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Zhang W, Li X, Li W, Zhang Y, Cai J, Feng S, Sun Z. Clinical diagnosis of pheochromocytoma and paraganglioma-induced secondary hypertension through UPLC-MS/MS analysis of plasma catecholamines and their metabolites. J Clin Hypertens (Greenwich) 2024; 26:416-424. [PMID: 38459755 PMCID: PMC11007807 DOI: 10.1111/jch.14779] [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: 09/01/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 03/10/2024]
Abstract
This study aimed to elucidate the clinical diagnostic value of plasma catecholamines and their metabolites for pheochromocytoma and paraganglioma (PPGL)-induced secondary hypertension using ultraperformance liquid chromatography-mass spectrometry (UPLC-MS/MS). The study population included 155 patients with PPGL that were divided into the PPGL with hypertension (n = 79) and a PPGL without hypertension (n = 76) groups, and 90 healthy volunteers and 90 patients with primary hypertension as the control groups. UPLC-MS/MS was performed to detect plasma levels of catecholamines and their metabolites, including dopamine, vanillylmandelic acid (VMA), norepinephrine, metanephrine, and normetanephrine. Receiver operating characteristic curves were generated to analyze the diagnostic value of the plasma levels of catecholamines and their metabolites in PPGL-induced secondary hypertension. Patients in the primary hypertension and PPGL without hypertension groups had higher levels of dopamine, VMA, norepinephrine, metanephrine, and normetanephrine than patients in the normal group (all p < .05). On the other hand, patients in the PPGL with hypertension group had higher levels of dopamine, VMA, norepinephrine, metanephrine, and normetanephrine than patients in the normal, primary hypertension, and PPGL without hypertension groups (all p < .05). Collectively, our findings showed that dopamine, VMA, norepinephrine, metanephrine, and normetanephrine are all effective biomarkers for the diagnosis of PPGL and PPGL-induced secondary hypertension.
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Affiliation(s)
- Weiyun Zhang
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
- The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
| | - Xiao Li
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
| | - Wanqin Li
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
| | - Yanmei Zhang
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
| | - Jiajia Cai
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
| | - Shiyu Feng
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
| | - Zhaohui Sun
- Department of Laboratory MedicineGeneral Hospital of Southern Theater Command of PLAGuangzhouChina
- The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
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Sun K, Gong M, Yu Y, Yang M, Zhang Y, Jiang Y, Song W. Comparison of saline infusion test and captopril challenge test in the diagnosis of Chinese with primary aldosteronism in different age groups. Front Endocrinol (Lausanne) 2024; 15:1343704. [PMID: 38586461 PMCID: PMC10995348 DOI: 10.3389/fendo.2024.1343704] [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: 11/24/2023] [Accepted: 03/04/2024] [Indexed: 04/09/2024] Open
Abstract
Background To explore the diagnostic accuracy and the optimal cutoff value between the saline infusion test (SIT) and captopril challenge test (CCT) [including the value and suppression of plasma aldosterone concentration (PAC)] for primary aldosteronism (PA) diagnosing. Methods A total of 318 patients with hypertension were consecutively enrolled, including 126 patients with PA and 192 patients with essential hypertension (EH), in this observational study. The characteristics of patients and laboratory examinations were collected and compared. The comparison between SIT and CCT was carried by drawing the receiver operator characteristic curve (ROC) and calculating the area under the curve (AUC) to explore the diagnostic accuracy and the optimal cutoff value. Results The average age was 51.59 ± 10.43 in the PA group and 45.72 ± 12.44 in the EH group (p<0.05). The optimal cutoff value was 10.7 ng/dL for post-CCT PAC, 6.8 ng/dL for post-SIT PAC, and 26.9% for suppression of post-CCT PAC. The diagnostic value of post-CCT PAC was the highest with 0.831 for the AUC and 0.552 for the Youden index. The optimal cutoff value for patients who were <50 years old was 11.5 ng/dL for post-CCT PAC and 8.4 ng/dL for post-SIT PAC. The suppression of post-CCT PAC turned to 18.2% for those of age 50 or older. Conclusion Compared with SIT, CCT had a higher diagnostic value when post-CCT PAC was used as the diagnostic criterion in Chinese people, while the selection of diagnostic thresholds depended on patient age.
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Affiliation(s)
| | | | | | | | | | - Yinong Jiang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Wei Song
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Wu F, Yuan X, Sun K, Zhang Y, Zhu L, Bai C, Cheng Y, Lu Y, Jiang Y, Song W. Effect of Accessory Renal Arteries on Essential Hypertension and Related Mechanisms. J Am Heart Assoc 2024; 13:e030427. [PMID: 38348775 PMCID: PMC11010091 DOI: 10.1161/jaha.123.030427] [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: 04/08/2023] [Accepted: 12/21/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND This case-control study aimed to determine whether there were differences between patients with essential hypertension with accessory renal arteries (ARAs) and those without ARAs. METHODS AND RESULTS The enrolled patients with essential hypertension were divided into the ARA group (n=200) and control group without ARAs (n=238). After propensity matching, 394 patients (197 in each of the 2 groups), were included. The 24-hour BP (4.33/2.43 mm Hg) and daytime BP (4.48/2.61 mm Hg) of patients in the ARA group were significantly higher than those of the control group (P<0.05). The flow-mediated dilation was lower in the ARA group (5.98±2.70 versus 5.18±2.66; P<0.05). In correlation analysis, the horizontal plasma aldosterone concentration had the highest correlation with 24-hour, daytime, and nighttime systolic BP (r=0.263, 0.247, and 0.243, respectively; P<0.05) and diastolic BP (r=0.325, 0.298, and 0.317, respectively; P<0.05). As for multivariate regression analysis, plasma aldosterone concentration was a significant risk factor for elevated 24-hour, daytime, and nighttime systolic BP (β=0.249 [95% CI, 0.150-0.349], 0.228 [95% CI, 0.128-0.329], and 0.282 [95% CI, 0.187-0.377], respectively; P<0.05) and elevated diastolic BP (β=0.289 [95% CI, 0.192-0.385], 0.256 [95% CI, 0.158-0.353], and 0.335 [95% CI, 0.243-0.427], respectively; P<0.05). Direct renin concentration was also a risk factor for 24-hour and daytime BPs, whereas heart rate was a risk factor correlated with 24-hour, daytime, and nighttime diastolic BP (all P<0.05). For the mixed-effects model for repeated measures, the results were similar to results of the multivariate regression analysis (all P<0.05). CONCLUSIONS ARAs could contribute a higher BP of patients with essential hypertension and might promote the development of essential hypertension. The mechanism might be related to overactivation of the renin-angiotensin-aldosterone system and sympathetic nervous system.
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Affiliation(s)
- Fengyuan Wu
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Xiaoyang Yuan
- Department of Clinical LaboratoryFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Kaiwen Sun
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Ying Zhang
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Lianxin Zhu
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Cuiping Bai
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Yunpeng Cheng
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Yan Lu
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Yinong Jiang
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Wei Song
- Department of CardiologyFirst Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
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Wang L, Lv XB, Yuan YT, Wang N, Yao HY, Zhang WC, Yin PF, Liu XH. Relationship between β1-AA and AT1-AA and Cardiac Function in Patients with Hypertension Complicated with Left Ventricular Diastolic Function Limitation. Cardiovasc Ther 2023; 2023:7611819. [PMID: 38125703 PMCID: PMC10733052 DOI: 10.1155/2023/7611819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/09/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Objective To investigate the association between β1 adrenergic receptor autoantibodies (β1-AA) and angiotensin II type-1 receptor autoantibodies (AT1-AA) and cardiac function in patients with hypertension complicated with left ventricular diastolic function limitation. Methods A total of 120 patients with essential hypertension who were not taking drug treatment and were hospitalised in the Department of Cardiology at the authors' hospital from April 2018 to December 2018 were enrolled in this study and divided into a diastolic dysfunction group (65 cases) and a normal diastolic group (55 cases) according to their left ventricular diastolic function. The levels of cardiac parameters, β1-AA, AT1-AA, and other indicators were compared. Logistic regression analysis was used to analyse the related factors affecting left ventricular diastolic dysfunction (LVDD). The diagnostic efficacy of related factors in the diagnosis of diastolic dysfunction was evaluated. Results Univariate analysis demonstrated that the left ventricular posterior wall diameter (10.29 ± 1.23 vs. 9.12 ± 1.53), left ventricular systolic dysfunction (10.56 ± 1.37 vs. 9.43 ± 1.44), systolic blood pressure (152.37 ± 10.24 vs. 140.33 ± 5.99), diastolic blood pressure (95.66 ± 6.34 vs. 87.33 ± 7.28), β1-AA (33 vs. 9 cases), and AT1-AA (35 cases vs. 12 cases) were higher in the dysfunction group than in the control group (all P < 0.05). Multivariate regression analysis showed that β1-AA (odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.369-4.345) and AT1-AA (OR = 2.02, 95% CI: 1.332-6.720) were independent risk factors for cardiac diastolic dysfunction (P < 0.05). Both autoimmune antibodies had a certain predictive value, and the combined prediction value of the two was the highest, with an area under the curve of 0.942 (95% CI: 0.881~0.985). Conclusion The positive rate of β1-AA and AT1-AA in essential hypertension patients with LVDD was higher than that in the normal group. Both β1-AA and AT1-AA could be used as early markers of LVDD in essential hypertension patients.
