Relationship Between Short-Term Blood Pressure Variability and Subclinical Renal Damage in Essential Hypertensive Patients

The authors aimed to analyze the relationship between subclinical renal damage, defined as the presence of microalbuminuria or an estimated glomerular filtration rate (eGFR) between 30 mL/min/1.73 m(2) and 60 mL/min/1.73 m(2) and short-term blood pressure (BP) variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24-hour BP, and SD of daytime and nighttime BP. A total of 328 hypertensive patients underwent 24-hour ambulatory BP monitoring, 24-hour albumin excretion rate determination, and eGFR calculation using the Chronic Kidney Disease Epidemiology Collaboration equation. ARV of 24-hour systolic BP (SBP) was significantly higher in patients with subc…

RELATIONSHIPS BETWEEN SHORT-TERM BLOOD PRESSURE VARIABILITY AND EARLY RENAL DYSFUNCTION IN HYPERTENSION

The prognostic significance of short–term blood pressure (BP) variability (STBPV), expressed as standard deviation (SD) of blood pressures (BP) intermittently recorded over 24 hours, is debated. Recently, indices of STBPV other than SD have been proposed. Among these, the 24-h BP Average Real Variability (ARV) seems to be associated more consistently than SD with an enhanced cardiovascular risk. The relationship between mild-to-moderate renal dysfunction (MMRD) and ARV was not investigated. Our study was aimed to analyse, in a large group of untreated essential hypertensives, the relationships between ARV, and other STBV indices, with MMRD. We enrolled 329 essential hypertensive patients, w…

LA VARIABILITA’ PRESSORIA A BREVE TERMINE NON E’ ASSOCIATA ALLA DISFUNZIONE RENALE LIEVE NELL'IPERTENSIONE ARTERIOSA PRIMARIA

RAZIONALE. Il significato prognostico della variabilità pressoria (VP) a breve termine, espressa come deviazione standard (SD), è controverso. Recentemente sono stati proposti altri indici di VP a breve termine, tra i quali l’Average Real Variability (ARV), sembra essere maggiormente associato al rischio cardiovascolare (CV). Non indagata, finora è la relazione tra ARV e disfunzione renale lieve. Scopo del nostro studio è stato quello di analizzare le relazioni dell’ ARV delle 24 h e di altri indici di VP a breve termine con l’ albuminuria (AER) ed il filtrato glomerulare (eGFR) in un gruppo di ipertesi essenziali, non trattati. CASISTICA E METODI. Sono stati arruolati 248 pazienti (età med…

LIPID PARAMETERS AND LEFT VENTRICULAR MASS IN ESSENTIAL HYPERTENSIVE PATIENTS

I polimorfismi del gene VDR FokI e BsmI non sembrano essere associati all’ipertensione arteriosa

Scopo. Il nostro obiettivo è stato quello di analizzare la relazione tra livelli plasmatici di vitamina D (VitD) e valori di pressione arteriosa clinica ed ambulatoria in ipertesi essenziali e di identificare un’eventuale associazione fra l’ipertensione e i polimorfismi del gene VDR, FokI e BsmI. Materiali e metodi. Abbiamo arruolato 71 ipertesi essenziali e 72 controlli di età compresa fra 18 e 75 anni. Nei pazienti sono stati valutati: pressione arteriosa clinica, monitoraggio ambulatorio della pressione arteriosa delle 24 ore, parametri antropometrici, indagini bioumorali di routine e livelli plasmatici di VitD con metodica HPLC. Entrambi i gruppi sono stati sottoposti a tipizzazione dei…

Absence of an independent association between serum uric acid and left ventricular mass in Caucasian hypertensive women and men

Background and aim: Experimentally uric acid may induce cardiomyocyte growth and interstitial fibrosis of the heart. However, clinical studies exploring the relationship between serum uric acid (SUA) and left ventricular (LV) mass yielded conflicting results. The aim of our study was to evaluate the relationships between SUA and LV mass in a large group of Caucasian essential hypertensive subjects. Methods and results: We enrolled 534 hypertensive patients free of cardiovascular complications and without severe renal insufficiency. In all subjects routine blood chemistry, including SUA determination, echocardiographic examination and 24 h ambulatory blood pressure (BP) monitoring were obtai…

