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Cuspidi C, Faggiano A, Mancia G, Grassi G. Echocardiographic Phenotypes of Subclinical Organ Damage: Clinical and Prognostic Value in the General Population. Findings from the Pamela Study. High Blood Press Cardiovasc Prev 2023; 30:497-511. [PMID: 38032423 DOI: 10.1007/s40292-023-00610-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Subclinical alterations in cardiac structure and function include a variety of abnormal phenotypes of established adverse prognostic significance such as left ventricular hypertrophy (LVH), alterations of LV geometry, left atrial (LA) enlargement, and aortic root (AR) dilatation. The excess cardiovascular (CV) risk associated with these phenotypes has been consistently demonstrated in different clinical settings such in patients with systemic hypertension, coronary heart disease, diabetes mellitus, chronic kidney disease, heart failure and in geneal population samples. The Pressioni Monitorate e Loro Associazioni (PAMELA), a longitudinal population-based study originally designed to assess the normality values, prognostic significance of office, home and 24-hour blood pressure, including among the many clinical and laboratory variables the collection of echocardiographic data, allowed to gather important information on the clinical prognostic significance of subclinical cardiac damage during a long follow-up period. This article summarizes the original findings provided by the PAMELA study on the clinical correlates and prognostic significance of echocardiographic markers of subclinical organa damage namely LVH, left atrial enlargement (LA) and AR dilatation at the community level.
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Affiliation(s)
- Cesare Cuspidi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
| | - Andrea Faggiano
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Giuseppe Mancia
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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van Rooyen JM, Poglitsch M, Mels CMC, Huisman HW, Gafane-Matemane LF, Le Roux S, Lammertyn L, Breet Y, Uys L, Schutte AE. Aldosterone and angiotensin II profiles in young black and white women using different hormonal contraceptives: the African-PREDICT study. J Hum Hypertens 2022; 36:711-717. [PMID: 34172825 DOI: 10.1038/s41371-021-00569-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 05/29/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023]
Abstract
Exogenous estrogens and progestins may affect the components of the renin-angiotensin-aldosterone system (RAAS). Changes in ventricular blood volume are associated with increased secretion of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP), which may also be affected by hormonal contraceptives. In this study, we aimed to compare components of the RAAS and NT-proBNP between groups using different hormonal contraceptives, including the combination pill, the injection or implant, and controls (no contraception) in black and white women of fertile age (20 - 30 years). Secondly, we determined whether blood pressure and NT-proBNP are associated with the RAAS components. We included 397 black and white women not using contraceptives, 120 using the combination pill, and 103 receiving an injection/implant. RAAS Triple-A analysis was carried out with LC-MS/MS quantification, and blood pressure measurements (ABPM) taken over 24 h. We found that serum aldosterone was higher (475.7 vs. 249.2 pmol/L; p < 0.001) in the combination pill group than in the no contraception group of white women. The aldosterone-angiotensin II ratio (AA2) was higher (5.4 vs. 2.5; p < 0.001) in the combination pill group than in the no contraception group. In the black women using the combination pill, we found a borderline-positive and borderline-negative association between 24-h systolic blood pressure and NT-proBNP with equilibrium (eq) Ang II, respectively. In white women using the combination pill, only CRP contributed positively and independently to NT-proBNP. To conclude, activation of RAAS by different hormonal contraceptives may increase future risk for the development of hypertension in young black and white women.
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Affiliation(s)
- Johannes M van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa. .,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
| | | | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Hugo W Huisman
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Lebo F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Shani Le Roux
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Leandi Lammertyn
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Yolandi Breet
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Lisa Uys
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.,School of Population Health, The University of New South Wales; The George Institute for Global Health, Sydney NWS, Australia
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Gafane-Matemane LF, Kruger R, Van Rooyen JM, Gona PN, Schutte AE. Soluble (Pro)renin Receptor Is Adversely Associated with Indices of Left Ventricular Structure and Function: The African-PREDICT Study. J Cardiovasc Dev Dis 2022; 9:jcdd9050130. [PMID: 35621841 PMCID: PMC9144018 DOI: 10.3390/jcdd9050130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
This study aims to compare soluble (pro)renin receptor [s(P)RR] levels between black and white adults and to explore the associations of left ventricular (LV) structure and function with s(P)RR in the total and ethnicity-stratified groups. The study sample included 1172 apparently healthy black (n = 587) and white (n = 585) participants of the African-PREDICT study aged 20−30 years. Echocardiography was performed to determine relative wall thickness (RWT), LV mass index, LV ejection fraction and stroke volume index (SVi). s(P)RR was analyzed from serum samples, while plasma renin activity-surrogate (PRA-S) and eq angiotensin II were determined using the RAS™ Fingerprint. s(P)RR was higher in the white participants compared to the black participants (p < 0.001). In multivariable-adjusted linear regression analyses, we observed a positive association between RWT and s(P)RR (β = 0.141; p = 0.005) and negative associations of LV ejection fraction (β = −0.123; p = 0.016) and SVi (β = −0.144; p = 0.004) with s(P)RR only in white adults. Higher s(P)RR observed in white vs. black participants was associated with higher RWT and poorer LV function only in young white adults but not in their black counterparts. These results suggest that s(P)RR may contribute to LV remodeling and dysfunction in white populations due to its role in volume−pressure regulation and its proinflammatory as well as profibrotic effects.
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Affiliation(s)
- Lebo F. Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa; (R.K.); (J.M.V.R.); (A.E.S.)
- Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
- Correspondence: ; Tel.: +27-18-299-2293
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa; (R.K.); (J.M.V.R.); (A.E.S.)
- Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
| | - Johannes M. Van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa; (R.K.); (J.M.V.R.); (A.E.S.)
- Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
| | - Philimon N. Gona
- College of Nursing & Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA;
| | - Aletta E. Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa; (R.K.); (J.M.V.R.); (A.E.S.)
- Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney 2052, Australia
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Gafane-Matemane LF, Kruger R, Smith W, Mels CMC, Van Rooyen JM, Mokwatsi GG, Uys AS, Brits SJ, Schutte AE. Characterization of the Renin-Angiotensin-Aldosterone System in Young Healthy Black Adults: The African Prospective Study on the Early Detection and Identification of Hypertension and Cardiovascular Disease (African-PREDICT Study). Hypertension 2021; 78:400-410. [PMID: 34176281 DOI: 10.1161/hypertensionaha.120.16879] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Lebo F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Johannes M Van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Gontse G Mokwatsi
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Aletta S Uys
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Sanette J Brits
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.)
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (L.F.G.-M., R.K., W.S., C.M.C.M., J.M.V.R., G.G.M., A.S.U., S.J.B., A.E.S.).,School of Population Health, University of New South Wales; Sydney, Australia (A.E.S.).,The George Institute for Global Health, Sydney, Australia (A.E.S.)
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