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Maqbool S, Shafiq S, Ali S, Rehman MEU, Malik J, Lee KY. Left Ventricular Hypertrophy (LVH) and Left Ventricular Geometric Patterns in Patients with Chronic Kidney Disease (CKD) Stage 2-5 With Preserved Ejection Fraction (EF): A Systematic Review to Explore CKD Stage-wise LVH Patterns. Curr Probl Cardiol 2023; 48:101590. [PMID: 36632930 DOI: 10.1016/j.cpcardiol.2023.101590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
Left ventricular hypertrophy (LVH) is the most common structural abnormality associated with CKD patients accounting for 70% of the patients suffering LVH with ESRD. This art of the state review is first of its nature which aimed to analyze the studies involving LVH in CKD patients, and stage-wise association of CKD with various geometrical patterns of LVH. The literature search was done through various databases like PubMed, EMBASE, CINAHIL, Web of Science, and Cochrane Library. After careful quality assessment a total of 7 studies, and 2121 patients were included in our study. The mean age of the patients was 61.5±12.4 years. Similarly, the mean value of eGFR was 39.81±13.71 ml/min. The incidence of LVH was 47.05%, and on stage-wise analysis, the higher CKD stage was associated with eccentric LVH as compared to lower stages. The ejection fraction (EF) values were showing preserved EF in all included studies. ESRD was showing more preponderance towards eccentric LVH as compared to other stages of CKD.
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Affiliation(s)
- Shahzaib Maqbool
- Department of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Saba Shafiq
- Department of Medicine, Holy Family Hospital, Rawalpindi, Pakistan
| | - Sarmad Ali
- Department of Cardiology, Rawalpindi Medical University, Rawalpindi, Pakistan
| | | | - Jahanzeb Malik
- Department of electrophysiology, Cardiovascular analytics group, Canterbury, UK
| | - Ka Yiu Lee
- Department of Health Sciences, Mid Sweden University, Ostersund, Jamtland, Sweden.
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Progressive Adverse Cardiac Remodeling and Obesity: Unwelcome News from "the City That Never Sleeps". J Am Soc Echocardiogr 2020; 32:1326-1330. [PMID: 31587757 DOI: 10.1016/j.echo.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022]
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Rader F, Franklin SS, Mirocha J, Vongpatanasin W, Haley RW, Victor RG. Superiority of Out-of-Office Blood Pressure for Predicting Hypertensive Heart Disease in Non-Hispanic Black Adults. Hypertension 2019; 74:1192-1199. [PMID: 31522619 DOI: 10.1161/hypertensionaha.119.13542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34-1.64 for out-of-office systolic BP and 1.15 [1.04-1.28] for clinic systolic BP; 1.71 [1.43-2.05] for out-of-office diastolic BP, and 1.03 [0.86-1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT00344903.
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Affiliation(s)
- Florian Rader
- From the Smidt Heart Institute, Hypertension Center of Excellence (F.R., R.G.V.), Cedars-Sinai Medical Center, Los Angeles, CA
| | - Stanley S Franklin
- Heart Disease Prevention Program Department of Medicine, University of California, Irvine (S.S.F.)
| | - James Mirocha
- Research Institute and Clinical and Translational Science Institute (J.M.), Cedars-Sinai Medical Center, Los Angeles, CA
| | - Wanpen Vongpatanasin
- Hypertension Section, Cardiology Division (W.V.), University of Texas Southwestern Medical Center, Dallas
| | - Robert W Haley
- Department of Internal Medicine/Division of Epidemiology (R.W.H.), University of Texas Southwestern Medical Center, Dallas
| | - Ronald G Victor
- From the Smidt Heart Institute, Hypertension Center of Excellence (F.R., R.G.V.), Cedars-Sinai Medical Center, Los Angeles, CA
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Ahmad FS, Cai X, Kunkel K, Ricardo AC, Lash JP, Raj DS, He J, Anderson AH, Budoff MJ, Wright Nunes JA, Roy J, Wright JT, Go AS, St. John Sutton MG, Kusek JW, Isakova T, Wolf M, Keane MG. Racial/Ethnic Differences in Left Ventricular Structure and Function in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort. Am J Hypertens 2017; 30:822-829. [PMID: 28444108 DOI: 10.1093/ajh/hpx058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease (CVD) and it is especially common among Blacks. Left ventricular hypertrophy (LVH) is an important subclinical marker of CVD, but there are limited data on racial variation in left ventricular structure and function among persons with CKD. METHODS In a cross-sectional analysis of the Chronic Renal Insufficiency Cohort Study, we compared the prevalence of different types of left ventricular remodeling (concentric hypertrophy, eccentric hypertrophy, and concentric remodeling) by race/ethnicity. We used multinomial logistic regression to test whether race/ethnicity associated with different types of left ventricular remodeling independently of potential confounding factors. RESULTS We identified 1,164 non-Hispanic Black and 1,155 non-Hispanic White participants who completed Year 1 visits with echocardiograms that had sufficient data to categorize left ventricular geometry type. Compared to non-Hispanic Whites, non-Hispanic Blacks had higher mean left ventricular mass index (54.7 ± 14.6 vs. 47.4 ± 12.2 g/m2.7; P < 0.0001) and prevalence of concentric LVH (45.8% vs. 24.9%). In addition to higher systolic blood pressure and treatment with >3 antihypertensive medications, Black race/ethnicity was independently associated with higher odds of concentric LVH compared to White race/ethnicity (odds ratio: 2.73; 95% confidence interval: 2.02, 3.69). CONCLUSION In a large, diverse cohort with CKD, we found significant differences in left ventricular mass and hypertrophic morphology between non-Hispanic Blacks and Whites. Future studies will evaluate whether higher prevalence of LVH contribute to racial/ethnic disparities in cardiovascular outcomes among CKD patients.
