 16 in 2020. CONCLUSIONS The COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.
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Affiliation(s)
- Viktoria Schwarz
- Emergency Department, Saarland University Medical Center, Homburg, Germany.
- Clinic of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), Saarland University Medical Center, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 100, Geb. 41, 66421, Homburg, Saar, Germany.
| | - Felix Mahfoud
- Clinic of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), Saarland University Medical Center, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 100, Geb. 41, 66421, Homburg, Saar, Germany
| | - Lucas Lauder
- Clinic of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), Saarland University Medical Center, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 100, Geb. 41, 66421, Homburg, Saar, Germany
| | - Wolfgang Reith
- Department of Neuroradiology, Saarland University Medical Center, Homburg, Germany
| | - Stefanie Behnke
- Department of Neurology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | - Bruno Scheller
- Clinic of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), Saarland University Medical Center, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 100, Geb. 41, 66421, Homburg, Saar, Germany
| | - Michael Böhm
- Clinic of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), Saarland University Medical Center, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 100, Geb. 41, 66421, Homburg, Saar, Germany
| | - Sebastian Ewen
- Emergency Department, Saarland University Medical Center, Homburg, Germany.
- Clinic of Internal Medicine III (Cardiology, Angiology and Intensive Care Medicine), Saarland University Medical Center, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str. 100, Geb. 41, 66421, Homburg, Saar, Germany.
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