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Derendinger FC, Vischer AS, Krisai P, Socrates T, Schumacher C, Mayr M, Burkard T. Ability of a 24-h ambulatory cuffless blood pressure monitoring device to track blood pressure changes in clinical practice. J Hypertens 2024; 42:662-671. [PMID: 38288945 PMCID: PMC10906216 DOI: 10.1097/hjh.0000000000003667] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE There is an increasing number of cuffless blood pressure (BP) measurement (BPM) devices. Despite promising results when comparing single measurements, the ability of these devices to track changes in BP levels over 24 h related to an initial calibration BP (CalibBP) is unknown. Our aim was to analyse this ability in a cuffless device using pulse transit time. METHODS We prospectively enrolled 166 participants for simultaneously performed cuffless (Somnotouch-NIBP) and cuff-based (Spacelabs 90217A/IEM Mobil-O-graph) 24 h BPM. As CalibBP for the cuffless device, first cuff-based BP was used. As surrogate for changes in BP levels after the CalibBP, we used the difference between the CalibBP and mean 24 h, awake and asleep BP measured by the two devices. In addition, we analysed the relationship between the difference of the CalibBP and the cuff-based BPM versus the difference between the cuff-based and the cuffless BPM devices. RESULTS Mean(SD) difference between the CalibBP and mean 24hBP by the cuff-based or cuffless BP device were 7.4 (13.2) versus 1.8 (8.3) mmHg for systolic ( P < 0.0001) and 6.6 (6.8) versus 1.6 (5.8) mmHg for diastolic ( P < 0.0001). A near linear relationship was seen among the difference between the CalibBP and the cuff-based BPM values and the difference between the cuff-based and cuffless BPM device. CONCLUSION Our data indicate a lower ability of the cuffless BPM device to track changes of BP levels after CalibBP. In addition, cuffless device accuracy was associated with the changes in BP levels after the initial CalibBP - the larger the BP level change, the larger the difference between the devices. REGISTRATION https://www.clinicaltrials.gov ; Unique identifier: NCT03054688; NCT03975582.
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Affiliation(s)
- Felicia C. Derendinger
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence
- Faculty of Medicine, University Basel, Basel, Switzerland
| | - Annina S. Vischer
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence
- Faculty of Medicine, University Basel, Basel, Switzerland
| | - Philipp Krisai
- Department of Cardiology
- Cardiovascular Research Institute Basel, University Hospital Basel
- Faculty of Medicine, University Basel, Basel, Switzerland
| | - Thenral Socrates
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence
- Faculty of Medicine, University Basel, Basel, Switzerland
| | - Christina Schumacher
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence
| | - Michael Mayr
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence
- Faculty of Medicine, University Basel, Basel, Switzerland
| | - Thilo Burkard
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence
- Department of Cardiology
- Faculty of Medicine, University Basel, Basel, Switzerland
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Brignole M, Rivasi G, Fedorowski A. Mechanism-based therapy of non-cardiac syncope: a practical guide. Europace 2024:euae073. [PMID: 38529800 DOI: 10.1093/europace/euae073] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
The term non-cardiac syncope includes all forms of syncope, in which primary intrinsic cardiac mechanism and non-syncopal transient loss of consciousness can be ruled out. Reflex syncope and orthostatic hypotension are the most frequent etiologies of non-cardiac syncope. As no specific therapy is effective for all types of non-cardiac syncope, identifying the underlying hemodynamic mechanism is the essential prerequisite for an effective personalized therapy and prevention of syncope recurrences. Indeed, choice of appropriate therapy and its efficacy are largely determined by the syncope mechanism rather than its etiology and clinical presentation. The two main hemodynamic phenomena leading to non-cardiac syncope include either profound hypotension or extrinsic asystole/pronounced bradycardia, corresponding to two different hemodynamic syncope phenotypes, the hypotensive and bradycardic phenotype. The choice of therapy - aimed at counteracting hypotension or bradycardia - depends on the given phenotype. Discontinuation of blood pressure lowering drugs, elastic garments, and blood pressure elevating agents such as fludrocortisone and midodrine are the most effective therapies in patients with hypotensive phenotype. Cardiac pacing, cardioneuroablation, and drugs preventing bradycardia such as theophylline are the most effective therapies in patients with bradycardic phenotype of extrinsic cause.
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Affiliation(s)
- Michele Brignole
- IRCCS Istituto Auxologico Italiano, Faint and Fall Research Centre, Department of Cardiology, S. Luca Hospital, Piazzale Brescia 20, 20149 Milano, Italy
| | - Giulia Rivasi
- Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Artur Fedorowski
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
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Palomo-Piñón S, Antonio-Villa NE, García-Cortés LR, Moreno-Noguez M, Alcocer L, Álvarez-López H, Cardona-Muñoz EG, Chávez-Mendoza A, Díaz-Díaz E, Enciso-Muñoz JM, Galván-Oseguera H, Rosas-Peralta M. Patients Living with Arterial Hypertension in Mexico: First Insights of The Mexican Registry of Arterial Hypertension (RIHTA Study). Am J Hypertens 2024:hpae024. [PMID: 38466237 DOI: 10.1093/ajh/hpae024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Arterial hypertension is a significant cause of morbidity and mortality in Mexico. However, there is limited data available to understand blood pressure management and cardiometabolic profiles. AIMS To assess the prevalence of controlled and uncontrolled blood pressure, as well as the prevalence of cardiometabolic risk factors among patients from the Mexican Registry of Arterial Hypertension (RIHTA). METHODS We conducted a cross-sectional analysis of participants living with arterial hypertension registered on RIHTA between December 2021 and April 2023. We used both the 2017 ACC/AHA and 2018 ESC/ESH thresholds to define controlled and uncontrolled arterial hypertension. We considered eleven cardiometabolic risk factors, which include overweight, obesity, central obesity, insulin resistance, diabetes, hypercholesterolemia, hypertriglyceridemia, low-HDL-C, high-LDL-C, low-eGFR, and high CVD risk. RESULTS In a sample of 5,590 participants (female: 61%, n=3,393; median age: 64 [IQR: 56-72] years), the prevalence of uncontrolled hypertension varied significantly, depending on the definition (2017 ACC/AHA: 59.9%, 95% CI: 58.6-61.2 and 2018 ESC/ESH: 20.1%, 95% CI: 19.0-21.2). In the sample, 40.43% exhibited at least 5-6 risk factors, and 32.4% had 3-4 risk factors, chiefly abdominal obesity (83.4%, 95% CI: 82.4-84.4), high-LDL-C (59.6%, 95% CI: 58.3-60.9), high-CVD risk (57.9%, 95% CI: 56.6-59.2), high triglycerides (56.2%, 95% CI: 54.9-57.5), and low-HDL-C (42.2%, 95% CI: 40.9-43.5). CONCLUSION There is a high prevalence of uncontrolled hypertension interlinked with a high burden of cardiometabolic comorbidities in Mexican adults living with arterial hypertension, underscoring the urgent need for targeted interventions and better healthcare policies to reduce the burden of the disease in our country.
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Affiliation(s)
- Silvia Palomo-Piñón
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Grupo Colaborativo en Hipertensión Arterial (GCHTA), Ciudad de México, México
| | | | - Luis Rey García-Cortés
- Coordinación Auxiliar Médica de Investigacion en Salud, Instituto Mexicano del Seguro Social, Estado de México, Oriente, México
| | - Moises Moreno-Noguez
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Coordinación Clinica de Educación e Investigación en Salud, Unidad de Médicina Familiar 55 Zumpango, Estado de México, México
| | - Luis Alcocer
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Hospital Ángeles del Pedregal, Ciudad de México, México
| | - Humberto Álvarez-López
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Hospital Puerta de Hierro Andares, Jalisco, México
| | - Ernesto G Cardona-Muñoz
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Universidad de Guadalajara, (CUCS), Jalisco, México
| | - Adolfo Chávez-Mendoza
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- UMAE Hospital de Cardiologia Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Enrique Díaz-Díaz
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- UMAE Hospital de Cardiologia Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - José Manuel Enciso-Muñoz
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Hospital General Zacatecas, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Zacatecas, Zacatecas
- Asociación Nacional de Cardiólogos de México, Ciudad de México, México
| | - Héctor Galván-Oseguera
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- UMAE Hospital de Cardiologia Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Martin Rosas-Peralta
- Grupo de Expertos en Hipertensión Arterial México (GREHTA), Ciudad de México, México
- Titular Academia Nacional de Medicina, Ciudad de México, México
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Schreiberova Z, Rehak J, Babkova B, Sin M, Rybarikova M, Paskova B, Sinova I, Hubnerova P, Maluskova M, Maresova K, Karhanova M. Hypertension, hyperlipidaemia and thrombophilia as the most common risk factors for retinal vein occlusion in patients under 50 years. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:44-49. [PMID: 36036564 DOI: 10.5507/bp.2022.036] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. METHODS We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. RESULTS The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. CONCLUSION The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.
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Affiliation(s)
- Zuzana Schreiberova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Jiri Rehak
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Barbora Babkova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Martin Sin
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
- Department of Ophthalmology, 1st Faculty of Medicine, Charles University and Military University Hospital Prague, Czech Republic
| | - Martina Rybarikova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Barbora Paskova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Irena Sinova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Petra Hubnerova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Miroslava Maluskova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Klara Maresova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Marta Karhanova
- Department of Ophthalmology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Hazukova R, Rezacova M, Pleskot M, Zadak Z, Cermakova E, Taborsky M. DNA damage and arterial hypertension. A systematic review and meta-analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:15-24. [PMID: 37916467 DOI: 10.5507/bp.2023.044] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/20/2023] [Indexed: 11/03/2023] Open
Abstract
Oxidative DNA damage markers (8OHdG, comet assay, gammaH2AX) are becoming widely used in clinical cardiology research. To conduct this review of DNA damage in relation to hypertension in humans, we used databases (e.g. PubMed, Web of Science) to search for English-language publications up to June 30, 2022 and the terms: DNA damage, comet assay, gammaH2AX, 8OHdG, strand breaks, and arterial hypertension. Exclusion criteria were: children, absence of relevant controls, extra-arterial hypertensive issues, animal, cell lines. From a total of 79526, 15 human studies were selected. A total of 902 hypertensive patients (pts): (comet: N=418 pts; 8OHdG: N=484 pts) and 587 controls (comet: N=203; 8OHdG: N=384) were included. DNA damage was significantly higher in hypertensive pts than healthy controls (comet 26.6±11.0 vs 11.7±4.07 arbitrary units /A.U./; P<0.05 and="" 8ohdg="" 13="" 1="" 4="" 12="" vs="" 6="" 97="" 2="" 67="" ng="" mg="" creatinine="" i=""> P<0.05) confirmed with meta-analysis for both. Greater DNA damage was observed in more adverse cases (concentric cardiac hypertrophy 43.4±15.4 vs 15.6±5.5; sustained/untreated hypertension 31.4±12.1 vs 14.2±5/35.0±5.0 vs 25.0 ±5.0; non-dippers 39.2±15.5 vs 29.4±11.1 A.U.; elderly 14.9±4.5 vs 9.3±4.1 ng/mg creatinine; without carvedilol 9.1±4.2 vs 5.7±3.9; with coronary heart disease 0.5±0.1 vs 0.2±0.1 ng/mL) (P<0.05) confirmed with meta-analysis. DNA damage correlated strongly positively with serum glycosylated haemoglobin (r=0.670; P<0.05) and negatively with total antioxidant status (r=-0.670 to -0.933; P<0.05). This is the first systematic review with meta-analysis showing that oxidative DNA damage was increased in humans with arterial hypertension compared to controls.
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Affiliation(s)
- Radka Hazukova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
- Department of Internal Medicine, Pardubice Regional Hospital, a.s., Pardubice, Czech Republic
- Department of Cardiology and Internal Medicine (Profi-Kardio, s.r.o.), Horice v Podkrkonosi, Czech Republic
| | - Martina Rezacova
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Miloslav Pleskot
- Department of Cardiology and Internal Medicine (Profi-Kardio, s.r.o.), Horice v Podkrkonosi, Czech Republic
| | - Zdenek Zadak
- Departments of Research and Development, University Hospital, Hradec Kralove, Czech Republic
| | - Eva Cermakova
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Hyseni V, Elezi S, Gjikolli B, Bakalli A. Predictors of coronary artery calcium burden in asymptomatic patients with newly diagnosed type 2 diabetes mellitus. Diab Vasc Dis Res 2024; 21:14791641241242336. [PMID: 38523063 PMCID: PMC10962046 DOI: 10.1177/14791641241242336] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE Long-standing diabetes mellitus is often associated with cardiovascular complications. We aimed to evaluate the presence, extent and composition of subclinical atherosclerotic plaques in coronary arteries by Computed Tomography in patients with newly diagnosed type 2 diabetes mellitus (NDT2DM), and to identify the predictors. METHODS In this study 101 consecutive patients with NDT2DM were included. Patients were categorized into five groups based on their Coronary Artery Calcium Score (CACS) ranging from 0, 0-10, 11-100, 101-400 to >400. All parameters were compared across these groups. RESULTS The average patient age was 54.4 ± 11.6 years and 48 (47.5%) were females. Eight (7.9%) patients had CACS 0, 6.9% CACS 1-10, 42.6% CACS 11-100, 22.8% CACS 101-400 and 19.8% had CACS >400. Multiple regression analysis for the general data identified weight (p = .04) and systolic blood pressure (p = .033) as independent predictors for CACS. CONCLUSIONS Asymptomatic patients with NDT2DM in more than 90% of cases may present with calcified atherosclerotic plaques and this may be predicted by: patient weight and the level of systolic arterial pressure. Our study emphasizes the need for comprehensive care and early prevention of cardiovascular complications in individuals with NDT2DM.
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Affiliation(s)
- Violeta Hyseni
- Clinic of Cardiology, University Clinical Center of Kosova. Pristina, Kosovo
| | - Shpend Elezi
- Clinic of Cardiology, University Clinical Center of Kosova. Pristina, Kosovo
- Medical Faculty, University of Prishtina, Prishtina Kosovo
| | - Bujar Gjikolli
- Clinic of Radiology, University Clinical Center of Kosova. Pristina, Kosovo
| | - Aurora Bakalli
- Clinic of Cardiology, University Clinical Center of Kosova. Pristina, Kosovo
- Medical Faculty, University of Prishtina, Prishtina Kosovo
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7
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Rodriguez NM, Loren P, Paez I, Martínez C, Chaparro A, Salazar LA. MicroRNAs: The Missing Link between Hypertension and Periodontitis? Int J Mol Sci 2024; 25:1992. [PMID: 38396672 PMCID: PMC10889313 DOI: 10.3390/ijms25041992] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Cardiovascular diseases are the leading cause of death worldwide, and arterial hypertension is a recognized cardiovascular risk factor that is responsible for high morbidity and mortality. Arterial hypertension is the result of an inflammatory process that results in the remodeling and thickening of the vascular walls, which is associated with an immunological response. Previous studies have attempted to demonstrate the relationship between oral disease, inflammation, and the development of systemic diseases. Currently, the existence of an association between periodontitis and hypertension is a controversial issue because the underlying pathophysiological processes and inflammatory mechanisms common to both diseases are unknown. This is due to the fact that periodontitis is a chronic inflammatory disease that affects the interface of teeth and surrounding tissues. However, the most likely explanation for understanding this association is related to low-grade chronic inflammation. An initial path in the study of the relationship between the mentioned pathologies is the possibility of an epigenetic influence, mediated by noncoding RNAs as microRNAs. Thus, in the present review we describe the role of microRNAs related to arterial hypertension and/or periodontitis. In addition, we identified 13 common microRNAs between periodontitis and hypertension. According to the predictions of the DIANA-mirPath program, they can regulate genes involved in 52 signaling pathways.
