1.12 C-Reactive Protein is Associated with Aortic Stiffness Independently of Microalbuminuria in Essential Hypertension

COMPARAZIONE DELLE RELAZIONI DI DIFFERENTI DEFINIZIONI DI SINDROME METABOLICA CON L'IPERTROFIA VENTRICOLARE SX NELL'IPERTENSIONE ESSENZIALE

Numerosi studi hanno dimostrato che la sindrome metabolica (SM), sia quando definita secondo i criteri dell'ATPIII, sia quando definita secondo i criteri dell'IDF, si associa ad un aumento della massa del ventricolo sx (VS). Tuttavia, non è noto se queste due differenti definizioni di SM abbiano la stessa capacità di identificare l'ipertrofia del VS (IVS) . Inoltre, una delle critiche mosse al concetto di SM è legata al fatto di essere una variabile dicotomica, limitando in tal modo la possibilità di definire la gravità del rischio cardiovascolare nel singolo paziente. Scopo del nostro studio è stato quello di valutare comparativamente la capacità di differenti definizioni di SM di identifi…

Comparison of the relationship among different defintions of metabolic syndrome and left ventricular hypertrophy in essential hypertension

The renal resistive index: is it a misnomer?

Progress in digital ultrasound technology and diffusion of Doppler ultrasound evaluation of the kidney enable a widespread non-invasive evaluation of renal haemodynamics. Initially most attention has been paid to the study of extraparenchymal renal arteries, mainly to detect renovascular disease. However, this approach has low reproducibility and accuracy. Therefore, interest has gradually moved towards the duplex evaluation of intrarenal anatomy, where the best and most reliable signals are obtained from the large segmental or interlobar arteries that run directly towards the transducer. Among the sonographic parameters used in the last decade, great emphasis has been placed on the intrare…

Relationships between glomerular filtration rate and left ventricular mass in uncomplicated essential hypertension

Indice ambulatoriale di rigidità arteriosa e filtrazione glomerulare nell’ipertensione arteriosa essenziale

Relationship between metabolic syndrome and left ventricular structure and function in subjects with isolated clinic hypertension

The Association of Microalbuminuria With Aortic Stiffness Is Independent of C-Reactive Protein in Essential Hypertension

BACKGROUND It has not been fully elucidated whether microalbuminuria (MAU) and high-sensitivity C-reactive protein (hsCRP) are associated with aortic distensibility independently of each other. Our study was aimed to evaluate the independent relationships of urinary albumin excretion rate (AER) and hsCRP with aortic stiffness in hypertensive patients. METHODS We enrolled 140 untreated nondiabetic essential hypertensives (mean age: 48 +/- 12 years). In all subjects, 24-hour AER and plasma levels of hsCRP were determined by immunoenzymatic assay. MAU was defined as an AER of 20-200 microg/min. Aortic stiffness was assessed by measurement of carotid-femoral pulse wave velocity (PWV). RESULTS C…

Relazioni tra aldosterone plasmatico, sindrome metabolica e massa ventricolare sinistra nell’ipertensione arteriosa essenziale

Relationship Between Ambulatory Artery Stiffness Index and Glomerular Filtration Rate in Essential Hypertension

Relazione tra la riduzione lieve-moderata della funzione renale e la massa ventricolare sinistra nell’ipertensione arteriosa.

BILATERAL RENAL ARTERY STENOSIS IN A HYPERTENSIVE LUPUS PATIENT WITHOUT RENAL DYSFUNCTION: A CASE REPORT

Systemic lupus erythematosus (SLE) is associated with a high prevalence of atherosclero-sis and an enhanced cardiovascular mortality. In adult subjects, several studies have shown the coexistence of SLE and renal artery stenosis, most of them with unilateral in-volvement or with renal dysfunction. We observed a 62-year-old man with SLE and a 10-year history of moderate-to-severe hy-pertension who was admitted to our hospital because of uncontrolled blood pressure val-ues (152/95 mmHg), despite drug therapy. No signs of renal impairment were evident. After an initial physical examination, which presented a periumbilical bruit, a renal ultra-sound was performed with evidence of bilateral rena…

Relationships between estimates of glomerular filtration rate and ultrasonographically determined renal volume in hypertensive patients.

Relazione tra aldosteronemia, sindrome metabolica e massa ventricolare sinistra nell’ipertensione essenziale

Relationship of a Body Shape Index and Body Roundness Index with carotid atherosclerosis in arterial hypertension.

