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…

Value of Home Blood Pressures as Predictor of Target Organ Damage in Mild Arterial Hypertension

Home blood pressure measurement has gained increasing importance for the management of hypertensive patients. The aim of our study was to compare levels of clinic (CBP), ambulatory (ABP), and home blood pressure (HBP) measurements, and their relationships with various indexes of target organ damage in I-II grade essential hypertension.Thirty-eight essential hypertensives underwent evaluation of clinic, ambulatory and home blood pressures. Each patient recorded HBP for 2 days with a digital BP monitor three times daily, the first time on the same day during which ABP monitoring was simultaneously performed. Moreover, in all subjects electrocardiogram recording, echocardiographic study, micro…

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

Influence of metabolic syndrome on hypertension-related target organ damage

Il controllo pressorio nell’insufficienza renale cronica: valutazione mediante monitoraggio ambulatorio.

Left ventricular structure and function in hypertensives with chronic renal insufficiency.

RELATIONSHIP BETWEEN OBESITY AND LEFT VENTRICULAR MASS IN CAUCASIAN HYPERTENSIVE SUBJECTS. DOES SEX MATTER?

Objective The excess of adiposity affects the heart through haemodynamic and non haemodynamic mechanisms leading to left ventricular hypertrophy (LVH) and ultimately to heart failure. It has been been previously observed, in a large study performed in American Indians, that the impact of obesity on left ventricular mass (LVM) is greater in women than men, while the results of other investigations carried out in other ethnic groups have yielded conflicting results .The aim of our study was to evaluate the potential influence of gender on the relationships between obesity and LVM in Caucasian patients with essential hypertension (EHs) . Design and method We enrolled 724 subjects with EH (mean…

Epidemiology and pathophysiology of left ventricular abnormalities in chronic kidney disease: a review.

Introduction Cardiovascular diseases are highly prevalent in patients with chronic kidney disease (CKD), and represent the major hazard for mortality in this population. Anomalies of left ventricular (LV) structure and function are very frequent too among CKD patients, and show a negative impact on cardiovascular prognosis. Methods We searched PubMed for manuscripts regarding left ventricular hypertrophy (LVH) in CKD. Definition of LVH was different according to different studies. Results In patients with end-stage renal disease, the prevalence of LVH is higher than 70%. Studies in patients with less advanced CKD have reported increasing prevalence of LVH along with declining renal function…

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

Nell'ipertensione arteriosa essenziale lo stress ossidativo si associa con l'attivazione endoteliale e l'infiammazione

Geometria ventricolare sinistra nell’insufficienza renale cronica.

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

Endothelin-1 and F2-isoprostane relate to and predict renal dysfunction in hypertensive patients.

Background. Hypertension and additional non-traditional risk factors can damage the kidney directly and by promoting atherogenesis. Evidence indicates that increased oxidative stress and inflammation may mediate a large part of the effects of risk factors on the kidney. We hypothesized that in hypertensive patients (HT), oxidative stress, measured as 8-ISO-prostaglandin F2alpha (8-ISO-PGF2alpha), should raise paralleling decreasing renal function and should correlate with estimated glomerular filtration rate (eGFR). Methods. In 626 HT with renal function ranging from stages 1 to 5 and 100 healthy controls, plasma levels of 8-ISO-PGF2alpha, high-sensitivity C-reactive protein (CRP), transfor…

Controllo pressorio e farmaci anti-ipertensivi in 490 pazienti con malattia renale cronica e ipertensione arteriosa

Factors Associated with Renal Dysfucntion in Arterial Hypertension: the REDHY study.

Fetuina e massa ventricolare nell’ipertensione essenziale e nell’insufficienza renale cronica di grado moderato

Left ventricular hypertrophy in hypertensives with chronic renal insufficiency

Markers di fibrosi miocardica e di infiammazione in ipertesi con e senza ipertrofia ventricolare.

Left ventricular hypertophy in overweight and obese hypertensives patients: impact of metabolic syndrome

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

The REDHY Study: Prevalence of Decreased Renal Function in Uncomplicated Essential Hypertension

Relationship between obesity and plasma aldosterone in essential hypertension: influence of gender

Valutazione della funzione diastolica del ventricolo sinistro in soggetti ipertesi con insufficienza renale cronica

Il propeptide carbossi-terminale del collagene tipo I è un predittore indipendente della massa del ventricolo sinistro in pazienti con ipertensione essenziale.

LIPID PARAMETERS AND LEFT VENTRICULAR MASS IN ESSENTIAL HYPERTENSIVE PATIENTS

Left ventricular hypertrophy: not so much determinant of renal outcome?

The relationships between lipid ratios and arterial stiffness

Although dyslipidemia is associated with cardiovascular disease, there are conflicting data about the role of serum lipids and their ratios in promoting arterial stiffness. The authors aimed to compare serum lipid profiles to predict arterial stiffness, which was assessed by brachial‐ankle pulse wave velocity in young Chinese men. A total of 1015 participants aged 18 to 44 years without serious comorbidities were recruited for conventional detection. Anthropometrics, brachial‐ankle pulse wave velocity, serum lipids, and other laboratory data were measured. Univariate analysis and multivariate logistic regression were performed to examine the relationship between serum lipid profiles and bra…

Left ventricular hypertrophy in the hypertensives with chronic renal insufficiency.

Diastolic function in hypertensives with chronic renal insufficiency and without left ventricular hypertrophy.

Cardiac arrhythmias as correlated with the circadian rhythm of arterial pressure in hypertensive subjects with and without left ventricular hypertrophy

To evaluate the relationship among supraventricular and ventricular arrhythmias with blood pressure and heart rate (HR) values, we studied 2 groups of 20 hypertensive men with (group I) and without (group II) left ventricular hypertrophy. Ambulatory electrocardiographic tracings were recorded continuously, together with ambulatory arterial pressure. Systolic (SBP) and diastolic (DBP) blood pressure values measured over 24 h showed no difference between the two groups, but we found greater variability in SBP in group I. The incidence of ventricular and supraventricular arrhythmias was significantly higher in patients of group I; moreover, we found a strong correlation between the incidence o…

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…

Hyperuricemia and high blood pressure at rest and during exercise: Guilty or innocent? The jury is still out

The authors investigated the hypothesis that high serum uric acid concentrations may be related to an exaggerated systolic blood pressure (SBP) response to maximal exercise testing in men with normotension, independent of potential confounding variables. In 4640 healthy men with normotension who underwent maximal treadmill exercise testing and fasting blood chemistry studies, including serum uric acid concentrations, an exaggerated SBP response, defined as SBP ≥ 210 mm Hg, was detected in 152 men (3.3%). After adjusting for potential confounders, participants in the highest quartile of serum uric acid (>6.6 mg/dL) had a higher odds ratio of demonstrating an exaggerated SBP to maximal exerci…

Screening della malattia coronarica.

