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Glantschnig T, Koppelstätter C, Zweiker D, Kolesnik E, Niederl E, Kraler E, Stoff I, Zweiker R, Weber T, Horn S, Weiss T, Wang W, Beaney T, Poulter NR, Perl S. May Measurement Month 2018-2019: an analysis of blood pressure screening results from Austria . Eur Heart J Suppl 2022; 24:F6-F8. [PMID: 36225278 PMCID: PMC9547501 DOI: 10.1093/eurheartjsupp/suac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Arterial hypertension is a global burden leading to over 10.8 million deaths per year worldwide. May Measurement Month (MMM) is a global project initiated by the International Society of Hypertension to raise the awareness of high blood pressure (BP) in the population. Following the MMM protocol 2508 participants ≥18 years had their BP measured in Austria in MMM18 and MMM19. Of those screened, 54.6% were found to be hypertensive, defined as a BP ≥140/90 mmHg and/or being on treatment for hypertension. Among those individuals with hypertension, 56.1% were on medication but only 42.0% of those treated had controlled BP (<140/90 mmHg). Lower BPs were found in those with previous myocardial infarction (MI), probably explained by a medical monitoring system of patients with MI in Austria. Those with hypertension were referred for further medical investigations and were provided lifestyle advice. Among a high number of individuals receiving antihypertensive treatment, BP is still not controlled. Further screening and monitoring of therapeutic effects is urgently required.
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Affiliation(s)
- Theresa Glantschnig
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - Christian Koppelstätter
- University Hospital Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - David Zweiker
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria,Wilhelminen Hospital, Montleartstraße 37, 1160 Vienna, Austria
| | - Ewald Kolesnik
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - Ella Niederl
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - Elisabeth Kraler
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - Ingrid Stoff
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - Robert Zweiker
- Department of Cardiology, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,Austrian Society of Hypertension, 4600 Wels, Austria
| | - Thomas Weber
- Austrian Society of Hypertension, 4600 Wels, Austria,Hospital Wels-Grieskirchen, Grieskirncherstraße 42, 4600 Wels, Austria
| | - Sabine Horn
- Austrian Society of Hypertension, 4600 Wels, Austria,Hospital Villach, Nicolaigasse 43, 9500 Villach, Austria
| | - Thomas Weiss
- Sigmund Freud University, Freudplatz 1, 1020 Vienna, Austria
| | - Wei Wang
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK,Department of Primary Care and Public Health, Imperial College London, St Dunstan’s Road, London W6 8RP, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Sabine Perl
- Corresponding author. Tel: 0043 316 385 12544, Fax: 0043 316 385 13733,
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Perl S, Zweiker D, Niederl E, Kolesnik E, Zweiker G, Kraler E, Stoff I, Haberfeld H, Dichtl W, Koppelstätter C, Lhotta K, Ederer H, Putz-Bankutti C, Beaney T, Xia X, Poulter NR, Weber T. May Measurement Month 2017: an analysis of blood pressure screening results in Austria-Europe. Eur Heart J Suppl 2019; 21:D17-D20. [PMID: 31043867 PMCID: PMC6479427 DOI: 10.1093/eurheartj/suz053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. Blood pressure measurement, the definition of hypertension (HTN), and statistical analysis followed the standard MMM protocol. In total, 2711 individuals (58.6% female) were screened during MMM17 in 56 centres. After multiple imputation, 1704 (62.9%) had HTN (≥140/90 mmHg). Of individuals not receiving antihypertensive medication, 764 (43.2%) were hypertensive. Of individuals receiving antihypertensive medication, 597 (63.5%) had uncontrolled BP. MMM17 was one of the largest BP screening campaigns undertaken in Austria. A large number of undiagnosed hypertensives was found and connected to a therapeutic strategy. An alarming number of uncontrolled but treated hypertensives should attract the attention of doctors and health care system in Austria.