Background and aims: A Body Shape Index (ABSI) and Body Roundness Index (BRI) are two new anthropometric adiposity indices that have shown to be associated better than BMI with adipose abdominal tissue, with the onset of diabetes and the risk of premature death. Little is known about the influence of ABSI and BRI on subclinical vascular damage. The study was aimed to assess the relationship between ABSI and BRI with carotid atherosclerosis damage in subjects with arterial hypertension. Methods and results: A total of 468 patients with arterial hypertension (30–80 years old) were enrolled; adiposity indices were calculated (BMI, WC, ABSI, BRI) and carotid ultrasonographic examination was per…

ASSOCIATION OF RENAL RESISTIVE INDEX WITH CAROTID INTIMA-MEDIA THICKNESS IN HYPERTENSIVE PATIENTS

Microalbuminuria Is Associated With Increased Aortic Stiffness Independently of C-Reactive Protein in Essential Hypertension

Influence of gender on the relationships between metabolic syndrome and left ventricular mass in hypertensive patients

Renal haemodynamics and coronary atherosclerotic burden are associated in patients with hypertension and mild coronary artery disease

Intrarenal hemodynamic alterations are independent predictors of cardiovascular events in different populations. It has been hypothesized that there is an association between renal hemodynamics and coronary atherosclerotic burden in patients with hypertension. Therefore, the present study examined the associations between renal hemodynamics, coronary atherosclerotic burden and carotid atherosclerotic disease. A total of 130 patients with hypertension aged between 30-80 years who had been referred for an elective coronary angiography were enrolled in the present study. A duplex ultrasound of the intrarenal vasculature was performed to evaluate the resistive index (RI), pulsatility index (PI)…

Relazione tra massa ventricolare sinistra e insufficienza renale di grado lieve e moderato nell’ipertensione arteriosa

RELATIONSHIP BETWEEN AORTIC PULSE WAVE VELOCITY AND RENAL RESISTIVE INDEX IN HYPERTENSIVE PATIENTS.

INTRODUCTION: The assessment of renal hemodynamic parameters by duplex Doppler sonography has been used for many years as a diagnostic tool in the daily workup of kidney diseases. Recent data suggest that these parameters, especially the intrarenal resistive index (RI), may be also associated with systemic vascular changes and cardiovascular risk. However, conflicting data exist about the independent association of aortic stiffness with RI. AIM: The aim was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (PWV), in the hypertensive subjects consecutively attending our hypertension centre. METHODS: We enrolled 264 subjects, aged between 3…

Renal haemodynamics and severity of carotid atherosclerosis in hypertensive patients with and without impaired renal function.

Background and Aim. Renal resistance index (RRI), assessed by Duplex-Doppler sonography, has been classically considered as a mere expression of intrarenal vascular resistance. Recent studies, however, have showed that RRI is also influenced by upstream factors, especially arterial compliance, confirming its possible role as a marker of systemic vascular alterations. Several studies have shown that carotid intima-media thickness (cIMT) and carotid plaques (cP), assessed by ultrasonography, are documented markers of subclinical organ damage as well as expression of progressive atherosclerotic disease, and that they get worse with the progressive deterioration of renal function. The study was…

Unfavourable interaction of microalbuminuria and mildly reduced creatinine clearance on aortic stiffness in essential hypertension

The aim of our study was to assess the independent relationships of urinary albumin excretion rate (AER), of creatinine clearance (CrCl) and of their interaction with aortic stiffness in hypertensive patients without overt renal insufficiency. We studied 222 untreated nondiabetic essential hypertensives. In patients with reliable 24-h urine collections, AER and CrCl were determined. Microalbuminuria (MAU) was defined as an AER of 20 to 200microg/min. Aortic stiffness was assessed by measurement of carotid-femoral pulse wave velocity (c-f PWV). C-f PWV was higher in subjects with MAU than in those without it (p<0.001, even after adjustment for age, sex and mean arterial pressure) and in subj…

Aneurysm of the superior thyroid artery in a 80-year-old man: case report.