Association of Oxidative Stress with Aortic Stiffness in Hypertensive Patients with Chronic Kidney Disease

Several studies have consistently demonstrated that arterial stiffness becomes progressively worse as CKD progresses and a negative correlation of oxidative stress with renal function has been described. There is also sound experimental evidence indicating that oxidative stress is involved in atherogenesis. The contribution of oxidative stress to aortic stiffness is less clear. Aim: To analyse the relationship between plasma levels of 8-ISO-prostaglandin F2alpha (8-ISOPGF2alpha), an index of lipid peroxidation, considered a reliable biomarker of oxidative stress, and aortic stiffness in a group of hypertensive patients with chronic kidney disease. Methods: We enrolled 126 hypertensive patie…

Value of home blood pressure as predictor of target organ damage in mild arterial hypertension

Relationship between aortic stiffness and albumin excretion rate in untreated essential hypertensive patients

Microalbuminuria and endothelial activation in treated and untreated diabetic and non-diabetic hypertensives

PLASMA ENDOTHELIN-1 IS ASSOCIATED WITH AORTIC STIFFNESS IN ESSENTIAL HYPERTENSION

Background: Experimental studies documented that endothelin-1 (ET-1) contributes to arterial stiffness and recently, in patients with chronic kidney diseases, it has been observed that selective endothelin-A receptor antagonism reduces arterial stiffness, in part independently of blood pressure lowering. Little is known about the relationships between ET-1 plasma levels and aortic distensibility in subjects with essential hypertension. Objective: The aim of our study was to analyse the relationships between plasma concentrations of ET-1 and carotid-femoral pulse wave velocity (c-f PWV), as an index of aortic stiffness, in a group of hypertensive patients without overt renal insufficiency [e…

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

Choroidal thickness is associated with renal hemodynamics in essential hypertension

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 blo…

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

A CASE OF CARDIAC COMPRESSION BY HEPATIC CYST IN A WOMAN WITH POLYCYSTIC KIDNEY DISEASE.

Liver cysts are common extrarenal manifestations of autosomal dominant polycystic kidney disease (ADPKD). They occur more frequently in women, and are also more in number and larger in size, than in men. Liver cysts tend to develop slower than the kidney cysts; their number and size increases with the age (worsening kidney function), number of pregnancies, and estrogen assumption. Although most patients with ADPKD report no liver symptoms, sometimes, chronic manifestations related to progressive increase of the polycystic liver are experienced. The quality of life can be severely impaired with huge hepatomegaly causing abdominal distension, pain, dyspepsia, dyspnoea, fatigue, physical and e…

Influence of Different Methods to Estimate the Glomerular Filtration Rate on the Prevalence of Decreased Renal Function in Arterial Hypertension

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

Predictors of Left Ventricular Hypertrophy in Hypertensive Patients with Normal ECG

Introduction: Early identification of left ventricular hypertrophy (LVH) in hypertensive patients is of great importance for correct stratification of cardiovascular (CV) risk. It is well known that ECGhas low sensibility in detecting LVH, while echocardiography, for organizational difficulties, cannot be performed routinely. Aim: To evaluate the prevalence of LVH and of anomalies of diastolic function in a group of hypertensive patients free of diabetes, CV diseases, and with normal ECG. Methods: We excluded patients with CV diseases, diabetes, chronic kidney disease (CKD), or having ECG-LVH or other ECG anomalies. Then, we enrolled 310 hypertensive patients (mean age 48 years). All enroll…

Fetuina-A, infiammazione e massa del ventricolo sinistro in pazienti con chronic kidney disease stage 3-4

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

Metabolic syndrome in overweight and obese hypertensives patients: impact on left ventricular mass.

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

Valutazione della funzione diastolica del ventricolo sinistro mediante Doppler tissutale in soggetti ipertesi con e senza insufficienza renale cronica

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

We are grateful to Dr Zhao Li and coauthors [1] for their interest in our work [2] and we appreciate the opportunity to comment some issues raised in their letter, a part of which have been already addressed in the discussion section of our article.They assessed the relationship between glomerular filtration rate (GFR), estimated by the chronic kidney disease (CKD)-Epidemiology Collaboration equation, and the aortic annular diameter measured from trailing edge to leading edge at the hinging points of the aortic cusps to the annulus in a general population of 5538 Chinese hypertensive patients [3]. At variance with our findings, no association was detected between GFR and aortic annular diam…

Blood Presssure Control and Anti-Hypertensive Drugs in 490 Patients with Arterial Hypertension and Chronic Kidney Disease.

Effects of drug therapy on cardiac arrhythmias and ischemia in hypertensives with LVH.

Left ventricular hypertrophy (LVH) in hypertensive subjects is associated with an increased prevalence of ventricular arrhythmias. To evaluate the effect of antihypertensive treatment on cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), we studied 46 hypertensive patients with LVH, divided into four groups randomly treated with enalapril, hydrochlorothiazide (HCTZ), atenolol, or verapamil (SR-V) for 6 months. Office blood pressure and office heart rate values were recorded, in basal conditions, after 1 and 6 months of treatment, and all patients underwent echocardiography, electrocardiographic Holter monitoring, and stress testing. All drugs significantly lowere…

Endotelina-1 e 8-isoprostano predicono il GFR stimato nell’ipertensione arteriosa

Hypertension, microalbuminuria and renal dysfunction. The REDHY (REnal Dysfunction in HYpertension) study

Relationships between 24 h blood pressure load and target organ damage in patients with mild-to-moderate essential hypertension.

Objective: To analyse the relationships between 24 h blood pressure load (the percentage of systolic/diastolic blood pressures exceeding 140/90 mmHg while awake and 120/80 mmHg during sleep) and some indices of hypertensive target organ involvement, independently of the mean level of 24 h blood pressure. Methods: One hundred and thirty patients with mild-to-moderate hypertension underwent 24 h ambulatory blood pressure monitoring, ocular fundus examination, microalbuminuria assay and two-dimensional guided M-mode echocardiography. The study population was divided into subsets according to the systolic and diastolic 24 h blood pressure load values predicted from the regression equation relat…

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…

Influenza della sindrome metabolica sulla stiffness aortica in ipertesi essenziali mai trattati farmacologicamente

Lipoprotein abnormalities in chronic kidney disease and renal transplantation

Chronic kidney disease (CKD) is one of the most important risk factors for cardiovascular disease (CVD). Despite the kidney having no direct implications for lipoproteins metabolism, advanced CKD dyslipidemia is usually present in patients with CKD, and the frequent lipid and lipoprotein alterations occurring in these patients play a role of primary importance in the development of CVD. Although hypertriglyceridemia is the main disorder, a number of lipoprotein abnormalities occur in these patients. Different enzymes pathways and proteins involved in lipoprotein metabolism are impaired in CKD. In addition, treatment of uremia may modify the expression of lipoprotein pattern as well as deter…

La funzione diastolica del ventricolo sinistro negli ipertesi con insufficienza renale cronica senza ipertrofia ventricolare.

Prevalenza della riduzione della funzione renale nell’ipertensione arteriosa non complicata. Influenza di differenti metodi di stima del filtrato glomerulare.

Endothelial activation and insulin resistance: Comparison between essential hypertensives and hypertensive patients with Metabolic Syndrome

Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram.

Background: Electrocardiography (ECG) has low sensitivity for detecting left ventricular hypertrophy (LVH), while echocardiography cannot be routinely performed. Design/methods: In this study we evaluate the prevalence of LVH and diastolic dysfunction in hypertensive patients with normal ECG. We excluded patients with cardiovascular (CV) diseases, diabetes, chronic kidney disease, or presenting ECG-LVH or other ECG anomalies. The enrolled 440 hypertensive patients underwent echocardiographic examination (Acuson Sequoia 512); LV mass was indexed by body surface area (LVMI) and LVH was defined as LVMI >125 g/m2 in men and >110 g/m2 in women. Diastolic function was evaluated by mitral inflow a…

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

Pattern di ipertrofia ventricolare sinistra negli ipertesi con insufficienza renale cronica.

