Serum uric acid is not independently associated with plasma renin activity and plasma aldosterone in hypertensive adults

Background and Aims In experimental investigations conducted in rats, raising serum uric acid (SUA) levels resulted in the 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 of SUA with plasma aldosterone concentration (PAC). The study aimed to assess the relationship between SUA levels, PRA, and PAC and the influence of age, gender, body mass index (BMI), and hyperuricemia on these relationships in subjects with essential hypertension (EH). Methods and Results We enrolled 372 hypertensive patients (mean age 45 ± 12 years, men 67%) with u…

EFFECTS OF ALLOPURINOL ON RENAL FUNCTION DECLINE IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASES

Aim: To evaluate retrospectively the effects of allopurinol treatment on renal function decline in non-gouty hypertensive patients with moderate-to-severe CKD. Methods: We selected 22 patients treated with allopurinol (A) (100–300 mg/die) that were compared with 44 subjects not treated with this drug (B), matched with A for estimated glomerular filtration rate (eGFR), age, gender and blood pressure values. Results: After a mean follow-up period of 16 months no significant difference was observed between the two groups regarding eGFR decline (A: -6.8 ± 11.6 ml/min/1.73 m2; B: -4.2 ± 9.3 ml/min/1.73 m2). Furthermore, the percentage of subjects with a value of eGFR reduction above the median w…

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…

Early Vascular Aging in Normotensive Patients With Systemic Lupus Erythematosus

Connective tissue diseases, like systemic lupus erythematosus (SLE), are associated with early and accelerated atherosclerosis. Recently, the concept of “early vascular aging” (EVA) has been more widely accepted. Aortic stiffness is one of the important markers of EVA. We evaluated EVA and subclinical atherosclerosis, by measuring aortic pulse wave velocity (aPWV) and carotid intima–media thickness (cIMT), in 50 normotensive patients with SLE (mean age: 39 ± 12 years). We compared these participants with 50 age- and sex-matched patients with essential hypertension (EH) and 20 healthy controls. Each participant underwent 24-hour ambulatory blood pressure monitoring (ABPM), aPWV, and cIMT me…

Average real variability of 24-h systolic blood pressure is associated with microalbuminuria in patients with primary hypertension.

Limited and conflicting data are available about the association between short-term blood pressure (BP) variability and urinary albumin excretion rate (uAER). The objective of our study was to analyze the relationships between microalbuminuria (MAU), defined as an uAER between 20 and 200 μg min(-1), and short-term BP variability (BPV), assessed as average real variability (ARV), weighted s.d. of 24-h BP and as s.d. of daytime and night-time BP. The study population consisted of 315 untreated essential hypertensives with normal estimated glomerular filtration rate (>60 ml min(-1) per 1.73 m(2)), who underwent 24-h ambulatory BP monitoring and 24-h uAER determination. MAU was detected in 82 (…

ASSOCIATION OF RENAL RESISTIVE INDEX WITH MARKERS OF EXTRARENAL VASCULAR CHANGES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Introduction: Recent data suggest that renal hemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RRI), may be associated with systemic vascular changes. However, limited and conflicting data exist about the relationship between aortic stiffness and RI in autoimmune diseases, like systemic lupus erythematosus (SLE). Aim: To evaluate the relationship between RRI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and between RRI and carotid atherosclerosis, evaluated by intima-media thickness (IMT) measurement in patients with SLE. Methods: In this cross-sectional study, we enrolled 39 SLE subjects (mean age 39 years) tha…

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 RELATIONSHIP BETWEEN AORTIC ROOT DIAMETER AND RENAL FUNCTION IN HYPERTENSIVE SUBJECTS

Introduction: Dilatation of aortic root is associated with presence and severity of aortic regurgitation and risk for aortic dissection. Recent studies performed in general population suggest that enlarged aortic root diameter (ARD) may predict cardiovascular events in absence of aneurysmatic alterations. Little is known about the influence of renal function on ARD. Aim: To assess the relationships between glomerular filtration rate (GFR) and ARD in hypertensive subjects. Methods: We enrolled 611 hypertensive individuals (mean age: 52 ± 15 years; men 63 %) consecutively attending our outpatient nephrology and hypertension unit. Patients on dialysis treatment, with valvulopathy more than mil…

[OP.3B.03] INFLUENCE OF SUBCLINICAL RENAL DAMAGE ON EARLY VASCULAR AGING IN PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Objective: It is well known that kidney is frequently involved in patients with Systemic Lupus Erythematosus (SLE) However, conflicting data exist about the impact of renal involvement on vascular damage in this group of patients. The aim of this study was to evaluate the influence of renal damage on assessed by aortic pulse wave velocity (aPWV), evaluated a by intima-media thickness (IMT) measurement and assessed by renal resistive index (RRI) measurement, in patients with SLE. Design and method: We enrolled 52 SLE subjects (mean age 39 +/- 12 years), divided in two subgroups according to ACR/SLICC classification: patients with lupus nephritis, (LNG), and individuals presenting other featu…

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

CORRELATIONS BETWEEN NON INVASIVE RENAL INDEX AND MARKERS OF ATHEROSCLEROSIS IN LUPUS PATIENTS.