Vitamina D, ipertensione arteriosa e sistema renina-angiotensina

Endothelial dysfunction and vitamin d status in essential hypertension, prelimary results

FOKI AND BSMI VITAMIN D RECEPTOR GENE POLYMORPHISMS, PLASMA RENIN ACTIVITY AND ESSENTIAL ARTERIAL HYPERTENSION

Objective: Our aims were to analyze the relationship between 25hydroxyvitamin D(25[OH]D) plasma levels and clinical and ambulatory blood pressure (BP) values, and to identify any possible association between hypertension and FokI and BsmI vitamin D receptor (VDR) gene polymorphisms in essential hypertensive patients. Design and method: Seventyone essential hypertensive patients and seventytwo controls, 18–75 years old, were enrolled. Clinical physical examination, routine blood chemistry, clinical BP, 24 hour ambulatory blood pressure monitoring, 25[OH]D and Plasma Renin Activity (PRA) assay, and FokI and BsmI VDR polymorphisms analysis were obtained. Results:We observed a significant negat…

Relationships between mild hyperuricaemia and aortic stiffness in untreated hypertensive patients.

Background and aims: Clinical studies exploring the relationship between serum uric acid (SUA) and arterial stiffness yielded conflicting results. Only in a few of these studies, arterial distensibility was examined by measuring aortic pulse wave velocity (PWV), which is considered the gold standard for evaluating arterial stiffness. In none of the previous investigations was the influence of SUA on aortic distensibility assessed, taking into account the effect of albuminuria. The purpose of our study was to comprehensively analyse the relationships between SUA and aortic PWV in a group of essential hypertensive patients. Methods and results: We enrolled 222 untreated and uncomplicated hype…

VITAMIN D RECEPTOR FOKI AND BSMI POLYMORPHISMS DO NOT SEEM TO BE ASSOCIATED WITH ARTERIAL HYPERTENSION

ENDOTHELIAL DYSFUNCTION AND VITAMIN D STATUS IN ESSENTIAL HYPERTENSION. PRELIMARY RESULTS

STUDIO DELLE INTERAZIONI E DELLE INFLUENZE DI OSTEOPROTEGERINA ED OSTEOPONTINA SULLE ALTERAZIONI VASCOLARI NELL’IPERTENSIONE ARTERIOSA ESSENZIALE

RELATIONSHIP BETWEEN VITAMIN D STATUS AND EARLY ARTERIAL CHANGES IN PRIMARY HYPERTENSION. PRELIMINARY DATA

ABSENCE OF RELATIONSHIPS BETWEEN SHORT-TERM BLOOD PRESSURE VARIABILITY AND EARLY RENAL DYSFUNCTION IN HYPERTENSION

Blood pressure variability

Vitamina D e biomarcatori di attivazione endoteliale e di infiammazione nell'ipertensione arteriosa essenziale

PP.42.06

DIFFERENTE IMPATTO NEI DUE SESSI DELL’OBESITÀ SULLA MASSA VENTRICOLARE SINISTRA IN SOGGETTI CAUCASICI CON IPERTENSIONE ARTERIOSA ESSENZIALE

Dati non univoci sono riportati in letteratura sul ruolo della dislipidemia nello sviluppo dell’ipertrofia ventricolare sinistra. Scopo del nostro studio, è stato quello di valutare le potenziali associazioni dei principali parametri lipidici con la massa ventricolare sinistra (LVM) in pazienti con ipertensione essenziale (EHs). Abbiamo arruolato 724 soggetti con EH (età media 45±12 anni; 63% maschi), senza complicanze cardiovascolari e non trattati con farmaci ipolipemizzanti. In tutti i soggetti dono stati dosati la colesterolemia totale (Tchol), la trigliceridemia (TG) e il colesterolo HDL (HDLc). Il colesterolo LDL (LDLc) è stato stimato con la formula di Friedewald ed è stato calcolato…