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Affiliation(s)
- Sabine Perl
- Division of Cardiology, Medical University Graz, Auenbruggerplatz 15, Graz, Austria
- Austrian Society of Hypertension, Wels, Austria
| | - David Zweiker
- Division of Cardiology, Medical University Graz, Auenbruggerplatz 15, Graz, Austria
- Austrian Society of Hypertension, Wels, Austria
| | - Ella Niederl
- Division of Cardiology, Medical University Graz, Auenbruggerplatz 15, Graz, Austria
- Austrian Society of Hypertension, Wels, Austria
| | - Ewald Kolesnik
- Division of Cardiology, Medical University Graz, Auenbruggerplatz 15, Graz, Austria
- Austrian Society of Hypertension, Wels, Austria
| | | | - Elisabeth Kraler
- Division of Cardiology, Medical University Graz, Auenbruggerplatz 15, Graz, Austria
- Austrian Society of Hypertension, Wels, Austria
| | - Ingrid Stoff
- Division of Cardiology, Medical University Graz, Auenbruggerplatz 15, Graz, Austria
- Austrian Society of Hypertension, Wels, Austria
| | - Heinz Haberfeld
- Österreichische Apothekerkammer, Spitalgasse 31, Wien, Austria
| | - Wolfgang Dichtl
- University Hospital Innsbruck, Anichstraße 35, Innsbruck, Austria
| | | | - Karl Lhotta
- Hospital Feldkirch, Carinagasse 47, Feldkirch, Austria
| | | | | | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, UK
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Leierer J, Rudnicki M, Perco P, Koppelstätter C, Braniff SJ, Mühlberger I, Eder S, Schwarzer C, Schneeberger S, Wagner S, Königsrainer A, Georg BA, Mayer G. SP773TRANSCRIPTOME ANALYSES OF ZERO KIDNEY GRAFT BIOPSIES REVEAL A ROLE OF METALLOTHIONEINS IN RENAL AGEING. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv201.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Weber T, Zweiker R, Watschinger B, Grüner P, Koppelstätter C, Brandt MC, Horina J, Brussee H, Hohenstein K, Lambert T, Auer J, Hoppe UC. Clinical application of interventional renal sympathetic denervation: recommendations of the Austrian Society of Hypertension 2012. Wien Klin Wochenschr 2012. [DOI: 10.1007/s00508-012-0257-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Petersen J, Plaikner M, Nasseri P, Rehder P, Koppelstätter C, Pauli GF, Glodny B. Influence of renal artery variants, number, location, and degree of renal artery stenoses on the atherosclerotic burden of the aorta. J Investig Med 2012; 60:1033-40. [PMID: 22847343 DOI: 10.2310/jim.0b013e3182650a29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the assumed influence of the number of renal arteries, the distribution and extent of renal artery stenosis (RAS), and the kidney length on calcified aortic atherosclerotic plaque burden. METHODS The computed tomographic angiographies of 1381 patients were analyzed retrospectively using a volumetric aortic calcium scoring method. The Spearman method was used to calculate the correlation between kidney length, number and diameter of renal arteries, as well as number, degree, and location of RASs on main or additional renal arteries with the extent of aortic atherosclerosis. Logistic regression analyses were conducted with the target variable "calcification present or absent." RESULTS Patients with multiple renal arteries (38.3%) had lower plaque volumes than patients without such variants (0.55 ± 0.97 vs 0.64 ± 1.06 mL; P < 0.05). Renal artery stenoses affected all renal vessels with equal frequency. The aortic calcium score correlated with the number of RASs (P < 0.0001) and the maximum degree of RAS up to a threshold of 60%. Location of an RAS in the various renal arteries was irrelevant. In regression analyses, the presence of RAS (Wald = 5.523), the degree of RAS (Wald = 6.251), and age (Wald = 223.1) were positive predictors of the aortic calcium score, whereas kidney length (Wald = 9.564) proved to be a negative predictor. CONCLUSION The aortic calcium score correlates with both the number of RASs and the maximum degree of RAS up to a threshold of 60% but correlates inversely with the number of renal arteries. Renal artery stenosis affects all renal vessels with equal frequency, and this finding should be considered in screening procedures.
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Affiliation(s)
- Johannes Petersen
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
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Glodny B, Nasseri P, Plaikner M, Unterholzner V, Rehder P, Koppelstätter C, Petersen J. Prediction of the presence of renal artery stenosis by calcium scoring of the abdominal aorta. Eur J Radiol 2012; 81:1393-9. [DOI: 10.1016/j.ejrad.2011.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/24/2011] [Accepted: 03/01/2011] [Indexed: 10/18/2022]
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Glodny B, Nasseri P, Rehder P, Unterholzner V, Plaikner M, Koppelstätter C, Petersen J. Reduced glomerular filtration rate due to loss of nephron mass may be an independent risk factor for atherosclerosis. Nephrol Dial Transplant 2010; 26:1882-7. [PMID: 21068141 DOI: 10.1093/ndt/gfq678] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Whether living with reduced nephron mass (RNM) poses a risk to humans is the subject of ongoing controversy. The aim of this study was to discover whether or not RNMs are associated with greater atherosclerotic plaque burdens. METHODS Using the post-operative abdominal CT scans of 739 nephrectomized patients [NP; 315 women and 424 men; mean age 64.5 ± 15.0 years; observation period 4.9 ± 5.7 years (3675.9 patient-years)] and of an age- and a gender-matched control group, a retrospective observational and case-control study was conducted. The V600 calcium scoring method was used to determine the aortic calcium volume score (ACS) and thus the APB. RESULTS The ACS was 0.47 ± 0.77 mm(3) in the NPs compared with 0.41 ± 0.69 mm(3) in the control group (P <0.0001). The ACS and the glomerular filtration rate (GFR using the CKD-EPI formula) after nephrectomy correlated inversely (P = - 0.3652; P <0.0001), and the ACS and the time since nephrectomy correlated positively (P = 0.2919; P <0.0001). In linear regression models, age, time interval and GFR after nephrectomy proved to be independent factors of influence on ACS (P <0.05 each). Including the control group, age, GFR after nephrectomy and nephrectomy were independent factors of influence on the ACS. The factor GFR after nephrectomy explains ~ 10.7% in NPs, and 28% of the variance of the ACS in all patients. CONCLUSIONS The factors 'low GFR' and RNM are risk factors for greater atherosclerotic plaque burden. Patients with RNM should undergo regular control examinations to monitor arterial blood pressure and treat hypertension if it occurs.