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Affiliation(s)
- Faraz S. Ahmad
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Xuan Cai
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Katherine Kunkel
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ana C. Ricardo
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - James P. Lash
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Dominic S. Raj
- Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Los Angeles, USA
| | - Amanda H. Anderson
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Matthew J. Budoff
- Los Angeles Biomedical Research Institute, Torrance, California, USA
| | | | - Jason Roy
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jackson T. Wright
- Department of Medicine, Case Western University School of Medicine, Cleveland, Ohio, USA
| | - Alan S. Go
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
- Departments of Epidemiology and Biostatistics and Department of Medicine, University of California School of Medicine, San Francisco, San Francisco, California, USA
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA
| | - Martin G. St. John Sutton
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - John W. Kusek
- Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Tamara Isakova
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Myles Wolf
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Martin G. Keane
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
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Zeng C, Cheng D, Sheng X, Jian G, Fan Y, Chen Y, Li J, Bao H, Wang N. Increased Serum Uric Acid Level Is a Risk Factor for Left Ventricular Hypertrophy but Not Independent of eGFR in Patients with Type 2 Diabetic Kidney Disease. J Diabetes Res 2017; 2017:5016093. [PMID: 28713836 PMCID: PMC5496120 DOI: 10.1155/2017/5016093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/30/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although the relation between serum uric acid (SUA) and left ventricular hypertrophy (LVH) has been studied for decades, however, their association remains debatable. METHODS This is a retrospective study in which a total of 435 hospitalized Chinese patients with type 2 DKD were enrolled. The subjects were stratified into quartiles according to SUA level. LVH was assessed by two-dimensional guided M-mode echocardiography. RESULTS There was a significant increase in the prevalence of LVH in patients with type 2 DKD across SUA quartiles (28.9, 26.5, 36.1, and 49.5%; p < 0.001). The Spearman analysis indicated that SUA was positively correlated to LVMI and negatively correlated to eGFR. The logistic regression analysis revealed that the odd ratio for LVH in the highest SUA quartile was 2.439 (95% CI 1.265-4.699; p = 0.008; model 1) or 2.576 (95% CI 1.150-5.768; p = 0.021; model 2) compared with that in the lowest SUA quartile. However, there was no significant increased risk of LVH in the subjects with the highest SUA quartile after adjusting the eGFR (OR = 1.750; 95% CI 0.685-4.470; p = 0.242; model 3). CONCLUSIONS In selected population, such as type 2 DKD, the elevated SUA level is positively linked with the increased risk of LVH, but this relationship is not independent of eGFR.
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Affiliation(s)
- Chuchu Zeng
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Dongsheng Cheng
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Xiaohua Sheng
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
- *Xiaohua Sheng: and
| | - Guihua Jian
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Ying Fan
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Yuqiang Chen
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Junhui Li
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Hongda Bao
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
| | - Niansong Wang
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
- *Niansong Wang:
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Finizola RM, Infante E, Finizola B, Pardo Pardo J, Flores Y, Granero R, Arai KJ. Pharmacotherapy for hypertension-induced left ventricular hypertrophy. Hippokratia 2016. [DOI: 10.1002/14651858.cd012039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Rosa M Finizola
- Cardiovascular Association Centroccidental; Unit of Special Projects; Prolongation career 17 with street 12 Barrio La Feria Barquisimeto Lara Venezuela 3001
| | - Elizabeth Infante
- Cardiovascular Association Centroccidental; Unit of Systems; Prolongation career 17 with street 12 Barrio La Feria Barquisimeto Lara Venezuela 3001
| | - Bartolome Finizola
- Cardiovascular Association Centroccidental; General Coordination; Prolongation career 17 with street 12 Barrio La Feria Barquisimeto Lara Venezuela 3001
| | - Jordi Pardo Pardo
- Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus; Centre for Practice-Changing Research; 501 Smyth Road, Box 711 Room L1258 Ottawa ON Canada K1H 8L6
| | - Yris Flores
- Cardiovascular Association Centroccidental; Echocardiography Department and Cardiac Tomography Department; Prolongation career 17 with street 12 Barrio La Feria Barquisimeto Lara Venezuela 3001
| | - Ricardo Granero
- ASCARDIO; Epidemiology; Carrera 17 con Calle 11 Barquisimeto Lara Venezuela 3001
| | - Kaduo J Arai
- Cardiovascular Association Centroccidental; Coronary Care Unit; Prolongation career 17 with street 12 Barrio La Feria Barquisimeto Lara Venezuela 3001
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Minutolo R, Gabbai FB, Chiodini P, Garofalo C, Stanzione G, Liberti ME, Pacilio M, Borrelli S, Provenzano M, Conte G, De Nicola L. Reassessment of Ambulatory Blood Pressure Improves Renal Risk Stratification in Nondialysis Chronic Kidney Disease. Hypertension 2015; 66:557-62. [DOI: 10.1161/hypertensionaha.115.05820] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 06/15/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Roberto Minutolo
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Francis B. Gabbai
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Paolo Chiodini
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Carlo Garofalo
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Giovanna Stanzione
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Maria Elena Liberti
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Mario Pacilio
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Silvio Borrelli
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Michele Provenzano
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Giuseppe Conte
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
| | - Luca De Nicola
- From the Division of Nephrology, Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences (R.M., C.G., G.S., M.E.L., M. Pacilio, S.B., M. Provenzano, G.C., L.D.N.), Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine (P.C.), Second University of Naples, Naples, Italy; and Department of Medicine, VA San Diego Healthcare System and University of California at San Diego Medical School (F.B.G.)
