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Liu J, Lu X, Chen L, Huo Y. Expert consensus on the management of hypertension in the young and middle-aged Chinese population. Int J Clin Pract 2019; 73:e13426. [PMID: 31573725 DOI: 10.1111/ijcp.13426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 09/21/2019] [Indexed: 11/30/2022] Open
Abstract
Hypertension, defined as blood pressure (BP) ≥140/90 mmHg, is one of the most common, yet reversible, risk factors for cardiovascular disease (CVD). Globally, 9.40 million people died from hypertension in 2010, accounting for 17.8% of total deaths; disability-adjusted life years (DALYs) caused by hypertension were 170 million person-years, or 7.0% of the total global DALYs.1 Data from China showed that hypertension accounted for 24.6% of all deaths, and 12.0% of total DALYs,2 and the direct medical cost of hypertension in China has reached 36.6 billion yuan per year.3.
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Affiliation(s)
- Jing Liu
- Peking University People's Hospital Ringgold standard institution, Department of Cardiology, Beijing, China
| | - Xinzheng Lu
- The First Affiliated Hospital of Nanjing Medical University, Department of Cardiology, Nanjing, China
| | - Luyuan Chen
- Guangdong General Hospital Ringgold standard institution, Deparment of Cardiology, Guangzhou, China
| | - Yong Huo
- Peking University People's Hospital Ringgold standard institution, Department of Cardiology, Beijing, China
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2
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Pizoń T, Rajzer M, Wojciechowska W, Wach-Pizoń M, Drożdż T, Wróbel K, Gruszka K, Rojek M, Kameczura T, Jurczyszyn A, Kąkol J, Czarnecka D. The relationship between plasma renin activity and serum lipid profiles in patients with primary arterial hypertension. J Renin Angiotensin Aldosterone Syst 2018; 19:1470320318810022. [PMID: 30404585 PMCID: PMC6240969 DOI: 10.1177/1470320318810022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction: The aim of the study was to evaluate clinical and biochemical differences between patients with low-renin and high-renin primary arterial hypertension (AH), mainly in reference to serum lipids, and to identify factors determining lipid concentrations. Materials and methods: In untreated patients with AH stage 1 we measured plasma renin activity (PRA) and subdivided the group into low-renin (PRA < 0.65 ng/mL/h) and high-renin (PRA ⩾ 0.65 ng/mL/h) AH. We compared office and 24-h ambulatory blood pressure, serum aldosterone, lipids and selected biochemical parameters between subgroups. Factors determining lipid concentration in both subgroups were assessed in regression analysis. Results: Patients with high-renin hypertension (N = 58) were characterized by higher heart rate (p = 0.04), lower serum sodium (p < 0.01) and aldosterone-to-renin ratio (p < 0.01), and significantly higher serum aldosterone (p = 0.03), albumin (p < 0.01), total protein (p < 0.01), total cholesterol (p = 0.01) and low-density lipoprotein cholesterol (LDL-C) (p = 0.04) than low-renin subjects (N = 39). In univariate linear regression, only PRA in the low-renin group was in a positive relationship with LDL-C (R2 = 0.15, β = 1.53 and p = 0.013); this association remained significant after adjustment for age, sex, and serum albumin and aldosterone concentrations. Conclusions: Higher serum levels of total and LDL-C characterized high-renin subjects, but the association between LDL-C level and PRA existed only in low-renin primary AH.
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Affiliation(s)
- Tomasz Pizoń
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland.,2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland
| | - Marek Rajzer
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Wiktoria Wojciechowska
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Wach-Pizoń
- 3 Department of Clinical and Environmental Allergology, University Hospital, Kraków, Poland
| | - Tomasz Drożdż
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Wróbel
- 2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland
| | - Krystian Gruszka
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Marta Rojek
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | | | - Artur Jurczyszyn
- 5 Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Janusz Kąkol
- 2 Department of Observational and Internal Medicine, University Hospital, Kraków, Poland
| | - Danuta Czarnecka
- 1 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
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3
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Sato A, Ueda C, Kimura R, Kobayashi C, Yamazaki Y, Ebina K. Angiotensin II induces the aggregation of native and oxidized low-density lipoprotein. EUROPEAN BIOPHYSICS JOURNAL: EBJ 2017; 47:1-9. [PMID: 28401261 DOI: 10.1007/s00249-017-1208-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/27/2017] [Accepted: 04/03/2017] [Indexed: 12/30/2022]
Abstract
Modifications of low-density lipoprotein (LDL), such as oxidation and aggregation, and angiotensin (Ang) peptides are involved in the pathogenesis of atherosclerosis. Here, we investigated the relationship between one of the Ang peptides, AngII, and two LDL modifications, oxidation and aggregation. Using polyacrylamide gel electrophoresis and aggregation assays, we noted that AngII markedly induced the aggregation of LDL and oxidized LDL (Ox-LDL), and bound to both the aggregated and non-aggregated forms. In contrast, a peptide (AngIII) formed by deletion of N-terminal Asp of AngII induced the aggregation of Ox-LDL but not LDL. From tyrosine fluorescence measurements, we noted that AngII interacted with two major lipid components in LDL and Ox-LDL, phosphatidylcholine (PC) and oxidized PC, while AngIII interacted with oxidized PC, but not with PC and lysophosphatidylcholine. Moreover, results from thiobarbituric acid-reactive substances assay proved that AngII did not induce oxidation of LDL. These results suggest that AngII can be involved in the pathogenesis of atherosclerosis by binding to LDL and Ox-LDL-especially to the major lipid components, PC and oxidized PC-followed by inducing the aggregation of LDL and Ox-LDL and that the N-terminal Asp of AngII is important for the binding and aggregation specificity of LDL and Ox-LDL.