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Affiliation(s)
- Nelia M Rodriguez
- Doctoral Program in Sciences, Major in Applied Cellular and Molecular Biology, Universidad de La Frontera, Temuco 4811230, Chile
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Pía Loren
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Isis Paez
- Doctoral Program in Sciences, Major in Applied Cellular and Molecular Biology, Universidad de La Frontera, Temuco 4811230, Chile
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
| | - Constanza Martínez
- Department of Oral Pathology and Conservative Dentistry, Periodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago 7620001, Chile
| | - Alejandra Chaparro
- Department of Oral Pathology and Conservative Dentistry, Periodontics, Faculty of Dentistry, Universidad de Los Andes, Santiago 7620001, Chile
- Center for Biomedical Research and Innovation (CIIB), Universidad de Los Andes, Santiago 7620001, Chile
| | - Luis A Salazar
- Center for Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Universidad de La Frontera, Temuco 4811230, Chile
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Caminiti R, Carresi C, Mollace R, Macrì R, Scarano F, Oppedisano F, Maiuolo J, Serra M, Ruga S, Nucera S, Tavernese A, Gliozzi M, Musolino V, Palma E, Muscoli C, Rubattu S, Volterrani M, Federici M, Volpe M, Mollace V. The potential effect of natural antioxidants on endothelial dysfunction associated with arterial hypertension. Front Cardiovasc Med 2024; 11:1345218. [PMID: 38370153 PMCID: PMC10869541 DOI: 10.3389/fcvm.2024.1345218] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Arterial hypertension represents a leading cause of cardiovascular morbidity and mortality worldwide, and the identification of effective solutions for treating the early stages of elevated blood pressure (BP) is still a relevant issue for cardiovascular risk prevention. The pathophysiological basis for the occurrence of elevated BP and the onset of arterial hypertension have been widely studied in recent years. In addition, consistent progress in the development of novel, powerful, antihypertensive drugs and their appropriate applications in controlling BP have increased our potential for successfully managing disease states characterized by abnormal blood pressure. However, the mechanisms responsible for the disruption of endogenous mechanisms contributing to the maintenance of BP within a normal range are yet to be fully clarified. Recently, evidence has shown that several natural antioxidants containing active ingredients originating from natural plant extracts, used alone or in combination, may represent a valid solution for counteracting the development of arterial hypertension. In particular, there is evidence to show that natural antioxidants may enhance the viability of endothelial cells undergoing oxidative damage, an effect that could play a crucial role in the pathophysiological events accompanying the early stages of arterial hypertension. The present review aims to reassess the role of oxidative stress on endothelial dysfunction in the onset and progression of arterial hypertension and that of natural antioxidants in covering several unmet needs in the treatment of such diseases.
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Affiliation(s)
- Rosamaria Caminiti
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Cristina Carresi
- Department of Health Sciences, Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Rocco Mollace
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
- Department of Systems Medicine, University “Tor Vergata” of Rome, Rome, Italy
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Federica Scarano
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Francesca Oppedisano
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Maria Serra
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Stefano Ruga
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Saverio Nucera
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Annamaria Tavernese
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Micaela Gliozzi
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Vincenzo Musolino
- Laboratory of Pharmaceutical Biology, Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Ernesto Palma
- Department of Health Sciences, Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Carolina Muscoli
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
- IRCCS San Raffaele Roma, Rome, Italy
| | - Speranza Rubattu
- IRCCS Neuromed, Pozzilli, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University, Rome, Italy
| | | | - Massimo Federici
- Department of Systems Medicine, University “Tor Vergata” of Rome, Rome, Italy
| | | | - Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
- Renato Dulbecco Institute, Catanzaro, Italy
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9
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Sidekhmenova AV, Aliev OI, Anishchenko AM, Dunaeva OI, Ulyakhina OA, Plotnikov MB. Influence of a Decrease in Blood Viscosity on Arterial Pressure in Normotensive and Spontaneously Hypertensive Rats. Bull Exp Biol Med 2024; 176:419-422. [PMID: 38488961 DOI: 10.1007/s10517-024-06038-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Indexed: 03/17/2024]
Abstract
We investigated the effect of a decrease in blood viscosity on the mean BP during isovolumic hemodilution and vasodilating activity of the endothelium in normotensive Wistar rats and spontaneously hypertensive rats (SHR). Blood viscosity was reduced by isovolumic hemodilution (replacement of 10% of circulating blood with an equal volume of plasma). Hemodilution caused the same reduction in blood viscosity by 16% in both groups of rats. In Wistar rats, a decrease in blood viscosity did not significantly change in the mean BP; no significant correlations between blood viscosity and mean BP were observed before and after hemodilution. In SHR, a decrease in blood viscosity led to a significant decrease in the mean BP by 18%. Correlations were found between the mean BP and blood viscosity in SHR before (r=0.63; p=0.028) and after (r=0.71; p=0.009) isovolumic hemodilution. In SHR, a decrease in the index of vasodilating activity of the endothelium due to a decrease in the vasodilatory response to intravenous administration of the endothelium-dependent vasodilator acetylcholine was revealed. In SHR, BP passively follows the change, in this case, the decrease in blood viscosity, which attests to impaired BP regulation in response to changes in shear stress on the vascular endothelium caused by the development of endothelial dysfunction in hypertensive animals.
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Affiliation(s)
- A V Sidekhmenova
- E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia.
| | - O I Aliev
- E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - A M Anishchenko
- E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
- Siberian State Medical University, Ministry of Health of the Russian Federation, Tomsk, Russia
| | - O I Dunaeva
- E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - O A Ulyakhina
- E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - M B Plotnikov
- E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
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10
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Santana-Garrido Á, Reyes-Goya C, André H, Vázquez CM, Mate A. Exploring the Potential of Wild Olive (Acebuche) Oil as a Pharm-Food to Prevent Ocular Hypertension and Fibrotic Events in the Retina of Hypertensive Mice. Mol Nutr Food Res 2024; 68:e2200623. [PMID: 38044285 DOI: 10.1002/mnfr.202200623] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 08/25/2023] [Indexed: 12/05/2023]
Abstract
SCOPE Our laboratory has previously described the antioxidant and anti-inflammatory potential of a wild olive (acebuche, ACE) oil against hypertension-associated vascular retinopathies. The current study aims to analyze the antifibrotic effect of ACE oil on the retina of hypertensive mice. METHODS AND RESULTS Mice are rendered hypertensive by administration of NG-nitro-L-arginine-methyl-ester (L-NAME) and simultaneously subjected to dietary supplementation with ACE oil or a reference extra virgin olive oil (EVOO). Intraocular pressure (IOP) is measured by rebound tonometry, and retinal vasculature/layers are analyzed by fundus fluorescein angiography and optical coherence tomography. Different fibrosis-related parameters are analyzed in the retina and choroid of normotensive and hypertensive mice with or without oil supplementation. Besides preventing the alterations found in hypertensive animals, including increased IOP, reduced fluorescein signal, and altered retinal layer thickness, the ACE oil-enriched diet improves collagen metabolism by regulating the expression of major fibrotic process modulators (matrix metalloproteinases, tissue inhibitors of metalloproteinases, connective tissue growth factor, and transforming growth factor beta family). CONCLUSION Regular consumption of EVOO and ACE oil (with better outcomes in the latter) might help reduce abnormally high IOP values in the context of hypertension-related retinal damage, with significant reduction in the surrounding fibrotic process.
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Affiliation(s)
- Álvaro Santana-Garrido
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Claudia Reyes-Goya
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
| | - Helder André
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Carmen M Vázquez
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Alfonso Mate
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, Sevilla, 41012, Spain
- Epidemiología Clínica y Riesgo Cardiovascular, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, 41013, Spain
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11
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Blaize C, Surtouque E, Font J, Dolladille C, Postel-Vinay S, Da Silva A, Alexandre J, Morice PM. Arterial hypertension associated with PARPi: A meta-analysis of 41 placebo randomized controlled trials combined with a World Health Organization's pharmacovigilance study. Fundam Clin Pharmacol 2024. [PMID: 38268495 DOI: 10.1111/fcp.12984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Arterial hypertension has been recently reported from randomized controlled trials (RCTs) assessing poly (ADP-ribose) polymerase inhibitor (PARPi). OBJECTIVE In a context of increasing use of PARPi, it is crucial to properly assess risk and incidence of this adverse event for clinical practice. METHODS We performed a systematic review and meta-analysis in MEDLINE, Cochrane CENTRAL and ClinicalTrials.gov up to January 4, 2023 with an ongoing surveillance up to June 7, 2023. RCTs comparing PARPi to placebo in adult patients with solid tumors were included if hypertension was reported. The primary outcome was the summary risk ratio (RR, with 95% CIs) of any hypertension of PARPi class in placebo RCTs. Secondary outcomes were the summary risk and incidence of hypertension of each individual PARPi. To provide clinical features of PARPi-associated hypertension, we independently queried the WHO's pharmacovigilance database, up to September 1, 2022. RESULTS In total, 41 placebo RCTs (n = 15 264 adult patients) were included. PARPi class was not associated with an increased risk of hypertension compared with placebo. In individual analyses, the risk of hypertension was lower with olaparib than placebo (RR 0.77 [95% CI: 0.68-0.86], P < 0.01; I2 = 19%, χ2 P = 0.26). Niraparib monotherapy increased the risk of any (RR 2.84 [95% CI: 1.76-4.57], P < 0.01; I2 = 66%, χ2 P = 0.01) hypertension with a summary incidence of 19.87% (95% CI: 15.23-25.50). In real-life setting, niraparib-associated hypertension occurs within 20 days and was serious in 66%. Co-prescription of at least one antihypertensive or therapy-induced hypertension was reported in 20.5% or 14.4% of cases, respectively. CONCLUSIONS In a context of extensive assessment of niraparib in combination, these data reinforce the need of a close monitoring of this adverse event to preserve its clinical benefit on patients' survival.
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Affiliation(s)
- Clémence Blaize
- Department of Pharmacology, Caen-Normandy University Hospital, Caen, France
| | - Ellina Surtouque
- Department of Pharmacology, Caen-Normandy University Hospital, Caen, France
| | - Jonaz Font
- Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
- Department of Cardiology, Caen-Normandy University Hospital, Caen, France
| | - Charles Dolladille
- Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
- PICARO Cardio-Oncology Program, Department of Pharmacology, Caen-Normandy University Hospital, Caen, France
| | - Sophie Postel-Vinay
- European Research Council (ERC) StG Team, Inserm Unit U981, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- Drug Development Department (DITEP), Gustave Roussy Cancer Campus, Villejuif, France
- Faculté de Médicine, Université Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Angélique Da Silva
- Department of Pharmacology, Caen-Normandy University Hospital, Caen, France
- Department of medical oncology, Caen-Normandy University Hospital, Caen, France
| | - Joachim Alexandre
- Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
- PICARO Cardio-Oncology Program, Department of Pharmacology, Caen-Normandy University Hospital, Caen, France
| | - Pierre-Marie Morice
- Department of Pharmacology, Caen-Normandy University Hospital, Caen, France
- Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
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12
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Aguirre-García MM, Amedei A, Hernández-Ruiz P, Gómez-García AP, Niccolai E, Moreno-Rodríguez AM, Pinto-Cardoso S, Alviter-Plata A, Escalona-Montaño AR, Ordaz-Robles ER, González-Salazar MDC, Springall Del Villar R, Berrios-Bárcenas EA, Ávila-Vanzzini N. Cytokine and microbiota profiles in obesity-related hypertension patients. Front Cell Infect Microbiol 2024; 13:1325261. [PMID: 38292856 PMCID: PMC10824975 DOI: 10.3389/fcimb.2023.1325261] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Background Systemic arterial hypertension is linked to a heightened risk of cardiovascular diseases on a global scale. In Mexico, nearly half of adults in vulnerable conditions experience hypertension. Imbalance in the oral and intestinal microbiota composition has been observed in patients with hypertension, documented by a decrease of bacteria producing short-chain fatty acids, which play a critical role in blood pressure regulation. Aim To examine the cytokines' profile and assess the characteristics of oral and gut microbiota in obesity-related hypertension in Mexican patients. Methods A cross-sectional, observational, and analytical study was carried out. Twenty-two patients were categorized by their body mass index (BMI) as overweight and obese, and the diagnosis of primary hypertension. DNA from supragingival dental plaque and feces samples was used to carry out 16S rRNA sequencing. Additionally, 13 cytokines were quantified. Results In the oral microbiota, Kluyvera was found to be significantly enriched in obese compared to overweight patients. Instead, the gut microbiota was dominated by Firmicutes. However, the correlation between certain genera and proinflammatory cytokines was noted. Conclusion This exploratory study provides insights into the complex relationship between the oral and gut microbiota and their association with systemic inflammation in obesity-related hypertension.
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Affiliation(s)
- María Magdalena Aguirre-García
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Interdisciplinary Internal Medicine Unit, Careggi University Hospital, Florence, Italy
| | - Paulina Hernández-Ruiz
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - Ana Pamela Gómez-García
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Aura M. Moreno-Rodríguez
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - Sandra Pinto-Cardoso
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, Mexico
| | - Adriana Alviter-Plata
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - Alma R. Escalona-Montaño
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - Erick R. Ordaz-Robles
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
| | - María del C. González-Salazar
- Outpatient Clinic, Cardiovascular Risk Factors Clinic, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, Mexico
| | | | - Enrique A. Berrios-Bárcenas
- Outpatient Clinic, Cardiovascular Risk Factors Clinic, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, Mexico
| | - Nydia Ávila-Vanzzini
- Unidad de Investigación UNAM-INC, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Instituto Nacional de Cardiología "Ignacio Chávez, Ciudad de México, Mexico
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Zavrnik Č, Stojnić N, Lukančič MM, Martens M, Danhieux K, Chham S, Mihevc M, Virtič Potočnik T, Ketiš ZK, van Olmen J, Susič AP. Development of a Qualitative Data Analysis Codebook for Arterial Hypertension and Type-2-Diabetes Integrated Care Evaluation. Int J Integr Care 2024; 24:20. [PMID: 38525482 PMCID: PMC10959140 DOI: 10.5334/ijic.7691] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Non-communicable diseases, such as arterial hypertension (HTN) and type-2 diabetes (T2D), pose a global public health problem. Integrated care with focus on person-centred principles aims to enhance healthcare quality and access. Previous qualitative research has identified facilitators and barriers for scaling-up integrated care, however the lack of standardized terms and measures hinder cross-country comparisons. This paper addresses these gaps by presenting a generic codebook for qualitative research on integrated care implementation for HTN and T2D. Description The codebook serves as a tool for deductive or deductive-inductive qualitative analysis, organizing concepts and themes from qualitative data. It consists of nine first level and 39 second level themes. First level codes cover core issues; and second level codes provide detailed insights into facilitators and barriers. Discussion This codebook is more widely applicable than previously developed tools because it includes a broader scope of stakeholders across micro, meso, and macro levels, and the themes being derived from highly diverse health systems across high- and low-income countries. Conclusion The codebook is a useful tool for implementation research on integrated care for HTN and T2D at global scale. It facilitates cross-country learning, contributing to improved implementation, scale-up and outcomes.