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de Beus E, Meijs MFL, Bots ML, Visseren FLJ, Blankestijn PJ. Presence of albuminuria predicts left ventricular mass in patients with chronic systemic arterial hypertension. Eur J Clin Invest 2015; 45:550-6. [PMID: 25786814 DOI: 10.1111/eci.12433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 03/13/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Increased left ventricular mass (LVM) is known to predict cardiovascular morbidity and mortality. LVM is high in patients with advanced kidney disease. Our aim was to study the relationship between renal parameters and LVM in hypertensive subjects at high risk of cardiovascular disease. DESIGN Cardiac MRI was performed in 527 patients participating in the single-centre SMART cohort study. Participants free from previous symptomatic coronary heart disease but with a history of hypertension were recruited. Subjects were screened for cardiovascular risk factors in a standardized way. Multivariable linear regression was used to study the relationship of both estimated glomerular filtration rate (eGFR) and presence of albuminuria with left ventricular mass. RESULTS Mean LVM was 121 g for men (SD 26) and 87 g for women (SD 20). Mean eGFR was 82 mL/min/1.73 m(²) (SD 19). A total of 73 patients (14%) had albuminuria. After adjusting for known determinants of LVM (height, weight, sex and age) eGFR did not relate to LVM while presence of albuminuria did (mean change in LVM per 10 mL/min/1.73 m(2) change in eGFR 0.79 g, 95% CI -0.33 to 1.91, P = 0.17, mean change in LVM in presence vs. absence of albuminuria 9.9 g, 95% CI 4.33 to 15.45, P = 0.001). Additional adjustment for systolic blood pressure did not change results (B for eGFR 0.54, 95% CI -0.58 to 1.66, P = 0.35, B for albuminuria 9.09, 95% CI 3.57 to 14.60, P = 0.001). CONCLUSIONS In this study in hypertensive patients with high vascular risk, albuminuria was related to increased LVM and eGFR was not.
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Affiliation(s)
- Esther de Beus
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Matthijs F L Meijs
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Peter J Blankestijn
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
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Rader F, Sachdev E, Arsanjani R, Siegel RJ. Left ventricular hypertrophy in valvular aortic stenosis: mechanisms and clinical implications. Am J Med 2015; 128:344-52. [PMID: 25460869 DOI: 10.1016/j.amjmed.2014.10.054] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 10/18/2014] [Accepted: 10/20/2014] [Indexed: 12/31/2022]
Abstract
Valvular aortic stenosis is the second most prevalent adult valve disease in the United States and causes progressive pressure overload, invariably leading to life-threatening complications. Surgical aortic valve replacement and, more recently, transcatheter aortic valve replacement effectively relieve the hemodynamic burden and improve the symptoms and survival of affected individuals. However, according to current American College of Cardiology/American Heart Association guidelines on the management of valvular heart disease, the indications for aortic valve replacement, including transcatheter aortic valve replacement, are based primarily on the development of clinical symptoms, because their presence indicates a dismal prognosis. Left ventricular hypertrophy develops in a sizeable proportion of patients before the onset of symptoms, and a growing body of literature demonstrates that regression of left ventricular hypertrophy resulting from aortic stenosis is incomplete after aortic valve replacement and associated with adverse early postoperative outcomes and worse long-term outcomes. Thus, reliance on the development of symptoms alone without consideration of structural abnormalities of the myocardium for optimal timing of aortic valve replacement potentially constitutes a missed opportunity to prevent postoperative morbidity and mortality from severe aortic stenosis, especially in the face of the quickly expanding indications of lower-risk transcatheter aortic valve replacement. The purpose of this review is to discuss the mechanisms and clinical implications of left ventricular hypertrophy in severe valvular aortic stenosis, which may eventually move to center stage as an indication for aortic valve replacement in the asymptomatic patient.