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Affiliation(s)
- Liang Wang
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
| | - Xue-Bai Lv
- Third Medical Center, The General Hospital of the People's Liberation Army, Beijing 100039, China
| | - Yu-Ting Yuan
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
| | - Ning Wang
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
| | - Hong-Ying Yao
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
| | - Wen-Chao Zhang
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
| | - Peng-Fei Yin
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
| | - Xiao-Hui Liu
- Department of Cardiology, Peking University International Hospital, Beijing 102206, China
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Smith L, Weber G. Differentiating essential hypertension from autonomic dysreflexia: a case report. Spinal Cord Ser Cases 2023; 9:51. [PMID: 37884525 PMCID: PMC10603167 DOI: 10.1038/s41394-023-00607-0] [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: 10/25/2022] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Autonomic dysreflexia (AD), a condition of critically raised blood pressure, is a severe complication of spinal cord injury. Primary (essential) hypertension may present with similar blood pressure levels to AD, though the causes, pathophysiology, presentation and treatment will differ. CASE PRESENTATION We report a case of a 74-year-old patient with a C1 spinal injury, who developed primary (essential) hypertension during her rehabilitation phase of care, requiring extensive investigations for autonomic dysreflexia. Despite this, no underlying cause was found; essential hypertension was subsequently confirmed with 24-hour ambulatory blood pressure monitoring. Treatment with an ACE inhibitor was introduced to good effect. DISCUSSION Essential hypertension can affect patients with spinal injury, even though most patients with higher level injuries (particularly cervical spinal cord injuries) are expected to have low resting baseline hypotension. Relevant features of this are presented within this case; a set of criteria to differentiate essential hypertension from autonomic dysreflexia are also proposed.
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Affiliation(s)
- Leon Smith
- Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Morrison Ave, Putney, 2112, NSW, Australia.
| | - Gerard Weber
- Spinal Injuries Unit, Royal Rehabilitation Centre Sydney, Morrison Ave, Putney, 2112, NSW, Australia
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Li J, Yang N, Chou H, Shi L, Wei M, Li Y. Central diastolic blood pressure, plasma aldosterone and uric acid are associated with microalbuminuria in essential hypertension: a case-control study. BMC Cardiovasc Disord 2023; 23:511. [PMID: 37848834 PMCID: PMC10583460 DOI: 10.1186/s12872-023-03515-1] [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: 06/16/2023] [Accepted: 09/16/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE To study the development of microalbuminuria (MAU) in essential hypertension (EHT), we investigated the association of MAU with central blood pressure (CBP), direct renin concentration (DRC), plasma aldosterone (PA), and uric acid (UA). METHOD We determined 24 h-urinary albumin excretion (24 h-UAE) in patients with EHT who were hospitalized at TEDA International Cardiovascular Hospital from June 2020 to May 2022. We defined MAU as 24 h-UAE in the range of 30 mg/24 h to 300 mg/24 h. Univariate and multivariate analyses were conducted to determine the associations of MAU with CBP, DRC, PA, and UA in EHT, considering demographic and clinical information. We also plotted receiver operating characteristic curves (ROCs) for predicting MAU using these results. RESULTS More than a quarter of patients (26.5%, 107/404, 95% CI: 22.2-31.1%) were diagnosed with MAU in EHT. A higher body mass index (BMI), longer duration of hypertension, and higher severity were associated with MAU. Also, nearly 10% more creatinine levels were recorded in the MAU group than in the control group (69.5 ± 18.7 µmol/L vs. 64.8 ± 12.5 µmol/L, P = 0.004). The increase was also observed for PA (15.5, 9.7-20.6 ng/dL vs. 12.3, 9.0-17.3 ng/dL, P = 0.024) and UA (419.8 ± 105.6 µmol/L vs. 375.1 ± 89.5 µmol/L, P < 0.001) in the MAU group compared to that in the control group. Several variables were associated with MAU, including central diastolic blood pressure (CDBP) (OR = 1.017, 95% CI: 1.002-1.032, P = 0.027), PA (OR = 1.043, 95% CI: 1.009-1.078, P = 0.012) and UA (OR = 1.005, 95% CI: 1.002-1.008, P < 0.001). For MAU prediction, the area under the curve (AUC) was 0.709 (95% CI: 0.662-0.753; P < 0.001) when CDBP, PA, and UA were used in combination, and the optimal probability of the cut-off value was 0.337. CONCLUSION We found that CDBP, PA, and UA, used for MAU prediction, might be associated with its development during EHT.
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Affiliation(s)
- Jinlong Li
- Department of Hypertension, Clinical School of Cardiovascular Disease, Tianjin Medical University, Tianjin, 300457, China
- Department of Hypertension, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Ning Yang
- Department of Hypertension, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Hongda Chou
- Department of Hypertension, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Leilei Shi
- Department of Hypertension, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Maoti Wei
- Center for Clinical Epidemiology, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Yuming Li
- Department of Hypertension, TEDA International Cardiovascular Hospital, Tianjin, 300457, China.
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Wang H, Xi Y, Chen Y, Wang L, Yang F, Lu X, Sun N. Efficacy of Allisartan Isoproxil in the Treatment of Mild-to-Moderate Essential Hypertension. Am J Hypertens 2023; 36:561-567. [PMID: 37343187 DOI: 10.1093/ajh/hpad055] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Allisartan isoproxil is a selective nonpeptide angiotensin II (AT1) receptor blocker developed by China, this study aimed to assess its clinical efficacy for essential hypertension (EH). METHODS Patients with mild-to-moderate EH, selected at 44 sites in China from September 9, 2016, to December 7, 2018, were administered 240 mg allisartan isoproxil daily for 4 weeks. Patients with controlled blood pressure (BP) continued monotherapy for 8 weeks, others were randomly assigned (1:1) to A + D group (allisartan isoproxil 240 mg + indapamide 1.5 mg) or A + C group (allisartan isoproxil + amlodipine besylate 5 mg) for 8 weeks. BP were measured at week 4, 8 and 12. RESULTS 2,126 patients were included in the analysis. After 12 weeks of treatment, systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased by 19.24 ± 12.02 and 10.63 ± 8.89 mm Hg, respectively, and the overall BP control rate was 78.56%. The sitting blood pressures (SBP/DBP) decreased by 19.12 ± 11.71/10.84 ± 8.73 mm Hg in patients with 12 weeks allisartan isoproxil monotherapy (both P < 0.0001). The BP reductions and control rates were comparable between A + D and A + C groups. 48 patients with monotherapy-controlled BP underwent ambulatory BP monitoring, with a mean decrease in ambulatory BP of 10.04 ± 10.87/5.50 ± 8.07 mm Hg after 12 weeks of treatment, and consistent reductions between day and night. SBP and DBP had trough-to-peak ratios of 64.64% and 62.63% and smoothness indices of 3.82 and 2.92, respectively. CONCLUSIONS An allisartan isoproxil-based antihypertensive regimen can effectively control BP in patients with mild-to-moderate EH. PROJECT REGISTRATION NO CTR20160138 (Registration and Information Disclosure Platform for China Drug Clinical Studies, http://www.chinadrugtrials.org.cn/index.html).
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Affiliation(s)
- Hongyi Wang
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Yang Xi
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Yuanyuan Chen
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Luyan Wang
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Fan Yang
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Xining Lu
- Department of Hypertension, Peking University People's Hospital, Beijing, China
| | - Ningling Sun
- Department of Hypertension, Peking University People's Hospital, Beijing, China
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Zhang B, Zhao D, Dai X, Pan D. Association between salt sensitivity and blood pressure variability in patients with essential hypertension and predictive value for cardiovascular events. Cardiovasc J Afr 2023; 34:225-230. [PMID: 36947177 DOI: 10.5830/cvja-2022-048] [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: 05/12/2022] [Accepted: 09/02/2022] [Indexed: 03/23/2023] Open
Abstract
We aimed to explore the association between salt sensitivity and blood pressure variability in patients with essential hypertension. A total of 730 patients with essential hypertension treated from 2016 to 2019 were subjected to salt-sensitivity risk stratification according to 24-hour ambulatory blood pressure monitoring. Their clinical data were compared among groups with different grades of salt-sensitivity risk, and the association between salt sensitivity and blood pressure variability was analysed. The influencing factors for cardiovascular events in patients with essential hypertension were analysed through multivariate regression analysis, and their predictive value was detected using receiver operating characteristic (ROC) curves. Salt sensitivity was positively correlated with night-time and 24-hour systolic standard deviation and 24-hour systolic blood pressure coefficient of variation. Age ≥ 55 years, family history of cardiovascular diseases, high risk of salt sensitivity, night-time systolic standard deviation ≥ 14 mmHg, 24-hour systolic standard deviation ≥ 20 mmHg and 24-hour systolic blood pressure coefficient of variation ≥ 13.5% were all independent risk factors for cardiovascular diseases in patients with essential hypertension (p < 0.05). The area under the ROC curve of the prediction model was 0.837. There was a positive correlation between salt sensitivity and blood pressure variability, which has predictive value for cardiovascular events in patients with essential hypertension.
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Affiliation(s)
- Biao Zhang
- Fuyang Second People's Hospital, Fuyang, Anhui Province, China
| | - Dexuan Zhao
- Fuyang Sixth People's Hospital, Fuyang, Anhui Province, China
| | - Xiaohua Dai
- First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Dengyue Pan
- Second People's Hospital, Fuyang, Anhui Province, China.