Metabolic syndrome in subjects with white-coat hypertension: impact on left ventricular structure and function

Some reports have suggested that white-coat hypertension (WCH) is associated with some features of the metabolic syndrome (MetS). These metabolic disturbances, instead of WCH per se, may potentially explain the greater extent of end-organ damage sometimes observed in WCH subjects (WCHs) when compared to normotensive individuals (NTs). The aim of the present cross-sectional study was to compare left ventricular (LV) structure and function in three groups of subjects: WCHs with MetS, WCHs without MetS and NTs. A total of 145 WCHs, 35% of whom had MetS, were enrolled. As controls, 35 NTs were also studied. In all subjects, routine blood chemistry, echocardiographic examination and 24-h ambulat…

Association between uric acid and renal function in hypertensive patients: which role for systemic vascular involvement?

The role of systemic vascular involvement in mediating the association between serum uric acid (SUA) and renal function in hypertension has not been explored. Main purpose of our study was to investigate whether morphofunctional vascular changes, assessed as carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV), might mediate the association between SUA and renal damage. We enrolled 523 hypertensive subjects with or without chronic kidney disease and divided population into tertiles of SUA based on sex-specific cutoff values. cIMT and aPWV were higher in uppermost SUA-tertile patients when compared to those in the lowest ones (all P < .001). Uricemia strongly correlate…

Inverse relationships between glomerular filtration rate and left ventricular mass in uncomplicated essential hypertension.

Left Ventricular Remodelling Conditions Left Atrial Volume and Function In Hypertensive Patients? Evaluation in RT3D Echocardiography

Spessore intimo-mediale, fetuina-A, attivazione endoteliale e stress ossidativo in ipertesi con differenti gradi di funzione renale

C-Reactive Protein is Associated with Aortic Stiffness Independentely of Microalbuminuria in Essential Hypertension

Clinical correlates of renal dysfunction in hypertensive patients without cardiovascular complications: the REDHY study

Our study was aimed to assess the clinical correlates of different degrees of renal dysfunction in a wide group of non-diabetic hypertensive patients, free from cardiovascular (CV) complications and known renal diseases, participating to the REDHY (REnal Dysfunction in HYpertension) study. A total of 1856 hypertensive subjects (mean age: 47+/-14 years), attending our hypertension centre, were evaluated. The glomerular filtration rate (GFR) was estimated by the simplified Modification of Diet in Renal Disease Study prediction equation. A 24-h urine sample was collected to determine albumin excretion rate (AER). Albuminuria was defined as an AER greater than 20 mug min(-1). We used the classi…

Relationships of different defintions of metabolic syndrome and left ventricular mass in essential hypertensive patients

Bilateral double renal arteries and bilateral renal veins. A color-Doppler sonographic finding in a patient with arterial hypertension

L’associazione tra stiffness aortica e proteina C-reattiva è indipendente dalla microalbuminuria nell’ipertensione essenziale

Influenza del sesso sulla relazione tra sindrome metabolica e massa ventricolare sinistra.

Association Between Uric Acid and Renal Hemodynamics: Pathophysiological Implications for Renal Damage in Hypertensive Patients

The role of vascular renal changes in mediating the association between serum uric acid (SUA) and renal damage is unclear. The purposes of this study were to investigate the relationship between SUA and renal resistive index (RRI), assessed by duplex Doppler ultrasonography, and to assess whether hemodynamic renal changes may explain the association between SUA and renal damage in hypertensive patients. A total of 530 hypertensive patients with and without chronic kidney disease were enrolled and divided into SUA tertiles based on sex-specific cutoff values. RRI and albuminuria were greater and glomerular filtration rate (GFR) was lower in the uppermost SUA tertile patients when compared wi…

Relationships between metabolic syndrome and left ventricular mass in hypertensive patients. Does sex matter ?

Several studies documented an association between metabolic syndrome (MetS) and left ventricular (LV) hypertrophy. However, only in a few of these studies the impact of MetS on left ventricular mass (LVM) was separately analysed by gender, with conflicting results. The aim of our study was to verify, in a wide sample of essential hypertensive patients, the influence of gender, if any, on the relationship between MetS and LVM. We enrolled 475 non-diabetic subjects (mean age: 46 +/- 11 years), with mild-to-moderate essential hypertension, of whom 40% had MetS, defined on the basis of Adult Treatment Panel III (ATPIII) criteria. All the patients underwent a 24-h ambulatory blood pressure monit…

Association of renal resistive index with aortic pulse wave velocity in hypertensive patients