Oxidant stress inversely relates to renal function in hypertension

Relationship between obesity and plasma aldosterone in essential hypertension: influence of gender

No independent association of serum uric acid with left ventricular mass in hypertensive patients

The nephroprotective effect of sacubitril/valsartan in heart failure: insights from the real-life clinical setting

Real-life data confirming the favourable renal outcome in patients with heart failure (HF) treated with Sacubitril/Valsartan, previously found in several trials (RCTs), are still scant. We evaluated the renal effects of Sacubitril/Valsartan in a real-life sample of HF patients. Observational analysis of 54 consecutive outpatients affected by HF with reduced ejection fraction (HFrEF) and clinical indication for Sacubitril/Valsartan. Patients were evaluated at baseline (T0) and after six (T6) and twelve (T12) months after initiating Sacubitril/Valsartan and compared with a group of 30 historical controls. Mean age: 65.5 ± 11.7 years. Older patients: 29 (53.7%). Mean baseline estimated glomeru…

Relation of oxidant stress with endothelial activation in hemodialysis.

Introduction and Aims: Enhanced oxidative stress may be implicated in the pathogenesis of atherosclerosis in hemodialysed patients (HDs). We hypothesized that in hypertensive HDs oxidative stress should be elevated and associated to endothelial activation, and inflammation. Methods:We examined oxidative stress, as measured by 8-ISO-PGF2alpha, endothelial activation by measuring endothelin-1 (ET-1) and adhesion molecules ICAM-1 and VCAM-1, and the biomarker of acute-phase inflammation CRP. In 52 mild HDs and in 50 healthy controls (Cs) we analysed, in the interdialytic day, plasma levels of 8-ISO-PGF2alpha, ET-1, ICAM-1 and VCAM-1, and high sensitivity CRP. Results: The comparison between Cs…

Seven-day subcutaneous continuous glucose monitoring demonstrates that treatment with acarbose attenuates late dumping syndrome in a woman with gastrectomy for gastric cancer.

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

Metabolic syndrome in hypertensive patients: An unholy alliance

For many years, it has been recognized that hypertension tends to cluster with various anthropometric and metabolic abnormalities including abdominal obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, glucose intolerance, insulin resistance and hyperuricemia. This constellation of various conditions has been transformed from a pathophysiological concept to a clinical entity, which has been defined metabolic syndrome (MetS). The consequences of the MetS have been difficult to assess without commonly accepted criteria to diagnose it. For this reason, on 2009 the International Diabetes Federation, the American Heart Association and other scientific organizations pro…

Resistive index of ophthalmic artery as an imaging biomarker of hypertension-related vascular and kidney damage

Aim: Resistive index of ophthalmic artery (RI-OA) is associated with atherosclerotic diseases. The aim of this study was to evaluate the association of RI-OA and hypertension-related vascular and kidney damage. Materials and methods: Two-hundred and eighty hypertensive patients underwent evaluation of RI-OA, carotid atherosclerosis and level of 24 h albuminuria. Results: Albuminuria and carotid atherosclerosis were positively associated with RI-OA independently of other cardiovascular risk factors. Receiver-operating characteristic curve analysis allowed us to calculate a cut-off value of RI-OA >0.625, which would be suspicious about the existence of atherosclerotic disease. Conclusion:…

C-reactive protein and ICAM-1 are stronger predictors of oxidant stress than blood pressure in established hypertension

Left ventricular diastolic function in hypertensives with chronic renal insufficiency.

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)…

Insufficienza renale cronica, ipertensione arteriosa e controllo pressorio: studio osservazionale di pazienti in terapia conservativa

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

Patterns of Left Ventricular Hypertrophy in Hypertensives with Chronic Renal Insufficiency

Is echocardiography mandatory for patients with chronic kidney disease?

This study aims at evaluating the prevalence of left ventricular diastolic dysfunction in a group of 319 hypertensive patients with stage 3b–4–5 chronic kidney disease (according to Kidney Disease Improving Global Outcomes classification), compared with 216 patients with essential hypertension and normal renal function. All patients underwent echocardiographic examination. Patients on stage 1–2–3a chronic kidney disease, dialysis treatment, or with previous manifestations of heart failure or other cardiovascular diseases were excluded. Patients with renal disease had significantly worse diastolic function (both considering trans-mitral flow and tissue Doppler imaging parameters). Diastolic …

INFLUENCE OF GLOMERULAR FILTRATION RATE ON LEFT VENTRICULAR MASS IN HYPERTENSIVE PATIENTS WITH NORMAL RENAL FUNCTION

Influence of different methods to estimate glomerular filtration rate on the prevalence of decreased renal function in essential hypertension. Preliminary results of the REDHY study.

Relationship between total arterial compliance and metabolic syndrome in essential hypertensive subjects

Insulin-like growth factor 1 and sodium-lithium countertransport in essential hypertension and in hypertensive left ventricular hypertrophy

The aim of this work was to study the insulin-like growth factor 1 (IGF1), a substance able to promote cell proliferation in vascular smooth muscle, in patients with mild-to-moderate hypertension and to analyse its relationship to sodium-lithium countertransport, a genetic marker of hypertension that is related to cardiovascular complications.We studied 32 hypertensive subjects, some with left ventricular hypertrophy, and 14 healthy subjects. Fasting plasma IGF1 was measured by means of a radioimmunoassay after octadecylsilica chromatography and Na(+)-Li+ countertransport was determined by the method of Canessa.Hypertensive patients had higher values of both IGF1 and Na(+)-Li+ countertransp…

Influence of metabolic syndrome on hypertension-related target organ damage

MuleG, Nardi E, Cottone S, Cusimano P, Volpe V, Piazza G, MongioviR, Mezzatesta G, Andronico G, Cerasola G (Universitadi Palermo, Palermo, Italy). Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503-513. Objectives. The aim of our study was to analyse, in a wide group of essential hypertensive patients without diabetes mellitus, the influence of metabolic syndrome (MS) (defined according to the criteria laid down in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults) on markers of preclinical cardiac, renal and retinal damage. Design. Cros…

Changes of plasma endothelin and growth factor levels, and of left ventricular mass, after chronic AT1-receptor blockade in human hypertension.

The stimulation of autocrine and paracrine factors such as basic fibroblast- (bFGF) and platelet-derived (PDGF) growth factors mediates many of the growth-promoting actions of angiotensin II. The aim of this study was to evaluate the effect of chronic AT1-receptor blockade on plasma endothelin-1 (ET-1) and growth factors levels, and on left ventricular mass, in essential hypertension (EH). The study population consisted of 16 patients with mild-moderate EH, and 25 normotensive controls. In the EH patients under basal conditions, and after 3 and 6 months of chronic therapy with Losartan 50 mg/day, we measured serum levels of ET-1, bFGF and PDGF, and tumor necrosis factor (TNF). At the same t…

[Cardiac arrhythmias in hypertensive subjects with and without left ventricular hypertrophy compared to the circadian profile of the blood pressure].