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Baniasad A, Mokhtari Ardekan A, Najafzadeh MJ, Mousavi Mehdiabadi F. The relationship between vitamin D and short-term blood pressure variability. Blood Press Monit 2023; 28:193-198. [PMID: 37404038 DOI: 10.1097/mbp.0000000000000652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
OBJECTIVES This study aimed to evaluate the relationships between serum levels of 25-hydroxyvitamin D (25(OH)D) and short-term blood pressure variability (BPV) in newly diagnosed hypertensive patients. METHODS One hundred newly diagnosed patients with stage one essential hypertension were included and divided into two groups, the deficient and non-deficient groups, according to their 25(OH)D level. The blood pressure was recorded automatically by a portable ambulatory blood pressure monitor for 24 h. RESULTS In the present study, there was no significant relationship between vitamin D levels and short-term BPV or other parameters derived from ambulatory blood pressure monitoring (ABPM) (P > 0.05). Age (r = 0.260, P = 0.009), serum phosphorus (r = 0.271, P = 0.007), and cholesterol levels (r = 0.310, P = 0.011) were positively correlated with 25(OH)D levels, while glomerular filtration rate (r = -0.232, P = 0.021) negatively correlated with vitamin D levels. There was no crude or adjusted relationship between the levels of 25(OH)D and any parameters of ABPM in multiple linear regression analysis. CONCLUSION Although the relationship between vitamin D levels and cardiovascular diseases has been confirmed, vitamin D deficiency does not cause an increase in cardiovascular risk by influencing the short-term BPV or other parameters derived from ABPM.
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Affiliation(s)
- Amir Baniasad
- Department of Internal Medicine, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences
| | - Abnoos Mokhtari Ardekan
- Department of Internal Medicine, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences
| | - Mohammad Javad Najafzadeh
- Department of Internal Medicine, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Mousavi Mehdiabadi
- Department of Internal Medicine, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences
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Xie M, Tang T, Liang H. Efficacy of single-pill combination in uncontrolled essential hypertension: A systematic review and network meta-analysis. Clin Cardiol 2023; 46:886-898. [PMID: 37432701 PMCID: PMC10436803 DOI: 10.1002/clc.24082] [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: 03/23/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/12/2023] Open
Abstract
This study aimed to evaluate the efficacy of single-pill combination (SPC) antihypertensive drugs in patients with uncontrolled essential hypertension. Through Searching Pubmed, EMBASE, the Cochrane Library, and Web of Science collected only randomized controlled trials on the efficacy of single-pill combination antihypertensive drugs in people with uncontrolled essential hypertension. The search period is from the establishment of the database to July 2022. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Assessment, and statistical analyses were performed using Review Manage 5.3 and Stata 15.1 software. This review ultimately included 32 references involving 16 273 patients with uncontrolled essential hypertension. The results of the network meta-analysis showed that a total of 11 single-pill combination antihypertensive drugs were included, namely: Amlodipine/valsartan, Telmisartan/amlodipine, Losartan/HCTZ, Candesartan/HCTZ, Amlodipine/benazepril, Telmisartan/HCTZ, Valsartan/HCTZ, Irbesartan/amlodipine, Amlodipine/losartan, Irbesartan/HCTZ, and Perindopril/amlodipine. According to SUCRA, Irbesartan/amlodipine may rank first in reducing systolic blood pressure (SUCRA: 92.2%); Amlodipine/losartan may rank first in reducing diastolic blood pressure (SUCRA: 95.1%); Telmisartan/amlodipine may rank first in blood pressure control rates (SUCRA: 83.5%); Amlodipine/losartan probably ranks first in diastolic response rate (SUCRA: 84.5%). Based on Ranking Plot of the Network, we can conclude that single-pill combination antihypertensive drugs are superior to monotherapy, and ARB/CCB combination has better advantages than other SPC in terms of systolic blood pressure, diastolic blood pressure, blood pressure control rate, and diastolic response rate. However, due to the small number of some drug studies, the lack of relevant studies has led to not being included in this study, which may impact the results, and readers should interpret the results with caution.
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Affiliation(s)
- Mengxin Xie
- Department of CardiologyDongguan Children's Hospital Affiliated to Guangdong Medical UniversityShilongDongguanChina
| | - Tianjiao Tang
- Department of CardiologyDongguan Children's Hospital Affiliated to Guangdong Medical UniversityShilongDongguanChina
| | - Hongsheng Liang
- Department of CardiologyDongguan Children's Hospital Affiliated to Guangdong Medical UniversityShilongDongguanChina
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Ji D, Zhang B, He B. The Diagnostic Value of the Deepest S Wave in 12-Lead Electrocardiogram to Elderly Patients with Essential Hypertension and Left Ventricular Hypertrophy. Clin Interv Aging 2022; 17:1663-1672. [PMID: 36444336 PMCID: PMC9700434 DOI: 10.2147/cia.s380814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/01/2022] [Accepted: 11/11/2022] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE This study aims to explore the diagnostic value of the deepest S wave (SD) in elderly patients with essential hypertension and left ventricular hypertrophy (LVH). METHODS A retrospective study was conducted in elderly patients with essential hypertension from October 2020 to December 2021. The 12-lead electrocardiogram (ECG) examination was carried out at the time of admission. Echocardiography was performed to estimate left ventricular mass (LVM) and the left ventricular muscle mass index (LVMI) was adjusted by the body surface area (BSA). The Receiver Operating Characteristic (ROC) curve for diagnosing hypertension with LVH was drawn, the cut-off value was determined according to the Youden index, and the area under the curve (AUC) was calculated. The diagnostic values of SD, SD+Sv4, ravl+Sv3, and Sv1+Rv5 were compared. RESULTS The results of SD, SD+Sv4, RavL+Sv3, and Sv1+Rv5 in the Study group were 2.03 (1.56-2.57) mV, 3.09 (2.38-3.98) mV, 2.19 (1.46-2.78) mV, and 3.38 (2.67-4.19) mV respectively, which were all higher than those in the Control group [0.93 (0.68-1.23) mV, 1.37 (1.32-2.18) mV, 1.03 (0.68-1.46) mV, and 2.28 (1.67-2.67) mV], P<0.001. Compared with the ROC curved by SD+Sv4, RavL+Sv3, and Sv1+Rv5, the AUC of the ROC curved by SD was [0.887, 95% CI (0.837-0.927)], and the cut-off value was 1.298 with the Sensitivity = 86.03 and Specificity = 86.59 in diagnosing essential hypertension with LVH. In female patients, the AUC of the ROC curved by SD was [0.891, 95% CI (0.841-0.934)], and the cut-off value was 1.304 with the Sensitivity of 89.32% and Specificity of 88.67%, which were all higher than those in male patients [AUC = 0.887, 95% CI (0.828-0.943); cut-off value = 1.288; Sensitivity = 82.12%, and Specificity = 84.22%]. CONCLUSION ECG can effectively diagnose elderly patients with essential hypertension and LVH and the diagnostic value of SD and SD+Sv4 are higher than the current Cornell criteria and Sokolow-Lyon criteria.
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Affiliation(s)
- Dapeng Ji
- Department of Cardiac Function, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, People’s Republic of China
| | - Bo Zhang
- Department of Cardiac Function, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, People’s Republic of China
| | - Bo He
- Department of Cardiac Function, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, People’s Republic of China
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Altuntas E, Cetın S, Usalp S. The relationship between gender and systemic immune-inflammation index in patients with new-onset essential hypertension. Cardiovasc J Afr 2022; 33:317-321. [PMID: 35900267 PMCID: PMC10031850 DOI: 10.5830/cvja-2022-030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/16/2022] [Accepted: 05/30/2022] [Indexed: 10/08/2023] Open
Abstract
AIM The systemic immune-inflammation index (SII) has been reported to have a prognostic ability in various cardiovascular diseases and tumours. In this study, we aimed to investigate whether there was an association between SII and gender and age in newly diagnosed, treatment-naïve, hypertensive patients. METHODS A total of 153 participants, of whom 93 were men and 60 were women, were included in this retrospective study. Retrospective evaluation of the patients was performed using electronic medical records. The SII was calculated according to the following formula at admission: SII = platelet × neutrophil/lymphocyte counts. RESULTS The SII was significantly higher in women compared to men (546.31 vs 385, respectively, p = 0.003) and was positively correlated with age. The receiver operating characteristic curve shows the SII cut-off value predicting new-onset essential hypertension with a sensitivity of 67.6% and a specificity of 67.2% in women. CONCLUSIONS According to these results, using the SII in cardiovascular diseases may be recommended to increase survival rate in hypertensive women.