Background: Recent data suggest that renal haemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes. However, conflicting data exist about the independent relationship between aortic stiffness and RI. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), in hypertensive patients. Design: Cross-sectional study. Methods: We enrolled 264 hypertensive subjects aged between 30 and 70 years. They were divided into two groups, either with normal renal function (n=140) or with chronic kidney disease (CKD) (n=124). E…

The Association of Microalbuminuria With Aortic Stiffness is Independent of C-Reactive Protein in Essential Hypertension

La relazione tra microalbuminuria e stiffness aortica è indipendente dal filtrato glomerulare nell’ipertensione essenziale

Inverse Relationship Between Ambulatory Arterial Stiffness Index and Glomerular Filtration Rate in Arterial Hypertension

BACKGROUND: Arterial stiffness and mild-to-moderate renal dysfunction are predictors of cardiovascular (CV) morbidity and mortality. Recently, the ambulatory arterial stiffness index (AASI) has been proposed as a surrogate index of arterial stiffness. It has been associated with an enhanced risk of stroke. The aim of our study was to assess the relationship between AASI and glomerular filtration rate (GFR) in a group of hypertensive patients with no CV complications. METHODS: A total of 143 untreated hypertensive subjects (mean age: 44 +/- 12 years; men 57%), with serum creatinine <1.5 mg/dl, were enrolled. AASI was calculated as one minus the regression slope of diastolic on systolic blood…

Different Morning Blood Pressure Increases are Associated to a Diverse Microvascular Damage

Subclinical atherosclerosis and fetuin-A plasma levels in essential hypertensive patients

The intima-media thickness (IMT) is considered as a surrogate marker for atherosclerotic disease. The aim of this study was to analyze the relationship of carotid IMT with fetuin-A in patients with essential hypertension (EH) and normal renal function. The plasma levels of fetuin-A, interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α) and the biomarker of oxidative stress 8-iso-PGF2alpha were assayed in samples from 105 untreated EH patients. Carotid IMT measurements were also performed. EH was studied overall and after dividing in EH with IMT ≥ and 0.9 mm (AUC (area under the curve) 0.738, P<0.0001). Our results suggest that in EH, fetuin-A is associated with the IMT independently of oxid…

Relationships between plasma aldosterone and left ventricular mass in hypertensive patients with the metabolic syndrome

ASSOCIATION OF RENAL RESISTIVE INDEX WITH AORTIC PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS.

The assessment of renal hemodynamic parameters by duplex Doppler sonography has been used for many years as a diagnostic tool in the daily work-up of kidney diseases. Recent data suggest that these parameters, especially the intrarenal resistive index (RI) may be also associated with systemic vascular changes and with an enhanced cardiovascular risk. However, conflicting data exist in literature about the independent association of aortic stiffness with RI. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (PWV), in the hypertensive subjects consecutively attending our hypertension centre. We enrolled 264 subject…

Microalbuminuria Is Associated With Aortic Stiffness Independently of Creatinine Clearance in Essential Hypertension

Relationship Between Carotid Atherosclerosis and Pulse Pressure with Renal Hemodynamics in Hypertensive Patients.

BACKGROUND Structural atherosclerotic damage, arterial stiffness, pulse pressure (PP), and renal hemodynamics may interact and influence each other. Renal resistance index (RRI) appears as a good indicator of systemic vascular changes. The aim of our study was to assess the independent relationships of carotid intima-media thickness (cIMT), aortic pulse wave velocity (aPWV), and peripheral PP with RRI in hypertensives with various degrees of renal function. METHODS We enrolled 463 hypertensive patients (30-70 years) with normal renal function (group 0; n = 280) and with chronic kidney disease (groups I-V; n = 183). All subjects underwent ultrasonographic examination of intrarenal and caroti…

Relationship between kidney findings and systemic vascular damage in elderly hypertensive patients without overt cardiovascular disease

Few studies have investigated the influence of age on the relationships between systemic vascular damage, kidney dysfunction, and intrarenal hemodynamic changes in patients with hypertension without overt cardiovascular disease. The authors enrolled 126 elderly patients with hypertension (aged ≥65 years) and 350 nonelderly patients with hypertension (aged <65 years). Carotid intima‐media thickness, renal resistive index, and aortic pulse wave velocity were performed in all patients. Elderly patients with hypertension had lower estimated glomerular filtration rates and higher albuminuria, renal resistive index, carotid intima‐media thickness, and aortic pulse wave velocity compared with none…

Association between Plasma Aldosterone plasmatico, Metabolic Syndrome and Left Ventricular Mass in Essential Hypertension.