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Affiliation(s)
- Florian Rader
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, Calif.
| | - Esha Sachdev
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Reza Arsanjani
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Robert J Siegel
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, Calif
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Sinha AD, Agarwal R. The complex relationship between CKD and ambulatory blood pressure patterns. Adv Chronic Kidney Dis 2015; 22:102-7. [PMID: 25704346 DOI: 10.1053/j.ackd.2015.01.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/05/2015] [Indexed: 01/13/2023]
Abstract
Hypertension and CKD frequently coexist, and both are risk factors for cardiovascular events and mortality. Among people with hypertension, the loss of the normal fall in night-time BP, called nondipping, can only be diagnosed by ambulatory BP monitoring (ABPM) and is a risk factor for cardiovascular events. The pathophysiology of nondipping is complex, and CKD is an independent risk factor for nondipping. In fact, nondipping can be seen in as many as 80% of people with CKD. However, the evidence for nondipping as an independent risk factor or causal agent for adverse outcomes in CKD remains mixed. ABPM has been shown to be superior to clinical BP measurement for correlating with end-organ damage and prognosis in CKD. This review covers the evidence for the use of ABPM in CKD, the evidence linking ABPM patterns to outcome in CKD and the evidence for treatment of nondipping in CKD.
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11
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Cornell product relates to albuminuria in hypertensive black adults independently of blood pressure: the SABPA study. ACTA ACUST UNITED AC 2015; 9:115-22. [DOI: 10.1016/j.jash.2014.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 12/03/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
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12
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Peterson GE, de Backer T, Contreras G, Wang X, Kendrick C, Greene T, Appel LJ, Randall OS, Lea J, Smogorzewski M, Vagaonescu T, Phillips RA. Relationship of left ventricular hypertrophy and diastolic function with cardiovascular and renal outcomes in African Americans with hypertensive chronic kidney disease. Hypertension 2013; 62:518-25. [PMID: 23836799 DOI: 10.1161/hypertensionaha.111.00904] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
African Americans with hypertension are at high risk for adverse outcomes from cardiovascular and renal disease. Patients with stage 3 or greater chronic kidney disease have a high prevalence of left ventricular (LV) hypertrophy and diastolic dysfunction. Our goal was to study prospectively the relationships of LV mass and diastolic function with subsequent cardiovascular and renal outcomes in the African American Study of Kidney Disease and Hypertension cohort study. Of 691 patients enrolled in the cohort, 578 had interpretable echocardiograms and complete relevant clinical data. Exposures were LV hypertrophy and diastolic parameters. Outcomes were cardiovascular events requiring hospitalization or causing death; a renal composite outcome of doubling of serum creatinine or end-stage renal disease (censoring death); and heart failure. We found strong independent relationships between LV hypertrophy and subsequent cardiovascular (hazard ratio, 1.16; 95% confidence interval, 1.05-1.27) events, but not renal outcomes. After adjustment for LV mass and clinical variables, lower systolic tissue Doppler velocities and diastolic parameters reflecting a less compliant LV (shorter deceleration time and abnormal E/A ratio) were significantly (P<0.05) associated with future heart failure events. This is the first study to show a strong relationship among LV hypertrophy, diastolic parameters, and adverse cardiac outcomes in African Americans with hypertension and chronic kidney disease. These echocardiographic risk factors may help identify high-risk patients with chronic kidney disease for aggressive therapeutic intervention.
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Affiliation(s)
- Gail E Peterson
- Division of Cardiology, UT Southwestern, 5909 Harry Hines Blvd, Dallas, TX 75235-9047, USA.
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Rahman M, Greene T, Phillips RA, Agodoa LY, Bakris GL, Charleston J, Contreras G, Gabbai F, Hiremath L, Jamerson K, Kendrick C, Kusek JW, Lash JP, Lea J, Miller ER, Rostand S, Toto R, Wang X, Wright JT, Appel LJ. A trial of 2 strategies to reduce nocturnal blood pressure in blacks with chronic kidney disease. Hypertension 2012; 61:82-8. [PMID: 23172931 DOI: 10.1161/hypertensionaha.112.200477] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of our study was to determine the effects of 2 antihypertensive drug dose schedules (PM dose and add-on dose) on nocturnal blood pressure (BP) in comparison with usual therapy (AM dose) in blacks with hypertensive chronic kidney disease and controlled office BP. In a 3-period, crossover trial, former participants of the African American Study of Kidney Disease were assigned to receive the following 3 regimens, each lasting 6 weeks, presented in random order: AM dose (once-daily antihypertensive medications taken in the morning), PM dose (once-daily antihypertensives taken at bedtime), and add-on dose (once-daily antihypertensives taken in the morning and an additional antihypertensive medication before bedtime [diltiazem 60-120 mg, hydralazine 25 mg, or additional ramipril 5 mg]). Ambulatory BP monitoring was performed at the end of each period. The primary outcome was nocturnal systolic BP. Mean age of the study population (n=147) was 65.4 years, 64% were men, and mean estimated glomerular filtration rate was 44.9 mL/min per 1.73 m(2). At the end of each period, mean (SE) nocturnal systolic BP was 125.6 (1.2) mm Hg in the AM dose, 123.9 (1.2) mm Hg in the PM dose, and 123.5 (1.2) mm Hg in the add-on dose. None of the pairwise differences in nocturnal, 24-hour, and daytime systolic BP was statistically significant. Among blacks with hypertensive chronic kidney disease, neither PM (bedtime) dosing of once-daily antihypertensive nor the addition of drugs taken at bedtime significantly reduced nocturnal BP compared with morning dosing of antihypertensive medications.