Objective: 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 in some groups of patients. However, conflicting data exist about the relationship between aortic stiffness and RI in autoimmune disease, like systemic lupus The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and carotid atherosclerosis, evaluated by intimal medial thickness measurement(IMT) in patients with SLE. Design and method: Cross-sectional study. We enrolled 39 SLE subjects (mean age 39 years). Each …

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…

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…

[OP.7B.08] INFLUENCE OF GENDER ON THE RELATIONSHIPS BETWEEN NEW INDICES OF ADIPOSITY AND LEFT VENTRICULAR MASS AND HYPERTROPHY IN HYPERTENSIVE PATIENTS

OBJECTIVE: The unfavourable effects of the association of obesity with hypertension on cardiac structure and function have been extensively studied. However, controversy still exists about the influence of gender on the relationship between obesity and left ventricular mass (LVM) and hypertrophy (LVH). Even if body mass index (BMI) and waist circumference (WC) are widely used as anthropometric predictors for cardiovascular diseases (CVD), their validity has been questioned. Recently, Body Shape Index (ABSI) and Body Roundness Index (BRI) were proposed as alternative measures of adiposity that may better reflect health status (1-2).Our study was aimed to assess the ability of ABSI and BRI in…

[OP.4B.03] CIRCULATING ALDOSTERONE LEVELS ARE ASSOCIATED WITH CONCENTRIC LEFT VENTRICULAR GEOMETRY IN ESSENTIAL HYPERTENSIVE PATIENTS

OBJECTIVE: Sound evidence indicates that aldosterone has a fundamental role in determining functional and structural changes in the heart. Moreover, it has been observed that high plasma aldosterone concentration (PAC) is related to the development of congestive heart failure and to cardiovascular mortality. However, previous studies on the association between circulating aldosterone levels and left ventricular (LV) mass (LVM) and LV geometry, in subjects without primary aldosteronism yielded conflicting results. The aim of our study was to evaluate in patients with essential hypertension the relationships of PAC with LV mass and geometry, and to asses the influence of gender on these relat…

EARLY VASCULAR AGING IN NORMOTENSIVE SUBJECTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. COMPARISON WITH YOUNG HYPERTENSIVE PATIENTS

Introduction: It is well known that connective tissue diseases, like Systemic Lupus Erythematosus, are associated with early and accelerated atherosclerosis. During the last year, it has well established the concept of ‘‘Early vascular aging’’ (EVA), whose the aortic stiffness represents one of the most important markers. Aim: To evaluate early vascular aging, assessed by measuring Aortic pulse wave velocity (aPWV), as an arterial stiffness index, in a group of normotensive patients with SLE and to compare these subjects with a group of young essential hypertensive (EH) individuals.Methods: In this cross-sectional study we have enrolled 50 normotensive SLE subjects (45 women and 5 men) with…

Relationship between aortic root size and glomerular filtration rate in hypertensive patients

OBJECTIVE: Recent studies suggest that enlarged aortic root diameter (ARD) may predict cardiovascular events in absence of aneurysmatic alterations. Little is known about the influence of renal function on ARD. Our study was aimed to assess the relationships between glomerular filtration rate (GFR) and ARD in hypertensive subjects. METHODS: We enrolled 611 hypertensive individuals (mean age: 52 ± 15 years; men 63%). ARD was measured by echocardiography at the level of Valsalva's sinuses using M-mode tracings. It was considered as absolute measure, normalized to body surface area (ARD/BSA) and indexed to height (ARD/H). GFR was estimated by the Chronic Kidney Disease Epidemiology Collaborati…

AORTIC STIFFNESS IS INCREASED IN NORMOTENSIVE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS Abstracts from the 17th National Congress of the Italian Society of Cardiovascular Prevention (SIPREC), Naples, 21-23 March 2019

Introduction: Patients with systemic lupus erythematosus (SLE) have an increased risk of developing cardiovascular (CV) events. A marker of early vascular aging (EVA) is aortic pulse wave velocity (aPWV) which is a measure of arterial stiffness. Aim: To evaluate aPWV and the prevalence of EVA in a group of normotensive patients with SLE and to compare these values with those obtained in age- and gender-matched control subjects. Method: Aortic PWV was measured by a validated oscillometric device (Arteriograph). EVA was identified when the age-adjusted z-score of aPWV exceeded ? 1.96 (EVA1). The aPWV z-score was calculated using the ratio ‘‘Observed PWV–Predicted PWV/SD Predicted’’ and we obt…

The Relationship Between Aortic Root Size and Hypertension: An Unsolved Conundrum

Thoracic aortic aneurysms rupture and dissection are among the most devastating vascular diseases, being characterized by elevated mortality, despite improvements in diagnostic imaging and surgical techniques. An increased aortic root diameter (ARD) represents the main risk factor for thoracic aortic dissection and rupture and for aortic valve regurgitation. Even though arterial hypertension is commonly regarded as a predisposing condition for the development of thoracic aorta aneurysms, the role of blood pressure (BP) as determinant of aortic root enlargement is still controversial. The use of different methods for indexation of ARD may have in part contributed to the heterogeneous finding…

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…

Reaction of melatonin with lipoperoxyl radicals in phospholipid bilayers.

Melatonin, at 5 to 500 microM was incorporated in unilamellar soybean phosphatidylcholine (PC) liposomes, the peroxidation of which was induced by 2,2'-azobis (2-amidinopropane-hydrochloride) (AAPH), and measured as production of conjugated diene lipid hydroperoxides. Concentration as low as 5 and 10 microM were poorly effective in reducing lipid peroxidation. Melatonin at 30 to 500 microM caused short inhibition periods, increasing with, but not linearly related to concentration, with a concurrent net decrease of the propagation rate. The time course of melatonin oxidation, measured as loss of fluorescence, was studied during the AAPH-stimulated peroxidation of soybean PC liposomes, or whe…