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Affiliation(s)
- Črt Zavrnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
| | - Nataša Stojnić
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
| | - Majda Mori Lukančič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
| | - Monika Martens
- Institute of Tropical Medicine Antwerp, Nationalestraat 155, BE-2000 Antwerp, Belgium
| | - Katrien Danhieux
- University of Antwerp, Department of Family Medicine and Population Health, Prinsstraat 6, BE-2000 Antwerp, Belgium
| | - Savina Chham
- National Institute of Public Health, Cambodia, Boeung Kok 2 quarter, KH-120408 Phnom Penh, Cambodia
| | - Matic Mihevc
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
- Primary Healthcare Centre Trebnje, Goliev trg 3, SI-8210 Trebnje, Slovenia
| | - Tina Virtič Potočnik
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Primary Healthcare Centre Slovenj Gradec, Partizanska pot 16, SI-2380 Slovenj Gradec, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Zalika Klemenc Ketiš
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Taborska ulica 8, SI-2000 Maribor, Slovenia
| | - Josefien van Olmen
- University of Antwerp, Department of Family Medicine and Population Health, Prinsstraat 6, BE-2000 Antwerp, Belgium
| | - Antonija Poplas Susič
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Metelkova ulica 9, SI-1000 Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, SI-1000 Ljubljana, Slovenia
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Osmanov EM, Reshetnikov AV, Lebedev GS, Manyakov RR, Guseynova AG, Omarov MA, Shaderkin IA. [The mobile applications developed for self-control arterial pressure: systematic review and content-analysis]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2024; 32:35-42. [PMID: 38349684 DOI: 10.32687/0869-866x-2024-32-1-35-42] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/02/2023] [Indexed: 02/15/2024]
Abstract
The high prevalence of arterial hypertension and necessity for permanent monitoring of blood pressure requires implementation of new methods of interaction between patient and physician in order to optimize medical care. The purpose of the study was to describe and to evaluate functional possibilities of Russian-speaking mobile applications utilized in collecting blood pressure readings to monitor efficiency of arterial hypertension treatment. The study was carried out in June 2023 in three mobile application stores: Apple Store, Google Play and RuStore. The Russian-speaking applications applied to hypertension self-controlling were considered. For final analysis 45 mobile applications were selected out of 380 applications tested. The most common functions, besides fixing blood pressure levels, were ability of fixing pulse rate (n=41), weight (n=21), sugar level (n=10), blood oxygen saturation (n=8), cholesterol (n=6), rhythm disturbances (n=6) and body temperature (n=5). Additionally, applications made it possible to add tags (n=33), to view statistics (n=41) (including average blood pressure (n=8), pulse pressure (n=9), average daily blood pressure (n=6) and to compare data for different periods of time (n=6), to filter data by tags (n=17), to export statistics (n=32). The 6 applications also supported technology of wireless reception of blood pressure and emergency data. The educational information about blood pressure was enclosed in 17 applications and dietary advice in 12 applications. The content included basic information about blood pressure, treatment, diet, and physical activity. No clinical studies that proved efficiency or inefficiency of analyzed applications were found. None of descriptions comprised both involvement of physicians in development of application and use of clinical recommendations. The results demonstrated large choice of applications used in recording blood pressure with purpose of hypertension self-control. Besides, mobile applications contain various functions and their combinations that can help patient to control blood pressure more effectively. The physicians are to be aware of capabilities of mobile applications developed with purpose of monitoring health of patients.
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Affiliation(s)
- E M Osmanov
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" of Minzdrav of Russia (Sechenov University), 119991, Moscow, Russia,
| | - A V Reshetnikov
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" of Minzdrav of Russia (Sechenov University), 119991, Moscow, Russia
| | - G S Lebedev
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" of Minzdrav of Russia (Sechenov University), 119991, Moscow, Russia
| | - R R Manyakov
- The Federal State Budget Educational Institution of Higher Education "The G. R. Derzhavin Tambov State University", 392000, Tambov, Russia
| | - A G Guseynova
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" of Minzdrav of Russia (Sechenov University), 119991, Moscow, Russia
| | - M A Omarov
- The Branch № 43 of the Federal State Institution "The Principal Bureau on Medical Social Expertise in Moscow", 119990, Moscow, Russia
| | - I A Shaderkin
- The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" of Minzdrav of Russia (Sechenov University), 119991, Moscow, Russia
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Zúñiga Salazar G, Zúñiga D, Balasubramanian S, Mehmood KT, Al-Baldawi S. The Relation Between Arterial Hypertension and Cognitive Impairment: A Literature Review. Cureus 2024; 16:e52782. [PMID: 38389623 PMCID: PMC10882260 DOI: 10.7759/cureus.52782] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
The global increase in dementia cases, driven by improved life expectancy and reduced elderly mortality rates, presents a significant public health challenge. Dementia, characterized by a gradual and irreversible decline in cognitive abilities, affects individuals aged 65 and older, disrupting lives and straining healthcare systems. Hypertension significantly influences dementia development. Research consistently links midlife hypertension to cognitive decline, mild cognitive impairment (MCI), and dementia, but findings in older adults vary. While some studies suggest that late-life hypertension accelerates cognitive decline and dementia risk, others propose a protective effect. The impact of hypertension on cognition varies across age groups, spanning from childhood to late life. High blood pressure during midlife and earlier life stages consistently predicts poorer cognitive outcomes. Executive function, attention, and motor speed are the cognitive domains most affected by hypertension, particularly in subcortical diseases. Memory impairments in hypertension-related dementias are complex, often overlapping with other causes. Understanding the inconsistent findings in older adults regarding hypertension, cognitive decline, and dementia risk requires comprehensive exploration of methodological and biological factors. Addressing hypertension and its management may hold the key to reducing the risk of cognitive decline and dementia, especially in midlife and earlier life stages.
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Affiliation(s)
| | - Diego Zúñiga
- Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
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Delmotte L, Desebbe O, Alexander B, Kouz K, Coeckelenbergh S, Schoettker P, Turgay T, Joosten A. Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study. J Pers Med 2023; 14:15. [PMID: 38276230 PMCID: PMC10817276 DOI: 10.3390/jpm14010015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/06/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction: Mobile health diagnostics have demonstrated effectiveness in detecting and managing chronic diseases. This method comparison study aims to assess the accuracy and precision of the previously evaluated OptiBP™ technology over a four-week study period. This device uses optical signals recorded by placing a patient's fingertip on a smartphone's camera to estimate blood pressure (BP). Methods: In adult participants without cardiac arrhythmias and minimal interarm blood pressure difference (systolic arterial pressure (SAP) < 15 mmHg or diastolic arterial pressure (DAP) < 10 mmHg), three pairs of 30 s BP measurements with the OptiBP™ (test method) were simultaneously compared using three pairs of measurements with the non-invasive oscillometric brachial cuff (reference method) on the opposite arm over a period of four consecutive weeks at a rate of two measurements per week (one in the morning and one in the afternoon). The agreement of BP values between the two technologies was analyzed using Bland-Altman and error grid analyses. The performance of the smartphone application was investigated using the International Organization for Standardization (ISO) definitions, which require the bias ± standard deviation (SD) between two technologies to be lower than 5 ± 8 mmHg. Results: Among the 65 eligible volunteers, 53 participants had adequate OptiBP™ BP values. In 12 patients, no OptiBP™ BP could be measured due to inadequate signals. Only nine participants had known chronic arterial hypertension and 76% of those patients were treated. The mean bias ± SD between both technologies was -1.4 mmHg ± 10.1 mmHg for systolic arterial pressure (SAP), 0.2 mmHg ± 6.5 mmHg for diastolic arterial pressure (DAP) and -0.5 mmHg ± 6.9 mmHg for mean arterial pressure (MAP). Error grid analyses indicated that 100% of the pairs of BP measurements were located in zones A (no risk) and B (low risk). Conclusions: In a cohort of volunteers, we observed an acceptable agreement between BP values obtained with the OptiBPTM and those obtained with the reference method over a four-week period. The OptiBPTM fulfills the ISO standards for MAP and DAP (but not SAP). The error grid analyses showed that 100% measurements were located in risk zones A and B. Despite the need for some technological improvements, this application may become an important tool to measure BP in the future.
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Affiliation(s)
- Lila Delmotte
- Department of Anesthesiology, Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium; (L.D.); (T.T.)
| | - Olivier Desebbe
- Department of Anesthesiology & Perioperative Medicine, Sauvegarde Clinic, Ramsay Santé, 69009 Lyon, France;
| | - Brenton Alexander
- Department of Anesthesiology, University of California San Diego, La Jolla, CA 92103, USA;
| | - Karim Kouz
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Sean Coeckelenbergh
- Department of Anesthesiology, Université Paris-Saclay, Paul Brousse Hospital, Assistance Publique Hôpitaux de Paris (APHP), 94800 Villejuif, France
- Outcomes Research Consortium, Cleveland, OH 44195, USA
| | - Patrick Schoettker
- Biospectal SA, 1003 Lausanne, Switzerland;
- Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Tuna Turgay
- Department of Anesthesiology, Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium; (L.D.); (T.T.)
| | - Alexandre Joosten
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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17
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Ayari M, Riahi S, Abdelaali I, Jomni T, Douggui MH. Iatrogenic orbital hematoma: an exceptional complication of upper gastrointestinal endoscopy. Future Sci OA 2023; 9:FSO903. [PMID: 37753363 PMCID: PMC10518837 DOI: 10.2144/fsoa-2023-0115] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Iatrogenic orbital hematoma is a rare event, most often manifested by a painful exophthalmos that could compromise the patient's visual prognosis. We report the case of a 51-year-old female patient with a history of non-ischemic dilated cardiomyopathy and high blood pressure, who developed a painful exophthalmos following an upper gastrointestinal sedation-free endoscopy. The diagnosis of an intra-orbital hematoma was made by computed tomographic scan and a conservative attitude was adopted after a thorough ophthalmological examination. Upper endoscopy may trigger this condition in the presence of pre-existing predisposing factors such as blood clotting disorders, high blood pressure or vascular malformation. This case highlights an uncommon complication of a commonly performed endoscopy that endoscopists should be aware of to provide safe and optimal examination.
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Affiliation(s)
- Myriam Ayari
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Sameh Riahi
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Imen Abdelaali
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Taieb Jomni
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
| | - Mohamed Hedi Douggui
- Gastroenterology Department, Internal Security Forces Hospital La Marsa, Tunis, 2070, Tunisia
- University of Tunis El Manar, Tunis, 1068, Tunisia
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18
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Di Vita U, Bocchino PP, Usmiani T, De Ferrari GM. Pickering syndrome in a patient with Takayasu's arteritis. Hosp Pract (1995) 2023; 51:303-305. [PMID: 37964534 DOI: 10.1080/21548331.2023.2277677] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Takayasu arteritis (TA) is a chronic granulomatous large vessel arteritis. The renal arteries are affected in up to 60% of patients with TA, with renal artery stenosis (RAS) potentially leading to ischemic nephropathy, severe arterial hypertension, and heart failure. Bilateral RAS may rarely present with recurrent flash pulmonary edema, a life-threatening association which has been termed Pickering syndrome. In this report, we describe a 55-year-old woman with severe refractory arterial hypertension admitted for acute pulmonary edema, initially treated unsuccessfully with medical therapy with vasodilators and diuretics. Given the instrumental findings of bilateral RAS and suggestive signs and symptoms, the diagnosis of TA was made, resulting as the first described case of Pickering syndrome being the clinical presentation of TA. Interventional therapy with renal artery angioplasty procedure was performed with stenting of both right and left renal arteries, leading to the resolution of the clinical scenario and the successful discharge of the patient. At the 1 year follow-up visit the patient was asymptomatic and in good clinical conditions; a significant reduction in antihypertensive therapy was achieved while immunosuppressive therapy was continued. This case highlights that secondary causes of TA should always be sought in patients with refractory hypertension who do not respond to standard treatment; also, TA should be suspected in young patients with bilateral RAS, especially when other typical signs of TA are present; lastly, a thorough investigation is essential in complicated cases, as rare diseases like TA may manifest in unusual ways.
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Affiliation(s)
- Umberto Di Vita
- Division of Cardiology, Department of Medical Sciences, University of Turin, "Città della Salute e della Scienza" hospital, Turin, Italy
| | - Pier Paolo Bocchino
- Division of Cardiology, Department of Medical Sciences, University of Turin, "Città della Salute e della Scienza" hospital, Turin, Italy
| | - Tullio Usmiani
- Division of Cardiology, Department of Medical Sciences, University of Turin, "Città della Salute e della Scienza" hospital, Turin, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Medical Sciences, University of Turin, "Città della Salute e della Scienza" hospital, Turin, Italy
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19
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Scalia G, Silven MP, Costanzo R, Chaurasia B, Furnari M, Iacopino DG, Nicoletti GF, Umana GE. Remote intracerebral hemorrhage following craniotomy for an intracerebral hematoma: A case report. Clin Case Rep 2023; 11:e8271. [PMID: 38033701 PMCID: PMC10682235 DOI: 10.1002/ccr3.8271] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/06/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023] Open
Abstract
Remote intracerebral hemorrhage (RICH) is a rare yet highly consequential complication that can occur after a craniotomy performed for the evacuation of an intracerebral hemorrhage (ICH). In this case report, we present the clinical details of a 74-year-old female patient who underwent a supratentorial craniotomy to address an ICH, and subsequently developed RICH. A 74-year-old woman was admitted to our department with a severe headache, onset of dysarthria, and left-sided brachio-crural hemiparesis. The patient had a history of arterial hypertension and a previous cerebral ischemia incident 2 years prior, potentially due to cerebral amyloid angiopathy. Despite the immediate surgical intervention and intensive care, she succumbed to respiratory distress after developing a contralateral ICH. RICH following craniotomy for an intracerebral hematoma is a rare but potentially devastating complication. Close monitoring, prompt recognition of neurological deterioration, and timely intervention are imperative to optimize patient outcomes. Further research is needed to better understand the underlying mechanisms and risk factors associated with this complication, allowing for improved prevention and management strategies in the future.