RELATIONSHIPS OF SERUM URIC ACID WITH PLASMA RENIN ACTIVITY AND PLASMA ALDOSTERONE IN UNTREATED HYPERTENSIVE SUBJECTS

In experimental studies conducted in rats, raising serum uric acid (SUA) levels resulted in stimulation of intrarenal renin expression. Studies in humans exploring the association of SUA with plasma renin activity (PRA) yielded conflicting results. Moreover, little is known about the relationship between plasma aldosterone concentration (PAC) and SUA. The aim of our study was to analyse the relationships between SUA, PRA and PAC and the influence of age and gender on these relationships in a group of subjects with primary hypertension. We enrolled 281 patients (men 59%), with untreated primary hypertension and normal renal function. The study population wad divided in two subgroups on the b…

SHORT-TERM VARIABILITY OF 24-H SYSTOLIC BLOOD PRESSURE IS ASSOCIATED WITH MICROALBUMINURIA IN PATIENTS WITH PRIMARY HYPERTENSION

Introduction: Limited and conflicting data are available about the association between short-term blood pressure (BP) variability and urinary albumin excretion rate (uAER). Aim: To analyse the relationships between microalbuminuria, defined as an uAER between 20 and 200 lg/min, and short-term BP variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24-h BP, and as SD of daytime and nighttime BP. Methods: The study population consisted of 316 untreated essential hypertensive patients with normal estimated glomerular filtration rate ([60 ml/min/1.73m2), which underwent 24-h ambulatory BP monitoring and 24-h uAER determination. Results: Microalbuminuria w…

Plasma aldosterone and its relationship with left ventricular mass in hypertensive patients with early-stage chronic kidney disease

Plasma aldosterone concentrations (PACs) are often increased in the advanced stages of chronic kidney disease (CKD); however, PAC has not been fully investigated in early CKD. Moreover, little is known about the relationship between aldosteronemia and left ventricular (LV) mass in subjects with mild-to-moderate CKD. The study objectives were to analyze PAC, LV mass (LVM), LV geometry and their relationships, in a group of hypertensive patients with stage I-III CKD. One hundred ninety-five hypertensive patients with stage I-III CKD were enrolled and compared with a control group of 82 hypertensive patients without renal dysfunction. LVM was higher in subjects with CKD than in the control gro…

RELATIONSHIP BETWEEN VITAMIN D STATUS AND EARLY ARTERIAL CHANGES IN PRIMARY HYPERTENSION. PRELIMINARY DATA

Relationship between aortic stifness and renal resistance index in hypertensive patients

L’aldosterone plasmatico e la sua relazione con la massa ventricolare sinistra nei pazienti ipertesi con malattia renale cronica I-III stadio NKF

RAZIONALE. La malattia renale cronica (CKD) è associata ad un’incrementata massa ventricolare sinistra (LVM), che può predisporre ad un aumentato rischio di eventi cardiovascolari. Le concentrazioni plasmatiche di aldosterone (PAC) sono spesso incrementate negli stadi avanzati di CKD. Poco è noto sui livelli di aldosterone e la loro relazione con la LVM nei soggetti con CKD lieve-moderataL’obiettivo del nostro studio è stato quello di analizzare PAC e LVM e la loro relazione in un gruppo di pazienti ipertesi con CKD agli stadi I-III National Kidney Foundation (NKF). CASISTICA E METODI. Abbiamo arruolato 195 pazienti ipertesi con CKD agli stadi I-III NKF e li abbiamo comparati ad un gruppo d…

I polimorfismi del gene VDR FokI e BsmI non sembrano essere associati all’ipertensione arteriosa