To evaluate possible correlations between cardiac arrhythmias and circadian pattern of blood pressure (BP) and of heart rate (HR), we studied 2 groups of 20 males with stable arterial hypertension of mild to moderate entity, with (Group I) or without (Group II) left ventricular hypertrophy (LVH). In patients with LVH the mean age (56 vs 46 years), the duration of the hypertensive state (48.1 vs 15.7 months), the thickening of interventricular septum (IVS; 13.7 vs 9.6 mm) and of the posterior wall of the left ventricle (13.2 vs 9.2 mm) and the mass of LV (149.8 vs 99.7 g/m2) were significantly greater (p less than 0.01). On the contrary, the 2 groups did not show significant differences conc…

11.5 Blood Pressure Control and Anti-Hypertensive Drugs in 490 Patients with Hypertension and Chronic Kidney Disease

RELATIONSHIPS BETWEEN PLASMA ALDOSTERONE LEVELS AND LEFT VENTRICULAR MASS AND GEOMETRY IN ESSENTIAL HYPERTENSIVE PATIENTS: DOES SEX MATTER?

Introduction: Experimental evidence suggested that aldosterone can cause myocardial hypertrophy and fibrosis. However, previous studies on the association between plasma aldosterone concentration (PAC) and left ventricular (LV) mass (LVM) and geometry, in subjects without primary aldosteronism yielded conflicting results. Aim: To evaluate the relationships of PAC with LV mass and geometry in patients with essential hypertension (EH), and to assess the influence of gender on these relationships. Methods: We enrolled 478 subjects (men: 63%; mean age 44 ± 12 years) with untreated EH. The measurements included 24-h blood pressures, plasma renin activity (PRA) and PAC, obtained by radioimmunoass…

Differences in cardiac structure and function between black and white patients: Another step in the evaluation of cardiovascular risk in chronic kidney disease

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.

Attivazione endoteliale in pazienti ipertesi non microalbuminurici

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…

PREVALENCE OF DIASTOLIC DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND CHRONIC KIDNEY DISEASE

Introduction: In patients with arterial hypertension and chronic kidney disease (CKD), the prevalence of diastolic heart failure (HF-PEF) is probably very high. However, in these patients the diagnosis is difficult, especially because the signs and symptoms suggestive of HF-PEF are very common in CKD; in these cases the detection of left ventricular structural and functional alterations (as reported in the 2012 ESC guidelines on heart failure), assumes a decisive role for the diagnosis of HF-PEF. Aim: To evaluate the prevalence of patients with diastolic dysfunction according to ESC guidelines 2012 in a population of Hypertensive patients with CKD. Methods: We studied 466 hypertensive patie…

Relazione tra stress ossidativo, angiotensina II ed endotelina-1: osservazione in pazienti con ipertensione essenziale.

PP.04.22

Endothelial activation and insulin resistance: Comparison beween essential hypertensives and hypertensive patients with metabolic syndrome

INFLUENZA DEL FILTRATO GLOMERULARE RENALE SULLA MASSA VENTRICOLARE SINISTRA IN SOGGETTI IPERTESI CON FUNZIONE RENALE NORMALE

Impact of the metabolic syndrome on total arterial compliance in essential hypertension patients.

The aim of the study was to cross-sectionally analyze, in a group of essential hypertension patients without diabetes mellitus, the influence of the metabolic syndrome (MS) on the stroke volume index to pulse pressure (SVi/PP) ratio, a measure of total arterial compliance. A total of 528 essential hypertension patients, aged 18 to 72 years, free from cardiovascular and renal disease (41% of whom had MS) were enrolled. All participants underwent routine blood chemistry, echocardiographic examination, and 3 blood pressure measurements at the end of echocardiographic examination. When compared with participants who did not have MS, hypertensive patients with MS exhibited lower SVi/PP ratio (0.…

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…

Relazione inversa tra stress ossidativo e funzione renale nell’ipertensione arteriosa.

Microalbuminuria and early endothelial activation in essential hypertension

We hypothesized that in essential hypertensive patients (EHs), plasma levels of pro-atherogenic adhesion molecules would be increased and related with urine albumin excretion (UAE). Thus, this study was aimed at evaluating biochemical markers of endothelial activation and their relationship with UAE in a group of patients with uncomplicated EH. In basal condition soluble forms of adhesion molecules intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1, as well as 24-h UAE were assayed. One hundred patients with essential hypertension and no diabetes or ultrasonographic evidence of atherosclerosis were included in the study. Seventy normotensive healthy subjec…

LEFT VENTRICULAR HYPERTROPHY IN HYPERTENSIVE PATIENTS WITH NORMAL ELECTROCARDIOGRAM

Objective: In hypertensive patients the presence of left ventricular hypertrophy (LVH) is associated with increased cardiovascular (CV) morbidity and mortality. Unfortunately electrocardiogram (ECG) has a low sensitivity in detecting LVH, while echocardiography cannot be routinely and extensively performed in all hypertensive patients. In this study we evaluated the prevalence of LVH and of anomalies of diastolic function in a group of hypertensive patients with normal ECG, and free of diabetes and CV diseases. Design and Methods: Patients with CV diseases, diabetes, chronic kidney disease (CKD), electrocardiographic LVH (Sokolow-Lyons or Cornell criterion) or “strain” were excluded. We enr…

Left ventricular hypertrophy and geometry in hypertensive patients with chronic kidney disease.

To evaluate 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.All patients underwent echocardiographic examination. Patients on stage 1 CKD, dialysis treatment, or with cardiovascular diseases were excluded.LVH was observed in 47.1% of patients with CKD and in 31.14% of essential hypertensive patients (P0.0001). We found increasingly higher left ventricular diameters, thicknesses, and mass from stage 2 to 5 CKD. Distribution of concentric and eccentric LVH was not different between the two groups. H…

Influence of the metabolic syndrome on aortic stiffness in never treated hypertensive patients

Summary Background and aim Metabolic syndrome (MS) carries an increased risk for cardiovascular events and there is a growing awareness that large artery stiffening is a powerful predictor of cardiovascular morbidity and mortality. Little is known about the relationship of MS with aortic stiffness. The aim of our study was to analyze, in patients with essential hypertension, the influence of MS, defined according to the criteria proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III), on carotid–femoral pulse wave velocity (PWV), a measure of aortic stiffness. Methods N…

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…

Relation of C-reactive protein to oxidative stress and to endothelial activation in essential hypertension.

Background: C-reactive protein (CRP) predicts cardiovascular outcome. Oxidative stress is considered to be involved in endothelial alteration. We hypothesized that in essential hypertension (EH), oxidative stress, as measured by 8-iso-prostaglandin-F2 alfa (8-iso-PGF2alfa), should be associated with increased CRP and endothelial activation, as evaluated by soluble intercellular adhesion molecule–1 (ICAM-1) and vascular adhesion molecule–1 (VCAM-1) plasma levels. Methods: In 83 subjects with mild EH and in 50 healthy control subjects we measured, in basal conditions, plasma levels of hs-CRP, 8-iso-PGF2 alfa, ICAM-1 and VCAM-1, and tumor necrosis factor–alfa (TNF-alfa). Results: Subjects with…

Micro-albuminuria as a predictor of cardiovascular damage in essential hypertension

5.16 Left Ventricular Geometry In Chronic Kidney Disease

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

Comparazione dei promotori dell’aterosclerosi in pazienti nefropatici in terapia conservativa e dialitica

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

Oxidant stress is inversely related to renal function in hypertension.

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

Markers of endothelial activation and left ventricular hypertrophy 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…

Influence of metabolic syndrome on clinic and 24-h pulse pressure in essential hypertension.