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Affiliation(s)
- Mahboob Rahman
- Division of Nephrology and Hypertension, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
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14
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Esquitin R, Razzouk L, Peterson GE, Wright JT, Phillips RA, De Backer TL, Baran DA, Kendrick C, Greene T, Reiffel J, Muntner P, Farkouh ME. Left ventricular hypertrophy by electrocardiography and echocardiography in the African American Study of Kidney Disease Cohort Study. JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION : JASH 2012; 6:193-200. [PMID: 22341790 DOI: 10.1016/j.jash.2012.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 01/12/2012] [Accepted: 01/12/2012] [Indexed: 10/28/2022]
Abstract
Although electrocardiographic criteria for diagnosing left ventricular hypertrophy have a low sensitivity in the general population, their test characteristics have not been evaluated in the high-prevalence group of American Americans with chronic kidney disease. The purpose of the current study was to evaluate these test characteristics among African Americans (n = 645) with hypertensive kidney disease as part of the African-American Study of Kidney Disease and Hypertension cohort. Electrocardiograms were read by 2 cardiologists at an independent core laboratory using the 2 Sokolow-Lyon criteria and the Cornell criteria. Left ventricular hypertrophy on echocardiography was defined as left ventricular mass index greater than 49.2 and greater than 46.7 g/m(2.7) in men and women, respectively. Sixty-nine percent of the population had left ventricular hypertrophy on echo, whereas 34% had left ventricular hypertrophy by any of the electrocardiographic criteria. Sensitivity by individual electrocardiographic criteria was 16.5% by Sokolow-Lyon-1, 19.3% by Sokolow-Lyon-2, and 24.7% by Cornell criteria, with specificity ranging from 89% to 92%. When using any of the 3 criteria, sensitivity increased to 40.4% with a decrease in specificity to 78.0%. Consistent with findings in a general population, left ventricular hypertrophy by electrocardiography had low sensitivity and high specificity in this cohort of African Americans with hypertensive kidney disease.
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MESH Headings
- Adrenergic beta-Antagonists/therapeutic use
- Black or African American
- Angiotensin-Converting Enzyme Inhibitors/therapeutic use
- Calcium Channel Blockers/therapeutic use
- Disease Progression
- Drug Therapy, Combination
- Echocardiography/methods
- Electrocardiography/methods
- Female
- Follow-Up Studies
- Humans
- Hypertension, Renal/complications
- Hypertension, Renal/drug therapy
- Hypertension, Renal/ethnology
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/ethnology
- Hypertrophy, Left Ventricular/etiology
- Incidence
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/diagnosis
- Kidney Failure, Chronic/ethnology
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- ROC Curve
- Reproducibility of Results
- United States/epidemiology
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Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens 2011; 26:343-9. [PMID: 22113443 DOI: 10.1038/jhh.2011.104] [Citation(s) in RCA: 179] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Left-ventricular hypertrophy (LVH) is a cardinal manifestation of hypertensive organ damage associated with an increased cardiovascular (CV) risk. We reviewed recent literature on the prevalence of LVH, as assessed by echocardiography, in order to offer an updated information on the magnitude of subclinical alterations in LV structure in contemporary human hypertension. A MEDLINE search using key words 'left ventricular hypertrophy', 'hypertension', 'echocardiography' and 'cardiac organ damage' was performed in order to identify relevant papers. Full articles published in English language in the last decade, (1 January 2000-1 December 2010), reporting studies in adult or elderly individuals, were considered. A total of 30 studies, including 37,700 untreated and treated patients (80.3% Caucasian, 52.4% men, 9.6% diabetics, 2.6% with CV disease) were considered. LVH was defined by 23 criteria; its prevalence ranged from 36% (conservative criteria) to 41% (less conservative criteria) in the pooled population. LVH prevalence was not different between women and men (range 37.9-46.2 versus 36.0-43.5%, respectively). Eccentric LVH was more frequent than concentric hypertrophy (range 20.3-23.0 versus 14.8-15.8, respectively, P<0.05); concentric phenotype was found in a consistent fraction (20%) of both genders. Despite the improved management of hypertension in the last two decades, LVH remains a highly frequent biomarker of cardiac damage in the hypertensive population. Our analysis calls for a more aggressive treatment of hypertension and related CV risk factors leading to LVH.