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Affiliation(s)
- Emine Altuntas
- Department of Cardiology, Sancaktepe Sehit Prof Dr Ilhan Varank Education and Research Hospital, Istanbul, Turkey.
| | - Sükrü Cetın
- Department of Cardiology, Sancaktepe Sehit Prof Dr Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Songül Usalp
- Department of Cardiology, Sancaktepe Sehit Prof Dr Ilhan Varank Education and Research Hospital, Istanbul, Turkey
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Wu VC, Wang SM, Huang KH, Tsai YC, Chan CK, Yang SY, Lin LY, Chang CC, Lu CC, Lin YH, Chen YM, Chueh JS. Long-term mortality and cardiovascular events in patients with unilateral primary aldosteronism after targeted treatments. Eur J Endocrinol 2021; 186:195-205. [PMID: 34851859 DOI: 10.1530/eje-21-0836] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/30/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Long-term outcomes (especially mortality and/or major cardiovascular events (MACE)) of the unilateral primary aldosteronism (uPA) patients who underwent medical or surgery-targeted treatment, relative to those with essential hypertension (EH), have been scarcely reported. DESIGN AND SETTINGS Using the prospectively designed observational Taiwan Primary Aldosteronism Investigation cohort, we identified 858 uPA cases among 1220 primary aldosteronism patients and another 1210 EH controls. EXPOSURES Operated uPA patients were grouped via their 1-year post-therapy statuses. RESULTS Primary Aldosteronism Surgical Outcome clinical complete success (hypertension remission) was achieved in 272 (49.9%) of 545 surgically treated uPA patients. After follow-up for 6.3 ± 4.0 years, both hypertension-remissive (hazard ratio (HR): 0.54; P < 0.001) and not-cured (HR: 0.61; P < 0.001) uPA patients showed a lower risk of all-cause mortality than that of EH controls; whereas the not-cured group had a higher risk of incident MACE (sub-hazard ratio (sHR), 1.41; P = 0.037) but similar atrial fibrillation (Af) and congestive heart failure (CHF). Mineralocorticoid receptor antagonist (MRA)-treated uPA patients had higher risks of MACE (sHR: 1.38; P = 0.033), Af (sHR:1.62, P = 0.049), and CHF (sHR: 1.44; P = 0.048) than those of EH controls, with mortality as a competing risk. Using inverse probability of treatment-weighted matching and counting adrenalectomy as a time-varying factor, treatment with adrenalectomy was associated with lower risks of all-cause mortality (HR: 0.57; P = 0.035), MACE (HR: 0.67; P = 0.037), and CHF (HR: 0.49; P = 0.005) compared to those of MRA therapy. CONCLUSIONS Adrenalectomy, independent of post-surgical hypertension remission, was associated with lower all-cause mortality of uPA patients, compared to that of EH patients. We further documented a more beneficial effect of adrenalectomy over MRA treatment on long-term mortality, MACE, and CHF in uPA patients.
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Affiliation(s)
- Vin-Cent Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shuo-Meng Wang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-How Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yao Chou Tsai
- Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chieh-Kai Chan
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Shao-Yu Yang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Lian-Yu Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Chen Chang
- Department of Imaging Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Chu Lu
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hung Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yung-Ming Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeff S Chueh
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
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Xue Y, Cui L, Qi J, Ojo O, Du X, Liu Y, Wang X. The effect of dietary fiber (oat bran) supplement on blood pressure in patients with essential hypertension: A randomized controlled trial. Nutr Metab Cardiovasc Dis 2021; 31:2458-2470. [PMID: 34090773 DOI: 10.1016/j.numecd.2021.04.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 10/22/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Insufficient dietary fiber (DF) intake is associated with increased blood pressure (BP) and the mode of action is unclear. The intake of DF supplements by participants in previous interventional studies was still far below the amount recommended by the World Health Organization. Therefore, this study aims to explore the effect of supplementing relatively sufficient DF on BP and gut microbiota in patients with essential hypertension (HTN). METHODS AND RESULTS Fifty participants who met the inclusion criteria were randomly divided into the DF group (n = 25) and control group (n = 25). All the participants received education on regular dietary guidance for HTN. In addition to dietary guidance, one bag of oat bran (30 g/d) supplement (containing DF 8.9 g) was delivered to the DF group. The office BP (oBP), 24 h ambulatory blood pressure, and gut microbiota were measured at baseline and third month. After intervention, the office systolic blood pressure (oSBP; P < 0.001) and office diastolic blood pressure (oDBP; P < 0.028) in the DF group were lower than those in the control group. Similarly, the changes in 24hmaxSBP (P = 0.002), 24hmaxDBP (P = 0.001), 24haveSBP (P < 0.007), and 24haveDBP (P = 0.008) were greater in the DF group than in the control group. The use of antihypertensive drugs in the DF group was significantly reduced (P = 0.021). The β diversity, including Jaccard (P = 0.008) and Bray-Curtis distance (P = 0.004), showed significant differences (P < 0.05) between two groups by the third month. The changes of Bifidobacterium (P = 0.019) and Spirillum (P = 0.006) in the DF group were significant. CONCLUSIONS Increased DF (oat bran) supplement improved BP, reduced the amount of antihypertensive drugs, and modulated the gut microbiota. TRIAL REGISTRATION NUMBER ChiCTR1900024055.
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Affiliation(s)
- Yuan Xue
- School of Nursing, Medical College, Soochow University, Suzhou, 215006, China; Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225000, China
| | - Lingling Cui
- School of Nursing, Medical College, Soochow University, Suzhou, 215006, China
| | - Jindan Qi
- School of Nursing, Medical College, Soochow University, Suzhou, 215006, China
| | - Omorogieva Ojo
- School of Health Sciences, Faculty of Education and Health, University of Greenwich, London, SE9 2UG, UK
| | - Xiaojiao Du
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Shizi Street, Suzhou, 215006, China
| | - Yuanyuan Liu
- School of Nursing, Medical College, Soochow University, Suzhou, 215006, China
| | - Xiaohua Wang
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Shizi Street, Suzhou, 215006, China.
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Yang S, Zhang H, Yang P, Wang C, Wu Q. Efficacy and Safety of LCZ696 for Short-term Management of Essential Hypertension Compared With ARBs: A Meta-analysis of Randomized Controlled Trials. J Cardiovasc Pharmacol 2021; 77:650-659. [PMID: 33951700 DOI: 10.1097/fjc.0000000000001001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/10/2021] [Indexed: 12/13/2022]
Abstract
ABSTRACT Whether LCZ696 (neprilysin inhibitor + valsartan) has greater advantages of blood pressure (BP) lowering than angiotensin II type 1 receptor blockers (ARBs) is unclear. To provide more detailed information about the benefits of LCZ696, we conducted a meta-analysis to evaluate the efficacy and safety of LCZ696 for short-term management of hypertension compared with ARBs. We searched PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov, using relevant keywords. We used a random or fixed effects model to calculate the weighted mean difference (WMD) of changes in BP and the risk ratio (RR) for BP control rates and adverse events (AEs). In this meta-analysis, 9 studies were incorporated. Compared with ARBs, LCZ696 revealed a significant reduction in mean sitting systolic BP [msSBP; WMD -4.79 mm Hg; 95% confidence interval (CI): -5.46 to -4.11 mm Hg], mean sitting diastolic BP (msDBP; WMD -2.12 mm Hg; 95% CI: -2.53 to -1.71 mm Hg), mean sitting pulse pressure (msPP; WMD -2.79 mm Hg; 95% CI: -3.52 to -2.07 mm Hg), and mean ambulatory pulse pressure (maPP; WMD -2.96 mm Hg; 95% CI: -3.35 to -2.57 mm Hg). LCZ696 had a higher BP control rate than ARBs (OR = 1.55; 95% CI: 1.39 to 1.73). There was no significant difference between LCZ696 and ARBs in the incidence of AEs (RR = 1.10; 95% CI: 0.96 to 1.25) and discontinuations because of AEs (RR = 0.97; 95% CI: 0.54 to 1.32). Overall, in short-term treatment, LCZ696 has greater advantages of antihypertensive efficacy and the safety is not inferior to ARBs. Further long-term studies are required to rule out the potential risks of beta amyloid accumulation and the potential for Alzheimer's disease.
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Affiliation(s)
- Shuai Yang
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, China; and
- Medical Center of the Graduate School, Nanchang University, Nanchang, China
| | - Hongzhou Zhang
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, China; and
- Medical Center of the Graduate School, Nanchang University, Nanchang, China
| | - Pingping Yang
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, China; and
- Medical Center of the Graduate School, Nanchang University, Nanchang, China
| | - Chenxi Wang
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, China; and
- Medical Center of the Graduate School, Nanchang University, Nanchang, China
| | - Qinghua Wu
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, China; and
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Erlic Z, Reel P, Reel S, Amar L, Pecori A, Larsen CK, Tetti M, Pamporaki C, Prehn C, Adamski J, Prejbisz A, Ceccato F, Scaroni C, Kroiss M, Dennedy MC, Deinum J, Langton K, Mulatero P, Reincke M, Lenzini L, Gimenez-Roqueplo AP, Assié G, Blanchard A, Zennaro MC, Jefferson E, Beuschlein F. Targeted Metabolomics as a Tool in Discriminating Endocrine From Primary Hypertension. J Clin Endocrinol Metab 2021; 106:1111-1128. [PMID: 33382876 PMCID: PMC7993566 DOI: 10.1210/clinem/dgaa954] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT Identification of patients with endocrine forms of hypertension (EHT) (primary hyperaldosteronism [PA], pheochromocytoma/paraganglioma [PPGL], and Cushing syndrome [CS]) provides the basis to implement individualized therapeutic strategies. Targeted metabolomics (TM) have revealed promising results in profiling cardiovascular diseases and endocrine conditions associated with hypertension. OBJECTIVE Use TM to identify distinct metabolic patterns between primary hypertension (PHT) and EHT and test its discriminating ability. METHODS Retrospective analyses of PHT and EHT patients from a European multicenter study (ENSAT-HT). TM was performed on stored blood samples using liquid chromatography mass spectrometry. To identify discriminating metabolites a "classical approach" (CA) (performing a series of univariate and multivariate analyses) and a "machine learning approach" (MLA) (using random forest) were used.The study included 282 adult patients (52% female; mean age 49 years) with proven PHT (n = 59) and EHT (n = 223 with 40 CS, 107 PA, and 76 PPGL), respectively. RESULTS From 155 metabolites eligible for statistical analyses, 31 were identified discriminating between PHT and EHT using the CA and 27 using the MLA, of which 16 metabolites (C9, C16, C16:1, C18:1, C18:2, arginine, aspartate, glutamate, ornithine, spermidine, lysoPCaC16:0, lysoPCaC20:4, lysoPCaC24:0, PCaeC42:0, SM C18:1, SM C20:2) were found by both approaches. The receiver operating characteristic curve built on the top 15 metabolites from the CA provided an area under the curve (AUC) of 0.86, which was similar to the performance of the 15 metabolites from MLA (AUC 0.83). CONCLUSION TM identifies distinct metabolic pattern between PHT and EHT providing promising discriminating performance.