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

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

Fetuin-A plasma concentration and left ventricular mass in essential hypertension

Controllo pressorio e farmaci anti-ipertensivi in 490 pazienti con ipertensione arteriosa e malattia renale cronica.

Inverse association between type 2 diabetes and aortic root dimension in hypertensive patients

Background Some data support the concept that aortic root diameter (ARD) in hypertension may be regarded as a marker of subclinical organ damage. The impact of type 2 diabetes mellitus (DM) on cardiac structure and function is known, although the relationship between DM and ARD is not clear. The aim of our study was to evaluate the influence of DM on ARD in hypertensive patients. Methods We enrolled 1693 hypertensive patients (aged 63.7 ± 9.6 years). The population was divided into two groups: the first one with DM (n = 747) and the second one without DM (n = 946). ARD was measured by echocardiography at level of Valsalva's sinuses using echocardiography M-mode tracings. It was considered a…

Attivazione endoteliale: confronto tra ipertensione essenziale, sindrome metabolica e diabete mellito associati ad ipertensione

Impact of metabolic syndrome on left ventricular mass in overweight and obese hypertensive subjects

BACKGROUND: Metabolic syndrome (MS) has been associated with an increased left ventricular (LV) mass in recent reports. Little is known about the association of MS with LV mass (LVM) in overweight and obese individuals. The aim of our study was to investigate the relation between MS and LVM in a population of overweight and obese hypertensive subjects. METHODS: 289 non-diabetic essential hypertensives with a body mass index >25 kg/m2, were enrolled. In all subjects routine blood chemistry, echocardiographic examination and 24-h ambulatory blood pressure monitoring were performed. RESULTS: In the group of overweight patients, participants with MS (n=58), when compared to those without it (n=…

La disfunzione renale nell’ipertensione essenziale: lo studio REDHY

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

Left Ventricular Geometry in Chronic Kidney Disease.

Relationships of “ambulatory” white coat effect with target organ damage in arterial hypertension

Oxidant stress and endothelial activation in hypertensive patients with and without left ventricular hypertrophy

Relazione tra microalbuminuria e velocità dell’onda sfigmica in ipertesi mai trattati farmacologicamente.

RELATIONSHIP BETWEEN OBESITY AND PLASMA ALDOSTERONE IN ESSENTIAL HYPERTENSION: INFLUENCE OF GENDER: PP.34.372

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…

Chronic Administration of Slow-Release Nifedipine Improves Arterial Compliance in Elderly Hypertensives with Systolic Hypertension

Coronary artery disease screening

Plasma endothelin-1 and 8-Iso-ProstaglandinF2alpha levels are related to renal function and predict estimated glomerular filtration rate in hypertensive patients

Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensives

In order to explore the relations between left ventricularmass (LVM) and the pulsatile (pulse pressure) andsteady (mean pressure) components of the bloodpressure (BP) curve, 304 young and middle-agedessential hypertensive patients were studied by meansof 24-h ambulatory BP monitoring and echocardio-graphy. In the overall study population, both the BPcomponents showed significant correlations with LVM.These correlations were unevenly distributed in thesubgroups of subjects younger and in those older than50 years. While in this latter subgroup, in multivariateanalysis, both 24-h mean BP (24-MBP) (b¼0.27;P¼0.008) and 24-h pulse pressure (24-h PP) (b¼0.23;P¼0.02) were associated with LVM, in th…

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…

Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensives

In order to explore the relations between left ventricular mass (LVM) and the pulsatile (pulse pressure) and steady (mean pressure) components of the blood pressure (BP) curve, 304 young and middle-aged essential hypertensive patients were studied by means of 24-h ambulatory BP monitoring and echocardiography. In the overall study population, both the BP components showed significant correlations with LVM. These correlations were unevenly distributed in the subgroups of subjects younger and in those older than 50 years. While in this latter subgroup, in multivariate analysis, both 24-h mean BP (24-MBP) (beta = 0.27; P = 0.008) and 24-h pulse pressure (24-h PP) (beta = 0.23; P = 0.02) were a…

Blood pressure and glycaemia, not insulin-resistance, influence endothelial dysfunction in metabolic syndrome

PREVALENZA DI IPERTROFIA VENTRICOLARE SINISTRA NELL’IPERTENSIONE ARTERIOSA: RIVALUTAZIONE CON I NUOVI CUT-OFF

Nelle linee guida 2013 ESH/ESC per il trattamento dell’ipertensione arteriosa si consiglia di utilizzare come cut-off per l’ipertrofia ventricolare sinistra (LVH) valutata con ecocardiografia, 95 g/m2 per il sesso femminile e 110 g/m2 per il sesso maschile e spessore parietale relativo (RWT) 0,42 per differenziare la forma concentrica dalla forma eccentrica. Tali cut-off sono diversi da quelli suggeriti nella versione precedente delle linee guida (110 g/m2 per il sesso femminile, 125 g/m2 per il sesso maschile e 0.45 per RWT). Scopo del presente studio è di valutare se tale variazione abbia determinato variazioni di rilievo nella valutazione della prevalenza di LVH nei pazienti ipertesi. A …

Oxidative stress relates to endothelial activation and inflammation in essential hypertensive patients

Fetuin-A and left ventricular hypertrophy in essential hypertension.

8.1 Factors Associated With Renal Dysfunction In Arterial Hypertension: The REDHY Study

Impatto del diabete sulla geometria ventricolare sinistra in soggetti ipertesi con malattia renale cronica

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

[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…

Fetuina e massa ventricolare sinistra nell'ipertensione essenziale e nell'insufficienza renale cronica

[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…

Usefulness of microalbuminuria in cardiovascular risk stratification of essential hypertensive patients

&lt;i&gt;Background/Aims:&lt;/i&gt; To evaluate the influence of microalbuminuria (albumin excretion rate – AER) determination and echocardiography (ECHO) on cardiovascular risk stratification, initially performed according the 1999 WHO/ISH guidelines by using only routine diagnostic procedures with or without fundal examination. &lt;i&gt;Methods:&lt;/i&gt; 312 essential hypertensives attending our institution were studied retrospectively. Cardiovascular risk was assessed in a semiquantitative way using four categories of absolute cardiovascular disease risk (low, medium, high and very high risk), as proposed by the 1999 WHO/ISH guidelines, on the basis of data on the average 10-year risk o…

Prevalenza della riduzione lieve e moderata della funzione renale nell’ipertensione arteriosa non complicata. Risultati preliminari dello studio REDHY.

Markers of myocardial fibrosis and inflammation in hypertensives with and without left ventricular hypertrophy

Left ventricular hypertrophy in overweight and obese hypertensive patients: impact of metabolic syndrome

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…

Electrocardiography plus limited echocardiography in young, newly identified, hypertensives: some considerations.

L’ipertrofia ventricolare sinistra negli ipertesi con insufficienza renale cronica.

Relationships between metabolic syndrome and steady and pulsatile components of clinic and 24-h blood pressure

Il propeptide carbossi-terminale del collagene di tipo 1 e’ un predittore indipendente della massa del ventricolo sinistro in pazienti con ipertensione essenziale.

La sindrome metabolica negli ipertesi essenziali mai trattati farmacologicamente: effetti sulla stiffness aortica

Influenza della microalbuminuria sulla stratificazione del rischio cardiovascolare globale nel paziente iperteso.