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Prakash SK, Haden-Pinneri K, Milewicz DM. Susceptibility to acute thoracic aortic dissections in patients dying outside the hospital: an autopsy study. Am Heart J 2011; 162:474-9. [PMID: 21884863 DOI: 10.1016/j.ahj.2011.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 06/20/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND The objectives of this study were to identify the incidence and predictors of death from acute thoracic aortic dissections (AoDs) and to describe their associated clinical findings. METHODS We analyzed the clinical and pathologic data from 141 consecutive autopsies of individuals with sudden death due to AoDs in Harris County, TX, from 2003 to 2010, which represented 20% (107/534) of all deaths attributed to AoDs during this period by the Texas Department of Health. Multivariate Cox regression was used to identify predictors of survival adjusting for differences in demographic and clinical characteristics. RESULTS During the study period, 141 of 145 fatal victims of acute thoracic dissections underwent a full autopsy and were included in the analysis. In 84% of cases, death was caused by pericardial tamponade from ascending AoD. The frequency of deaths showed seasonal variation with peak incidence in the winter months. Compared with patients presenting to hospitals with AoD, individuals dying outside the hospital were more likely to be female, African American, younger than 50 years and to have had prior aortic disease. One third of subjects with AoD had seen a physician within 1 week of sudden death. The most consistent pathologic abnormality was marked ventricular hypertrophy (257 g/m(2) on average) out of proportion to expected values for age, gender, and body size. Hispanic patients and patients with congenital disorders, such as bicuspid aortic valve and Marfan syndrome, were significantly more likely to die of AoD at a younger age (38% vs 13%, P < .002). CONCLUSIONS Our findings identify differences between patients hospitalized for AoD versus those who died without being hospitalized. Previously unreported vulnerabilities to sudden death from AoD in minority populations, specifically Hispanics, were also identified that merit follow-up in prospective studies.
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Affiliation(s)
- Siddharth K Prakash
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Renin inhibition and microalbuminuria development: meaningful predictor of kidney disease progression. Curr Opin Nephrol Hypertens 2010; 19:437-43. [PMID: 20644476 DOI: 10.1097/mnh.0b013e32833d14c3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Microalbuminuria is an indicator of increased cardiovascular disease risk. Herein, we review microalbuminuria as a predictor of the onset and progression of renal disease in people with and without diabetes. We evaluate the data on the use of direct renin inhibitors (DRIs) for treatment of hypertension with microalbuminuria. RECENT FINDINGS It is known that DRIs have an antiproteinuric effect, whether used alone or with an angiotensin receptor blocker (ARB), independent of its hypotensive effects in patients with type 2 diabetes. A current study will determine if adding the DRI aliskiren to an angiotensin-converting enzyme inhibitor (ACEi) or an ARB will reduce cardiovascular and renal risk in patients with type 2 diabetes. SUMMARY DRIs are the latest addition to the class of renin-angiotensin-aldosterone system (RAAS) inhibitors available for patients with hypertension and kidney disease. Whether these drugs can improve upon the reduction of cardiovascular and renal risk with an ACEi or an ARB is unknown. Microalbuminuria is a surrogate marker for both cardiovascular and possibly renal endpoints. However, an ongoing issue is that the majority of patients with microalbuminuria will die of cardiovascular events before the onset of end-stage renal disease, limiting the value of using longitudinal measures of microalbuminuria progression as a measure of therapeutic benefit with newer RAAS-blocking drugs such as DRIs.
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Left ventricular hypertrophy as a determinant of renal outcome in patients with high cardiovascular risk. J Hypertens 2010; 28:2299-308. [DOI: 10.1097/hjh.0b013e32833d95fe] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Rasić S, Hadzović-Dzuvo A, Rebić D, Uncanin S, Hadzić A, Mujaković A, Kulenović I. The metabolic syndrome in patients on peritoneal dialysis: prevalence and influence on cardiovascular morbidity. Bosn J Basic Med Sci 2010; 10 Suppl 1:S3-7. [PMID: 20433428 PMCID: PMC5627710 DOI: 10.17305/bjbms.2010.2638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The metabolic syndrome (MS) is a multi-factorial disorder which includes a main risk factors associated with the development of cardiovascular, neurologic, renal and endocrine diseases, especially type 2 diabetes. This study has been conducted to estimate the prevalence of the MS in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and its association with cardiovascular morbidity. The study included 37 patients (25 type 2 diabetic patients and 12 non-diabetic patients), who had been on peritoneal dialysis for > 3 months. At the beginning of CAPD treatment (baseline) and at the end of follow-up, we measured: body mass index (BMI), blood pressure, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (HDLC) and defined the prevalence of the MS using the modified National Cholesterol Education Program (NCEP; Adult Treatment Panel III) for peritoneal dialysis patients. The overall prevalence of the MS was 89.2%. The metabolic syndrome was estimated in all (100%) type 2 diabetic patients (vs. 60% patients on the beginning of CAPD treatment). In non-diabetic peritoneal patients, the MS was estimated in 50% cases, according to 33.3% at the beginning CAPD treatment. Development of the MS was significantly higher in the type 2 diabetic patients in compared with non-diabetic patients until the end of follow-up examination (p=0.0005). The prevalence of LVH in type 2 diabetic patients with the MS was significantly higher (p=0.002) than in non-diabetic peritoneal patients with the MS. We didn't found statistical significantly difference in the prevalence of ischemic heart disease between this two category of peritoneal dialysis patients (p=0.076). The results indicate that the metabolic syndrome is presented in high percentage in peritoneal dialysis patients, and it's also important risk factor of high cardiovascular morbidity rate in these patients, especially in type 2 diabetic patients.