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Affiliation(s)
- Zoran Erlic
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Parminder Reel
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Smarti Reel
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Laurence Amar
- Université de Paris, PARCC, INSERM, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Unité Hypertension artérielle, Paris, France
| | - Alessio Pecori
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | | | - Martina Tetti
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | - Christina Pamporaki
- Institute of Clinical Chemistry and Laboratory Medicine, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Cornelia Prehn
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Jerzy Adamski
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 8 Medical Drive, Singapore, Singapore
| | - Aleksander Prejbisz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Filippo Ceccato
- UOC Endocrinologia, Dipartimento di Medicina DIMED, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Carla Scaroni
- UOC Endocrinologia, Dipartimento di Medicina DIMED, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Matthias Kroiss
- Clinical Chemistry and Laboratory Medicine, Core Unit Clinical Mass Spectrometry, Universitätsklinikum Würzburg, Germany
- Schwerpunkt Endokrinologie/Diabetologie, Medizinische Klinik und Poliklinik I, Universitätsklinikum Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, Universität Würzburg, Würzburg, Germany
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
| | - Michael C Dennedy
- The Discipline of Pharmacology and Therapeutics, School of Medicine, National University of Ireland 33 Galway, Ireland
| | - Jaap Deinum
- Department of Medicine, Section of Vascular Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katharina Langton
- Institute of Clinical Chemistry and Laboratory Medicine, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
| | - Livia Lenzini
- Clinica dell’Ipertensione Arteriosa, Department of Medicine-DIMED, University of Padua, Padua
| | - Anne-Paule Gimenez-Roqueplo
- Université de Paris, PARCC, INSERM, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Guillaume Assié
- Université de Paris, Institut Cochin, INSERM, CNRS, PARIS, France
- Department of Endocrinology, Center for Rare Adrenal Diseases, AP-HP, Hôpital Cochin, Paris, France
- Department of Endocrinology, Center for Rare Adrenal Diseases, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Anne Blanchard
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Centre d’Investigations Cliniques 9201, Paris, France
| | - Maria Christina Zennaro
- Université de Paris, PARCC, INSERM, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Emily Jefferson
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Felix Beuschlein
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, UniversitätsSpital Zürich, Zurich, Switzerland
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
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Deng Y, Huang C, Su J, Pan CW, Ke C. Identification of biomarkers for essential hypertension based on metabolomics. Nutr Metab Cardiovasc Dis 2021; 31:382-395. [PMID: 33495028 DOI: 10.1016/j.numecd.2020.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/14/2020] [Revised: 11/10/2020] [Accepted: 11/20/2020] [Indexed: 01/09/2023]
Abstract
AIM Essential hypertension (EH) is one of the most important public health problems worldwide. However, the pathogenesis of EH is unclear and early diagnostic methods are lacking. Metabolomics demonstrates great potential for biomarker discovery and the mechanistic exploration of metabolic diseases. DATA SYNTHESIS This review included human and animal metabolomics studies related to EH in the PubMed and Web of Science databases between February 1996 and May 2020. The study designs, EH standards, and reported metabolic biomarkers were systematically examined and compared. The pathway analysis was conducted through the online software MetaboAnalyst 4.0. Twenty-two human studies and fifteen animal studies were included in this systematic review. There were many frequently reported biomarkers with consistent trends (e.g., pyruvate, lactic acid, valine, and tryptophan) in human and animal studies, and thus had potential as biomarkers of EH. In addition, several shared metabolic pathways, including alanine, aspartate, and glutamate metabolism, aminoacyl-tRNA biosynthesis, and arginine biosynthesis, were identified in human and animal metabolomics studies. These biomarkers and pathways, closely related to insulin resistance, the inflammatory state, and impaired nitric oxide production, were demonstrated to contribute to EH development. CONCLUSIONS This study summarized valuable metabolic biomarkers and pathways that could offer opportunities for the early diagnosis or prediction of EH and the discovery of the metabolic mechanisms of EH.
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Affiliation(s)
- Yueting Deng
- Medical College of Soochow University, Suzhou, 215123, PR China
| | - Chen Huang
- Medical College of Soochow University, Suzhou, 215123, PR China
| | - Jingyue Su
- Medical College of Soochow University, Suzhou, 215123, PR China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, PR China.
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, PR China.
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18
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Nardi E, Mulè G, Giammanco A, Mattina A, Geraci G, Nardi C, Averna M. Left ventricular hypertrophy in chronic kidney disease: A diagnostic criteria comparison. Nutr Metab Cardiovasc Dis 2021; 31:137-144. [PMID: 33092976 DOI: 10.1016/j.numecd.2020.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/16/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS CKD patients have a high prevalence of LVH and this leads to an increase of cardiovascular risk. The aim of this study was to assess the prevalence of left ventricular hypertrophy (LVH) and left ventricular geometry in a group of 293 hypertensive patients with stage 2-5 chronic kidney disease (CKD), compared with 289 essential hypertensive patients with normal renal function. METHODS AND RESULTS All patients underwent echocardiographic examination. Patients on stage 1 CKD, dialysis treatment, or with cardiovascular diseases were excluded. LVH was observed in 62.8% of patients with CKD and in 51.9% of essential hypertensive patients (P < 0.0001). We found increasingly higher left ventricular diameters, thicknesses, and mass from stage 2-5 CKD. Distribution of concentric and eccentric LVH was not very different between the two groups. However, after introducing mixed hypertrophy, the difference between the two groups group was disclosed (P = 0.027). Multiple regression analysis confirmed that the association between renal function and left ventricular mass (β -0.287; P < 0.0001) was independent by potential confounders. Diastolic function was significantly worse in patients with CKD, especially in more advanced stages. CONCLUSION Our study confirms that LVH is highly prevalent in patients with CKD, especially by using the most recent cut off; in this population, LVH is often characterized by the simultaneous increase of wall thicknesses and diameters with negative effects on diastolic function.
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Affiliation(s)
- Emilio Nardi
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
| | - Antonina Giammanco
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
| | - Alessandro Mattina
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy; Diabetes and Islet Transplantation Unit, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), UPMC, Palermo, Italy
| | - Giulio Geraci
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy; University of Palermo - Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, Palermo, Italy
| | - Chiara Nardi
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
| | - Maurizio Averna
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
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Fuss CT, Brohm K, Kurlbaum M, Hannemann A, Kendl S, Fassnacht M, Deutschbein T, Hahner S, Kroiss M. Confirmatory testing of primary aldosteronism with saline infusion test and LC-MS/MS. Eur J Endocrinol 2021; 184:167-178. [PMID: 33112272 PMCID: PMC7709890 DOI: 10.1530/eje-20-0073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 10/20/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Saline infusion testing (SIT) for confirmation of primary aldosteronism (PA) is based on impaired aldosterone suppression in PA compared to essential hypertension (EH). In the past, aldosterone was quantified using immunoassays (IA). Liquid chromatography tandem mass spectrometry (LC-MS/MS) is increasingly used in clinical routine. We aimed at a method-specific aldosterone threshold for the diagnosis of PA during SIT and explored the diagnostic utility of steroid panel analysis. DESIGN Retrospective cohort study of 187 paired SIT samples (2009-2018). Diagnosis of PA (n = 103) and EH (n = 84) was established based on clinical routine workup without using LC-MS/MS values. SETTING Tertiary care center. METHODS LC-MS/MS using a commercial steroid panel. Receiver operator characteristics analysis was used to determine method-specific cut-offs using a positive predictive value (PPV) of 90% as criterion. RESULTS Aldosterone measured by IA was on average 31 ng/L higher than with LC-MS/MS. The cut-offs for PA confirmation were 54 ng/L for IA (sensitivity: 95%, 95% CI: 89.0-98.4; specificity: 87%, 95% CI: 77.8-93.3; area under the curve (AUC): 0.955, 95% CI: 0.924-0.986; PPV: 90%, 95% CI: 83.7-93.9) and 69 ng/L for LC-MS/MS (79%, 95% CI: 69.5-86.1; 89%, 95% CI: 80.6-95.0; 0.902, 95% CI: 0.857-0.947; 90%, 95% CI: 82.8-94.4). Other steroids did not improve SIT. CONCLUSIONS Aldosterone quantification with LC-MS/MS and IA yields comparable SIT-cut-offs. Lower AUC for LC-MS/MS is likely due to the spectrum of disease in PA and previous decision making based on IA results. Until data of a prospective trial with clinical endpoints are available, the suggested cut-off can be used in clinical routine.