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Affiliation(s)
- Gianluca Scalia
- Neurosurgery Unit, Department of Head and Neck SurgeryARNAS GaribaldiCataniaItaly
| | - Manikon Poullay Silven
- Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical ClinicAzienda Ospedaliera Universitaria Policlinico (AOUP) “Paolo Giaccone”PalermoItaly
| | - Roberta Costanzo
- Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical ClinicAzienda Ospedaliera Universitaria Policlinico (AOUP) “Paolo Giaccone”PalermoItaly
| | | | - Massimo Furnari
- Neurosurgery Unit, Department of Head and Neck SurgeryARNAS GaribaldiCataniaItaly
| | - Domenico Gerardo Iacopino
- Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical ClinicAzienda Ospedaliera Universitaria Policlinico (AOUP) “Paolo Giaccone”PalermoItaly
- Neurosurgery ClinicBirgunjNepal
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20
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Zakiev VD, Kotovskaya YV, Tkacheva ON. [Sartans in the treatment of arterial hypertension: focus on telmisartan and azilsartan. A review]. TERAPEVT ARKH 2023; 95:810-817. [PMID: 38158926 DOI: 10.26442/00403660.2023.09.202423] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/04/2023] [Indexed: 01/03/2024]
Abstract
The activity of the renin-angiotensin-aldosterone system is one of the main pathogenetic mechanisms underlying cardiovascular diseases at all stages of the cardiovascular continuum. This article discusses the role of telmisartan and azilsartan as the most powerful sartans in modern cardiology. Azilsartan and especially telmisartan have a significant organoprotection and are superior to other antihypertensive drugs in terms of lowering blood pressure. However, the effect of azilsartan on hard endpoints has not been studied while the efficacy of telmisartan on hard endpoints has been evaluated in plenty clinical trials including 3 large randomized clinical trials with several thousand patients. The article also presents calculations showing the better cost-effectiveness of telmisartan compared to azilsartan.
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Affiliation(s)
- V D Zakiev
- Pirogov Russian National Research Medical University
| | | | - O N Tkacheva
- Pirogov Russian National Research Medical University
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21
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Mercadal L, Boffa JJ, Collet JP. Heart disease in hemodialysis: physiopathology and therapeutic breakthroughs. Nephrol Ther 2023; 19:542-551. [PMID: 37915198 DOI: 10.1684/ndt.2023.47] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Especially exposed to frequent cardiovascular events and its related mortality, some cardiovascular therapies of the hemodialyzed population as well as coronary investigations remain controversial. We have collected data and discussed recent trials and guidelines dedicated to this patient subset.
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Affiliation(s)
- Lucile Mercadal
- Hôpitaux Sorbonne Université, sites Pitié-Salpêtrière, Tenon, AP-HP, service de néphrologie, Paris, France
| | - Jean-Jacques Boffa
- Hôpitaux Sorbonne Université, sites Pitié-Salpêtrière, Tenon, AP-HP, service de néphrologie, Paris, France
- Sorbonne Université, INSERM UMR_S 1155, Paris, France
| | - Jean-Philippe Collet
- Sorbonne Université, ACTION Study Group, INSERM UMRS 1166, Institut de cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
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22
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Jasaityte R, Bajraktarevic R, Blaschke-Waluga D, Seeland U, Regitz-Zagrosek V, Landmesser U, Stangl K, Knebel F, Stangl V, Brand A. Determinants of myocardial work indices in women. Echocardiography 2023; 40:1196-1204. [PMID: 37794766 DOI: 10.1111/echo.15695] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/17/2023] [Accepted: 09/10/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE By incorporating myocardial deformation and afterload, novel echocardiographic myocardial work indices appear to be advantageous compared to load-dependent left ventricular (LV) deformation analyses. As such, these indices may provide a more accurate and, above all, load-independent estimation of LV function in patients with chronically increased afterload. To date however, data on the relation of these indices to clinical and conventional echocardiographic parameters are scarce. PURPOSE Our aim was to evaluate the relationship between myocardial work indices and age, body mass index (BMI), NTproBNP, the clinical history of arterial hypertension and diastolic dysfunction as well as selected conventional echocardiographic parameters in women. METHODS We analyzed echocardiographic data of women included in the Berlin Female Risk Evaluation (BEFRI) trial. Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW) and Global Work Efficiency (GWE) were calculated using commercially available software based on noninvasive pressure-strain loops. The impact of selected clinical and echocardiographic characteristics on myocardial work parameters was investigated by uni- and multivariate regression analyses. RESULTS A total of 224 women were included in the final analysis. 155 of them were normotensive and 69 had a history of arterial hypertension. Diastolic dysfunction was more prevalent in subjects with arterial hypertension. Study participants with arterial hypertension showed higher GWI and GCW whereas GWW and GWE did not significantly differ between groups. GCW and GWW were lower and GWE higher in the presence of normal diastolic function. In multivariate regression analyses, arterial hypertension, LV GLS, and interventricular septal thickness were significantly associated with GWI. GCW showed significant associations with the clinical history of arterial hypertension, LV GLS, age and IVRT. Similarly, LV GLS, IVRT and mitral inflow E wave deceleration time were identified to be significant determinants of GWW and GWE. CONCLUSION Our data confirm that, in a randomly selected sample of the general urban female population, myocardial work parameters are predominantly determined by LV GLS. In addition, the presence of arterial hypertension was identified to be a significant determinant of GWI and GCW, but not for GWW and GWE. Finally, a prolonged LV relaxation time was significantly associated with GWW and GWE, suggesting more wasted myocardial work and lower GWE values with increasing LV relaxation time.
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Affiliation(s)
- Ruta Jasaityte
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
- Jessa Hospital, Department of Cardiology, Hasselt, Belgium
- Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Rija Bajraktarevic
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
| | - Daniela Blaschke-Waluga
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
| | - Ute Seeland
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Vera Regitz-Zagrosek
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Institute of Gender in Medicine, Berlin, Germany
| | - Ulf Landmesser
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - Karl Stangl
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Fabian Knebel
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Department of Cardiology, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Verena Stangl
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Anna Brand
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Campus Benjamin Franklin, Berlin, Germany
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23
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Agafonova IG, Kotelnikov VN, Geltser BI. Estimation of Renal Clearance in Hypertensive Rats According to fMRI Data. Bull Exp Biol Med 2023; 176:14-18. [PMID: 38085393 DOI: 10.1007/s10517-023-05958-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Indexed: 12/19/2023]
Abstract
Renal clearance in Wistar rats with multifactorial cardiovasorenal model of arterial hypertension was assessed by fMRI using (EPI_Diffusion_map) protocol after injection of extracellular contrast agent gadolinium Gd-DTPA. Linear regression analysis was used to assess local concentrations of the contrast agent in the abdominal aorta, kidney compartments, pelvis, and bladder areas. Detection of marker clearance in order to verify the glomerular filtration rate was performed by the RPP (Rutland-Patlak plot) method. In 3 months after hypertension modeling, glomerular filtration rate decreased by 2 times in comparison with the control (31.2±0.44 and 62.3±1.31 μl/min/100 g, respectively; p<0.001). Our findings can indicate the formation of hypertensive nephroangiosclerosis in rats with experimental arterial hypertension. It was found that kidney damage in hypertensive rats is associated with hypofiltration.
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Affiliation(s)
- I G Agafonova
- G. B. Elyakov Pacific Institute of Bioorganic Chemistry, Far East Division of the Russian Academy of Sciences, Vladivostok, Russia.
| | - V N Kotelnikov
- Far Eastern Branch of the State Research Test Institute of Military Medicine, Ministry of Defense of the Russian Federation, Vladivostok, Russia
- Far Eastern Federal University, Vladivostok, Russia
| | - B I Geltser
- Far Eastern Federal University, Vladivostok, Russia
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24
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Celant M, Toro EF, Bertaglia G, Cozzio S, Caleffi V, Valiani A, Blanco PJ, Müller LO. Modeling essential hypertension with a closed-loop mathematical model for the entire human circulation. Int J Numer Method Biomed Eng 2023; 39:e3748. [PMID: 37408358 DOI: 10.1002/cnm.3748] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 07/07/2023]
Abstract
Arterial hypertension, defined as an increase in systemic arterial pressure, is a major risk factor for the development of diseases affecting the cardiovascular system. Every year, 9.4 million deaths worldwide are caused by complications arising from hypertension. Despite well-established approaches to diagnosis and treatment, fewer than half of all hypertensive patients have adequately controlled blood pressure. In this scenario, computational models of hypertension can be a practical approach for better quantifying the role played by different components of the cardiovascular system in the determination of this condition. In the present work we adopt a global closed-loop multi-scale mathematical model for the entire human circulation to reproduce a hypertensive scenario. In particular, we modify the model to reproduce alterations in the cardiovascular system that are cause and/or consequence of the hypertensive state. The adaptation does not only affect large systemic arteries and the heart but also the microcirculation, the pulmonary circulation and the venous system. Model outputs for the hypertensive scenario are validated through assessment of computational results against current knowledge on the impact of hypertension on the cardiovascular system.
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Affiliation(s)
- Morena Celant
- Department of Mathematics, University of Trento, Trento, Italy
| | - Eleuterio F Toro
- Laboratory of Applied Mathematics, DICAM, University of Trento, Trento, Italy
| | - Giulia Bertaglia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Susanna Cozzio
- U.O. di Medicina Interna, Ospedale di Rovereto, Azienda Sanitaria per i Servizi Provinciali di Trento, Trento, Italy
| | - Valerio Caleffi
- Department of Engineering, University of Ferrara, Ferrara, Italy
| | | | - Pablo J Blanco
- National Laboratory for Scientific Computing, Petròpolis, Brazil
| | - Lucas O Müller
- Department of Mathematics, University of Trento, Trento, Italy
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25
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Arias-Chávez DJ, Mailloux-Salinas P, Aparicio JL, Bravo G, Gómez-Viquez NL. Combined fructose and sucrose consumption from an early age aggravates cardiac oxidative damage and causes a dilated cardiomyopathy in SHR rats. J Clin Biochem Nutr 2023; 73:205-213. [PMID: 37970552 PMCID: PMC10636576 DOI: 10.3164/jcbn.23-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/29/2023] [Indexed: 11/17/2023] Open
Abstract
Obesity increases the risk of arterial hypertension in young adults and favors an early-onset cardiomyopathy by generating oxidative stress. In this sense, indiscriminate consumption of sucrose and fructose sweetened beverages from early ages causes obesity, however its consequences on the heart when there is a genetic predisposition to develop hypertension are not clear. We compared the effects of sucrose, fructose, and their combination in weanling male spontaneously hypertensive rats to determine the relationship between genetic hypertension, obesity, and consumption of these sugars on the degree of cardiac hypertrophy, oxidative stress and Ca2+/calmodulin dependent protein kinase II delta oxidation. Histological, biochemical, and Western blot studies were performed 12 weeks after treatment initiation. We found that chronic consumption of sucrose or fructose leads to obesity, exacerbates genetic arterial hypertension-induced metabolic alterations, and increases cardiac oxidative stress, Ca2+/calmodulin dependent protein kinase II delta oxidation and cardiac hypertrophy. Nonetheless, when sucrose and fructose are consumed together, metabolic alterations worsen and are accompanied by dilated cardiomyopathy. These data suggest that sucrose and fructose combined consumption starting from maternal weaning in rats with genetic predisposition to arterial hypertension accelerates the progression of cardiomyopathy resulting in an early dilated cardiomyopathy.
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Affiliation(s)
- David Julian Arias-Chávez
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional, Mexico City, Mexico. Calz. de los Tenorios 235, Col. Granjas Coapa, Ciudad de México14330, México
| | - Patrick Mailloux-Salinas
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional, Mexico City, Mexico. Calz. de los Tenorios 235, Col. Granjas Coapa, Ciudad de México14330, México
| | - Jessica Ledesma Aparicio
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional, Mexico City, Mexico. Calz. de los Tenorios 235, Col. Granjas Coapa, Ciudad de México14330, México
| | - Guadalupe Bravo
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional, Mexico City, Mexico. Calz. de los Tenorios 235, Col. Granjas Coapa, Ciudad de México14330, México
| | - Norma Leticia Gómez-Viquez
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional, Mexico City, Mexico. Calz. de los Tenorios 235, Col. Granjas Coapa, Ciudad de México14330, México
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Taheri S, Peters N, Zietz A, Abel B, Hubert G, Barinka F, Wiestler H, Kovacic I, Linker R, Schlachetzki F, Backhaus R. Clinical Course and Recurrence in Transient Global Amnesia: A Study From the TEMPiS Telestroke Network. J Clin Neurol 2023; 19:530-538. [PMID: 37455507 PMCID: PMC10622726 DOI: 10.3988/jcn.2022.0368] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/17/2022] [Accepted: 03/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND PURPOSE While the clinical hallmarks of transient global amnesia (TGA) are well defined, its pathophysiological causes are poorly understood. Specifically, risk factors for recurrences are yet to be determined. METHODS This retrospective study analyzed TGA cases diagnosed and treated within the TEMPiS telestroke network and a university stroke center in Germany. Demographic and clinical data were assessed and characteristics of TGA episodes were recorded, such as season of occurrence, trigger factors, duration, and concomitant symptoms. Follow-up of the potential recurrence of TGA was performed using a standardized questionnaire. RESULTS Overall 109 patients were included (age 64±8 years [mean±SD], 59.6% female). The most common vascular risk factor was arterial hypertension (60.6%), and other concomitant conditions included migraine (11.9%), hypothyroidism (22.9%), and atrial fibrillation (4.6%). The most frequent concomitant clinical feature accompanying the TGA episode at admission was elevated blood pressure (48.6%). Nineteen patients experienced at least one recurrent TGA episode. Migraine and hypothyroidism were only observed in subjects with a single TGA episode without recurrence (migraine: 14.4% without recurrence vs. none in the recurrence group, p=0.02; hypothyroidism: 27.8% without recurrence vs. none in the recurrence group, p=0.009). In contrast, atrial fibrillation was more common in subjects with TGA recurrence (p<0.001). CONCLUSIONS Arterial hypertension is prevalent in TGA patients, with elevated blood pressure being the most-frequent concomitant condition. In our cohort, recurrence of TGA occurred in approximately one-fifth of patients. Concomitant conditions such as migraine, hypothyroidism, and atrial fibrillation occurred at different frequencies in the two groups.