RAZIONALE. Il nostro obiettivo è stato quello di analizzare la relazione tra livelli plasmatici di VitaminaD (VitD) e valori di pressione arteriosa clinica ed ambulatoria in ipertesi essenziali e di identificare un’eventuale associazione fra l’ipertensione e i polimorfismi del gene VDR, FokI e BsmI. CASISTICA E METODI. Abbiamo arruolato 71 ipertesi essenziali e 72 controlli di età compresa fra 18 e 75 anni. Nei pazienti sono stati valutati: pressione arteriosa clinica, monitoraggio ambulatorio della pressione arteriosa delle 24 ore, parametri antropometrici, indagini bioumorali di routine e livelli plasmatici di VitD con metodica HPLC. Entrambi i gruppi sono stati sottoposti a tipizzazione …

FOKI AND BSMI VITAMIN D RECEPTOR GENE POLYMORPHISMS, ARE THEY ASSOCIATED WITH INTIMA MEDIA THICKNESS IN ESSENTIAL HYPERTENSIVE INDIVIDUALS

Objective: Analyzing 25hydroxyvitaminD (25[OH]D) serum levels and common carotid intimamedia thickness (IMT) relationship, and evaluating the association of FokI and BsmI vitamin D receptor (VDR) gene polymorphisms with IMT in essential hypertensive patients were our study aims. Design and method: We enrolled seventyone essential hypertensive patients, 18–75 years old. Patients underwent clinical blood pressure (BP) measurement, 24 hour ambulatory blood pressure monitoring, routine blood test, 25[OH]D assay and common carotid IMT evaluation. FokI and BsmIVDRpolymorphisms were analyzed by polymerase chain reactionrestriction fragment length polymorphism (PCRRFLP).

BRUGADA PATTERN IN HEROIN ADDICTION: SYNDROME OR PHENOCOPY?

Brugada phenocopies (BrPs) are clinical entities that show an electrocardiogram (ECG) pattern similar to what is observed in Brugada syndrome (BrS). They are caused by different clinical conditions. We describe a case of BrP in a man that developed acute kidney failure secondary to rhabdomyolysis, after heroin addiction. His initial ECG showed Brugada type 1 pattern resolved after hemodialytic treatment. A provocative test with ajmaline, which resulted negative, was performed to confirm the diagnosis. BrPs can mimic a true BrS and a fast recognition of these clinical and electrocardiographic findings may avoid diagnostic mistakes thus preventing unnecessary or inaccurate treatmen

RELATIONSHIP BETWEEN ASYMPTOMATIC HYPERURICEMIA AND RENAL FUNCTION DECLINE IN HYPERTENSIVE SUBJECTS.

Introduction: It is well known that the deposition of uric acid crystals exert direct toxic effect on the renal parenchyma and vasculature. Both experimental and some clinical studies suggest the possibility that an increased uric acid level can lead to kidney disease even without deposition of uric acid crystals. However, other studies yielded conflicting results, especially regarding the role of uric acid in the progression of established kidney disease. Aim: To evaluate retrospectively the relationship between asymptomatic hyperuricemia and renal function decline in non-gouty hypertensive patients. Methods: We enrolled 97 hypertensive subjects, 48 with chronic kidney diseases (CKD) and 4…

RELAZIONI TRA PARAMETRI LIPIDICI E MASSA VENTRICOLARE SINISTRA IN SOGGETTI CON IPERTENSIONE ARTERIOSA ESSENZIALE

Dati non univoci sono riportati in letteratura sul ruolo della dislipidemia nello sviluppo dell’ipertrofia ventricolare sinistra. Scopo del nostro studio, è stato quello di valutare le potenziali associazioni dei principali parametri lipidici con la massa ventricolare sinistra (LVM) in pazienti con ipertensione essenziale (EHs). Abbiamo arruolato 724 soggetti con EH (età media 45±12 anni; 63% maschi), senza complicanze cardiovascolari e non trattati con farmaci ipolipemizzanti. In tutti i soggetti dono stati dosati la colesterolemia totale (Tchol), la trigliceridemia (TG) e il colesterolo HDL (HDLc). Il colesterolo LDL (LDLc) è stato stimato con la formula di Friedewald ed è stato calcolato…