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Affiliation(s)
- Carmina Teresa Fuss
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Katharina Brohm
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Max Kurlbaum
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
- Central Laboratory, Core Unit Clinical Mass Spectrometry, University Hospital Würzburg, Würzburg, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sabine Kendl
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Martin Fassnacht
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Timo Deutschbein
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefanie Hahner
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Matthias Kroiss
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
- Central Laboratory, Core Unit Clinical Mass Spectrometry, University Hospital Würzburg, Würzburg, Germany
- Department of Medicine IV, University Hospital Munich, Ludwig-Maximilians-Universität München, Munich, Germany
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Yucel O, Gunes H, Kerkutluoglu M, Ozturk B, Kirisci M, Alkan FB. Adrenomedullin and non-dipping circadian pattern in newly diagnosed essential hypertension. ACTA ACUST UNITED AC 2020; 121:881-887. [PMID: 33300358 DOI: 10.4149/bll_2020_145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE There is frequently a relationship between nocturnal hypertension and non-dipping pattern and endothelial dysfunction. Studies conducted previously have indicated that adrenomedullin (AM) (a potent, long-lasting, vasodilatory peptide) is capable of regulating endothelial cell function. The aim of the current research is to investigate the association between absolute night-time blood pressure (BP) and circadian BP pat-tern with serum AM and high-sensitivity C-reactive protein (hsCRP) levels in cases in whom untreated arterial hypertension has been newly diagnosed. METHODS Ambulatory BP monitoring was performed in 100 individuals with hypertension (50 dippers,50 non-dippers) and 50 healthy controls for 24 hours. Measurement and recording of AM and hsCRP serum levels were performed. RESULTS A strong correlation between night-time BP levels and AM and hsCRP levels was determined(p<0.001). On the contrary, higher AM levels were determined in the non-dipper group compared to the dipper and normotensive groups (non-dipper group, 258±27 pg/mL; dipper group, 199±30 pg/mL; normotensive group, 150±11 pg/mL; p<0.001). The non-dipper group exhibited significantly higher hsCRP levels in comparison with the remaining two groups (p=0.017). An independent association was determined between AM (p=0.014) and hsCRP (p=0.032) and a non-dipping pattern in a multivariate logistic regression analysis. CONCLUSIONS The nocturnal hypertensive and non-dipper groups exhibited increased AM levels. An independent association was identified between AM and hsCRP and a non-dipping pattern. It is implied that increased AM levels in individuals with non-dipper hypertension may be related to a longer exposure time to high BP. The mentioned findings indicate a potential future part of AM in identifying patients with hypertension that are at higher risk of target organ damage (Tab. 3, Fig. 4, Ref. 41).
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Yoshikawa M, Asaba K, Nakayama T. The APLNR gene polymorphism rs7119375 is associated with an increased risk of development of essential hypertension in the Chinese population: A meta-analysis. Medicine (Baltimore) 2020; 99:e22418. [PMID: 33327224 PMCID: PMC7738041 DOI: 10.1097/md.0000000000022418] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hypertension (HT) has recently been defined as a systolic blood pressure (BP) of ≥130 mm Hg and/or a diastolic BP of ≥80 mm Hg. It is important to further understand the pathophysiology of essential HT as its proportion is larger among most of the diagnosed HT cases. The apelin and apelin receptor (APLNR) are known to play roles in regulating BP, but the putative associations of single nucleotide polymorphisms in the APLNR gene with the risk of development of essential HT have not yet been fully investigated. Herein, we conducted a meta-analysis to investigate the relationship between single nucleotide polymorphisms in the APLNR gene and the risk of essential HT.We conducted a search in the PubMed and Web of Science databases for eligible studies. The pooled odds ratios (ORs) with their 95% confidence intervals (CI) were calculated using random-effects models when heterogeneity was expected across the studies. Otherwise, fixed-effect models were used.Regarding the SNP rs7119375, 5 studies were analyzed, which included a total of 3567 essential HT patients and 3256 healthy controls. Four of the 5 studies were from China and 1 was from Mexico. The meta-analysis showed the existence of a significant association between the AA genotype of rs7119375 and the risk of developing essential HT in the Chinese population, as determined using additive and recessive models (OR, 2.11; 95% CI, 1.12-3.96; I = 86% for AA vs GG. OR, 1.53; 95% CI, 1.21-1.94; I = 28% for AA vs AG. OR, 1.88; 95% CI, 1.13-3.12; I = 79% for AA vs AG + GG).Our study showed, for the first time, the existence of an association between rs7119375 and the risk of development of essential HT in the Chinese population, although the sample size was small and there was considerable population heterogeneity. The apelin/APLNR system could be a novel therapeutic target for the treatment of essential HT, and more studies are warranted to further investigate the association.
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Affiliation(s)
- Masahiro Yoshikawa
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine
| | - Kensuke Asaba
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomohiro Nakayama
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine
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Cassano V, Crescibene D, Hribal ML, Pelaia C, Armentaro G, Magurno M, Toscani A, Miceli S, Andreozzi F, Maio R, Perticone M, Sesti G, Perticone F, Sciacqua A. Uric Acid and Vascular Damage in Essential Hypertension: Role of Insulin Resistance. Nutrients 2020; 12:nu12092509. [PMID: 32825165 PMCID: PMC7551393 DOI: 10.3390/nu12092509] [Citation(s) in RCA: 16] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/16/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023] Open
Abstract
Increased levels of uric acid (UA) have been shown to be correlated with many clinical conditions. Uric acid may adversely affect the insulin signalling pathway inducing insulin resistance (IR). Several studies report the association between arterial stiffness (AS), an early indicator of atherosclerosis, and UA. The purpose of the present study was to evaluate the association between UA and AS, considering the potential role of IR. We enrolled 1114 newly diagnosed, never-treated hypertensive patients. Insulin resistance was assessed by the homeostatic model assessment (HOMA) index. Arterial stiffness was evaluated as the measurement of the carotid–femoral pulse wave velocity (PWV). The study cohort was divided into subgroups, according to increasing tertiles of UA. The mean values of UA were 5.2 ± 1.6 mg/dL in the overall population. Pulse wave velocity was linearly correlated with UA (p < 0.0001), HOMA (p < 0.0001), high sensitivity C-reactive protein (p < 0.0001), systolic blood pressure (p < 0.0001) and LDL cholesterol (p = 0.005). Uric acid was the strongest predictor of PWV and was associated with the highest risk for increased AS. The interaction analysis showed that the joint effect of increased UA and HOMA was significantly higher than that expected in the absence of interaction under the additive model, indicating that the two biomarkers synergically interacted for promoting vascular damage. Our data showed that UA interacted with IR to increase AS in a large cohort of newly diagnosed, never-treated hypertensive patients.
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Affiliation(s)
- Velia Cassano
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Daniele Crescibene
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Marcello Magurno
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Alfredo Toscani
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Sofia Miceli
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Raffaele Maio
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Maria Perticone
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00161 Rome, Italy;
| | - Francesco Perticone
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences; University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.C.); (D.C.); (M.L.H.); (C.P.); (G.A.); (M.M.); (A.T.); (S.M.); (F.A.); (R.M.); (M.P.); (F.P.)
- Correspondence: ; Tel.: +39-0961-3647147
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Li L, Zhong D, Xie Y, Yang X, Yu Z, Zhang D, Jiang X, Wu Y, Wu F. Blood microRNA 202-3p associates with the risk of essential hypertension by targeting soluble ST2. Biosci Rep 2020; 40:222775. [PMID: 32338289 PMCID: PMC7201562 DOI: 10.1042/bsr20200378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/07/2020] [Accepted: 04/20/2020] [Indexed: 02/05/2023] Open
Abstract
MicroRNA (miR)-202-3p has attracted a great deal of attention in the fields of oncology, gynecology, and metabolic disorders. However, its role in cardiovascular diseases remains to be clarified. We previously found that disruption of miR-202-3p mediated regulation of expression of soluble (s)ST2, a decoy receptor for interleukin (IL)-33, promotes essential hypertension (EH). In the present study, we first measured miR-202-3p expression levels in the blood of 182 EH cases and 159 healthy controls using TaqMan assays. miR-202-3p levels were shown to be significantly higher in EH cases than controls (fold change = 3.58, P<0.001). Logistic regression analysis revealed that higher miR-202-3p expression was associated with an increased occurrence of EH (adjusted odds ratio (OR): 1.57; 95% confidence interval (CI), 1.36-1.82; P<0.001). Addition of miR-202-3p to traditional risk factors showed an additive prediction value for EH. Further functional experiments indicated that miR-202-3p could be induced by angiotensin II (Ang II) and inhibited by Ang II-triggered soluble ST2 (sST2) expression in a negative feedback manner. Moreover, blood miR-202-3p levels were negatively correlated with sST2 expression in vivo. Our study shows that blood miR-202-3p levels were significantly associated with the occurrence of EH. These findings indicate that miR-202-3p exerts a protective role against EH by antagonizing the induction of sST2 by Ang II.