Influenza della sindrome metabolica sulla massa del ventricolo sinistro nell’iperteso obeso

Relationship of Metabolic Syndrome With Pulse Pressure in Patients With Essential Hypertension

BACKGROUND: Pulse pressure is largely dependent on arterial stiffness. Recent studies have documented reduced large artery compliance in nondiabetic subjects with metabolic syndrome (MS). The aim of our study was to analyze, in a group of patients with essential hypertension and without diabetes mellitus, the influence of MS on clinic and 24-h pulse pressures. METHODS: A total of 528 hypertensive subjects, aged 18 to 72 years, who were free of cardiovascular and renal diseases were enrolled. Of the subjects, 41% had MS. In all subjects routine blood chemistry, echocardiographic examination, and 24-h ambulatory blood pressure monitoring were performed. RESULTS: When compared with subjects wi…

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…

Metabolic syndrome and cardiac morphofunctional changes in subjects with white-coat hypertension

Prevalence of decreased renal function in uncomplicated essential hypertension.

Valutazione dello stress ossidativo in pazienti ipertesi sottoposti a trapianto renale

Valutazione della funzione diastolica del ventricolo sinistro mediante Doppler tissutale in soggetti ipertesi diabetici e non diabetici

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

Is increased brachial pulse pressure a reliable predictor of cardiovascular risk in old hypertensive subjects with metabolic syndrome? Reply.

Metabolic syndrome in overweight and obese hypertensive patients: impact on left ventricular mass.

Prevalence of decreased renal function in uncomplicated essential hypertension. Preliminary results of the REDHY study

Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients

. Objectives.  To evaluate, in a group of nondiabetic essential hypertensive patients with normal renal function, the relationship between albumin excretion rate (AER) and carotid-femoral pulse wave velocity (PWV), as an index of aortic stiffness. Design.  Cross-sectional study. Setting.  Outpatient hypertension clinic. Subjects.  Seventy patients with mild-to-moderate essential hypertension, aged 42 ± 8 years, never pharmacologically treated. All subjects underwent routine laboratory tests, 24-h ambulatory blood pressure (BP) monitoring, measurement of carotid-femoral PWV, by means of a computerized method, and AER. Results.  Microalbuminuric patients (AER ≥ 20 μg min−1; n = 19), when comp…

Diabetes and aortic root dimension: A controversial subject.

Fetuin-A and left ventricular mass in essential hypertension and in moderate chronic kidney disease.

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

Endotelin-1 and 8-isoprostanes Predict Estimated Glomerular Filtration Rate in Arterial Hypertension

Statin-induced autoimmune myositis: a proposal of an “experience-based” diagnostic algorithm from the analysis of 69 patients

AbstractStatin-induced autoimmune myositis (SIAM) represents a rare clinical entity that can be triggered by prolonged statin treatment. Its pathogenetic substrate consists of an autoimmune-mediated mechanism, evidenced by the detection of antibodies directed against the 3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR Ab), the target enzyme of statin therapies. To facilitate the diagnosis of nuanced SIAM clinical cases, the present study proposes an “experience-based” diagnostic algorithm for SIAM. We have analyzed the clinical data of 69 patients diagnosed with SIAM. Sixty-seven patients have been collected from the 55 available and complete case records regarding SIAM in the l…

Influenza di differenti metodi di stima del filtrato glomerulare sulla prevalenza della riduzione lieve e moderata della funzione renale nell’ipertensione arteriosa non complicata. Risultati preliminari dello studio REDHY.

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

(2006). Oxidant stress and endothelial activation in hypertensive patients with and without left ventricular hypertrophy.

Blood Pressure control by 24-hour Ambulatory Monitoring in Chronic Renal Failure.

La funzione diastolica del ventricolo sinistro negli ipertesi con insufficienza renale cronica e senza ipertrofia ventricolare.

La disfunzione renale nell’ipertensione arteriosa

L’ipertensione arteriosa rappresenta una causa sempre più comune di insufficienza renale cronica terminale; è ben noto inoltre come la presenza di una disfunzione renale, anche lieve, comporti un significativo incremento del rischio cardiovascolare. Recentemente è stata valutata la prevalenza della disfunzione renale in pazienti ipertesi senza complicanze cardiovascolari o patologia renale nota, partecipanti allo studio Renal Dysfunction in Hypertension (REDHY), utilizzando quattro metodi di stima del filtrato glomerulare (GFR): la clearance della creatinina (CrCl), l’equazione semplificata dello studio Modification of Diet in Renal Disease (MDRD), la formula di Cockcroft-Gault (CG) e l’equ…

Markers di fibrosi miocardica e di infiammazione in ipertesi con e senza ipertrofia ventricolare sinistra

Left ventricular hypertrophy in chronic kidney disease: A diagnostic criteria comparison.

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 &lt; 0.0001). We found increasingl…

La sindrome metabolica nei soggetti con ipertensione arteriosa essenziale: effetti sulla pressione di polso clinica e delle 24 ore

Sindrome metabolica e danno d’organo nell’ipertensione arteriosa essenziale.

Relationships between ambulatory white coat effect and left ventricular mass in arterial hypertension

The aim of our study was to analyze, in a group of 296 essential hypertensives, the relationship between left ventricular mass (LVM) and ambulatory white coat effect (WCE); that is the difference between the elevation of the first measurements of ambulatory blood pressure monitoring and the mean daytime pressure. The study population was separated into two groups according to the median of the WCE. The LVM was greater in the groups with higher systolic and diastolic ambulatory WCE. The significant association between ambulatory WCE and LVM was confirmed by the results of multiple regression analysis, suggesting that ambulatory WCE may not be an innocent phenomenon.

[OP.2D.05] RELATIONSHIP OF OXIDATIVE STRESS WITH CARDIAC HYPERTROPHY IN HYPERTENSIVE PATIENTS

OBJECTIVE: Left ventricular hypertrophy is common in hypertensive patients. In these subjects increased oxidative stress has been observed. Our aim was to evaluate the association of biomarkers of both oxidative stress and inflammation with markers of cardiovascular damage in a large group of hypertensives with different stages of renal function. DESIGN AND METHOD: In 517 hypertensives we analyzed left ventricular mass indexed for body surface area, and we assayed plasma levels of 8-isoprostaglandin F2alpha and high sensitivity C reactive protein. RESULTS: Multivariate analysis carried out considering left ventricular mass as dependent variable, and including 8-isoprostaglandin F2alpha, hig…

Adiponectin relates inversely to atherosclerotic factors independently of blood pressure in essential hypertension

Efficacy and safety of lomitapide in familial chylomicronaemia syndrome

Familial chylomicronaemia syndrome (FCS) is a rare autosomal recessive disorder, resulting in elevated triglycerides (TGs), abdominal pain and pancreatitis. Treatment options are limited. Lomitapide, a microsomal triglyceride transfer protein inhibitor, is approved for the treatment of homozygous familial hypercholesterolaemia. Whether its therapeutic use may be extended to FCS remains unknown. The aim of this study was to evaluate the efficacy and safety of lomitapide in adult patients with FCS.The open-label, single-arm 'LOCHNES' study of lomitapide in FCS enrolled patients18 years with genetically confirmed FCS, elevated fasting TG ≥ 750 mg/dL and history of pancreatitis. Patients were a…

RELATIONSHIP BETWEEN OXIDATIVE STRESS AND AORTIC STIFFNESS IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE

Effects of Nifedipine on Blood Pressure, Arterial Compliance and Left Ventricular Mass in Elderly Patients with Isolated Systolic Hypertension

The aim of this study was to evaluate the effects of acute and chronic administration of slow-release nifedipine (SRN) on blood pressure (BP), aortic index (AI), average wall stress (AWS), left ventricular mass (LVM), and other hemodynamic parameters in elderly patients with isolated systolic hypertension (ISH) (systolic blood pressure [SBP] > 175 mmHg). We studied 10 patients (mean age 73.7 ± 5.6 years) in which after a washout period, in basal conditions, 3 h after the administration of SRN (20 mg), and 180 days after chronic therapy (40 mg daily), we evaluated the changes of BP, HR, AI, AWS, LVM, and other parameters obtained by means of echocardiography. After SRN we observed a signific…

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

Impact of metabolic syndrome on left ventricular mass: Is the same in all ethnic groups and in men and women?