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Affiliation(s)
- Shadi Taheri
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
- University of Basel, Basel, Switzerland.
| | - Nils Peters
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
- University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
| | - Annaelle Zietz
- University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland
| | - Berthold Abel
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
| | - Gordian Hubert
- Department of Neurology, TEMPiS Telemedical Stroke Center, München Klinik Harlaching, Munich, Germany
| | - Filip Barinka
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Hanni Wiestler
- Department of Neurology, TEMPiS Telemedical Stroke Center, München Klinik Harlaching, Munich, Germany
| | - Irena Kovacic
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Ralf Linker
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Felix Schlachetzki
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Roland Backhaus
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
- Swiss Clinical Neuroscience Institute, Zurich, Switzerland
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Schmidt-Lauber C, Alba Schmidt E, Hänzelmann S, Petersen EL, Behrendt CA, Twerenbold R, Blankenberg S, Huber TB, Wenzel UO. Increased blood pressure after nonsevere COVID-19. J Hypertens 2023; 41:1721-1729. [PMID: 37682048 PMCID: PMC10552808 DOI: 10.1097/hjh.0000000000003522] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Various sequelae have been described after nonsevere coronavirus disease 2019 (COVID-19), but knowledge on postacute effects on blood pressure is limited. METHODS This is a cross-sectional analysis of blood pressure profiles in individuals after nonsevere COVID-19 compared with matched population-based individuals without prior COVID-19. Data were derived from the ongoing and prospective Hamburg City Health Study, a population-based study in Hamburg, Germany, and its associated COVID-19 program, which included individuals at least 4 months after COVID-19. Matching was performed by age, sex, education, and preexisting hypertension in a 1 : 4 ratio. RESULTS Four hundred and thirty-two individuals after COVID-19 (mean age 56.1 years) were matched to 1728 controls without prior COVID-19 (56.2 years). About 92.8% of COVID-19 courses were mild or moderate, only 7.2% were hospitalized, and no individual had been treated on an intensive care unit. Even after adjustment for relevant competing risk factors, DBP [+4.7 mmHg, 95% confidence interval (95% CI) 3.97-5.7, P < 0.001] was significantly higher in individuals after COVID-19. For SBP, a trend towards increased values was observed (+1.4 mmHg, 95% CI -0.4 to 3.2, P = 0.120). Hypertensive blood pressures at least 130/80 mmHg (according to the ACC/AHA guideline) and at least 140/90 mmHg (ESC/ESH guideline) occurred significantly more often in individuals after COVID-19 than matched controls (odds ratio 2.0, 95% CI 1.5-2.7, P < 0.001 and odds ratio 1.6, 95% CI 1.3-2.0, P < 0.001, respectively), mainly driven by changes in DBP. CONCLUSION Blood pressure is higher in individuals after nonsevere COVID-19 compared with uninfected individuals suggesting a significant hypertensive sequela.
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Affiliation(s)
- Christian Schmidt-Lauber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf
- Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg
- Research Center On Rare Kidney Diseases (RECORD), University Hospital Erlangen, Erlangen
| | - Elisa Alba Schmidt
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf
- Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg
| | - Sonja Hänzelmann
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf
- Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg
- Institute of Medical Systems Biology, University Medical Center Hamburg-Eppendorf
| | - Elina L. Petersen
- Department of Cardiology, University Heart and Vascular Center, Hamburg
| | | | - Raphael Twerenbold
- Department of Cardiology, University Heart and Vascular Center, Hamburg
- University Center of Cardiovascular Science, University Medical Center Hamburg-Eppendorf, Hamburg
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg–Kiel–Lübeck, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center, Hamburg
- University Center of Cardiovascular Science, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Tobias B. Huber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf
- Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg
| | - Ulrich O. Wenzel
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf
- Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg
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Dorogovtsev VN, Yankevich DS, Gaydashev AE, Martyushev-Poklad AV, Podolskaya JA, Borisov IV, Grechko AV. Preclinical Orthostatic Abnormalities May Predict Early Increase in Vascular Stiffness in Different Age Groups: A Pilot Study. Diagnostics (Basel) 2023; 13:3243. [PMID: 37892064 PMCID: PMC10606479 DOI: 10.3390/diagnostics13203243] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Clinical orthostatic hypotension (OH) and hypertension (OHT) are risk factors for arterial hypertension (AH) and cardiovascular diseases (CVD) and are associated with increased vascular stiffness. Preclinical OH and OHT are poorly understood. The main objective was to investigate preclinical orthostatic abnormalities and their association with increased vascular stiffness in different age groups of adults. A specially designed head-up tilt test standardized for hydrostatic column height was used to detect them. Three age groups of clinically healthy subjects were examined. In the group of young adults up to 30 years old, a significant predominance of orthostatic normotension (ONT) and an insignificant number of subjects with preclinical OH and OHT were found. In the age group over 45 years, compared to the group under 30 years, there was a twofold decrease in the proportion of individuals with ONT and a significant increase with preclinical OH and OHT. In all age groups, there was a significant orthostatic increase in vascular stiffness (as measured by the brachial-ankle pulse wave velocity (baPWV), which was recovered to the baseline level when returning to the supine position. Overall, subjects with preclinical OH and OHT had significantly higher baPWV values compared to those with ONT (p = 0.001 and p = 0.002, respectively), with all subjects having vascular stiffness values within normal age-related values.
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Affiliation(s)
- Victor N. Dorogovtsev
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Dmitry S. Yankevich
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Andrey E. Gaydashev
- Problem Scientific Research Laboratory, Smolensk State Medical University, 214019 Smolensk, Russia;
| | - Andrey V. Martyushev-Poklad
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Julia A. Podolskaya
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Ilya V. Borisov
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
| | - Andrey V. Grechko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia; (D.S.Y.); (A.V.M.-P.); (J.A.P.); (A.V.G.)
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Pallarés-Carratalá V, Ruiz-García A, Serrano-Cumplido A, Arranz-Martínez E, Divisón-Garrote JA, Moyá-Amengual A, Escobar-Cervantes C, Barrios V. Prevalence Rates of Arterial Hypertension According to the Threshold Criteria of 140/90 or 130/80 mmHg and Associated Cardiometabolic and Renal Factors: SIMETAP-HTN Study. Medicina (Kaunas) 2023; 59:1846. [PMID: 37893564 PMCID: PMC10608132 DOI: 10.3390/medicina59101846] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and objectives: Arterial hypertension (HTN) is the leading preventable cause of atherosclerotic cardiovascular diseases (ASCVD) and death from all causes. This study aimed to determine the prevalence rates of HTN diagnosed according to the threshold diagnostic criteria 130/80 mmHg and 140/90 mmHg, to compare blood pressure (BP) control, and to evaluate their associations with cardiovascular diseases and cardiometabolic and renal risk factors. Materials and Methods: This was a cross-sectional observational study conducted in primary care with a population-based random sample: 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of HTN were calculated. BP control was compared in HTN patients with and without ASCVD or chronic kidney disease (CKD). Their associations with cardiovascular diseases and cardiometabolic and renal factors were assessed using bivariate and multivariate analysis. Results: Adjusted prevalence rates of HTN diagnosed according to 140/90 and 130/90 criteria were 30.9% (32.9% male; 29.7% female) and 54.9% (63.2% male; 49.3% female), respectively. BP < 130/80 mmHg was achieved in 60.5% of HTN patients without ASCVD or CKD according to 140/90 criterion, and 65.5% according to 130/80 criterion. This BP-control was achieved in 70% of HTN patients with ASCVD and 71% with CKD, according to both criteria. Coronary heart disease (CHD), heart failure, atrial fibrillation, stroke, diabetes, prediabetes, low glomerular filtration rate (eGFR), hyperuricemia, hypercholesterolemia, obesity, overweight, and increased waist-to-height ratio were independently associated with HTN according to both criteria. Conclusions: Almost a third of the adult population has HTN according to the 140/90 criterion, and more than half according to the 130/90 criterion, with a higher prevalence in men. The main clinical conditions associated with HTN were heart failure, diabetes, CHD, low eGFR, and obesity.
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Affiliation(s)
- Vicente Pallarés-Carratalá
- Health Surveillance Unit, Mutual Insurance Union, 12004 Castellon, Spain
- Department of Medicine, Jaume I University, 12006 Castellon, Spain
| | - Antonio Ruiz-García
- Lipids and Cardiovascular Prevention Unit, Pinto University Health Centre, Pinto, 28320 Madrid, Spain
- Department of Medicine, European University of Madrid, Villaviciosa de Odon, 28670 Madrid, Spain
| | | | | | | | | | | | - Vivencio Barrios
- Ramon y Cajal University Hospital, 28034 Madrid, Spain;
- Department of Medicine, Alcala University, 28801 Madrid, Spain
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Venditti V, Bleve E, Morano S, Filardi T. Gender-Related Factors in Medication Adherence for Metabolic and Cardiovascular Health. Metabolites 2023; 13:1087. [PMID: 37887412 PMCID: PMC10609002 DOI: 10.3390/metabo13101087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
This review explores the impact of gender on medication adherence in the context of metabolic and cardiovascular diseases. Optimal adherence to medication is crucial for achieving treatment goals and preventing adverse outcomes in chronic diseases. The review examines specific conditions such as type 2 diabetes, hypercholesterolemia, arterial hypertension, cardiovascular diseases, and heart failure. In type 2 diabetes, female sex, younger age, new drug prescription, non-white ethnicity, low education level, and low income were identified as predictors of non-adherence. Depressive disorders were also found to influence adherence. In hypercholesterolemia, women exhibited poorer adherence to statin therapy compared to men, with statin-related side effects and patient perception being significant factors. Adherence to anti-hypertensive therapy showed conflicting results, with studies reporting both higher and lower adherence in women. Limited evidence suggests that women may have poorer adherence after acute myocardial infarction and stroke. Regarding heart failure, adherence studies have shown inconsistent findings. The reasons for gender differences in medication adherence are multifactorial and include sociodemographic, disease-related, treatment-related, and psychological factors. This review emphasizes the need for further research to better understand these differences and develop gender-customized interventions that can improve medication adherence and reduce the burden of metabolic and cardiovascular diseases.
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Affiliation(s)
- Vittorio Venditti
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (V.V.); (E.B.); (S.M.)
| | - Enrico Bleve
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (V.V.); (E.B.); (S.M.)
| | - Susanna Morano
- Department of Experimental Medicine, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy; (V.V.); (E.B.); (S.M.)
| | - Tiziana Filardi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta, 247, 00166 Rome, Italy
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Karabaeva RZ, Vochshenkova TA, Zare A, Jafari N, Baneshi H, Mussin NM, Albayev RK, Kaliyev AA, Baspakova A, Tamadon A. Genetic and epigenetic factors of arterial hypertension: a bibliometric- and in-silico-based analyses. Front Mol Biosci 2023; 10:1221337. [PMID: 37900914 PMCID: PMC10602687 DOI: 10.3389/fmolb.2023.1221337] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/21/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction: Arterial hypertension (AH) is a pervasive global health concern with multifaceted origins encompassing both genetic and environmental components. Previous research has firmly established the association between AH and diverse genetic factors. Consequently, scientists have conducted extensive genetic investigations in recent years to unravel the intricate pathophysiology of AH. Methods: In this study, we conducted a comprehensive bibliometric analysis employing VOSviewer software to identify the most noteworthy genetic factors that have been the focal point of numerous investigations within the AH field in recent years. Our analysis revealed genes and microRNAs intricately linked to AH, underscoring their pivotal roles in this condition. Additionally, we performed molecular docking analyses to ascertain microRNAs with the highest binding affinity to these identified genes. Furthermore, we constructed a network to elucidate the in-silico-based functional interactions between the identified microRNAs and genes, shedding light on their potential roles in AH pathogenesis. Results: Notably, this pioneering in silico examination of genetic factors associated with AH promises novel insights into our understanding of this complex condition. Our findings prominently highlight miR-7110-5p, miR-7110-3p, miR-663, miR-328-3p, and miR-140-5p as microRNAs exhibiting a remarkable affinity for target genes. These microRNAs hold promise as valuable diagnostic and therapeutic factors, offering new avenues for the diagnosis and treatment of AH in the foreseeable future. Conclusion: In summary, this research underscores the critical importance of genetic factors in AH and, through in silico analyses, identifies specific microRNAs with significant potential for further investigation and clinical applications in AH management.
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Affiliation(s)
- Raushan Zh Karabaeva
- Gerontology Center, Medical Center of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
- Therapeutic Department, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Tamara A. Vochshenkova
- Gerontology Center, Medical Center of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
- Therapeutic Department, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | | | - Rustam Kuanyshbekovich Albayev
- Gerontology Center, Medical Center of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | | | - Akmaral Baspakova
- Department for Scientific Work, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Amin Tamadon
- PerciaVista R&D Co., Shiraz, Iran
- Department for Scientific Work, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Golovin DA, Rostovtseva TM, Kudryavtsev YS, Berdalin AB, Lelyuk SE, Lelyuk VG. Carotid Dolichoarteriopathy (Elongation) of the Carotid Arteries in Patients with Ischemic Stroke Anamnesis. Biomedicines 2023; 11:2751. [PMID: 37893124 PMCID: PMC10604229 DOI: 10.3390/biomedicines11102751] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 10/29/2023] Open
Abstract
Carotid artery elongation (ECA) is widespread in the asymptomatic population and among people with a history of ischemic stroke (IS). There are different points of view on the ways these changes contribute to brain ischemic damage pathogenesis. Materials and Methods: From 2019 to 2021, we included 1171 people who had suffered from IS less than one year before the investigation in the study, 404 (34.5%) women aged 27 to 95 years (64 ± 13 years) and 767 men (21-90; 60 ± 11 years). All patients involved in the study underwent multimodal radiological investigation in addition to assessments of their clinical and neurological data. Results: In this study, we were unable to detect a relationship between ECA localization and acute ischemic lesions. The frequency of ECA detection in patients with IS was the same as that in carotid and vertebral-basilar arterial systems. The prevalence of ECA was the same in patients with different IS subtypes (TOAST). There was no association between the localization of ECA and ischemic lesions; moreover, there were no differences in the IS frequency between anterior and posterior circulation. There were statistically significant decreases in linear peak systolic and end diastolic velocities in the internal carotid and vertebral arteries, as well as in the intracranial arteries in patients with ECA.
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Affiliation(s)
- Denis A. Golovin
- Department of Clinical and Experimental Physiology of Circulatory System, Ultrasound and Functional Diagnostics of Federal State Budgetary Institution, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency Russian Federation, 123182 Moscow, Russia; (T.M.R.); (Y.S.K.); (V.G.L.)
| | - Tatyana M. Rostovtseva
- Department of Clinical and Experimental Physiology of Circulatory System, Ultrasound and Functional Diagnostics of Federal State Budgetary Institution, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency Russian Federation, 123182 Moscow, Russia; (T.M.R.); (Y.S.K.); (V.G.L.)
| | - Yuri S. Kudryavtsev
- Department of Clinical and Experimental Physiology of Circulatory System, Ultrasound and Functional Diagnostics of Federal State Budgetary Institution, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency Russian Federation, 123182 Moscow, Russia; (T.M.R.); (Y.S.K.); (V.G.L.)
| | - Alexander B. Berdalin
- Department of Clinical and Experimental Physiology of Circulatory System, Ultrasound and Functional Diagnostics of Federal State Budgetary Institution, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency Russian Federation, 123182 Moscow, Russia; (T.M.R.); (Y.S.K.); (V.G.L.)
| | - Svetlana E. Lelyuk
- Federal State Budgetary Educational Institution, Further Professional Education “Russian Medical Academy of Continuous Professional Education”, Ministry of Healthcare of the Russian Federation, 127051 Moscow, Russia
| | - Vladimir G. Lelyuk
- Department of Clinical and Experimental Physiology of Circulatory System, Ultrasound and Functional Diagnostics of Federal State Budgetary Institution, Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency Russian Federation, 123182 Moscow, Russia; (T.M.R.); (Y.S.K.); (V.G.L.)