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Affiliation(s)
- Senija Rasić
- Clinic of Nephrology, University of Sarajevo Clinics Centre, Bolnicka 25, Sarajevo, Bosnia and Herzegovina
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Home and ambulatory blood pressure monitoring in chronic kidney disease. Curr Opin Nephrol Hypertens 2009; 18:507-12. [DOI: 10.1097/mnh.0b013e3283319b9d] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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The message for World Kidney Day 2009: hypertension and kidney disease--a marriage that should be prevented. J Hypertens 2009; 27:666-9. [PMID: 19262237 DOI: 10.1097/hjh.0b013e328327706a] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The prevalence of chronic kidney disease (CKD) continues to increase worldwide as does end-stage renal disease. The most common, but not the only, causes of CKD are hypertension and diabetes. CKD is associated with a significant increase in cardiovascular risk as most patients with CKD die of a cardiovascular cause. Moreover, cardiovascular risk increases proportionally as estimated glomerular filtration rate falls below 60 ml/min. Cardiovascular causes of death in CKD are more prevalent than those from cancer; as a result, the identification and reduction of CKD is a public health priority. High blood pressure is a key pathogenic factor that contributes to the deterioration of kidney function. The presence of kidney disease is a common and underappreciated preexisting medical cause of resistant hypertension. Therefore, treatment of hypertension has become the most important intervention in the management of all forms of CKD. For this reason, the forthcoming World Kidney Day on 12 March 2009 will emphasize the role of hypertension.
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease: a marriage that should be prevented. J Clin Hypertens (Greenwich) 2009; 11:144-7. [PMID: 19302426 DOI: 10.1111/j.1751-7176.2009.00092.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The prevalence of chronic kidney disease (CKD) continues to increase worldwide as does end stage renal disease. The most common, but not only, causes of CKD are hypertension and diabetes. CKD is associated with a significant increase in cardiovascular (CV) risk as most patients with CKD die of a CV cause. Moreover, CV risk increases proportionally as estimated glomerular filtration rate falls below 60 mL/min. CV causes of death in CKD are more prevalent than those from cancer; as a result, the identification and reduction of CKD is a public health priority. High blood pressure is a key pathogenic factor that contributes to the deterioration of kidney function. The presence of kidney disease is a common and underappreciated preexisting medical cause of resistant hypertension. Therefore, treatment of hypertension has become the most important intervention in the management of all forms of CKD. For this reason, World Kidney Day on March 12, 2009 will emphasize the role of hypertension.
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Affiliation(s)
- George L Bakris
- Hypertensive Diseases Unit, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
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Bakris GL, Ritz E. The message for World Kidney Day 2009: Hypertension and kidney disease: a marriage that should be prevented. Nephrol Dial Transplant 2009; 24:695-7. [PMID: 19225021 DOI: 10.1093/ndt/gfp027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- George L Bakris
- Department of Medicine, Hypertensive Diseases Unit, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease: a marriage that should be prevented. Kidney Int 2009; 75:449-52. [PMID: 19218998 DOI: 10.1038/ki.2008.694] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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26
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Bakris GL, Ritz E. Hypertension and Kidney Disease: A Marriage That Should Be Prevented. Int J Organ Transplant Med 2009. [DOI: 10.1016/s1561-5413(09)60001-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Heffernan KS, Jae SY, Vieira VJ, Iwamoto GA, Wilund KR, Woods JA, Fernhall B. C-reactive protein and cardiac vagal activity following resistance exercise training in young African-American and white men. Am J Physiol Regul Integr Comp Physiol 2009; 296:R1098-105. [PMID: 19193941 DOI: 10.1152/ajpregu.90936.2008] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
African Americans have a greater prevalence of hypertension and diabetes compared with white Americans, and both autonomic dysregulation and inflammation have been implicated in the etiology of these disease states. The purpose of this study was to examine the cardiac autonomic and systemic inflammatory response to resistance training in young African-American and white men. Linear (time and frequency domain) and nonlinear (sample entropy) heart rate variability, baroreflex sensitivity, tonic and reflex vagal activity, and postexercise heart rate recovery were used to assess cardiac vagal modulation. C-reactive protein (CRP) and white blood cell count were used as inflammatory markers. Twenty two white and 19 African-American men completed 6 wk of resistance training followed by 4 wk of exercise detraining (Post 2). Sample entropy, tonic and reflex vagal activity, and heart rate recovery were increased in white and African-American men following resistance training (P < 0.05). Following detraining (Post 2), sample entropy, tonic and reflex vagal activity, and heart rate recovery returned to baseline values in white men but remained above baseline in African-American men. While there were no changes in white blood cell count or CRP in white men, these inflammatory markers decreased in African-American men following resistance training, with reductions being maintained following detraining (P < 0.05). In conclusion, resistance training improves cardiac autonomic function and reduces inflammation in African-American men, and these adaptations remained after the cessation of training. Resistance training may be an important lifestyle modification for improving cardiac autonomic health and reducing inflammation in young African-American men.