[1] Mule G, Nardi E, Cottone S, et al. Impact of metabolic syndrome on left ventricular mass in overweight and obese hypertensive subjects. Int J Cardiol 2007;121:267–75. [2] Grundy SM, Brewer Jr HB, Cleeman JI, Smith Jr SC, Lenfant C. American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433–8. [3] IsomaaB,Almgren P, TuomiT, et al. Cardiovascularmorbidity andmortality associated with the metabolic syndrome. Diabetes Care 2001;24:683–9. [4] Reilly MP, Rader DJ. The metabolic syndrome:…

Diastolic function in chronic renal insufficiency

Nell’ipertensione essenziale, proteina C reattiva ed ICAM-1 sono predittori di stress ossidativo maggiori dei valori pressori.

Relation of C-reactive protein to oxidative stress and to endothelial dysfunction in essential hypertension

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…

Left ventricular mass 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…

Aortic stiffness in untreated hypertensive patients: influence of metabolic syndrome

Effects of four different anti-hypertensive treatments on cardiac arrhythmias and transient episodes of myocardial ischemia in hypertensives with left ventricular hypertrophy

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…

Relazione tra sindrome metabolica e pressione di polso in soggetti con ipertensione arteriosa essenziale

Relazione tra stiffness aortica e catecolamine plasmatiche in ipertesi essenziali mai trattati farmacologicamente.

Microalbuminuria, renal dysfunction and cardiovascular complication in essential hypertension

To evaluate the prevalence of microalbuminuria (albumin excretion rate, AER) in a wide hypertensive population, and to evaluate any relationship with cardiovascular damage and renal dysfunction.A transversal study.In 383 hospitalized Caucasian essential hypertensives (198 men, 185 women) of mean age 44 +/- 0.5 years and mean clinic blood pressure 170.3 +/- 0.95/ 103.4 +/- 0.47 mmHg, metabolic parameters, serum creatinine level (Cs), creatinine clearance rate (Ccs), 24 AER and plasma renin activity (PRA) were measured. Furthermore, each patient underwent 24 h ambulatory blood pressure monitoring (ABPM) and echocardiography to measure left ventricular mass, which was indexed both by body surf…

Influenza di differenti metodi di stima del filtrato glomerulare sulla prevalenza della riduzione della funzione renale nell’ipertensione arteriosa non complicata.

Left ventricular diastolic function in hypertesives with chronic renal insufficiency.

C-reactive protein and intercellular adhesion molecule-1 are stronger predictors of oxidant stress than blood pressure in established hypertension

Oxidant stress is implicated in the pathogenesis of atherosclerosis in cardiovascular diseases. Our aim was to test oxidative stress, as 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha), and its relationship with inflammation markers C-reactive protein (CRP) and tumour necrosis factor-alpha (TNFalpha), and endothelial activation assayed as soluble intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in essential hypertension.In 216 essential hypertensive patients and 55 healthy control individuals, plasma levels of high-sensitivity CRP and TNFalpha, 8-iso-PGF2alpha, ICAM-1 and VCAM-1 were measured in basal conditions. Moreover, basal and 24-h ambulatory blood p…

L'iter diagnostico della cardiopatia dilatativa

Metabolic syndrome in subjects with essential hypertension: Relationships with subclinical cardiovascular and renal damage

It has long been recognized that arterial hypertension is often a part of a larger constellation of anthropometric and metabolic abnormalities that includes abdominal (or visceral) obesity, a characteristic dyslipidemia (low high-density lipoprotein cholesterol and high triglycerides), glucose intolerance, insulin-resistance and hyperuricemia. These traits occur simultaneously to a greater degree than would be expected by chance alone, supporting the existence of a discrete disorder that, over the years, has been defined by a variety of terms, including plurimetabolic syndrome, the deadly quartet, dysmetabolic syndrome, insulin resistance syndrome, cardiometabolic syndrome and more recently…

Association between biomarkers of inflammation and left ventricular hypertrophy in moderate chronic kidney disease.

Aims: Left ventricular hyper- trophy (LVH) is a predictor for cardiovascu- lar mortality, and it is considered to be a surro- gate marker of preclinical cardiovascular dis- ease. This study aimed at evaluating whether fetuin-A plasma levels are decreased in pa- tients with moderate chronic kidney disease (CKD) and their linkage to plasma concentra- tions of hs-C-reactive protein (CRP), cardio- trophyn-1 (CT-1), tumor necrosis factor- (TNF-), propeptide of collagen Type I (PIP) and to LVH. Material and methods: We enrolled 64 moderate CKD and 55 essential hypertensives (EH) with normal renal func- tion as controls. All the patients underwent an echocardiographic examination; plasma sam- ples…

Inappropriately high left ventricular mass: Marker of very high cardiovascular risk in patients with chronic kidney disease

There is increasing knowledge of the burden of cardiovascular (CV) diseases affecting patients with chronic kidney disease (CKD). CV diseases are the main cause of death in the CKD population, and the majority of patients with CKD die before ever reaching the end-stage renal disease; in fact, for patients with CKD, the risk of a fatal CV event is much higher than the risk to develop end-stage renal disease. Although patients with CKD manifest a high prevalence of traditional CV risk factors, this does not fully account for the burden of CV diseases in CKD.

Impact of diabetes on left ventricular geometry in hypertensive patients with chronic kidney disease

Inverse relationship between ambulatory artery stiffness index and glomerular filtration rate in essential hypertension

Pericardial thickening in chronic kidney disease: what meaning?

Impact of diabetes on left ventricular geometry and diastolic function in hypertensive patients with chronic kidney disease

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)…

Fetuina e massa ventricolare sinistra nell’ipertensione essenziale e nell’insufficienza renale

Ipertrofia ventricolare sinistra nell’iperteso obeso: influenza della sindrome metabolica

12.8 Endotelin-1 and 8-Isoprostanes Predict Estimated Glomerular Filtration Rate in Arterial Hypertension

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…

Increased prevalence of cardiac arrhythmias and transient episodes of myocardial ischemia in hypertensives with left ventricular hypertrophy but without clinical history of coronary heart disease.