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Luque del Moral R, Gastelurrutia MA, Martinez-Martinez F, Jacomé JA, Dago A, Suarez B, Fikri-Benbrahim N, Martí M, Nuñez C, Sierra-Alarcón S, Fernandez-Gomez FJ. Effect of Pharmaceutical Intervention in Pharmacologically Treated Hypertensive Patients-A Cluster-Randomized Clinical Trial: AFPRES-CLM Study. J Pers Med 2023; 13:1484. [PMID: 37888095 PMCID: PMC10608270 DOI: 10.3390/jpm13101484] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Evaluate the effect of a community pharmaceutical intervention on the control of blood pressure in hypertensive patients treated pharmacologically. METHODS A cluster-randomized clinical trial of 6 months was carried out. It was conducted in the Autonomous Community of Castilla-La Mancha (Spain). Sixty-three community pharmacies and 347 patients completed the study. Intervention patients received the community pharmaceutical intervention based on a protocol that addresses the individual needs of each patient related to the control of their blood pressure, which included Health Education, Pharmacotherapy Follow-up and 24 h Ambulatory Blood Pressure Measurement. Control patients received usual care in the community pharmacy. RESULTS The pharmaceutical intervention resulted in better control of blood pressure (85.8% vs. 66.3% p < 0.001), lower use of emergencies (p = 0.002) and improvement trends in the physical components of quality of life, measured by SF-36 questionnaire, after 6 months of pharmaceutical intervention. No significant changes were observed for any of these variables in the control group. There were also detected 354 negative medication-related outcomes that were satisfactorily resolved in a 74.9% of the cases and 330 healthcare education interventions and 29 Ambulatory Blood Pressure Monitorings were performed in order to increase adherence to pharmacological treatment and minimize Negative Outcomes associated with Medication and prevent medication-related problems. CONCLUSIONS Community pharmaceutical intervention can increase hypertensive patients with controlled blood pressure, after 6 months, compared with usual care.
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Affiliation(s)
- Raúl Luque del Moral
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
- Council of Official Associations of Pharmaceutics of Castilla-La Mancha, 45005 Toledo, Spain
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
| | - Miguel A. Gastelurrutia
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
| | - Fernando Martinez-Martinez
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
| | - Julio A. Jacomé
- Pharmaceutical Care Foundation, 08017 Barcelona, Spain; (J.A.J.); (A.D.); (M.M.)
| | - Ana Dago
- Pharmaceutical Care Foundation, 08017 Barcelona, Spain; (J.A.J.); (A.D.); (M.M.)
| | - Blanca Suarez
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
- Council of Official Associations of Pharmaceutics of Castilla-La Mancha, 45005 Toledo, Spain
| | - Narjis Fikri-Benbrahim
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
| | - Mercé Martí
- Pharmaceutical Care Foundation, 08017 Barcelona, Spain; (J.A.J.); (A.D.); (M.M.)
| | - Cristina Nuñez
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
- Murcia Research Institute of Health Sciences (IMIB), 30120 Murcia, Spain
| | - Sandra Sierra-Alarcón
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
- Murcia Research Institute of Health Sciences (IMIB), 30120 Murcia, Spain
| | - Francisco-José Fernandez-Gomez
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
- Murcia Research Institute of Health Sciences (IMIB), 30120 Murcia, Spain
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Guede-Rojas F, Ibacache-Saavedra P, Leal MI, Tuesta M, Durán-Marín C, Carrasco-Marín F, Cigarroa I, Alvarez C, Izquierdo M, Delgado-Floody P. A Higher Skeletal Muscle Mass and Lower Adiposity Phenotype Is Associated with Better Cardiometabolic Control in Adults with Hip and Knee Osteoarthritis: Results from the Chilean National Health Survey 2016-2017. Nutrients 2023; 15:4263. [PMID: 37836547 PMCID: PMC10574707 DOI: 10.3390/nu15194263] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE This study aimed to (1) characterize cardiometabolic factors in self-reported hip and knee osteoarthritis (OAD) across four body composition phenotypes defined by muscle mass and adiposity, and (2) associate risk factors with diabetes and hypertension (HTN). METHODS A cross-sectional analysis of the Chilean National Health Survey 2016-17 (n = 4996) stratified participants into four groups: low skeletal muscle mass/high waist circumference (Low-SMM/High-WC), low SMM/low WC (Low-SMM/Low-WC), high SMM/high WC (High-SMM/High-WC), and high SMM/low WC (reference group). Each group was further divided into subgroups with or without diagnosed hip or knee OAD. The main outcomes were fasting plasma glucose, systolic (SBP)/diastolic (DBP) blood pressure (continuous outcomes), and other secondary factors such as cardiovascular risk (CVR). RESULTS In the hip OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (145 vs. 127 mmHg, p < 0.0001, diff +18 mmHg). In the knee OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (141 vs. 134 mmHg, p < 0.0001, diff +7 mmHg). The SBP showed a significant interaction between the group and OAD diagnosis (p = 0.007 hip OAD; p < 0.0001 knee OAD). CONCLUSIONS Hip and knee OAD associates with elevated SBP/DBP in older adults. OAD groups showed an OR above 2 for diabetes, 2.7 for HTN, 4.5 for metabolic syndrome, and over 2 for moderate-to-high cardiovascular risk. OAD interacts substantially with cardiometabolic factors, especially in low muscle mass/high adiposity phenotypes. Lifestyle optimization of physical activity and nutrition to preserve muscle mass and mitigate adiposity is essential for cardiometabolic health promotion in OAD patients.
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Affiliation(s)
- Francisco Guede-Rojas
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (F.G.-R.); (P.I.-S.); (M.I.L.); (M.T.); (C.A.)
| | - Paulina Ibacache-Saavedra
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (F.G.-R.); (P.I.-S.); (M.I.L.); (M.T.); (C.A.)
| | - María Inés Leal
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (F.G.-R.); (P.I.-S.); (M.I.L.); (M.T.); (C.A.)
| | - Marcelo Tuesta
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (F.G.-R.); (P.I.-S.); (M.I.L.); (M.T.); (C.A.)
| | - Cristóbal Durán-Marín
- Physical Therapy, Faculty of Rehabilitation Sciences Carrera de Kinesiología, Universidad Andres Bello, Concepción 4260000, Chile;
| | | | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile;
| | - Cristian Alvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile; (F.G.-R.); (P.I.-S.); (M.I.L.); (M.T.); (C.A.)
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain;
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Pedro Delgado-Floody
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4811230, Chile
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain
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Jeong S, Poudyal S, Klagges S, Kuhnt T, Papsdorf K, Hambsch P, Wach J, Güresir E, Nägler F, Rühle A, Nicolay NH, Seidel C. Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy. Cancers (Basel) 2023; 15:4845. [PMID: 37835539 PMCID: PMC10571851 DOI: 10.3390/cancers15194845] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Brain metastases (BM) cause relevant morbidity and mortality in cancer patients. The presence of cerebrovascular diseases can alter the tumor microenvironment, cellular proliferation and treatment resistance. However, it is largely unknown if the presence of distinct cerebrovascular risk factors may alter the prognosis of patients with BM. METHODS Patients admitted for the radiotherapy of BM at a large tertiary cancer center were included. Patient and survival data, including cerebrovascular risk factors (diabetes mellitus (DM), smoking, arterial hypertension, peripheral arterial occlusive disease, hypercholesterolemia and smoking) were recorded. RESULTS 203 patients were included. Patients with DM (n = 39) had significantly shorter overall survival (OS) (HR 1.75 (1.20-2.56), p = 0.003, log-rank). Other vascular comorbidities were not associated with differences in OS. DM remained prognostically significant in the multivariate Cox regression including established prognostic factors (HR 1.92 (1.20-3.06), p = 0.006). Furthermore, subgroup analyses revealed a prognostic role of DM in patients with non-small cell lung cancer, both in univariate (HR 1.68 (0.97-2.93), p = 0.066) and multivariate analysis (HR 2.73 (1.33-5.63), p = 0.006), and a trend in melanoma patients. CONCLUSION DM is associated with reduced survival in patients with BM. Further research is necessary to better understand the molecular mechanisms and therapeutic implications of this important interaction.
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Affiliation(s)
- Seong Jeong
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Soniya Poudyal
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | | | - Thomas Kuhnt
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Kirsten Papsdorf
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Peter Hambsch
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Johannes Wach
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
- Department of Neurosurgery, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Erdem Güresir
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
- Department of Neurosurgery, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Franziska Nägler
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Alexander Rühle
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Nils H. Nicolay
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
| | - Clemens Seidel
- Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, Germany (S.P.); (T.K.)
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, Germany; (J.W.)
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Pirola CJ, Sookoian S. Non-alcoholic fatty liver disease mediates the effect of obesity on arterial hypertension. Liver Int 2023; 43:2167-2176. [PMID: 37312639 DOI: 10.1111/liv.15643] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND It has been consistently shown that obesity contributes directly to arterial hypertension and cardiovascular disease (CVD), independently of other risk factors. Likewise, non-alcoholic fatty liver disease (NAFLD) is acknowledged as a contributor and a risk enhancer for CVD. OBJECTIVES We tested the hypothesis of a causal role of NAFLD in the effect of obesity on arterial hypertension. METHODS Using causal mediation analysis, we quantified the magnitude of the body mass index (BMI) effect on arterial hypertension and CV-traits mediated by NAFLD. First, we analysed data from 1348 young adults in the Bogalusa Heart Study (BHS), a cohort aimed at assessing the natural history of CVD. Then, we used data from 3359 participants of the National Health and Nutrition Examination Survey (2017-2018 cycle, NHANES) to replicate the findings. RESULTS We found that roughly 92% of the effects of BMI on arterial hypertension in the BHS and 51% in the NHANES population are mediated by NAFLD. In addition, indirect effects of BMI on systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) through NAFLD explained up to 91%, 93%, and 100% of the total effect, respectively, in the BHS. In the NHANES survey, indirect effects of BMI through NAFLD on CV traits explain a significant proportion of the total effects (SBP = 60.4%, HR = 100%, and pulse pressure = 88%). CONCLUSION NAFLD mediates a substantial proportion of the effect of obesity on the presence of hypertension and CV-parameters independently of relevant covariates. This conclusion has implications for clinical management.
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Affiliation(s)
- Carlos J Pirola
- Systems Biology of Complex Diseases, Centro de Altos Estudios en Ciencias Humanas y de la Salud (CAECIHS), Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Silvia Sookoian
- Clinical and Molecular Hepatology, Centro de Altos Estudios en Ciencias Humanas y de la Salud (CAECIHS), Universidad Abierta Interamericana, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Universidad Maimónides, Buenos Aires, Argentina
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Dobreva EA, Gorbacheva AM, Bibik EE, Eremkina AK, Elfimova AR, Salimkhanov RK, Kovaleva EV, Maganeva IS, Mokrysheva NG. Cardiovascular and metabolic status in patients with primary hyperparathyroidism: a single-center experience. Front Endocrinol (Lausanne) 2023; 14:1266728. [PMID: 37842310 PMCID: PMC10570793 DOI: 10.3389/fendo.2023.1266728] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Cardiovascular diseases (CVD) and metabolic disorders (MD) have retained leading positions in the structure of morbidity and mortality for many years. Primary hyperparathyroidism (PHPT) is also associated with a greater incidence of CVD and MD. The aim of the present study was to describe the prevalence and structure of CVD and MD in hospitalized patients with PHPT and to search for possible associations between these pathologies. Methods 838 patients with a verified PHPT were included in the study. The studied cohort was divided into 2 groups according to their age at the time of admission: patients aged 18 to 49 years (group A, n = 150); patients aged 50 years and older (group B, n = 688). Results There were no significant differences between two groups in parameters of calcium-phosphorus metabolism. Obesity was diagnosed in 24.2% of patients in group A and in 35.9% in group B. Type 2 diabetes mellitus was more common in older patients (14.4% in group B vs. 2.6% in group A). Arterial hypertension, ischemic heart disease, chronic heart failure and brachiocephalic arteries atherosclerosis were more frequent in older patients, occurring in 79.1%, 10.8%, 8.4%, and 84% of cases respectively. The cutoff points that increased the risk of CVD detection turned out to be age above 56 years, eGFR below 92 ml/min/1.73m2, BMI above 28.3 kg/m2. Discussion The present study demonstrated a high incidence of some CVD, as well as disorders of lipid, carbohydrate and purine metabolism in patients with PHPT.
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Affiliation(s)
- Ekaterina A. Dobreva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Anna M. Gorbacheva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Ekaterina E. Bibik
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Anna K. Eremkina
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Alina R. Elfimova
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Rustam Kh. Salimkhanov
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Elena V. Kovaleva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Irina S. Maganeva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
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Maselienė T, Struckutė E, Breivienė R, Ramašauskaitė D, Dženkevičiūtė V. The Importance of Inflammatory and Angiogenic Markers in the Evaluation of Early Cardiovascular Disease Risk in Women with Hypertensive Disorders of Pregnancy. J Cardiovasc Dev Dis 2023; 10:407. [PMID: 37887854 PMCID: PMC10607798 DOI: 10.3390/jcdd10100407] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Women with hypertensive disorders of pregnancy (HDP) have a significantly higher risk of developing cardiovascular diseases later in life. The stratification of this risk using biomarkers during pregnancy can help to identify these women and apply early prevention. OBJECTIVE We aimed to determine proinflammatory cytokines and angiogenic markers, echocardiographic parameter changes after delivery and predict early cardiovascular disease risk in women with arterial hypertension and its complications during pregnancy. METHODS We conducted a literature search using the PubMed database for the last ten years. A total of 17 articles were included to our study and full text reviewed. RESULTS Four out of six studies found higher postpartum Interleukin-6 (IL-6) levels in women with HDP. IL-6 correlated positively with waist circumference, body mass index, and triglycerides, and negatively with high density lipoproteins (HDL). Two out of four studies found higher postpartum tumor necrosis factor alpha (TNF-α) levels in women with HDP but later concentration equalizes. One out of eight studies found higher placental growth factor (PlGF) and two out of eight found more elevated soluble fms-like tyrosine kinase-1 (sFlt-1) in women with HDP. With decreasing PlGF and increasing sFlt-1, common carotid artery intima and media thickness, aortic root diameter, left atrial diameter, left ventricle mass, systolic, diastolic, and mean blood pressure increased, whereas HDL decreased. One out of four studies found higher sFlt-1/PlGF. CONCLUSION IL-6 remains significantly higher after delivery. Few studies found higher TNF-α, sFlt-1, PlGF and their ratio postpartum. All studies found a correlation between angiogenic factors, IL-6, and cardiovascular disease risk factors.