ASSOCIATION BETWEEN RENAL RESISTIVE INDEX AND CAROTID INTIMA-MEDIA THICKNESS IN HYPERTENSIVE PATIENTS.

Introduction: The assessment of renal hemodynamic parameters by duplex Doppler sonography has been used for many years as a diagnostic tool in the daily work-up of kidney diseases. Recent data suggest that these parameters, especially the intrarenal resistive index (RI) may be also associated with changes of the systemic vascular tree and with an enhanced cardiovascular risk. However, conflicting data exist in literature about the independent association of carotid intima-media thickness (IMT) with RI. Aim: To evaluate the relationship between RI and carotid IMT in the hypertensive subjects consecutively attending our hypertension centre. Methods: We enrolled 264 subjects, aged between 30 a…

Para-perirenal distribution of body fat is associated with reduced glomerular filtration rate regardless of other indices of adiposity in hypertensive patients

Obesity is a well‐known risk factor for the development and progression of chronic kidney disease. Recently, para‐perirenal ultrasonographic fat thickness (PUFT) has shown to correlate with both total and visceral fat better than body mass index (BMI), waist circumference (WC), and other indices of obesity. Moreover, a local paracrine and mechanical action of the PUFT on kidney has been described in recent studies. Aim of our study was to assess the relationship between glomerular filtration rate (GFR) and PUFT in comparison with other anthropometric and ultrasonographic indices of adiposity. Two hundred and ninety‐six hypertensive patients were enrolled. PUFT, cutis‐rectis thickness and re…

RELATIONSHIP BETWEEN URIC ACID AND RENAL DAMAGE IN HYPERTENSIVE PATIENTS: WHICH ROLE FOR RENAL HAEMODYNAMICS

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Relazioni tra stiffness aortica ed indice di resistenza intrarenale nell’ipertensione arteriosa

Per molti anni lo studio mediante eco-color-doppler dei parametri semiquantitativi emodinamici renali è stato utilizzato per rilevare le alterazioni della perfusione del rene trapiantato, per la diagnosi della stenosi dell’arteria renale o per valutare la progressione di alcune nefropatie. Più recentemente è stato osservato che tali parametri, ed in particolare l’indice di resistenza intrarenale (IR), non sono soltanto espressione della perfusione parenchimale, ma sono associati anche ad alterazioni morfo-funzionali sistemiche dell’albero vascolare. Vari studi hanno dimostrato come la stiffness aortica vada aumentando con il progressivo deterioramento della funzione renale. Tuttavia, dati c…

Plasma Aldosterone and Its Relationships With Left Ventricular Mass in Essential Hypertensive Patients With the Metabolic Syndrome

BACKGROUND: The association of aldosterone with the metabolic syndrome (MetS) has not been fully elucidated. The aim of our study was to evaluate the relationships of plasma aldosterone concentration (PAC) with MetS and left ventricular mass (LVM) in nondiabetic Caucasian patients with essential hypertension. METHODS: Measurements were taken with the patients off antihypertensive medications. The measurements included 24-h blood pressure (BP) readings, plasma renin activity (PRA) and aldosterone, and an echocardiogram. RESULTS: Subjects with MetS (n = 201) had higher age-adjusted PAC (10.2 +/- 5.8 vs. 11.6 +/- 5.9 ng/dl; P = 0.01) and greater age-adjusted LVM indexed for height2.7 (LVMH2.7)…

The Influence of Sex on The Relationships Between Metabolic Syndrome and Left Ventricular Mass in Hypertensive Patients

Relazione tra riduzione lieve-moderata della funzione renale e massa ventricolare sinistra nell’ipertensione arteriosa essenziale

9.11 Association between Plasma Aldosterone, Metabolic Syndrome and Left Ventricular Mass in Essential Hypertension

Insufficienza renale di grado lieve e moderato e massa ventricolare sinistra nell’ipertensione essenziale

SEVERITY OF CAROTID DISEASE AND RENAL HEMODYNAMICS IN HYPERTENSIVE PATIENTS WITH AND WITHOUT IMPAIRED RENAL FUNCTION

Relationships of Plasma Aldosterone with Metabolic Syndrome and Left Ventricular Mass in Essential Hypertensive Patients

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