To evaluate the behavior of cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), in relation to the circadian pattern of blood pressure in patients suffering from arterial hypertension, with or without echocardiographically ascertained left ventricular hypertrophy (LVH), we studied 128 patients, 87 men (M) and 41 women (F), aging from 21 to 76 years, subdivided into two groups: Group I, including 66 patients with LVH (45 M and 21 F; mean age of 53.7 ± 9.1 years; Group II, including 62 patients without LVH ( 42 M and 20 F; mean age of 49.7 ± 9.5 years). Office blood pressure (OBP) as well as nighttime ambulatory blood pressure (ABP) were higher in patients with LVH …

Sindrome metabolica ed alterazioni morfo-funzionali cardiache nei soggetti con ipertensione clinica isolata

Hyperalphalipoproteinemia and Beyond: The Role of HDL in Cardiovascular Diseases

Hyperalphalipoproteinemia (HALP) is a lipid disorder characterized by elevated plasma high-density lipoprotein cholesterol (HDL-C) levels above the 90th percentile of the distribution of HDL-C values in the general population. Secondary non-genetic factors such as drugs, pregnancy, alcohol intake, and liver diseases might induce HDL increases. Primary forms of HALP are caused by mutations in the genes coding for cholesteryl ester transfer protein (CETP), hepatic lipase (HL), apolipoprotein C-III (apo C-III), scavenger receptor class B type I (SR-BI) and endothelial lipase (EL). However, in the last decades, genome-wide association studies (GWAS) have also suggested a polygenic inheritance o…

Influence of the calcium antagonist amlodipine on left ventricular mass and function in patients with essential hypertension

This study was conducted to evaluate the influence of antihypertensive treatment with the calcium antagonist amlodipine on left ventricular structure and systolic and diastolic function in patients with essential hypertension.

Relationship of metabolic syndrome with pulse pressure in essential hypertensive patients.

Relationship between Plasma Aldosterone and Left Ventricular Mass in Hypertensive Subjects with Mild-to-Moderate Chronic Kidney Disease

Introduction: Plasma aldosterone (ALD) levels are generally increased in subjects with chronic kidney disease (CKD), especially in those with end-stage renal disease. Convincing clinical and experimental data indicate that aldosterone plays a fundamental role in determining functional and structural changes of the heart. On the other hand, it is known that hypertensive patients with renal dysfunction, also of mild degree, show an increased prevalence of cardiovascular organ damage. Little is known about the relationships between aldosteronaemia and left ventricular mass in subjects with mild-to-moderate CKD. Aim: To analyse the relationships between ALD and left ventricular mass (LVM), in a…

Metabolic syndrome amplifies hypertension-related target organ damage

Effects of drug therapy on cardiac arrhythmias and ischemia in hypertensives with LVH.

Left ventricular hypertrophy (LVH) in hypertensive subjects is associated with an increased prevalence of ventricular arrhythmias. To evaluate the effect of antihypertensive treatment on cardiac arrhythmias (CA) and transient episodes of myocardial ischemia (TEMI), we studied 46 hypertensive patients with LVH, divided into four groups randomly treated with enalapril, hydrochlorothiazide (HCTZ), atenolol, or verapamil (SR-V) for 6 months. Office blood pressure and office heart rate values were recorded, in basal conditions, after 1 and 6 months of treatment, and all patients underwent echocardiography, electrocardiographic Holter monitoring, and stress testing. All drugs significantly lowere…

Left ventricular mass in hypertensive patients with mild-to-moderate reduction of renal function

Aim: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular (CV) morbidity and mortality. The aim of the present study was to evaluate the relationship between LV mass and mild-to-moderate renal dysfunction in a group of non-diabetic hypertensives, free of CV diseases, participating in the Renal Dysfunction in Hypertension (REDHY) study. Methods: Patients with diabetes, a body mass index (BMI) of more than 35 kg/m 2 , secondary hypertension, CV diseases and a glomerular filtration rate (GFR) of less than 30 mL/min per 1.73 m 2 were excluded. The final sample included 455 patients, who underwent echocardiographic examination and ambulatory blood pressure monitoring.…

PREVALENZA DELLA RIDUZIONE DELLA FUNZIONE RENALE NELL’IPERTENSIONE ARTERIOSA NON COMPLICATA: STUDIO REDHY.

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

Electrocardiography for Assessment of Hypertensive Heart Disease: A New Role for an Old Tool

Left ventricular (LV) hypertrophy (LVH), detected either by electrocardiography (ECG) or echocardiography (ECHO), has long been recognized as a powerful predictor of serious cardiovascular (CV) sequelae. A very large and highly consistent body of evidence indicates that LVH is not only an adaptation to increased hemodynamic load in hypertension, but is also independently associated with an enhanced risk for myocardial infarction, cardiac sudden death, congestive heart failure, and stroke in the general population, as well as in patients with systemic hypertension, coronary heart disease, chronic kidney disease, and atrial fibrillation. Intriguingly, the cumulative incidence of cardiovascula…

Relazione tra obesità ed aldosteronemia nell'ipertensione essenziale: influenza del sesso.

Una relazione tra obesità e aldosteronemia (ALD), indipendente dall’attività reninica plasmatica (PRA), è stata ipotizzata sulla base di diverse evidenze sperimentali, ma non è stata confermata in tutti gli studi clinici effettuati sull’argomento. Inoltre, pochi dati esistono in letteratura sull’eventuale influenza del sesso su tale relazione. Scopo del nostro studio è stato quello di esaminare, prima globalmente e poi separatamente nei due sessi, l’eventuale associazione tra indice di massa corporea (BMI), circonferenza addominale (W) e ALD in un ampio gruppo di ipertesi essenziali non diabetici, afferenti al nostro Centro di Riferimento per lo studio dell’Ipertensione Arteriosa. Sono stat…

Need for anti-hypertensive drugs and blood pressure control in 490 consecutive patients with chronic kidney diseases and hypertension.

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

Young woman with Branchio-Oto-Renal Syndrome and a novel mutation in the EYA-1 gene

Branchio-oto-renal (BOR) syndrome is an autosomal dominant disease clinically characterized by the coexistence of some or all of the following major disorders: deafness, cervical branchial fistulae, preauricular pits, and renal abnormalities. Most families with BOR syndrome have mutations on the EYA-1 gene on chromosome 8q. We present the case of a 23-year-old Italian woman without a familial history of BOR syndrome. The patient, who had hearing loss and a history of surgeries for correction of bilateral cervical branchial fistulae and bilateral preauricular pits, presented with renal impairment, hypertension and overt proteinuria. DNA sequencing showed a novel heterozygous mutation 1420-14…

Influence of gender on the relation between the metabolic syndrome and left ventricular mass

Influence of gender on the relation between the metabolic syndrome and left ventricular mass

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

Impact of type 2 diabetes on left ventricular geometry and diastolic function in hypertensive patients with chronic kidney disease.

Left ventricular hypertrophy (LVH) and diastolic dysfunction are very common in patients with chronic kidney disease (CKD). Aim of this study was to evaluate the impact of type 2 diabetes on LV geometry and diastolic function in hypertensive patients with CKD. We enrolled 288 Caucasian subjects with hypertension and CKD; of them, 112 had diabetes. Patients with cardiovascular (CV) diseases, glomerular filtration rate (GFR)60 ml min(-1) per 1.73 m(2), dialysis treatment and other major non-CV diseases were excluded. All patients underwent routine biochemical analyses and echocardiographic examination with tissue Doppler imaging (TDI). Patients with diabetes had significantly higher LV wall t…

Influence of metabolic syndrome on clinic and 24-h pulse pressure in essential hyptension

Relationship of oxidant stress with endothelial activation in hemodialysed hypertensive patients.

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…

Fattori associati alla disfunzione renale nell’ipertensione arteriosa: lo studio REDHY

A proposito di testi in tema di urinatores, IURA, 2004-2005

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

TALE ARTICOLO NON HA ABSTRACT