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Affiliation(s)
- Tatjana Maselienė
- Clinics of Internal and Family Medicine, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Emilija Struckutė
- Clinics of Obstetrics and Gyneacology, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania; (E.S.); (R.B.); (D.R.)
| | - Rūta Breivienė
- Clinics of Obstetrics and Gyneacology, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania; (E.S.); (R.B.); (D.R.)
| | - Diana Ramašauskaitė
- Clinics of Obstetrics and Gyneacology, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania; (E.S.); (R.B.); (D.R.)
| | - Vilma Dženkevičiūtė
- Clinics of Cardiology, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania;
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Pawlak-Chomicka R, Uruski P, Krauze T, Piskorski J, Tykarski A, Guzik P. Arterial Blood Pressure Features of Hypertensive Patients with Typical and Atypical 460 nm Skin Fluorescence Response to Transient Ischaemia. J Clin Med 2023; 12:5886. [PMID: 37762826 PMCID: PMC10531863 DOI: 10.3390/jcm12185886] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Flow-mediated skin fluorescence (FMSF) at 460 nm is a non-invasive method for assessing dynamic changes in the reduced form of nicotinamide adenine dinucleotide (NADH) and microcirculation in forearm skin under varying conditions of tissue perfusion. Typically, fluorescence increases during ischaemia, but atypical cases show a temporary signal decrease instead of a constant increase. This study aimed to explore the clinical implications of atypical FMSF patterns in patients with newly diagnosed untreated hypertension. NADH fluorescence and pulse wave analysis were performed on 65 patients. Differences in peripheral and arterial pulse pressure profiles were examined based on FMSF curve courses. Patients with atypical curve courses had significantly (p < 0.05 or lower for all) higher heart rate, peripheral and central diastolic pressure, tension time index, central rate pressure product, shorter diastole duration, and reservoir pressure-time integral. Hypertensive patients with atypical FMSF signals had less advantageous blood pressure profiles. Although the underlying factors causing these symptoms are unknown, the atypical FMSF pattern may reflect increased sympathetic stimulation and vascular resistance. The visual assessment of the FMSF curve may have important clinical implications that deserve further investigation.
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Affiliation(s)
- Regina Pawlak-Chomicka
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (R.P.-C.); (P.U.); (A.T.)
| | - Paweł Uruski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (R.P.-C.); (P.U.); (A.T.)
| | - Tomasz Krauze
- Department of Cardiology-Intensive Therapy and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland;
| | - Jarosław Piskorski
- Institute of Physics, University of Zielona Gora, 65-516 Zielona Gora, Poland;
| | - Andrzej Tykarski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznan, Poland; (R.P.-C.); (P.U.); (A.T.)
| | - Przemysław Guzik
- Department of Cardiology-Intensive Therapy and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland;
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Socrates T, Krisai P, Meienberg A, Mayr M, Burkard T, Vischer AS. Effect of Cuff Inflation on Blood Pressure, Arousals, Sleep Efficiency, and Desaturations: Sub-Analysis of the VAST Pilot Study. Diagnostics (Basel) 2023; 13:2874. [PMID: 37761241 PMCID: PMC10529092 DOI: 10.3390/diagnostics13182874] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
The influence of cuff inflations on night-time measurements during 24 h ambulatory blood pressure (BP) measurements is unknown. We investigated the potential effect of cuff inflations on sleep parameters using measurements taken simultaneously with a cuffless device using pulse-transit-time (PTT). On the first day of measurement, standard cuff-based 24 h BP and cuffless measurements were simultaneously performed on the right and left arms (CUFF/PTT-D). In this experiment, 1-2 days after the first measurement, the cuffless device was worn alone (PTT-D). Only data from the cuffless device were analyzed. The following mean sleep parameters were analyzed: mean systolic and diastolic BP, arousals, sleep efficiency, total arousals, arousal per hour, and desaturations. In total, 21 individuals were prospectively enrolled. The mean (SD) age was 47 (±15) years, and 57% were female. The mean systolic asleep BP during CUFF/PTT-D and during PTT-D were 131 (±21) and 131 (±26) mmHg, respectively. The mean diastolic asleep BP values during CUFF/PTT-D and during PTT-D were 80 (±14) and 84 (±14) mmHg, respectively (p = 0.860, p = 0.100, respectively). Systolic and diastolic asleep mean difference was 0.1 (±18.0) and -3.6 (±9.8) mmHg, respectively. There were significantly more total arousals during PTT-D (p = 0.042). There were no significant differences seen in sleep efficiency (p = 0.339) or desaturations (p = 0.896) between the two measurement periods. We could not show any significant impact from cuff inflations during sleep, as documented by PTT-D measurements.
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Affiliation(s)
- Thenral Socrates
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (A.M.); (M.M.); (T.B.); (A.S.V.)
| | - Philipp Krisai
- Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
- University of Basel, 4031 Basel, Switzerland
| | - Andrea Meienberg
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (A.M.); (M.M.); (T.B.); (A.S.V.)
| | - Michael Mayr
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (A.M.); (M.M.); (T.B.); (A.S.V.)
- University of Basel, 4031 Basel, Switzerland
| | - Thilo Burkard
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (A.M.); (M.M.); (T.B.); (A.S.V.)
- Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
- University of Basel, 4031 Basel, Switzerland
| | - Annina S. Vischer
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (A.M.); (M.M.); (T.B.); (A.S.V.)
- University of Basel, 4031 Basel, Switzerland
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Pais R, Cariou B, Noureddin M, Francque S, Schattenberg JM, Abdelmalek MF, Lalazar G, Varma S, Dietrich J, Miller V, Sanyal A, Ratziu V. A proposal from the liver forum for the management of comorbidities in non-alcoholic steatohepatitis therapeutic trials. J Hepatol 2023; 79:829-841. [PMID: 37001695 DOI: 10.1016/j.jhep.2023.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/08/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
The current document has been developed by the Liver Forum who mandated the NAFLD-Associated Comorbidities Working Group - a multistakeholder group comprised of experts from academic medicine, industry and patient associations - to identify aspects of diverse comorbidities frequently associated with non-alcoholic steatohepatitis (NASH) that can interfere with the conduct of therapeutic trials and, in particular, impact efficacy and safety results. The objective of this paper is to propose guidance for the management of relevant comorbidities in both candidates and actual participants in NASH therapeutic trials. We relied on specific guidelines from scientific societies, when available, but adapted them to the particulars of NASH trials with the aim of addressing multiple interacting requirements such as maintaining patient safety, reaching holistic therapeutic objectives, minimising confounding effects on efficacy and safety of investigational agents and allowing for trial completion. We divided the field of action into: first, analysis and stabilisation of the patient's condition before inclusion in the trial and, second, management of comorbidities during trial conduct. For the former, we discussed the concept of acceptable vs. optimal control of comorbidities, defined metabolic and ponderal stability prior to randomisation and weighed the pros and cons of a run-in period. For the latter, we analysed non-hepatological comorbid conditions for changes or acute events possibly occurring during the trial, including changes in alcohol consumption, in order to detail when specific interventions are necessary and how best to manage concomitant drug intake in line with methodological constraints. These recommendations are intended to act as a guide for clinical trialists and are open to further refinement when additional data become available.
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Affiliation(s)
- Raluca Pais
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Institute of Cardiometabolism and Nutrition, France; Centre de Recherche Saint Antoine, INSERM UMRS_938 Paris, France
| | - Bertrand Cariou
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du Thorax, F-44000 Nantes, France
| | | | - Sven Francque
- Department of Gastroenterology Hepatology, Antwerp University Hospital, Drie Eikenstraat 655, B-2650 Edegem, Belgium; InflaMed Centre of Excellence, Laboratory for Experimental Medicine and Paediatrics, Translational Sciences in Inflammation and Immunology, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Belgium
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manal F Abdelmalek
- Division of Gastroenterology and Hepatology, Duke University, Durham, NC, USA
| | - Gadi Lalazar
- Liver Unit, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Sharat Varma
- Novo Nordisk A/S, Vandtårnsvej 108-110, 2860 Søborg Denmark
| | - Julie Dietrich
- GENFIT, Parc Eurasanté 885, Avenue Eugène Avinée, 59120, Loos, France
| | - Veronica Miller
- Forum for Collaborative Research, University of California Berkeley School of Public Health, Washington D.C., USA
| | - Arun Sanyal
- Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Vlad Ratziu
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Institute of Cardiometabolism and Nutrition, France; INSERM UMRS 1138 CRC, Paris, France.
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Seryapina AA, Malyavko AA, Polityko YK, Yanshole LV, Tsentalovich YP, Markel AL. Metabolic profile of blood serum in experimental arterial hypertension. Vavilovskii Zhurnal Genet Selektsii 2023; 27:530-538. [PMID: 37867609 PMCID: PMC10587007 DOI: 10.18699/vjgb-23-64] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 10/24/2023] Open
Abstract
The etiology of essential hypertension is intricate, since it employs simultaneously various body systems related to the regulation of blood pressure in one way or another: the sympathetic nervous system, renin-angiotensin-aldosterone and hypothalamic-pituitary-adrenal systems, renal and endothelial mechanisms. The pathogenesis of hypertension is influenced by a variety of both genetic and environmental factors, which determines the heterogeneity of the disease in human population. Hence, there is a need to perform research on experimental models - inbred animal strains, one of them being ISIAH rat strain, which is designed to simulate inherited stress-induced arterial hypertension as close as possible to primary (or essential) hypertension in humans. To determine specific markers of diseases, various omics technologies are applied, including metabolomics, which makes it possible to evaluate the content of low-molecular compounds - amino acids, lipids, carbohydrates, nucleic acids fragments - in biological samples available for clinical analysis (blood and urine). We analyzed the metabolic profile of the blood serum of male ISIAH rats with a genetic stress-dependent form of arterial hypertension in comparison with the normotensive WAG rats. Using the method of nuclear magnetic resonance spectroscopy (NMR spectroscopy), 56 metabolites in blood serum samples were identified, 18 of which were shown to have significant interstrain differences in serum concentrations. Statistical analysis of the data obtained showed that the hypertensive status of ISIAH rats is characterized by increased concentrations of leucine, isoleucine, valine, myo-inositol, isobutyrate, glutamate, glutamine, ornithine and creatine phosphate, and reduced concentrations of 2-hydroxyisobutyrate, betaine, tyrosine and tryptophan. Such a ratio of the metabolite concentrations is associated with changes in the regulation of glucose metabolism (metabolic markers - leucine, isoleucine, valine, myo-inositol), of nitric oxide synthesis (ornithine) and catecholamine pathway (tyrosine), and with inflammatory processes (metabolic markers - betaine, tryptophan), all of these changes being typical for hypertensive status. Thus, metabolic profiling of the stress-dependent form of arterial hypertension seems to be an important result for a personalized approach to the prevention and treatment of hypertensive disease.
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Affiliation(s)
- A A Seryapina
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A A Malyavko
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Yu K Polityko
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - L V Yanshole
- International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Yu P Tsentalovich
- International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A L Markel
- Novosibirsk State University, Novosibirsk, Russia
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Minuz P, Albini FL, Imbalzano E, Izzo R, Masi S, Pengo MF, Pucci G, Scalise F, Salvetti M, Tocci G, Cicero A, Iaccarino G, Savoia C, Sechi L, Parati G, Borghi C, Volpe M, Ferri C, Grassi G, Muiesan ML. Telemedicine and Digital Medicine in the Clinical Management of Hypertension and Hypertension-Related Cardiovascular Diseases: A Position Paper of the Italian Society of Arterial Hypertension (SIIA). High Blood Press Cardiovasc Prev 2023; 30:387-399. [PMID: 37594686 PMCID: PMC10600275 DOI: 10.1007/s40292-023-00595-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
High blood pressure is the leading cause of death and disability globally and an important treatable risk factor for cardiovascular, cerebrovascular and chronic kidney diseases. Digital technology, including mobile health solutions and digital therapy, is expanding rapidly in clinical medicine and has the potential to improve the quality of care and effectiveness of drug treatment by making medical interventions timely, tailored to hypertensive patients' needs and by improving treatment adherence. Thus, the systematic application of digital technologies could support diagnosis and awareness of hypertension and its complications, ultimately leading to improved BP control at the population level. The progressive implementation of digital medicine in the national health systems must be accompanied by the supervision and guidance of health authorities and scientific societies to ensure the correct use of these new technologies with consequent maximization of the potential benefits. The role of scientific societies in relation to the rapid adoption of digital technologies, therefore, should encompass the entire spectrum of activities pertaining to their institutional role: information, training, promotion of research, scientific collaboration and advice, evaluation and validation of technological tools, and collaboration with regulatory and health authorities.
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Affiliation(s)
- Pietro Minuz
- Department of Medicine, University of Verona, Medicina Generale C, Policlinico GB Rossi, Piazzale LA Scuro 10, 37134, Verona, Italy.
| | | | - Egidio Imbalzano
- Hypertension Unit, Division of Internal Medicine, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy
| | - Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Institute of Cardiovascular Science, University College London, London, UK
| | - Martino F Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Unit of Internal Medicine, "Santa Maria" Terni Hospital, Terni, Italy
| | - Filippo Scalise
- Center for the Study of Hypertension and Vascular Diseases-Clinical Institute Verano Brianza, Policlinico di Monza, Monza, Italy
| | - Massimo Salvetti
- Department of Clinical and Experimental Sciences, University of Brescia and Emergency Medicine ASST Spedali Civili di Brescia, Brescia, Italy
| | - Giuliano Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy
| | - Arrigo Cicero
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Guido Iaccarino
- Center for Research on Hypertension and Related Conditions, Federico II University of Naples, Naples, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine, University of Rome Sapienza and IRCCS San Raffaele Roma, Rome, Italy
| | - Leonardo Sechi
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Massimo Volpe
- Clinical and Molecular Medicine, University of Rome Sapienza and IRCCS San Raffaele Roma, Rome, Italy
| | - Claudio Ferri
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Guido Grassi
- Clinica Medica, University of Milano-Bicocca, Milan, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia and Emergency Medicine ASST Spedali Civili di Brescia, Brescia, Italy
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Pereira‐Acácio A, Veloso‐Santos JPM, Alves‐Bezerra D, Costa‐Sarmento G, Muzi‐Filho H, Vieyra A. Different antihypertensive and metabolic responses to rostafuroxin in undernourished and normonourished male rats: Outcomes on bodily Na + handling. Physiol Rep 2023; 11:e15820. [PMID: 37667414 PMCID: PMC10477346 DOI: 10.14814/phy2.15820] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023] Open
Abstract
Hypertension is a pandemic nowadays. We aimed to investigate whether chronic undernutrition modifies the response to the antihypertensive drug rostafuroxin in juvenile hypertensive rats. Chronic undernutrition was induced in male rats using a multideficient diet known as the Regional Basic Diet (RBD), mimicking alimentary habits in impoverished regions worldwide. Animals were given RBD-or a control/CTRL normal diet for rodents-from weaning to 90 days, and rostafuroxin (1 mg/kg body mass) was orally administered from day 60 onwards. For the last 2 days, the rats were hosted in metabolic cages to measure food/energy, water, Na+ ingestion, and urinary volume. Rostafuroxin increased food/energy/Na+ intake in CTRL and RBD rats but had opposite effects on Na+ balance (intake minus urinary excretion). The drug normalized the decreased plasma Na+ concentration in RBD rats, increased urinary volume in RBD but not in CTRL, and decreased and increased urinary Na+ concentration in the RBD and CTRL groups, respectively. Rostafuroxin decreased the ouabain-sensitive (Na+ +K+ )ATPase and increased the ouabain-resistant Na+ -ATPase from proximal tubule cells in both groups and normalized the systolic blood pressure in RBD without effect in CTRL rats. We conclude that chronic undernutrition modifies the response of blood pressure and metabolic responses to rostafuroxin.