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Affiliation(s)
- Kevin S Heffernan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
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28
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease: a marriage that should be prevented. ACTA ACUST UNITED AC 2009; 3:80-3. [DOI: 10.1016/j.jash.2009.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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29
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease-a marriage that should be prevented. Pediatr Nephrol 2009; 24:427-30. [PMID: 19152007 DOI: 10.1007/s00467-008-1112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 12/18/2008] [Indexed: 10/21/2022]
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30
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Bakris GL, Ritz E. World Kidney Day 2009: Hypertension and Kidney Disease Is a Marriage That Should Be Prevented. Am J Kidney Dis 2009; 53:373-6. [DOI: 10.1053/j.ajkd.2009.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 01/13/2009] [Indexed: 11/11/2022]
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31
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease: a marriage that should be prevented. Clin J Am Soc Nephrol 2009; 4:517-9. [PMID: 19211670 DOI: 10.2215/cjn.00080109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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32
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease—a marriage that should be prevented. Clin Exp Nephrol 2009; 13:96-9. [DOI: 10.1007/s10157-008-0128-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Indexed: 10/21/2022]
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The message for World Kidney Day 2009: Hypertension and kidney disease: A marriage that should be prevented. Nephrology (Carlton) 2009; 14:49-51. [DOI: 10.1111/j.1440-1797.2009.01099.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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35
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Bakris GL, Ritz E. The message for World Kidney Day 2009: hypertension and kidney disease--a marriage that should be prevented. J Hum Hypertens 2009; 23:222-5. [PMID: 19158823 DOI: 10.1038/jhh.2008.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The prevalence of chronic kidney disease (CKD) continues to increase worldwide as does end stage renal disease. The most common, but not the only, causes of CKD are hypertension and diabetes. CKD is associated with a significant increase in cardiovascular (CV) risk as most patients with CKD die of a CV cause. Moreover, CV risk increases proportionally as eGFR falls below 60 ml min(-1). CV causes of death in CKD are more prevalent than those from cancer are; as a result, the identification and reduction of CKD is a public health priority. High blood pressure is a key pathogenic factor that contributes to the deterioration of kidney function. The presence of kidney disease is a common and underappreciated pre-existing medical cause of resistant hypertension. Therefore, treatment of hypertension has become the most important intervention in the management of all forms of CKD. For this reason, the forthcoming World Kidney Day on 12 March 2009 will emphasize the role of hypertension.
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36
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Pogue V, Rahman M, Lipkowitz M, Toto R, Miller E, Faulkner M, Rostand S, Hiremath L, Sika M, Kendrick C, Hu B, Greene T, Appel L, Phillips RA. Disparate estimates of hypertension control from ambulatory and clinic blood pressure measurements in hypertensive kidney disease. Hypertension 2009; 53:20-7. [PMID: 19047584 DOI: 10.1161/hypertensionaha.108.115154] [Citation(s) in RCA: 222] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Ambulatory blood pressure (ABP) monitoring provides unique information about day-night patterns of blood pressure (BP). The objectives of this article were to describe ABP patterns in African Americans with hypertensive kidney disease, to examine the joint distribution of clinic BP and ABP, and to determine associations of hypertensive target organ damage with clinic BP and ABP. This study is a cross-sectional analysis of baseline data from the African American Study of Kidney Disease Cohort Study. Masked hypertension was defined by elevated daytime (>or= 135/85 mm Hg) or elevated nighttime (>or= 120/70 mm Hg) ABP in those with controlled clinic BP (<140/90 mm Hg); nondipping was defined by a
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Affiliation(s)
- Velvie Pogue
- Division of Nephrology, Department of Medicine, Columbia University Medical Center, Harlem Hospital Center, New York, NY 10037, USA.
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Abstract
The well-described association between chronic kidney disease and cardiovascular disease is typically thought to originate from loss of renal function, as estimated by the glomerular filtration rate. However, recent data suggest that urinary albumin excretion has an important role in this association. Albuminuria is a marker of underlying vascular dysfunction and has been correlated with structural and functional integrity of the vasculature. Although the traditional upper limit of normal daily albumin excretion has been 30 mg/d, recent epidemiologic data suggest that levels in the general population are actually much lower. Further, within this range of low-grade albuminuria (LGA), increasing excretion rates are associated with increasing risk of cardiovascular disease. This association is independent of renal function, and in the earliest stages of chronic kidney disease, LGA seems to be a more important determinant than the glomerular filtration rate. This emerging association underscores the complexity of albumin excretion, in which subtle changes in albumin excretion reflect widespread vascular processes. Using the key words albuminuria, low-grade albuminuria, and microalbuminuria in a PubMed search of literature from January 1, 1995, to February 29, 2008, this review summarizes the most recent data on LGA and its association with cardiovascular and renal disease.
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Affiliation(s)
- John Danziger
- Renal Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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