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Affiliation(s)
- Lu Li
- Research Center of Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Guangdong, China
- Center for Pathgen Biology and Immunology, Shantou University Medical College, Guangdong, China
| | - Danrong Zhong
- Research Center of Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Guangdong, China
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Shantou University Medical College, Guangdong, China
| | - Yudan Xie
- Research Center of Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Guangdong, China
| | - Xinlei Yang
- Biobank Center, The Second Afflicted Hospital of Nanchang University, Jiangxi, China
| | - Zuozhong Yu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Dangui Zhang
- Research Center of Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Guangdong, China
| | - Xinghua Jiang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yanqing Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Fangqin Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
- Correspondence: Fangqin Wu ()
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Geraci G, Maria Zammuto M, Vadalà M, Mattina A, Castellucci M, Guarrasi G, Nardi E, Maida C, Zanoli L, Cillino S, Cottone S, Mulè G. Choroidal thickness is associated with renal hemodynamics in essential hypertension. J Clin Hypertens (Greenwich) 2020; 22:245-253. [PMID: 31945274 PMCID: PMC8030072 DOI: 10.1111/jch.13777] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 10/26/2019] [Accepted: 11/17/2019] [Indexed: 01/02/2023]
Abstract
The choroid is the most vascularized structure of the eye and plays a central role in the development of the retinal vascular changes that occur in arterial hypertension. Changes of choroidal thickness (ChT) assessed by optical coherence tomography (OCT) technology could reflect the vascular complications of hypertension. Also, intrarenal hemodynamic damage, associated with endothelial dysfunction, demonstrated to be a good indicator of systemic morphofunctional arterial impairment. The aim of this study is to assess the relationship between ChT and renal hemodynamics in subjects with essential hypertension. Routine laboratory tests, clinical history, and physical examination, including blood pressure assessment, were performed in 90 subjects with essential hypertension. All patients underwent Doppler ultrasonographic evaluation of intra-renal hemodynamics and OCT imaging to assess ChT. When subjects were divided in two groups based on renal resistive index (RRI), group I (RRI ≥ 75% percentile) showed significantly lower values of ChT than group II (RRI < 75% percentile) (P < .001). When divided in two groups based on the ChT median values, patients with lower ChT had significantly higher RRI values than those with ChT above the median values (P < .05). In multivariate model including age, eGFR, and other variables as confounding factors, RRI ≥ 75% was independently associated with ChT. ChT was significantly correlated with renal resistive index in subjects with essential hypertension, confirmed in multivariate analyses. This result could be referred to changes in vascular elastic properties that occur in retinal and intrarenal vascular system probably due to oxidative stress and endothelial dysfunction commonly found in early complications of hypertension.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Maria Vadalà
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Alessandro Mattina
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Internal MedicineUniversity of PalermoPalermoItaly
- IRCCS Centro Neurolesi "Bonibo‐Pulejo"MessinaItaly
| | - Massimo Castellucci
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Giulia Guarrasi
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Internal MedicineUniversity of PalermoPalermoItaly
| | - Carlo Maida
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Luca Zanoli
- Clinical and Experimental MedicineSection of NephrologyUniversity of CataniaCataniaItaly
| | - Salvatore Cillino
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
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25
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Dąbrowska E, Harazny JM, Miszkowska-Nagórna E, Stefański A, Graff B, Kunicka K, Świerblewska E, Rojek A, Szyndler A, Gąsecki D, Wolf J, Gruchała M, Laurent S, Schmieder RE, Narkiewicz K. Aortic stiffness is not only associated with structural but also functional parameters of retinal microcirculation. Microvasc Res 2020; 129:103974. [PMID: 31923388 DOI: 10.1016/j.mvr.2020.103974] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/05/2019] [Revised: 12/22/2019] [Accepted: 01/01/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The aim of the study was to test the hypothesis that alterations in large arteries are associated with microvascular remodelling and decreased retinal capillary blood flow. METHODS The study group comprised of 88 patients with essential hypertension and 32 healthy controls. Retinal microcirculation was evaluated by scanning laser Doppler flowmetry. Macrovascular changes were assessed on the basis of arterial stiffness measurement (carotid-femoral pulse wave velocity), its hemodynamic consequences (central pulse pressure, augmentation pressure, augmentation index) and intima media thickness of common carotid artery. RESULTS Pulse wave velocity was inversely correlated to mean retinal capillary blood flow in hypertensive patients (R = -0.32, p < 0.01). This relationship remained significant in multivariate regression analysis after adjustment for age, sex, central systolic blood pressure (BP) and body mass index (β = -31.27, p < 0.001). Lumen diameter (LD) of retinal arterioles was significantly smaller in hypertensive then normotensive subjects (79.4 vs. 83.8, p = 0.03). Central and brachial systolic, diastolic and mean BPs were significantly correlated with LD and outer diameter of retinal arterioles. The relationship between LD and central BPs remained significant in multivariate analysis (β = -0.15, p = 0.03 for cSBP; β = -0.22, p = 0.04 for cDBP; β = -0.21, p = 0.03 for cMBP). Moreover, in a subgroup with cardiac damage central and brachial pulse pressure were positively associated with retinal wall thickness, wall cross sectional area, and wall to lumen ratio. CONCLUSION In conclusion, the study provides a strong evidence that microcirculation is coupled with macrocirculation not only in terms of structural but also functional parameters.
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Affiliation(s)
- Edyta Dąbrowska
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland; First Department of Cardiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.
| | - Joanna M Harazny
- Department of Pathophysiology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland; Clinical Research Centre, Department of Nephrology and Hypertension, Univerity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Eliza Miszkowska-Nagórna
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Adrian Stefański
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Beata Graff
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Kunicka
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Świerblewska
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Agnieszka Rojek
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Anna Szyndler
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Dariusz Gąsecki
- Department of Neurology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruchała
- First Department of Cardiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | | | - Roland E Schmieder
- Clinical Research Centre, Department of Nephrology and Hypertension, Univerity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
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Jiang K, Ferguson CM, Abumoawad A, Saad A, Textor SC, Lerman LO. A modified two-compartment model for measurement of renal function using dynamic contrast-enhanced computed tomography. PLoS One 2019; 14:e0219605. [PMID: 31291361 PMCID: PMC6619810 DOI: 10.1371/journal.pone.0219605] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/27/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives To validate and adapt a modified two-compartment model, originally developed for magnetic resonance imaging, for measuring human single-kidney glomerular filtration rate (GFR) and perfusion using dynamic contrast-enhanced computed tomography (DCE-CT). Methods This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Thirty-eight patients with essential hypertension (EH, n = 13) or atherosclerotic renal artery stenosis (ARAS, n = 25) underwent renal DCE-CT for GFR and perfusion measurement using a modified two-compartment model. Iothalamate clearance was used to measure reference total GFR, which was apportioned into single-kidney GFR by renal blood flow. Renal perfusion was also calculated using a conventional deconvolution algorithm. Validation of GFR and perfusion and inter-observer reproducibility, were conducted by using the Pearson correlation and Bland-Altman analysis. Results Both the two-compartment model and iothalamate clearance detected in ARAS patients lower GFR in the stenotic compared to the contralateral and EH kidneys. GFRs measured by DCE-CT and iothalamate clearance showed a close match (r = 0.94, P<0.001, and mean difference 2.5±12.2mL/min). Inter-observer bias and variation in model-derived GFR (r = 0.97, P<0.001; mean difference, 0.3±7.7mL/min) were minimal. Renal perfusion by deconvolution agreed well with that by the compartment model when the blood transit delay from abdominal aorta to kidney was negligible. Conclusion The proposed two-compartment model faithfully depicts contrast dynamics using DCE-CT and may provide a reliable tool for measuring human single-kidney GFR and perfusion.
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Affiliation(s)
- Kai Jiang
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Christopher M. Ferguson
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Abdelrhman Abumoawad
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ahmed Saad
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Stephen C. Textor
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Lilach O. Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
- * E-mail:
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Liu L, Gu T, Bao X, Zheng S, Zhao J, Zhang L. Microarray Profiling of Circular RNA Identifies hsa_circ_0126991 as a Potential Risk Factor for Essential Hypertension. Cytogenet Genome Res 2019; 157:203-212. [PMID: 31108493 DOI: 10.1159/000500063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 01/18/2023] Open
Abstract
Essential hypertension (EH), a major cause of cardiovascular diseases, is an important public health issue. However, the molecular mechanisms involved in EH remain unknown. Circular RNA (circRNA) is a novel promising biomarker for the disease. The purpose of the present study was to determine the expression of circRNAs in the blood of EH patients and to evaluate the performance of circRNA for early diagnosis of EH. A total of 178 subjects were recruited in the case-control study. Initial screening was done by using the Agilent human circRNA microarray followed by qRT-PCR validation. Finally, miRNAs were combined with circRNAs to create a new early prediction model for EH. The expression level of hsa_circ_0126991 in EH patients was significantly higher in comparison with healthy controls (p < 0.0001). Using the interaction of miR-10a-5p in combination with hsa_circ_0126991 led to a sensitivity of 0.708, a specificity of 0.764, and combined area under the curve of 0.774 (95% CI: 0.705-0.843) for early diagnosis of EH. In summary, the present study uncovered a novel perspective that hyperexpression of hsa_circ_0126991 is correlated with the risk of EH and may serve as a stable biomarker for early diagnosis of EH.
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Kalyuzhnaya OV, Bairova TA, Kolesnikova LI. Predictive Models for the Risk of Dyslipidemia in Adolescents with Essential Arterial Hypertension. Bull Exp Biol Med 2018; 166:297-300. [PMID: 30488199 DOI: 10.1007/s10517-018-4336-y] [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: 06/06/2018] [Indexed: 11/27/2022]
Abstract
Predictive models of comorbidity, dyslipidemic disorders and essential arterial hypertension, in Russian adolescents aged 12 to 18 years (mean 15.48±1.53) were formulated with consideration for biochemical (lipid profiles) and genetic parameters (carrier state of gene polymorphic variants of apolipoprotein genes ApoA1 (-75G/A and +83C/T), ApoB (Ins/Del), ApoC3 (S1/S2), and ApoE (ε2/ε3/ε4). Significant prognostic risk factors for the mentioned comorbid pathologies were lipid metabolism parameters HDL-Ch, LDL-Ch, VLDL-Ch and carrier state of the +83T allele of the ApoA1 gene and Del allele of the ApoB gene. The obtained mathematical model is characterized by high predictive accuracy: the percentage of correct classification or the rate of correct assignment of each participant to the proper group was 96.33%.