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Affiliation(s)
- Amaury Pereira‐Acácio
- Graduate Program of Translational Biomedicine/BIOTRANSUniversity of Grande RioDuque de CaxiasBrazil
- Carlos Chagas Filho Institute of BiophysicsFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Center for Structural Biology and Bioimaging/CENABIOFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative Medicine/REGENERARio de JaneiroBrazil
| | - João P. M. Veloso‐Santos
- Carlos Chagas Filho Institute of BiophysicsFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Center for Structural Biology and Bioimaging/CENABIOFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative Medicine/REGENERARio de JaneiroBrazil
| | - Danilo Alves‐Bezerra
- Graduate Program of Translational Biomedicine/BIOTRANSUniversity of Grande RioDuque de CaxiasBrazil
- National Center for Structural Biology and Bioimaging/CENABIOFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative Medicine/REGENERARio de JaneiroBrazil
| | - Glória Costa‐Sarmento
- Carlos Chagas Filho Institute of BiophysicsFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Center for Structural Biology and Bioimaging/CENABIOFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative Medicine/REGENERARio de JaneiroBrazil
| | - Humberto Muzi‐Filho
- Carlos Chagas Filho Institute of BiophysicsFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Center for Structural Biology and Bioimaging/CENABIOFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative Medicine/REGENERARio de JaneiroBrazil
| | - Adalberto Vieyra
- Graduate Program of Translational Biomedicine/BIOTRANSUniversity of Grande RioDuque de CaxiasBrazil
- Carlos Chagas Filho Institute of BiophysicsFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Center for Structural Biology and Bioimaging/CENABIOFederal University of Rio de JaneiroRio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative Medicine/REGENERARio de JaneiroBrazil
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Wagener M, Dolan E, Arnous S, Galvin J, Murphy AW, Casserly I, Eustace J, O’Connor S, McCreery C, Shand J, Wall C, Matiullah S, Sharif F. Renal Denervation as a Complementary Treatment Option for Uncontrolled Arterial Hypertension: A Situation Assessment. J Clin Med 2023; 12:5634. [PMID: 37685701 PMCID: PMC10488551 DOI: 10.3390/jcm12175634] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Uncontrolled arterial hypertension is a major global health issue. Catheter-based renal denervation has shown to lower blood pressure in sham-controlled trials and represents a device-based, complementary treatment option for hypertension. In this situation assessment, the authors, who are practicing experts in hypertension, nephrology, general practice and cardiology in the Republic of Ireland, discuss the current evidence base for the BP-lowering efficacy and safety of catheter-based renal denervation with different modalities. Although important questions remain regarding the identification of responders, and long-term efficacy and safety of the intervention, renal denervation has the potential to provide much-needed help to address hypertension and its adverse consequences. The therapeutic approach needs to be multidisciplinary and personalised to take into account the perspective of patients and healthcare professionals in a shared decision-making process.
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Affiliation(s)
- Max Wagener
- University Hospital Galway, University of Galway, H91 TK33 Galway, Ireland
| | - Eamon Dolan
- Stroke and Hypertension Unit, Connolly Hospital, D15 X40D Dublin, Ireland
| | - Samer Arnous
- University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Joseph Galvin
- The Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland
| | - Andrew W. Murphy
- Turloughmore Medical Centre, University of Galway, H91 TK33 Galway, Ireland
| | - Ivan Casserly
- The Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland
| | | | | | | | - James Shand
- St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | | | | | - Faisal Sharif
- University Hospital Galway, University of Galway, H91 TK33 Galway, Ireland
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46
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Basile C, Mancusi C, Franzone A, Avvedimento M, Bardi L, Angellotti D, Castiello DS, Mariani A, Manzo R, De Luca N, Cirillo P, De Simone G, Esposito G. Renin-angiotensin system inhibitors reduce cardiovascular mortality in hypertensive patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: insights from the EffecTAVI registry. Front Cardiovasc Med 2023; 10:1234368. [PMID: 37692038 PMCID: PMC10491454 DOI: 10.3389/fcvm.2023.1234368] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/20/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives Arterial hypertension is associated with the triggering of the renin-angiotensin system, leading to left ventricle fibrosis and worse cardiovascular outcomes. In this study, patients with comorbid arterial hypertension and severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) were selected from the EffecTAVI registry to evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on cardiovascular mortality. Methods We enrolled 327 patients undergoing TAVI from the EffecTAVI registry. Using Kaplan-Meier event rates and study-stratified multivariable Cox proportional hazards regression models, we evaluated 2-year clinical outcomes according to the ACEI/ARB therapy status at enrollment. Results Among the included patients, 222 (67.9%) were on ACEIs/ARBs at baseline, whereas 105 (32.1%) were not. Treatment with ACEIs/ARBs was significantly associated with a 2-year decrease in the rate of cardiovascular mortality (HR = 0.44, 95% CI: 0.23-0.81, p = 0.009). This association remained stable after both multivariable adjustment and propensity score matching. Conclusion In a cohort of hypertensive patients with severe AS who were selected from the EffecTAVI registry, ACEI/ARB treatment at baseline was found to be independently associated with a lower risk of 2-year cardiovascular mortality, suggesting a potential benefit of this treatment. More trials are needed to validate this finding and to understand the full benefit of this treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
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47
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Boussé Traore PWH, Tine JAD, Bassoum O, Kane A, Faye A. Paying more attention to arterial hypertension, dyslipidaemia, women and the rural environment in our ongoing fight against cardiovascular diseases and their risk factors. Cardiovasc J Afr 2023; 34:1-14. [PMID: 37594257 DOI: 10.5830/cvja-2023-033] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 06/14/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The diagnostic and therapeutic efforts instituted by the state of Senegal since the results of the STEPwise survey in 2015 could and should be reinforced with an effective and targeted preventative approach against cardiovascular accidents. This study aimed to (1) identify the pathological population that contains the most incidents of stroke in Senegal, (2) identify the prevalence, and geographical and gender distribution of biological co-morbidities with hypertension, stroke and advice for a change in behaviour, and (3) research the factors associated with the occurrence of cardiovascular accidents specific to the Senegalese context. METHODS This was a secondary analysis of the STEPwise WHO Senegal 2015 survey: a descriptive quantitative epidemiological study with an analytical aim. RESULTS Biological co-morbidities with arterial hypertension as well as cardiovascular accidents affected more women than men. Biological co-morbidities with arterial hypertension predominated in urban areas, while cardiovascular accidents were more common in rural areas. The population with arterial hypertension and total hypercholesterolaemia simultaneously was at the top of a list of 25 pathological populations in terms of the proportion of cardiovascular accidents within them. In addition, total hypercholesterolaemia was found in the first three populations with the most cardiovascular accidents. Regarding advice for behavioural change, advice for smoking cessation was the most widespread. All advice was given mostly to the gender most affected by the health problem, but some advice was mostly addressed to the environment least affected by the problem. Therefore, despite being the most affected, the rural environment received the least advice for a change in behaviour with regard to the practice of any of the forms of the physical activities described, the consumption of oil of palm, the consumption of cubed sugar or sugary drinks, smoked and non-smoked tobacco and attempted smoking cessation. In multivariate analysis, it was found that arterial hypertension produced a 2.74 times greater risk of having a cardiovascular accident (adjusted odds ratio = 2.74; 95% confidence interval = 1.88-3.99; p < 0.001). CONCLUSION In Senegal, we need to pay more attention to arterial hypertension, dyslipidaemia, women and the rural environment in our ongoing fight against cardiovascular diseases and their risk factors.
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Affiliation(s)
- Pêngd-Wendé Habib Boussé Traore
- Institute of Health and Development, Public Health Service, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal; Cardiology Department, Dalal Jamm Hospital, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Jean Augustin Diégane Tine
- Institute of Health and Development, Public Health Service, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Oumar Bassoum
- Institute of Health and Development, Public Health Service, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Abdoul Kane
- Cardiology Department, Dalal Jamm Hospital, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
| | - Adama Faye
- Institute of Health and Development, Public Health Service, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University, Dakar, Senegal
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48
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Rosch S, Rommel K, Blazek S, Kresoja K, Schöber A, von Roeder M, Desch S, Thiele H, Lurz P, Fengler K. Twenty-Four-Month Blood Pressure Results After Renal Denervation Using Endovascular Ultrasound. J Am Heart Assoc 2023; 12:e030767. [PMID: 37581398 PMCID: PMC10492948 DOI: 10.1161/jaha.123.030767] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Renal denervation has proven its efficacy to lower blood pressure in comparison to sham treatment in recent randomized clinical trials. Although there is a large body of evidence for the durability and safety of radiofrequency-based renal denervation, there are a paucity of data for endovascular ultrasound-based renal denervation (uRDN). We aimed to assess the long-term efficacy and safety of uRDN in a single-center cohort of patients. METHODS AND RESULTS Data from 2 previous studies on uRDN were pooled. Ambulatory 24-hour blood pressure measurements were taken before as well as 3, 6, 12, and 24 months after treatment with uRDN. A total of 130 patients (mean age 63±9 years, 24% women) underwent uRDN. After 3, 6, 12, and 24 months, systolic mean 24-hour ambulatory blood pressure values were reduced by 10±12, 10±14, 8±15, and 10±15 mm Hg, respectively, when compared with baseline (P<0.001). Corresponding diastolic values were reduced by 6±8, 6±8, 5±9, and 6±9 mm Hg, respectively (P<0.001). Periprocedural adverse events occurred in 16 patients, and all recovered without sequelae. CONCLUSIONS In this single-center study, uRDN effectively lowered blood pressure up to 24 months after treatment.
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Affiliation(s)
- Sebastian Rosch
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Karl‐Philipp Rommel
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Stephan Blazek
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Karl‐Patrik Kresoja
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Anne Schöber
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | | | - Steffen Desch
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Holger Thiele
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Philipp Lurz
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
| | - Karl Fengler
- Department of CardiologyHeart Center Leipzig at University of LeipzigLeipzigGermany
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49
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Nistor M, Schmidt M, Klingner C, Klingner C, Schwab M, Bischoff SJ, Matziolis G, Rodríguez-González GL, Schiffner R. Renal Glucose Release after Unilateral Renal Denervation during a Hypoglycemic Clamp in Pigs with an Altered Hypothalamic Pituitary Adrenal Axis after Late-Gestational Dexamethasone Injection. Int J Mol Sci 2023; 24:12738. [PMID: 37628918 PMCID: PMC10454812 DOI: 10.3390/ijms241612738] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Previously, we demonstrated in pigs that renal denervation halves glucose release during hypoglycaemia and that a prenatal dexamethasone injection caused increased ACTH and cortisol concentrations as markers of a heightened hypothalamic pituitary adrenal axis (HPAA) during hypoglycaemia. In this study, we investigated the influence of an altered HPAA on renal glucose release during hypoglycaemia. Pigs whose mothers had received two late-gestational dexamethasone injections were subjected to a 75 min hyperinsulinaemic-hypoglycaemic clamp (<3 mmol/L) after unilateral surgical denervation. Para-aminohippurate (PAH) clearance, inulin, sodium excretion and arterio-venous blood glucose difference were measured every fifteen minutes. The statistical analysis was performed with a Wilcoxon signed-rank test. PAH, inulin, the calculated glomerular filtration rate and plasma flow did not change through renal denervation. Urinary sodium excretion increased significantly (p = 0.019). Side-dependent renal net glucose release (SGN) decreased by 25 ± 23% (p = 0.004). At 25 percent, the SGN decrease was only half of that observed in non-HPAA-altered animals in our prior investigation. The current findings may suggest that specimens with an elevated HPAA undergo long-term adaptations to maintain glucose homeostasis. Nonetheless, the decrease in SGN warrants further investigations and potentially caution in performing renal denervation in certain patient groups, such as diabetics at risk of hypoglycaemia.
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Affiliation(s)
- Marius Nistor
- Orthopaedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany; (M.N.)
| | - Martin Schmidt
- Institute for Biochemistry II, Jena University Hospital, 07743 Jena, Germany
| | - Carsten Klingner
- Department of Neurology, Jena University Hospital, 07747 Jena, Germany (M.S.)
| | - Caroline Klingner
- Department of Neurology, Jena University Hospital, 07747 Jena, Germany (M.S.)
| | - Matthias Schwab
- Department of Neurology, Jena University Hospital, 07747 Jena, Germany (M.S.)
| | | | - Georg Matziolis
- Orthopaedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany; (M.N.)
| | | | - René Schiffner
- Orthopaedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany; (M.N.)
- Emergency Department, Otto-von-Guericke University, 39120 Magdeburg, Germany
- Emergency Department, Helios University Clinic Wuppertal, 42283 Wuppertal, Germany
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50
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Fezzi S, Gibson W, Wagener M, Murphy D, Coen E, Serruys PW, Onuma Y, Sharif F. Feasibility and Safety of Same-Day Discharge Following Radiofrequency Renal Artery Sympathetic Denervation. J Am Heart Assoc 2023; 12:e030742. [PMID: 37489723 PMCID: PMC10492993 DOI: 10.1161/jaha.123.030742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Simone Fezzi
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
- The Lambe Institute for Translational Medicine and CURAMUniversity of GalwayGalwayIreland
- Division of Cardiology, Department of MedicineUniversity of VeronaVeronaItaly
| | - William Gibson
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
| | - Max Wagener
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
| | - Darragh Murphy
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
| | - Eileen Coen
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
| | - Patrick W. Serruys
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
| | - Yoshinobu Onuma
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
| | - Faisal Sharif
- Department of Cardiology, Saolta Group, Galway University HospitalHealth Service Executive and University of GalwayGalwayIreland
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