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Affiliation(s)
- Bernhard Glodny
- Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
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Rudnicki M, Eder S, Perco P, Enrich J, Scheiber K, Koppelstätter C, Schratzberger G, Mayer B, Oberbauer R, Meyer TW, Mayer G. Gene expression profiles of human proximal tubular epithelial cells in proteinuric nephropathies. Kidney Int 2006; 71:325-35. [PMID: 17183245 DOI: 10.1038/sj.ki.5002043] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In kidney disease renal proximal tubular epithelial cells (RPTEC) actively contribute to the progression of tubulointerstitial fibrosis by mediating both an inflammatory response and via epithelial-to-mesenchymal transition. Using laser capture microdissection we specifically isolated RPTEC from cryosections of the healthy parts of kidneys removed owing to renal cell carcinoma and from kidney biopsies from patients with proteinuric nephropathies. RNA was extracted and hybridized to complementary DNA microarrays after linear RNA amplification. Statistical analysis identified 168 unique genes with known gene ontology association, which separated patients from controls. Besides distinct alterations in signal-transduction pathways (e.g. Wnt signalling), functional annotation revealed a significant upregulation of genes involved in cell proliferation and cell cycle control (like insulin-like growth factor 1 or cell division cycle 34), cell differentiation (e.g. bone morphogenetic protein 7), immune response, intracellular transport and metabolism in RPTEC from patients. On the contrary we found differential expression of a number of genes responsible for cell adhesion (like BH-protocadherin) with a marked downregulation of most of these transcripts. In summary, our results obtained from RPTEC revealed a differential regulation of genes, which are likely to be involved in either pro-fibrotic or tubulo-protective mechanisms in proteinuric patients at an early stage of kidney disease.
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Affiliation(s)
- M Rudnicki
- Division of Nephrology, Medical University Innsbruck, Innsbruck, Austria.
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Wolf D, Rumpold H, Koppelstätter C, Gastl GA, Steurer M, Mayer G, Gunsilius E, Tilg H, Wolf AM. Telomere length of in vivo expanded CD4(+)CD25 (+) regulatory T-cells is preserved in cancer patients. Cancer Immunol Immunother 2006; 55:1198-208. [PMID: 16362412 PMCID: PMC11029849 DOI: 10.1007/s00262-005-0107-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2005] [Accepted: 11/12/2005] [Indexed: 12/26/2022]
Abstract
PURPOSE CD4(+)CD25(+) regulatory T-cells (Treg) are increased in the peripheral blood of cancer patients. It remains unclear whether this is due to redistribution or active proliferation. The latter would require the upregulation of telomerase activity, whose regulation also remains unknown for Treg. EXPERIMENTAL DESIGN Treg and CD4(+)CD25(-) T-cells were isolated from peripheral blood of cancer patients (n=23) and healthy age-matched controls (n=17) and analyzed for their content of T-cell receptor excision circles (TREC) and for telomere length using flow-FISH, real-time PCR and Southern blotting. The in vitro regulation of telomerase of Treg was studied using PCR-ELISA in bulk cultures as well as in isolated proliferating and non-proliferating Treg. RESULTS Treg isolated from peripheral blood of cancer patients exhibit significantly decreased levels of TREC when compared to Treg from healthy controls. Despite their in vivo proliferation, telomere length is not further shortened in Treg from cancer patients. Accordingly, telomerase activity of Treg was readily inducible in vitro. Notably, sorting of in vitro proliferating Treg revealed a significant telomere shortening in Treg with high-proliferative capacity. The latter are characterized by shortened telomeres despite high telomerase activity. CONCLUSIONS Increased frequencies of Treg in peripheral blood of cancer patients are due to active proliferation rather than due to redistribution from other compartments (i.e., secondary lymphoid organs or bone marrow). In vivo expansion does not further shorten telomere length, probably due to induction of telomerase activity. In contrast, under conditions of strong in vitro stimulation telomerase induction seems to be insufficient to avoid progressive telomere shortening.
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Affiliation(s)
- Dominik Wolf
- Department of Hematology and Oncology, Innsbruck Medical University, Anichstr. 35, 6020 Innsbruck, Austria.
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