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Affiliation(s)
- Akira Sato
- Faculty of Pharmacy, Iwaki Meisei University, 5-5-1, Chuodai-Iino, Iwaki, Fukushima, 970-8551, Japan.
| | - Chiemi Ueda
- Faculty of Pharmacy, Iwaki Meisei University, 5-5-1, Chuodai-Iino, Iwaki, Fukushima, 970-8551, Japan
| | - Ryu Kimura
- Faculty of Pharmacy, Iwaki Meisei University, 5-5-1, Chuodai-Iino, Iwaki, Fukushima, 970-8551, Japan
| | - Chisato Kobayashi
- Faculty of Pharmacy, Iwaki Meisei University, 5-5-1, Chuodai-Iino, Iwaki, Fukushima, 970-8551, Japan
| | - Yoji Yamazaki
- Faculty of Pharmacy, Iwaki Meisei University, 5-5-1, Chuodai-Iino, Iwaki, Fukushima, 970-8551, Japan
| | - Keiichi Ebina
- Faculty of Pharmacy, Iwaki Meisei University, 5-5-1, Chuodai-Iino, Iwaki, Fukushima, 970-8551, Japan
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4
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Tsai YY, Rainey WE, Bollag WB. Very low-density lipoprotein (VLDL)-induced signals mediating aldosterone production. J Endocrinol 2017; 232:R115-R129. [PMID: 27913572 PMCID: PMC8310676 DOI: 10.1530/joe-16-0237] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 01/14/2023]
Abstract
Aldosterone, secreted by the adrenal zona glomerulosa, enhances sodium retention, thus increasing blood volume and pressure. Excessive production of aldosterone results in high blood pressure and contributes to cardiovascular and renal disease, stroke and visual loss. Hypertension is also associated with obesity, which is correlated with other serious health risks as well. Although weight gain is associated with increased blood pressure, the mechanism by which excess fat deposits increase blood pressure remains unclear. Several studies have suggested that aldosterone levels are elevated with obesity and may represent a link between obesity and hypertension. In addition to hypertension, obese patients typically have dyslipidemia, including elevated serum levels of very low-density lipoprotein (VLDL). VLDL, which functions to transport triglycerides from the liver to peripheral tissues, has been demonstrated to stimulate aldosterone production. Recent studies suggest that the signaling pathways activated by VLDL are similar to those utilized by AngII. Thus, VLDL increases cytosolic calcium levels and stimulates phospholipase D (PLD) activity to result in the induction of steroidogenic acute regulatory (StAR) protein and aldosterone synthase (CYP11B2) expression. These effects seem to be mediated by the ability of VLDL to increase the phosphorylation (activation) of their regulatory transcription factors, such as the cAMP response element-binding (CREB) protein family of transcription factors. Thus, research into the pathways by which VLDL stimulates aldosterone production may identify novel targets for the development of therapies for the treatment of hypertension, particularly those associated with obesity, and other aldosterone-modulated pathologies.
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Affiliation(s)
- Ying-Ying Tsai
- Department of PhysiologyMedical College of Georgia at Augusta University (formerly Georgia Regents University), Augusta, Georgia, USA
| | - William E Rainey
- Departments of Molecular & Integrative Physiology and Internal MedicineUniversity of Michigan, Ann Arbor, Michigan, USA
| | - Wendy B Bollag
- Department of PhysiologyMedical College of Georgia at Augusta University (formerly Georgia Regents University), Augusta, Georgia, USA
- Charlie Norwood VA Medical CenterOne Freedom Way, Augusta, Georgia, USA
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Zhang Y, Ma KL, Ruan XZ, Liu BC. Dysregulation of the Low-Density Lipoprotein Receptor Pathway Is Involved in Lipid Disorder-Mediated Organ Injury. Int J Biol Sci 2016; 12:569-79. [PMID: 27019638 PMCID: PMC4807419 DOI: 10.7150/ijbs.14027] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/26/2016] [Indexed: 12/12/2022] Open
Abstract
The low-density lipoprotein receptor (LDLR) pathway is a negative feedback system that plays important roles in the regulation of plasma and intracellular cholesterol homeostasis. To maintain a cholesterol homeostasis, LDLR expression is tightly regulated by sterol regulatory element-binding protein-2 (SREBP-2) and SREBP cleavage-activating protein (SCAP) in transcriptional level and by proprotein convertase subtilisin/kexin type 9 (PCSK9) in posttranscriptional level. The dysregulation of LDLR expression results in abnormal lipid accumulation in cells and tissues, such as vascular smooth muscle cells, hepatic cells, renal mesangial cells, renal tubular cells and podocytes. It has been demonstrated that inflammation, renin-angiotensin system (RAS) activation, and hyperglycemia induce the disruption of LDLR pathway, which might contribute to lipid disorder-mediated organ injury (atherosclerosis, non-alcoholic fatty liver disease, kidney fibrosis, etc). The mammalian target of rapamycin (mTOR) pathway is a critical mediator in the disruption of LDLR pathway caused by pathogenic factors. The mTOR complex1 activation upregulates LDLR expression at the transcriptional and posttranscriptional levels, consequently resulting in lipid deposition. This paper mainly reviews the mechanisms for the dysregulation of LDLR pathway and its roles in lipid disorder-mediated organ injury under various pathogenic conditions. Understanding these mechanisms leading to the abnormality of LDLR expression contributes to find potential new drug targets in lipid disorder-mediated diseases.
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