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Affiliation(s)
- O V Kalyuzhnaya
- Research Centre for the Problems of Family Health and Human Reproduction, Irkutsk, Russia.
| | - T A Bairova
- Research Centre for the Problems of Family Health and Human Reproduction, Irkutsk, Russia
| | - L I Kolesnikova
- Research Centre for the Problems of Family Health and Human Reproduction, Irkutsk, Russia
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Tayefi M, Hassanian SM, Maftouh M, Moohebati M, Bahrami A, Parizadeh SM, Mahdizadeh A, Ghazizadeh H, Bazeli J, Heidari-Bakavoli A, Kianifar H, Mohammadzadeh E, Rahmani F, Esmaeili H, Ebrahimi M, Azarpazhooh MR, Nematy M, Safarian M, Ferns GA, Avan A, Ghayour-Mobarhan M. Relationship between platelet count and platelet width distribution and serum uric acid concentrations in patients with untreated essential hypertension. Biofactors 2018; 44:532-538. [PMID: 30260522 DOI: 10.1002/biof.1453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/24/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 11/09/2022]
Abstract
Hematological parameters have emerged as independent determinants of high serum concentrations of uric acid (UA) and predictive factors in the evaluation of the total cardiovascular risk in patients with essential hypertensive. Here, we have investigated the possible relationships between hematological factors and serum uric acid levels in hypertensive patients recruited as part of Mashhad Stroke and Heart Atherosclerotic Disorders cohort study. Two-thousand three-hundred and thirty-four hypertensive individuals were recruited from this cohort and these were divided into two groups; those with either high or low serum UA concentrations. Demographic, biochemical, and hematological characteristics of population were evaluated in all the subjects. Logistic-regression analysis was performed to determine the association of hematological parameters with hypertension (HTN). Of the 2334 hypertensive subjects, 290 cases had low UA, and 2044 had high serum UA concentrations. Compared with the low UA group, the patients with high serum UA, had higher values for several hematological parameters, whilst platelet counts (PLT) were lower. Multiple linear regression analysis showed that PLT and serum high sensitivity-c reactive protein (hs-CRP) were correlated with serum UA level. Stepwise multiple logistic regression model confirmed that platelet distribution width (PDW) and gender were independent determinant of a high serum UA. PDW and PLT appear to be independently associated with serum UA level in patients with HTN. © 2018 BioFactors, 44(6):532-538, 2018.
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Affiliation(s)
- Maryam Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Maftouh
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afsane Bahrami
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed MohammadReza Parizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adeleh Mahdizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Bazeli
- Department of Emergency Medicine, School of Nursing and Midwifery, Gonabad University of Medical Science, Gonabad, Iran
| | | | - Hamidreza Kianifar
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Mohammadzadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Rahmani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeili
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ebrahimi
- Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohsen Nematy
- Department of Clinical Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safarian
- Department of Clinical Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Grassi G, Mancia G. Monographic issue of pharmacological research on hypertension. Pharmacol Res 2018; 134:221-222. [PMID: 29964162 DOI: 10.1016/j.phrs.2018.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Guido Grassi
- Clinica Medica, University of Milano-Bicocca, 20126 Milan, Italy; Istituto a Carattere Scientifico IRCCS Multimedica, 20099 Sesto San Giovanni, Milan, Italy.
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Abstract
This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension.We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects.Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P < .05), and shifted respiratory peak toward left (P < .05). Compared to 16 breaths/minute, traditional spectral analysis showed increased LF power and LF/HF ratio, decreased HF power of HRV at 8 breaths per minute (P < .05). As breathing rate decreased, corrected spectral analysis showed increased HF power, decreased LF power, LF/HF ratio of HRV (P < .05). Compared to controls, resting baroreflex sensitivity decreased in hypertensive subjects. Slow breathing increased baroreflex sensitivity in hypertensive subjects (from 59.48 ± 6.39 to 78.93 ± 5.04 ms/mm Hg, P < .05) and controls (from 88.49 ± 6.01 to 112.91 ± 7.29 ms/mm Hg, P < .05).Slow breathing can increase HF power and decrease LF power and LF/HF ratio in essential hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.
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Affiliation(s)
| | - Qinghua Chang
- Cardiovascular Institute, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning Province, China
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Abstract
Essential hypertension is associated with structural alterations in the microvessels; in particular, an increase in the media thickness to internal lumen ratio of small resistance arteries (MLR) and a reduction in capillary density have been observed. The evaluation of the morphological characteristics of small resistance arteries in humans is challenging. The gold-standard method is generally considered to be the measurement by wire or pressure micromyography of MLR of subcutaneous small vessels obtained by local biopsies. However, noninvasive techniques for the evaluation of retinal arterioles were recently proposed; in particular, 2 approaches, scanning laser Doppler flowmetry (SLDF) and adaptive optics (AO), seem to provide useful information. Both of them provide an estimation of the wall to lumen ratio (WLR) of retinal arterioles. Moreover, a noninvasive measurement of basal and total capillary density may be obtained by videomicroscopy/capillaroscopy. It has been recently demonstrated that AO has a substantial advantage over SLDF in terms of evaluation of microvascular morphology, since WLR measured with AO is more closely correlated with the M/L of subcutaneous small arteries. The possibility to noninvasively assess in a reliable way, microvascular morphology in a clinical setting may represent a major advancement, since micromyography has substantial limitations in its application due to the local invasiveness of the procedure.
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Affiliation(s)
- Damiano Rizzoni
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Istituto Clinico Città di Brescia, Division of Medicine, Brescia, Italy
| | - Claudia Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carolina De Ciuceis
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesco Semeraro
- Eye Clinic, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Marco Rizzoni
- Department of Information Engineering, University of Brescia, Brescia, Italy
| | - Franco Docchio
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
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Raina S, Agarwal VK, Kapoor D, Sharma KN, Yadav RS. Hypertension as Determinant of Hyperuricemia: A Case Control Study from the Sub-Himalayan Region in North India. J Assoc Physicians India 2018; 66:14-18. [PMID: 30341839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Association between hyperuricemia and hypertension has been recognized for many years. Whether hyperuricemia is the cause or the effect is debatable. MATERIALS AND METHODS This case control study was conducted to assess serum uric acid (SUA) levels in fifty newly diagnosed essential hypertensive patients and fifty normotensive controls which were matched for age and sex. Detailed anthropometric characteristics including height, weight, body mass index and waist hip ratio were measured. Hypertension was classified according to Joint National Committee (JNC) 7 criteria. Hyperuricemia was defined as SUA level of 6.8mg/dl or more in both men and women. SUA was measured by uricase method. Before collecting the blood samples, patients were advised to proceed on overnight fast of minimum eight hrs. Student's t‑test for mean of continuous variables and Chi‑square test for proportions were used for statistical significance. RESULTS Present study included 50 newly diagnosed cases of essential hypertension and 50 age and sex matched normotensive healthy volunteer. Prevalence of hyperuricemia was 24% among the cases and 6% among the controls (P < 0 .05). Odds ratio was 4.9 (Cl=1.3 to 18.8). The mean SUA was significantly higher in the cases (5.5±1.7 mg/dl) than in the controls (4.9±1.1 mg/dl; P< 0.05). Odds ratio in male hyperuricemic hypertensive versus hyperuricemic normotensive was 6(CI=1.0 to 33.2) and 4.46(CI=0.4 to 42.5) among female hyperuricemic hypertensive versus hyperuricemic normotensives. CONCLUSION Strong positive association was observed between hypertension and hyperuricemia in both male and female patients in this study.
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Affiliation(s)
| | | | | | | | - R S Yadav
- Professor, Dr. Rajendra Prasad Govt. Medical College, Tanda, Kangra, Himachal Pradesh
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Abstract
The biochemical properties of erythrocyte or human red blood cell (RBC) membrane acetylcholinesterase (AChE) and its applications on laboratory class and on research are reviewed. Evidence of the biochemical and the pathophysiological properties like the association between the RBC AChE enzyme activity and the clinical and biophysical parameters implicated in several diseases are overviewed, and the achievement of RBC AChE as a biomarker and as a prognostic factor are presented. Beyond its function as an enzyme, a special focus is highlighted in this review for a new function of the RBC AChE, namely a component of the signal transduction pathway of nitric oxide.
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Affiliation(s)
- Carlota Saldanha
- Instituto de Bioquímica, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028 Lisboa, Portugal.
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Ptinopoulou AG, Pikilidou MI, Tziolas IM, Haidich AB, Mark PB, Zebekakis PE, Lasaridis AN. Changes in Kidney Function in a Population With Essential Hypertension in Real Life Settings. Iran J Kidney Dis 2017; 11:192-200. [PMID: 28575879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/06/2016] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Hypertension has been identified as one of the commonest modifiable determinants for chronic kidney disease progression. A variety of antihypertensive drugs are available and their effect on kidney function has been investigated by a large number of randomized controlled trials. Observational studies, although scarcely been used, outpatient can reflect everyday practice, where drug exposures vary over time, and may provide an alternative for detecting longitudinal changes in kidney function. MATERIALS AND METHODS We applied mixed model repeated measures analysis to investigate the effect of antihypertensive drug categories and their combinations on kidney function change over time in a cohort of 779 patients with essential hypertension, using the data from a Greek hypertension outpatient clinic. Antihypertensive drugs were grouped in 5 categories. Their effect was evaluated and their combinations with and without renin-angiotensin-system inhibitors (RASI) to each other. In addition, the combination of RASI with calcium channel blockers (CCBs) was studied. RESULTS Diuretics, RASI, CCBs, and beta-blockers had a significant renoprotective and blood pressure lowering effect. Combinations with RASI had a smaller beneficial effect on kidney function compared to CCBs (0.75 mL/min/1.73 m2 per year of drug use versus 0.97 mL/min/1.73 m2). There was no additional effect when combining RASI with CCBs. However, the lowering effect on systolic blood pressure was greater (-0.83 mm Hg per year of drug use, P < .001). CONCLUSIONS RASI were found to have a smaller, although significant, renoprotective effect. There was no additional effect on kidney function when combining RASI with CCBs.
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